%0 Journal Article
%T Efficacy of Dietary Therapy for Eosinophilic Esophagitis in Children and Adults: An Updated Systematic Review and Meta-Analysis.
%A Arias Á
%A Tejera-Muñoz A
%A Gutiérrez-Ramírez L
%A Molina-Infante J
%A Lucendo AJ
%A  
%J Nutrients
%V 16
%N 14
%D 2024 Jul 11
%M 39064673
%F 6.706
%R 10.3390/nu16142231
%X <B>BACKGROUND: </B>Several dietary approaches have been used to induce remission in patients with eosinophilic esophagitis (EoE), yielding varied results.<BR><B>METHODS: </B>We searched the MEDLINE, EMBASE, and Scopus databases up to May 2024 to identify studies including dietary interventions for EoE used as monotherapy. Summary estimates with 95% CIs for achieving <15 eosinophils/HPF were calculated for each approach. Fixed or random effects models were used depending on heterogeneity (I2); publication bias risks were assessed using funnel plot analyses. Subgroup analyses results were compared using meta-regression.<BR><B>RESULTS: </B>Forty-three studies with 2825 patients were included in quantitative summaries. The overall rate of histologic remission was 60.6% (95% CI, 54.6-66.5%). Effectiveness rates were 94.5% (95% CI, 92.3-96.4%) for elemental diets, 63.9% (95% CI, 58.5-69.2%) for six-food elimination diets, 54.7% (95% CI, 45.7-63.6%) for four-food elimination diets, 44.3% (95% CI, 36.1-52.8%) for two-food elimination diets, 46.4% (95% CI, 40-52.9%) for one-food elimination diets, and 39.5% (95% CI, 30.3-49.2%) for allergy testing-directed food elimination diets. Overall, superior efficacy was noted in children than in adults and in retrospective compared to prospective studies.<BR><B>CONCLUSIONS: </B>Diet therapy remains an effective therapeutic asset for pediatric and adult patients with EoE, with increasing efficacy noted as the levels of dietary restriction increase.