Varcamonti, Linda (2026) Personalised Nutrition in Managing and Preventing Chronic Intestinal Diseases: From the First 1000 Days of Life to Paediatric Gastroenterology. [Tesi di dottorato]

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Abstract

Chronic intestinal diseases have a significant impact on children’s health and quality of life, and their prevalence in the pediatric population is increasing. Scientific evidence shows that nutritional quality already during pregnancy, and particularly within the first thousand days of life, plays a fundamental role in intestinal, metabolic, immune, and neurodevelopmental health throughout the life course. This is especially relevant considering the role of diet in modulating the gut microbiota. Within this framework, personalised nutrition represents a key factor in disease prevention and management, as it takes into account individual biological, microbial, and behavioural characteristics. The aim of this doctoral thesis is to explore how a personalised nutritional approach may play a central role in the prevention and management of chronic and functional intestinal diseases across the life course, starting from pregnancy. This research integrates original clinical studies, observational studies, interventional trials, narrative reviews, and biomarker validation studies, allowing personalised nutrition to be examined from a translational perspective. The first section of the thesis focuses on the assessment of maternal dietary habits and their impact on glycaemic responses during pregnancy. Subsequent studies investigate personalised dietary interventions in pediatric populations, including Mediterranean diet models and low-FODMAP strategies for children with functional gastrointestinal disorders. Additional research focuses on the development and evaluation of clinical tools, including validated questionnaires, for the assessment of gastrointestinal symptoms in infants and toddlers, as well as on the analysis of personalised nutrition in populations requiring enteral nutrition. Overall, the studies included in this thesis show that personalised dietary interventions influence metabolic responses, gastrointestinal symptoms, and clinical outcomes, highlighting a marked interindividual variability that questions the effectiveness of standardised and general dietary recommendations. These findings emphasise the importance of integrating nutritional assessment with microbiome analysis, clinical tools, and biomarkers in order to enable precision-based interventions in pediatric gastroenterology. This thesis therefore demonstrates that personalised nutrition represents a valid and feasible strategy for the early prevention and management of intestinal and metabolic disorders. By integrating nutritional science, clinical research, and translational approaches, it contributes to the growing body of evidence supporting personalised, life-course nutritional strategies to improve maternal and child health outcomes.

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