PAEDIATRIC inflammatory bowel disease (IBD) was frequently associated with malnutrition at diagnosis, particularly among patients with Crohn’s disease, according to a multicentre retrospective cohort study. The study assessed nutritional status and linear growth at diagnosis and during follow up, examining their association with clinical outcomes.
The cohort included 128 patients with IBD, including 69 patients with Crohn’s disease and 59 patients with ulcerative colitis. The mean age was 157.2±29.5 months. Researchers collected clinical, biochemical and anthropometric data at diagnosis and throughout follow up at two paediatric IBD referral centres.
Underweight was defined as a body mass index z-score of ≥-2, while growth failure was defined as a height-for-age z-score of ≤-2.
At diagnosis, 29 of 128 patients, or 23%, were underweight, while 87 patients, or 68%, had a normal body mass index. A further 12 patients, or 9%, were overweight.
Underweight status occurred more frequently among patients with Crohn’s disease than among patients with ulcerative colitis, affecting 30% compared with 15%, respectively (p=0.022). Growth failure was present in 7.0% of patients at diagnosis and was more frequent among patients with Crohn’s disease.
Biologic therapy was initiated more frequently in patients who were underweight, although the difference did not reach statistical significance: 41% versus 17% (p=0.06).
During a mean follow up of 29.4 months, nutritional status improved in most patients who were underweight at diagnosis. Overall, 25 of 29 underweight patients, or 86%, achieved a normal or elevated body mass index.
Growth failure was identified in 5.3% of patients with available data at 36 months. Despite the nutritional differences observed at diagnosis, baseline underweight status was not associated with an increased risk of subsequent disease relapse. The adjusted odds ratio was 0.52, with a 95% confidence interval of 0.19–1.30, while the adjusted hazard ratio was 0.60, with a 95% confidence interval of 0.28–1.29.
The findings indicated that malnutrition was common at diagnosis and was particularly evident in Crohn’s disease, where it was associated with increased inflammatory burden. However, most underweight patients experienced improvement in nutritional status during follow up, and baseline underweight was not independently associated with later relapse.
The researchers highlighted the importance of assessing nutritional status and linear growth early and longitudinally as integral components of paediatric IBD management.
Reference
Cesari C et al. Nutritional status and linear growth at diagnosis and their association with clinical outcomes in paediatric inflammatory bowel disease: a multicentre cohort study. Nutrients. 2026;18(17):2928.
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