Body Mass Index at Presentation of Inflammatory Bowel Disease in Children

Abstract

Purpose: The evidence for an association between inflammatory bowel disease (IBD) and obesity is conflicting. Therefore, we set out to review the body mass index (BMI) at presentation of IBD to understand if the rise of the obesity rate in the general population, lead to an increase of obesity in patients with IBD at the time of diagnosis. Methods: Retrospective review of all patients with IBD seen at Children's Hospital and Medical Center from January 1st 2010 to December 31st 2014. From the initial visit and endoscopy, we obtained: age; sex; BMI; disease phenotype; disease severity. Results: We had a total of 95 patients, 35 patients were excluded due to incomplete data or referral being made after diagnosis was made. 28 were males and 32 were females, Age range was 2-17 years. A 37 had Crohn's disease, 19 ulcerative colitis, and 4 indeterminate colitis. Disease severity in 19 cases was mild, 29 moderate and 12 severe. BMI distribution was as follows-obese (5.0%), overweight (6.7%), normal weight (65.0%), mild malnutrition (8.3%), moderate malnutrition (15.0%), severe malnutrition (1.7%). Conclusion: Our data is consistent with other series. Showing most children had a normal BMI, regardless of disease severity or phenotypes. One confounding factor is the possibility of delay in referral to GI. This could mean some obese children may fall in the normal BMI range at the time of diagnosis due to ongoing weight loss. Future studies should include prospective cohort studies, comparing incidence of IBD in obese and non-obese patients, severity at presentation, duration of symptoms, and clinical outcomes.

Effect of Life Style Modification on the health status for Patients with Ulcerative Colitis

“…Table (5) demonstrate that that there is no statistically significant difference between the study participants in terms of age, gender, occupation and residence, and total knowledge level pre, post, and follow-up of intervention; however, there are statistically significant differences between the participants of the study group in terms of education and total Knowledge level pre, post, and follow-up of the intervention.…”

Disease Activity Is Associated with Obesity in Newly Diagnosed Pediatric Patients with Ulcerative Colitis

“…In parallel with this observation, 18.60% of healthy pediatric males and 14.50% of females were obese in Poland [ 16 ]. In recent studies from North America, the prevalence of obese pediatric patients with CD is about four times, and that of patients with UC is three times higher than in Hungary [ 20 , 36 ]. Differences between the North American and the Hungarian pediatric populations could be attributed to the fact of differences in dietary habits as these countries are geographically, traditionally, and socio-economically far away from each other.…”

“…Thus, studies may not be comparable. For example, in some studies, BMI was considered abnormal above +2 Z-score values, whereas in some others, BMI was considered elevated above the 75th, the 85th, or the 95th centile values [ 17 , 18 , 20 ]. Since Hungarian reference curves do not list 85th and 95th centile values, a comparison of nutritional status and risk assignment of Hungarian pediatric patients with IBD based on these cut-off values can be done only by approximation.…”