Prevalence of Malnutrition and Nutritional Characteristics of Patients With Inflammatory Bowel Disease

Casanova, M J; Chaparro, María; Molina, Begoña; Merino, Olga; Batanero, Ricardo; Dueñas-Sadornil, Carmen; Robledo, Pilar; García‐Albert, Ana M.; Gómez-Sánchez, Maria Bienvenida; Calvet, Xavier; Trallero, Maria Del Roser; Montoro, Miguel; Vázquez, Iria; Charro, Mara; Barragán, Amaya; Martínez-Cerezo, Francisco José; Megías-Rangil, Isabel; Huguet, José María; Martí-Bonmatí, E.; Calvo, Marta; Campderá, M.; Muñoz-Vicente, Margarita; Merchante, Ángel Muñoz; Avila, Ansel David; Serrano-Aguayo, Pilar; Francisco, Ruth de; Hervías, Daniel; Bujanda, Luís; Rodríguez, G E; Castro-Laria, Luisa; Acosta, Manuel Barreiro‐de; Domselaar, Manuel Van; Piscina, Patricia Ramírez de la; Santos-Fernández, Javier; Algaba, Alicia; Torra, Sandra; Pozzati, Liliana; López-Serrano, Pilar; Arribas, Maria Del Rosario; Rincón, Maria Luisa; Peláez, Andrés; Castro, Elena; Garcı́a-Herola, Antonio; Santander, Cecilio; Hernández-Alonso, Moisés; Martín-Noguerol, Elisa; Gómez-Lozano, María; Monedero, Tamara; Villòria, Albert; Figuerola, Ariadna; Castaño-García, Andrés; Bañales, Jesús M.; Díaz-Hernández, Laura; Argüelles-Arias, Federico; López-Díaz, Javier; Pérez-Martínez, Isabel; García-Talavera, Noelia; Nuevo-Siguairo, Olivia Karina; Riestra, Sabino; Gisbert, Javier P.

doi:10.1093/ecco-jcc/jjx102

Cited by 151 publications

(159 citation statements)

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“…As previously described [6], low and/or inadequate nutrient intake can contribute considerably to the onset of malnutrition in CD patients; therefore, their investigation would be useful for planning effective dietary strategies and supplementation, when indicated. To date, however, only a few studies assessed dietary intake in these patients, agreeing with altered micronutrient intakes when compared to established recommended values [19,21] as well as to a national survey [20,24].…”

Section: Discussionmentioning

confidence: 96%

“…Generally, CD patients are at risk of nutritional deficiencies both during periods of disease exacerbation (due to reduced oral intake, malabsorption, and nutrient losses through the gut) and remission [3][4][5]. Specifically, poor and/or inadequate oral intake may play an important role in the onset of malnutrition due to many factors such as voluntary food restrictions, increased satiety, reduced sensation of pleasure related to eating, changes in mood, and even medical advice [6,7].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of nutritional adequacy in adult patients with Crohn’s disease: a cross-sectional study

et al. 2020

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Purpose Inadequate oral intake may play an important role in the onset of malnutrition in patients with Crohn's disease (CD). The aims of this cross-sectional study were: (1) to compare dietary intake in clinically active and quiescent CD patients, and (2) to assess patients' nutritional adequacy relative to the dietary reference values (DRVs) for the Italian population using LARN (Livelli di Assunzione di Riferimento di Nutrienti ed energia per la popolazione italiana). Methods Patients aged between 18 and 65 years with a diagnosis of CD were recruited. All participants underwent anthropometry and were instructed to fill in a 3-day food record. Disease activity was clinically defined using the Crohn's disease activity index (CDAI). Results Overall, 117 patients, 71 males and 46 females, with a mean age of 39.6 ± 13.8 years and a mean body weight of 65.4 ± 11.8 kg, were ultimately included. Our findings showed that the amount of nutrients was similar between patients with active and quiescent disease. The mean intake of macronutrients was adequate, except for fiber, while dietary micronutrients were insufficient. Median intakes of sodium, phosphorus, and fluorine met LARN recommendations in both sexes, and the DRVs were accomplished by many patients (53/117; 104/117 and 98/117, respectively). Interestingly, dietary amounts of iron and zinc were barely acceptable in males but not in females. However, a few of the patients (< 15) met the LARN for potassium, calcium, and magnesium, regardless of sex and CDAI. With respect to vitamins, no relevant difference was found between the active and quiescent groups, and none of them met recommended values in both sexes. Conclusions This study showed that the assessment of dietary intake can be crucial for optimizing dietary intervention with focused nutrition counseling, to improve nutritional status in CD patients.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Evaluation of nutritional adequacy in adult patients with Crohn’s disease: a cross-sectional study

