Effective alternatives for dietary interventions for necrotizing enterocolitis: a systematic review of in vivo studies

Abstract

Necrotizing enterocolitis (NEC) is a significant cause of morbidity and mortality among neonates and low birth weight children in the United States. Current treatment options, such as antibiotics and intestinal resections, often result in complications related to pediatric nutrition and development. This systematic review aimed to identify alternative dietary bioactive compounds that have shown promising outcomes in ameliorating NEC in vivo studies conducted within the past six years. Following PRISMA guidelines and registering in PROSPERO (CRD42023330617), we conducted a comprehensive search of PubMed, Scopus, and Web of Science. Our analysis included 19 studies, predominantly involving in vivo models of rats (Rattus norvegicus) and mice (Mus musculus). The findings revealed that various types of compounds have demonstrated successful amelioration of NEC symptoms. Specifically, six studies employed plant phenolics, seven utilized plant metabolites/cytotoxic chemicals, three explored the efficacy of vitamins, and three investigated the potential of whole food extracts. Importantly, all administered compounds exhibited positive effects in mitigating the disease. These results highlight the potential of natural cytotoxic chemicals derived from medicinal plants in identifying and implementing powerful alternative drugs and therapies for NEC. Such approaches have the capacity to impact multiple pathways involved in the development and progression of NEC symptoms.

Graphical Abstract

Keywords:

• Necrotizing enterocolitis
• microbiome
• dietary bioactives

Disclosure statement

No potential conflict of interest was reported by the authors.

Registration and Protocol

This systematic review was conducted according to the protocol: Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement 2020. The review is registered in PROSPERO under the number CRD42023330617 (Centre for Reviews and Dissemination, University of York).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.