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Body composition, energy expenditure and physical activity

Nutritional status and body composition in children with inflammatory bowel disease: a prospective, controlled, and longitudinal study

Abstract

Background

Malnutrition and growth retardation (GR) are major extraintestinal presentations of inflammatory bowel disease (IBD) in childhood and are especially prevalent among those with Crohn’s disease (CD). We aimed to evaluate nutritional and growth status and body composition (BC) of children with IBD during a 1-year follow-up.

Methods

Thirty-eight children with IBD and 57 age- and sex-matched controls were recruited prospectively. Anthropometry (weight, height, body mass index (BMI), and triceps skinfold thickness (TSFT) indicated as z scores for age and sex and mid-arm circumference) and bioelectrical impedance analysis were performed at baseline (T0) and after 1 year (T1). Disease activity was evaluated by clinical scoring systems. GR was defined as HAZ < −2, undernutrition as WAZ < −2, severe malnutrition (SM) as BMIZ < −2, and obesity was defined as BMIZ > +2. A p value of <0.05 was considered statistically significant.

Results

Thirty-six children with IBD (22 ulcerative colitis, 12 CD, and 2 indeterminate colitis) and 43 controls completed the study. Most patients were in remission during the study period (T0:71.4%; T1:72.2%). No significant differences were found regarding the frequency of GR (5.6%/8.3%), undernutrition (11.1%/2.8%), and SM (11.1%/5.6%) between T0 and T1 in the IBD group. The changes in anthropometrics and BC measurements during the study period did not differ between the groups except for the TSFT z score.

Conclusion

Most patients with IBD were well nourished and grown, although some children were underweight and had GR. Our results suggest that, in IBD patients, the fat mass (FM) showed a gradual increase over time compared with controls.

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Fig. 1: Flow chart showing the allocation of children with IBD and control group.
Fig. 2: Anthropometric parameters over the course of 1 year.
Fig. 3: Body composition over the course of 1 year.
Fig. 4: Nutritional status of children with IBD over the course of 1 year.

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Acknowledgements

We thank all our patients and their families for consenting to this study. We also thank Nazmiye Kursun (Ankara University, School of Medicine, Department of Biostatistics) for statistical analysis.

Funding

This research was supported by the Ankara University Research Fund (research number: 15H0230004).

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Contributions

SS was responsible for data acquisition and analysis, and drafting of the manuscript. KA was responsible for critical review of manuscript. BM and ŞZ were responsible for critical review of BC measurements. KZ was responsible for study concept and design, analysis, intrepretation of data and drafting of the manuscript. All authors approved the final version of the manuscript.

Corresponding authors

Correspondence to S. Selbuz or Z. Kuloğlu.

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The authors declare that they have no conflict of interest.

Ethics

The Ethics Committee of our University, School of Medicine approved the study protocol (03-106-15). Written informed consent was obtained from all participants and their parents.

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Selbuz, S., Kansu, A., Berberoğlu, M. et al. Nutritional status and body composition in children with inflammatory bowel disease: a prospective, controlled, and longitudinal study. Eur J Clin Nutr 74, 1173–1180 (2020). https://doi.org/10.1038/s41430-019-0555-1

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