Abstract
BackgroundThe relationship between nutrition and Crohn’s disease (CD) is complex and involves several therapeutic possibilities including: nutrition treatment for malnourished patients, optimization of growth and development, prevention of osteoporosis, first-line therapy for active disease, and maintenance of disease remission. In children and adolescents with CD, malnutrition is a common problem that adversely affects the prognosis. In at-risk adolescent CD patients, it is important to assess body composition, food intake, energy expenditure, nutrient balance and serum levels of nutrients before planning interventions for this population. The aim of this study was to provide a snapshot of the nutritional status of adolescents with CD in Brazil.MethodsWe prospectively selected 22 patients with mildly to moderately active CD, 29 patients with inactive CD and 35 controls (first-degree relatives of and in the same age bracket as the CD patients). The age range of participants was between 13.2 and 19.4 years old. We collected anthropometric data including weight, height, and body mass index (BMI), which were expressed as Z scores: weight-for-age, height-for-age and BMI-for-age, respectively, as well as using bioimpedance to determine body composition and assessing the Tanner stage. We also assessed macronutrients and micronutrients (serum levels and dietary intake of both). We used the chi-square test to determine whether any of the studied variables were associated with inactive or active CD. The level of significance was set at 5 % (p < 0.05). We have written informed parental consent for participation for any minors and written informed consent for any participants that were adults.ResultsThe mean values for lean body mass, Tanner stage, height-for-age Z score and BMI-for-age Z score were lower in the active CD group than in the inactive CD and control groups (p < 0.05 for both). Compared with the controls, the CD patients showed significant differences in terms of the quality of dietary intake (particularly in caloric intake, dietary protein intake, dietary fiber intake, and micronutrient intake), which were reflected in the serum levels of nutrients, mainly vitamins A and E (p < 0.05).ConclusionsAdolescents with CD (including those with mildly to moderately active or inactive disease) have a nutritional risk, which makes it important to conduct nutritional assessments in such patients.
Highlights
The relationship between nutrition and Crohn’s disease (CD) is complex and involves several therapeutic possibilities including: nutrition treatment for malnourished patients, optimization of growth and development, prevention of osteoporosis, first-line therapy for active disease, and maintenance of disease remission
In patients with inflammatory bowel disease (IBD), body mass indices (BMIs) and weights are below normal when compared with reference values or with the values reported for healthy controls [5, 6]
Patients with inactive CD showed an increase of the median duration of the disease, the difference was not significant
Summary
The relationship between nutrition and Crohn’s disease (CD) is complex and involves several therapeutic possibilities including: nutrition treatment for malnourished patients, optimization of growth and development, prevention of osteoporosis, first-line therapy for active disease, and maintenance of disease remission. Because the peak onset of pediatric inflammatory bowel disease (IBD) occurs in late adolescence, this event may turn out to be a potent influence on puberty and growth development [1,2,3] In this setting, the most specific complication of pediatric CD is growth deficit, which is caused by a combination of inadequate caloric intake, increased loss of calories and persistent active inflammation of the intestinal mucosa [4]. In patients with IBD (principally in those with CD), body mass indices (BMIs) and weights are below normal when compared with reference values or with the values reported for healthy controls [5, 6] At this age, micronutrient deficiencies can influence the progression and clinical outcome of IBD, affecting the immune and antioxidant defense systems, as well as tissue repair, growth, and bone mineralization [7]
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