Background Poor outcome of inflammatory bowel disease (IBD) is associated with malnutrition. Our aim was to compare body composition (BC) and physical activity (PA) between patients with IBD and healthy controls, and to assess the changes in BC, PA and health related quality of life (HRQoL) in children with IBD during anti-TNF therapy. Methods 32 children with IBD (21 with Crohn’s disease (CD), (age: 15.2 ± 2.6 years, 9 male) and 11 with ulcerative colitis (UC), (age: 16.4 ± 2.2 years, 5 male) participated in this prospective, observational follow up study conducted at Semmelweis University, Hungary. As control population, 307 children (age: 14.3 ± 2.1) (mean ± SD) were included. We assessed BC via bioelectric impedance, PA and HRQoL by questionnaires at initiation of anti-TNF therapy, and at two and six months later. The general linear model and Friedman test were applied to track changes in each variable. Results During follow-up, the fat-free mass Z score of children with CD increased significantly (-0.3 vs 0.1, p = 0.04), while the BC of patients with UC did not change. PA of CD patients was lower at baseline compared to healthy controls (1.1 vs. 2.4), but by the end of the follow up the difference disappeared. Conclusions The fat-free mass as well as PA of CD patients increased during the first six months of anti-TNF treatment. As malnutrition and inactivity affects children with IBD during an important physical and mental developmental period, encouraging them to engage in more physical activity, and monitoring nutritional status should be an important goal in patient care.

PurposeIn this study we assessed nutritional intake, body composition, and their relationship in patients with paediatric inflammatory bowel disease (IBD).MethodsWe conducted a longitudinal, prospective study of 38 patients' nutritional intake using 3-day food records (FR) and bioimpedance analysis of body composition. FR were evaluated by Nutricomp DietCAD software. Results were analysed with Microsoft Excel 2013 and IBM SPSS Statistics 22 software.ResultsPatients treated with biological and conventional therapy (CT) had a higher intake of vegetable protein and carbohydrate from starch than those treated earlier with exclusive enteral nutrition (EEN) in the remission phase (F = 5.926, F = 5.130, P < 0.05). The former EEN group had a higher intake of iron compared to the other two groups (F = 3.967, P = 0.036). Protein intake and fat-free mass (FFM) had a significant positive correlation, while added sugar correlated with body fat mass (BFM) in the same way (R2 = 0.122, R2 = 0.169, P < 0.05). Body-fat mass in patients of the biological therapy (BT) group overstepped the healthy median, and the FFM in the EEN group stayed under it.ConclusionsOur results confirm that it is essential to monitor body composition and not only measure body weight. Patients should be advised based on their body composition, therapy, and phase of the disease.