Personalized Diet Management Can Optimize Compliance to a High-Fiber, High-Water Diet in Children with Refractory Functional Constipation

Diet modification to increase water and fiber consumption is considered an important component in the management of constipation. This prospective randomized study aimed to evaluate the compliance of 86 children with refractory functional constipation (mean age 4.4 years, range 1 to 11 years)—to a high-fiber, high-water diet following either physician's dietary advice (PI group) (n=42) or physician's dietary advice plus personalized diet management by a registered dietitian (DM group) (n=44). Dietary intake was assessed by a 24-hour dietary recall at baseline and 1 month later. The changes in water and fiber consumption were used as compliance criteria. DM group had comparable anthropometric measurements; sex distribution; and baseline intakes of energy, macronutrient, water, and dietary fiber compared with the PI group. Comparison of nutrient intakes between the two visits within each group showed a significant increase in fiber consumption in both groups that was more pronounced in the DM group. Water, energy, and carbohydrate consumption increased significantly only in the DM group. Multivariate regression analysis revealed that the intervention group was the only significant independent predictor for the change in fiber and water consumption after controlling for age, sex, and weight-for-age z score. Children receiving personalized diet management for refractory functional constipation achieved better compliance in increasing fiber and water consumption.