Because ModuLife is physician-supervised, patients and their healthcare providers can easily collaborate to ensure that patients receive ongoing support and maintain habits that prolong the remission of their disease.

Some studies in the scientific literature discuss fatty acids’ benefits to the intestinal mucosa. For instance, a palmitic acid-enriched diet has promoted B lymphocyte proliferation, IgA production, and cellular proliferation after a 75% bowel resection ( Figure 1, right panel) [ 51]. Even if the whole fatty acids content of Modulen ® is not specified, some of them spotlighted may contribute to clinical remission ( Figure 1, right panel) [ 32]. Among them, medium-chain triglycerides (MCT), which include caproic, caprylic, capric, and lauric acid esterified, are digested and absorbed easier than long-chain triglycerides. In comparison, MCT are shorter carbon chain, more hydrophilic, and then does not require bile acids or cholecystokinin. Their absorption is passive and permits to gain portal system without chylomicron formation ( Figure 1, right panel). MCT have shown their capacity to enhance intestinal mass and cellular proliferation at the proximal level [ 52], as well as villi length, crypts depth, and IgA production [ 53]. Additionally, studies have demonstrated that MCT can attenuate Clostridium difficile-induced inflammation [ 54]. More specific outcomes have been presented in in vitro studies with IPEC-J2 cells, in which caprylic acid enhanced the β-defensin 1/2 secretion [ 55] and capric acid attenuates the oxidation, IP, and cyclophosphamide-induced inflammation ( Figure 1, right panel) [ 56]. There is no cure for Crohn’s disease- a chronic condition that causes inflammation of the digestive system or gut. Most patients typically rely on anti-inflammatory drugs and surgical interventions to manage their symptoms, which can be expensive, for both the patient and health care providers. However, a randomized control trial, has shown that a nutrition-based approach, combining CDED and Modulen IBD is effective for the management and remission of Crohn’s disease. Even though studies are contradicting each other about Modulen ® efficiency on disease location [ 3, 4, 10], numerous clinicians noticed that at least one ileal damage is requested. The pathophysiological differences may explain this outcome. For instance, NOD2 mutations are associated with CD with at least one lesion located in the small intestine. In view of its numerous intestinal functions, this receptor can play a significant role in EN mechanisms after microbiota recognition. This suggests that the possible modification of the intestinal microbiota by Modulen ® could be primordial to induce remission. Additional studies on intestinal consequent microbiota are encouraged, both in terms of taxonomy and time. Albeit the outcome could suggest enhancing the dietary therapy with prebiotics or probiotics, one should note that the contrary could appear if the ensuing microbiota variations are highly specific.The inflammatory status of patients was evaluated in parallel. The clinical studies demonstrate that symptoms decrease along with inflammatory serum markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels [ 1, 2, 4, 7, 9], platelets [ 1, 4], fibrinogen [ 7], and TNFα levels [ 2] ( Table 1). Among the studies already mentioned, three of them reported a significant increase in albumin levels. Furthermore, these serological results were accompanied by reduced inflammation at the mucosal level. Ileal biopsies from CD patients pre- and post-EEN revealed a decrease of IL-1β and IFN-γ mRNA, whereas colonic ones only presented IL-1β and CXCL-8 mRNA reduction [ 2, 37]. These results attest to the anti-inflammatory effects of Modulen ®. B6, B1, A, B2, folic acid, K, biotin, D, B12) and choline bitartrate. MODULEN® (400 g powder) Nutrition Information Serve size: 50 g (made up volume 250 ml) Serves per container: 8Nutrient Units Per serve Per 100 mlEnergy kJ / kcal 1037 / 250 415 / 100Protein (14% kcal) g 9.0 3.6Carbohydrate (44% kcal) of which: g 27 10.8- Sugars g 10.5 4.2Fat (42% kcal) of which: g 11.5 4.6- Saturated g 6.6 2.6- Monounsaturated fatty acids g 2.0 0.78- Polyunsaturated fatty acids g 1.2 0.48- MCT g 3.0 1.2Fibre (0% kcal) g 0 0Sodium mg 85 34VitaminsBiotin μg 8.0 3.2Folic acid μg 60 24Niacin mg 2.9 1.2mg NE 4.9 2.0Pantothenic acid mg 1.2 0.48Vitamin A μg 210 84Vitamin B1 mg 0.29 0.12Vitamin B2 mg 0.32 0.13Vitamin B6 mg 0.41 0.16Vitamin B12 μg 0.80 0.32Vitamin C mg 23 9.2Vitamin D μg 2.5 1.0Vitamin E mg TE 3.3 1.3Vitamin K μg 13 5.2MineralsCalcium mg 222 89Chloride mg 182 73Chromium μg 12 4.8Copper mg 0.24 0.10Iodine μg 24 10Iron mg 2.7 1.1Magnesium mg 50 20Manganese mg 0.49 0.20Molybdenum μg 18 7.2Phosphorus mg 150 60Potassium mg 300 120Selenium μg 8.5 3.4Zinc mg 2.3 0.92Other NutrientsCholine mg 17 6.8 Modulen (400g powder)

