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Relations between disease status and body composition in pediatric inflammatory bowel disease

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Abstract

To evaluate the effect of remission status on physical activity and body composition in pediatric patients with inflammatory bowel disease (PIBD) and healthy peers. Single-center cohort study, including 54 PIBD patients and 33 healthy peers. During the initial study visit, a brief demographic questionnaire, physical activity questionnaire completed by participants, and instructions on recording dietary intake were given. Physicians completed the Physician Global Assessment (PGA) for disease severity. Medical chart abstraction was done to obtain disease variables of interest. DEXA scan completed 1 week later to obtain information on body composition. Variables of interest were compared between the three groups (IBD-Remission, IBD-Active, and healthy controls) using an ANOVA or Chi-square test as appropriate. IBD patients were older than controls, reported lower quality of life (73.9 vs. 80.9), and engaged in less MVPA (195.4 versus 361.1). The IBD-Active group had a significantly lower lean body mass, bone mineral density, and time spent in MVPA compared to the IBD-Remission group and healthy controls. IBD-Remission group had a significantly lower percentage of biologic use (55% vs. 87%) and comorbidities (26% vs. 44%) compared to IBD-active group. IBD-remission group also had a lower fat mass percentage. In this study, we report significantly favorable LBM, BMD, and time spent in MVPA in patients with IBD in remission compared to those not in remission with the former demonstrating a body composition resembling that of healthy peers.

Conclusion: While an improvement in BMD was observed with remission, the scores were still lower than controls.

What is Known:

• Body composition deficits in pediatric inflammatory bowel disease are common and some persist despite achievement of remission leading to long term outcomes including osteopenia and osteoporosis.

• Weight restoration in patients with pediatric IBD is primarily explained by gains in fat mass without similar gains in lean mass.

What is New:

• While an improvement in bone mineral density was observed, the achievement of remission significantly improves affects physical activity and body composition in pediatric inflammatory bowel disease.

• However, some parameters of body composition do not reach levels comparable to healthy peers.

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Abbreviations

(Anti-TNF treatment):

Anti-tumor necrosis factor treatment

(BMI):

Body mass index

(BMD):

Bone mineral density

(CRP):

C-reactive protein

(CD):

Crohn’s disease

(DEXA):

Dual-energy X-ray absorptiometry

(ESR):

Erythrocyte sedimentation rate

(FMI):

Fat mass index

(GLTEQ):

Godin leisure-time exercise questionnaire

(IBD):

Inflammatory bowel disease

(LM):

Lean mass

(MVPA):

Moderate-to-Vigorous physical activity

(PIBD):

Pediatric IBD

(PGA):

Physician global assessment

(PedsQL):

Pediatric quality of life inventory

(UC):

Ulcerative colitis

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Funding

This work has been supported in part by the Nutrition and Obesity Research Center Pilot and Feasibility Program as well as the Kaul Pediatric Research Institute.

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Authors and Affiliations

  1. Department of Pediatrics, University of Alabama at Birmingham, 1600 7th Avenue South, McWane Suite 5604, Birmingham, AL, 35294, USA

    Saurabh Talathi, Pooja Nagaraj, Traci Jester, Jeanine Maclin & Margaux J. Barnes

  2. Children’s of Alabama, 1600 7th Avenue South, McWane Suite 5604, Birmingham, AL, 35294, USA

    Taylor Knight

Authors
  1. Saurabh Talathi
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  2. Pooja Nagaraj
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  3. Traci Jester
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  4. Jeanine Maclin
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Contributions

M.B. designed and directed the project. S.T. conceptualized and implemented the current analysis. P.N. supervised data collection and data analysis. T.J., T.K., and J.M. assisted with data collection and methodological design. S.T., M.B., and P.N. wrote the paper with input from all authors.

Corresponding author

Correspondence to Margaux J. Barnes.

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The authors’ declare that they have no conflicts of interest.

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The authors have no financial relationships relevant to this article to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Communicated by Peter de Winter

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Talathi, S., Nagaraj, P., Jester, T. et al. Relations between disease status and body composition in pediatric inflammatory bowel disease. Eur J Pediatr 179, 1499–1505 (2020). https://doi.org/10.1007/s00431-020-03629-0

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  • DOI: https://doi.org/10.1007/s00431-020-03629-0

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