Background Enteral nutrition (EN) is increasingly used for treating pediatric Crohn 's disease (CD). We retrospectively studied the use of EN in Belgium and to assess the effect of diet on disease activity and growth. The Belgian Society for Pediatric Gastroenterology and Nutrition (BESPGHAN) is currently implementing the Improve Care Now (ICN) registry for Belgian CD patients. The ICN registry collects clinical data at each outpatient visit, including nutritional and growth status and the use of EN. Methods The medical files of Belgian pediatric patients (<18 yrs old) diagnosed with CD and identified to be included in the newly implemented ICN registry were analyzed from 2015 to 2020 for disease classification, use of EN, growth delay and BMI. Eleven variables were selected from the dataset. The response variable was BMI (kg/m2). The predictor variables were Modulife program diet, exclusive enteral nutrition (EEN), any specific diet (milkfree, lactosefree, glutenfree, meat free, excluding processed foods, including supplements), dietician involved, treatment, age at diagnosis, disease location and behavior, growth delay. Statistical analysis was conducted using the SPSS software v.28. Pie plots with %, mean and SD were calculated for BMI. Independent samples t-tests were used to compare BMI based on variables with 2 groups or ANOVA for more than 2 groups. A p-value =< 0.05 was considered significant. Effect size was calculated for each variable as well as power analysis. Results Data were collected from the databases of UZ Brussel, ULB, UCL and CHC Liège during the period 2015 – 2020. The final dataset consisted of 124 patients (39.5% UZBrussel, 43.5% UCL and 17% CHC Liege). We found no association between disease location or behavior and BMI (p 0.566 & 0.864 respectively). Growth delay was significantly associated with BMI (p < 0.05). Patients not needing biological treatment had a statistically higher BMI (p-value < 0.001). A large proportion of patients (81%) received EEN but results ...