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  • Original Article
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Body composition, energy expenditure and physical activity

Detailed assessment of nutritional status and eating patterns in children with gastrointestinal diseases attending an outpatients clinic and contemporary healthy controls

European Journal of Clinical Nutrition volume 68, pages 700–706 (2014)Cite this article

Subjects

Abstract

Background/objectives:

In the era of modern multidisciplinary clinical management, very little is known about the prevalence and presentation of malnutrition in children with gastrointestinal disorders (GastroD) particularly employing composite, global measures of nutritional status.

Subjects/methods:

Anthropometry, body composition, dietary intake, eating habits and grip strength were assessed with bedside methods in 168 patients from outpatient gastroenterology clinics (n, median (IQR) years; Crohn’s disease (CD): n=53, 14.2 (11.6:15.4); ulcerative colitis (UC): n=27, 12.2 (10.7:14.2); coeliac disease: n=31, 9.3 (7.5:13.6); other GastroD: n=57, 9.8 (7.2:13.8)) and compared with 62 contemporary healthy controls (n, median (IQR): 9.8 (6.9:13.8)) and the results of the recent UK, National Diet and Nutritional Survey (NDNS).

Results:

Children with CD had lower BMI z-scores than controls (median (IQR): −0.3 (−0.9:0.4) vs 0.3 (−0.6:1.4); P=0.02) but only 2% were classified as thin (BMI z-score <−2 s.d.). The prevalence of obesity in children with UC was 19%, 6% in CD, 11% in children with other GastroD and 15% in controls. No difference was found in grip strength measurement between groups. Except for CD children, the proportion of patients with suboptimal micronutrient intake was similar to that of controls and the cohort of children from the latest NDNS. A higher proportion of children with CD had suboptimal intake for riboflavin, vitamin B6 and calcium and consumed significantly more meat products, juices (including carbonated drinks), spreads/jams and crisps and savoury snacks and significantly fewer portions of dairy, fish, fruits and vegetables compared with healthy controls.

Conclusions:

GastroD affect children’s body composition, growth, strength, dietary intake and eating habits, particularly CD, but to a lesser extent than expected.

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Acknowledgements

This study was funded by the Greek State Scholarship Foundation and the Hellenic Foundation of Gastroenterology & Nutrition. The IBD team at Yorkhill Hospital, Glasgow are supported by the Catherine McEwan Foundation and Yorkhill IBD fund. RKR is supported by an NHS Research Scotland career fellowship award.

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Author notes

  1. M Tsiountsioura, J E Wong, J Upton, K McIntyre and D Dimakou: These authors contributed equally to this work.

Authors and Affiliations

  1. Human Nutrition Unit, School of Medicine, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK

    M Tsiountsioura, J E Wong, J Upton, K McIntyre, D Dimakou, C Edwards & K Gerasimidis

  2. School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia

    J E Wong

  3. Department of Paediatric Gastroenterology, Hepatology and Nutrition, Royal Hospital for Sick Children, Glasgow, UK

    E Buchanan, T Cardigan, D Flynn, J Bishop, R K Russell, A Barclay & P McGrogan

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  1. M Tsiountsioura
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Corresponding author

Correspondence to K Gerasimidis.

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Competing interests

PM received an education grant from Cow & Gate and speaker’s fees from Nestle, MSD, Mead Johnson. RR received consultancy fees from Merck, Shape and Dome, honoraria from Nestle and MSD and an educational grant from Mead Johnson. DF received honoraria from Fresenius Kabi and financial support to attend conferences by Danone. CAE received travel expenses by ISLI Europe. None of the remaining co-authors has to declare a conflict of interest relevant to this study.

Additional information

Part of this work was presented at the Annual ESPEN conference 2012 in Barcelona, Spain.

Contributors: JEW, JU, KM, EB, TC and DD carried out the participants’ recruitment, MT and KG carried out statistical data analyses and drafted the manuscript. KG, CAE, PM, DF, JB, RKR and AB participated in the design of the study coordination and helped to draft the manuscript. All authors read and approved the final manuscript.

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Tsiountsioura, M., Wong, J., Upton, J. et al. Detailed assessment of nutritional status and eating patterns in children with gastrointestinal diseases attending an outpatients clinic and contemporary healthy controls. Eur J Clin Nutr 68, 700–706 (2014). https://doi.org/10.1038/ejcn.2013.286

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