Modulen ® effectiveness to induce remission has been shown in many studies ( Table 1). These studies have several limitations, while they are mainly retrospective or with no randomized control, and the endpoints were clinical remission rather than mucosal healing. Among patients treated exclusively with Modulen ®, 65% of patients (19/27 children) have displayed a PCDAI ≤ 15 after 6–8 weeks [ 1] and 79% (23/29 children) have reached clinical remission with a PCDAI ≤ 10 after 8 weeks of CT32I Nestlé ® formula treatment [ 2]. A similar rate (80%) has been described by Buchanan et al. (105/114 children), who have combined both oral and nasogastric administration [ 3]. The mode of administration depends on patients’ clinical status [ 33], but does not affect the clinical remission rate. After eight weeks of exclusive Modulen ®, oral and nasogastric administration induces 75% and 85% of clinical remission respectively (PCDAI < 10), without any statistical difference between treatments ( Table 2) [ 4]. Considering the severe corticosteroid side effects, numerous studies have already illustrated that exclusive nutrition has an equal efficiency to corticosteroids in children contrary in adults [ 34]. To our knowledge, only two studies comparing corticosteroids to exclusive nutrition have been performed by adopting the current Modulen ® formula [ 5, 6]. In the first one [ 5], an exclusive 10-week diet induced clinical remission and the PCDAI reduction was similar to corticosteroid treatment. However, endoscopic and histological healing was achieved at 73% in the polymeric diet group (14/19 children), significantly higher compared to 40% in the corticosteroid group (6/15). In the second one [ 6], PCDAI significantly decreased after eight weeks of polymeric diet compared to corticosteroids, from the second week until the third. In a long-term follow-up on mesalamine maintenance, the remission rate was longer when the induction treatment was performed by the polymeric diet, as more than 80% of individuals were in remission one year after. Another study has compared corticosteroids, cyclosporine A and enteral nutrition (EN) with an elemental diet (Flexical, Mead Johnson) or a polymeric diet (Nestlé) ( Table 1) [ 35]. After 8 weeks of treatments, among the three patients treated with the polymeric diet, two of them had an improved histological inflammation. This outcome was similar to the elemental diet (5/6) and cyclosporine A (6/9), while it did not improve on prednisolone (1/10). However, the number of TNFα secreting cells only decreased on cyclosporine A. Finally, in addition to gut integrity, Modulen ® elements will likely benefit other organs and physiological processes allowing a well-being stage. Naturally, physical ameliorations go along with mental ones, thus achieving an effective quality of life. The platform which uses a machine-learning algorithm and nutrition data to generate personalized meal plans, was developed by Nestlé Research using its expertise in digital health and nutritional science. The recipe selection and educational components are managed by the Foundation. A new study has found that the Crohn’s Disease Exclusion Diet (CDED), a novel whole-food based dietary approach, combined with Modulen IBD, a Nestlé Health Science nutritional supplement for partial enteral nutrition (PEN), is effective for the management of Crohn’s disease.As directed by a Healthcare Professional1 kcal/ml: 50 g powder (6 scoops) + 210 ml water = 250 ml 1.5 kcal/ml: 75 g powder (9 scoops) + 190 ml = 250 ml1 kcal/ml: 200 g powder (24 scoops) + 850 ml water = 1000 ml 1.5 kcal/ml: 300 g powder (36 scoops) + 750 ml = 1000 ml Nestlé Health Science, a leader in the science of nutrition, is a globally managed business unit of Nestlé. We are committed to redefining the management of health, offering an extensive portfolio of science-based consumer health, medical nutrition, pharmaceutical therapies, and vitamin and supplement brands. Our extensive research network provides the foundation for products that empower healthier lives through nutrition. Headquartered in Switzerland, we have more than 12,000 employees around the world, with products available in more than 140 countries. What can I eat?” That’s the number one question that people with chronic digestive issues ask the Crohn’s & Colitis Foundation in the U.S.A. Mechanisms of action of Modulen ® on intestinal epithelium. The left panel represents the consequences of a liquid, exclusive, and fibers/lactose/gluten-free diet, as well as TGF(transforming growth factor-beta) MCT (medium-chain triglycerides), palmitic acid, α-linolenic acid, and 15-HETE (15-hydroxyeicosatetraenoic acid);. The right panel focuses on leucine, caprylic, glutamic and palmitic acid, MCT, TGF-β, and β-casofensin. Contains Transforming Growth Factor –ß2 (TGF-ß2) from patented manufacturing process. TGF-ß2 has natural anti-inflammatory properties to reduce inflammation associated with inflammatory bowel disease

Modulen® IBD is a nutritionally complete formula suitable for oral and tube feeding, especially designed for the dietary management of Crohn’s Disease in paediatric (>5years) and adult patients. The new Gut Friendly Recipes a free, online, recipe finder with more than 500 easy recipes for gut-friendly and nutritious meals, helps to answer that question. The easy-to-navigate recipe finder was launched on January 31, 2023 by the Crohn’s & Colitis Foundation and Nestlé Health Science.Meets the RDI for adult patients in 2000ml per day; for children the RDI is met per volume appropriate for age Other than intestinal symptoms, CD can lead to extra-intestinal ones such as bone, skin, ocular, and thromboembolic complications. These events were not investigated after EN and more specifically Modulen ® therapy. This goes along with other organ consequences. The most alarming repercussion is steatosis as non-alcoholic fatty liver disease is common in IBD. Considering TGF-β2 content, and the risk of hepatic fibrosis, hepatologists could avoid Modulen ® therapy for CD patients. For more information about how Nestlé Health Science works with Crohn’s Disease patients, please visit www.mymodulife.com www.gutfriendlyrecipes.org offers a broad selection of delicious recipes for Inflammatory Bowel Disease (IBD) patients, people with chronic digestive issues, and for anyone seeking nutritious and gut-friendly meals. The recipe finder is designed for use by patients, caregivers, nutritionists, dietitians, and physicians caring for patients with IBD or other digestive and gastrointestinal issues who need help with meal choices and planning what foods they can eat. All recipes offered are evidence-based and approved by dietitians for gut-friendly eating.