et al. 2020

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“…A plan for safety monitoring of those on immunosuppressive drugs or anti‐tumour necrosis factor existed only for two‐thirds of relevant cases. Nutritional risk screening occurred in fewer than 40% of admissions, despite the high prevalence of malnutrition in the IBD population . Osteoporosis is common in IBD patients because of the use of steroids and the underlying disease process.…”

Section: Discussionmentioning

confidence: 99%

“…Nutritional risk screening occurred in fewer than 40% of admissions, despite the high prevalence of malnutrition in the IBD population. 13 Osteoporosis is common in IBD patients because of the use of steroids and the underlying disease process. Although 57% of hospitals had outpatient protocols for dual-energy X-ray absorptiometry (DEXA) scans for patients on corticosteroids for more than 3 months, documentation of DEXA scans within 5 years was present in only 9% of patient records.…”

Section: Discussionmentioning

confidence: 99%

Crohn's & Colitis Australia inflammatory bowel disease audit: measuring the quality of care in Australia

Massuger

Moore

Andrews

et al. 2019

Internal Medicine Journal

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Background Australia has among the highest prevalence of Crohn disease and ulcerative colitis in the world. Management of the chronic gastrointestinal disorders results in significant societal costs and the standard of care is inconsistent across Australia. Aim To audit the quality of care received by patients admitted for inflammatory bowel disease (IBD) across Australia against national IBD standards. Methods A retrospective cross‐sectional survey and clinical audit was undertaken assessing organisational resources, clinical processes and outcome measures. This study was conducted in Australian hospitals that care for inpatients with Crohn disease or ulcerative colitis. The main outcome measures were adherence to national IBD standards and comparison of quality of care between hospitals with and without multidisciplinary IBD services. Results A total of 71 hospitals completed the organisational survey. Only one hospital had a complete multidisciplinary IBD service and 17 had a partial IBD service (IBD nurse, helpline and clinical lead). A total of 1440 inpatient records was reviewed from 52 hospitals (mean age 37 years; 51% female, 53% Crohn disease), approximately 26% of IBD inpatient episodes over a 12‐month period in Australia. These patients were chronically unwell with high rates of anaemia (30%) and frequent readmissions (40% within 2 years). In general, care was inconsistent, and documentation was poor. Hospitals with a partial IBD service performed better in many processes and outcome measures: for example, 22% reduction in admissions through emergency departments and greater adherence to standards for safety monitoring of biological (89% vs 59%) and immunosuppressive drugs (79% vs 55%) in those hospitals than those without. Conclusion Patients admitted to hospital suffering from IBD are young, chronically unwell and are subject to substantial variations in clinical documentation and quality of care. Only one hospital met accepted standards for multidisciplinary care; hospitals with even a minimal IBD service provided improved care.

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“…The frequency of malnutrition in patients with inflammatory bowel disease was high. One of the predictive factors of malnutrition is avoidance New Concepts in Inflammatory Bowel Diseaseof some foods during flares which were associated with higher risk of malnutrition, and many patients had self-imposed food restrictions depending on their beliefs and thoughts [22].…”

Section: Complications Of Ibdmentioning

confidence: 99%

Introductory Chapter: Inflammatory Bowel Disease

Mahdi¹

2018

New Concepts in Inflammatory Bowel Disease

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Prevalence of Malnutrition and Nutritional Characteristics of Patients With Inflammatory Bowel Disease

Abstract: The prevalence of malnutrition in inflammatory bowel disease patients was high. We identified some predictive factors of malnutrition. Most of the patients had self-imposed food restrictions, based on their beliefs.

Cited by 151 publications

References 50 publications

Evaluation of nutritional adequacy in adult patients with Crohn’s disease: a cross-sectional study

Evaluation of nutritional adequacy in adult patients with Crohn’s disease: a cross-sectional study

Crohn's & Colitis Australia inflammatory bowel disease audit: measuring the quality of care in Australia

Introductory Chapter: Inflammatory Bowel Disease

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