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

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. 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. 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. 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.