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P569 Nutritional status in a cohort of paediatric patients with inflammatory bowel disease at diagnosis

N. Egea Castillo*1, G. Pujol2, K. Rosales3, A. Gutierrez4, D. Garcia-Arenas2, V. Vila5, S. Pinillos6, J. Martin de Carpi7

1Hospital Sant Joan de Déu, Gastroenterology, Barcelona, Spain, 2Hospital Sant Joan de Déu, Barcelona, Spain, 3Hospital Sant Joan de Déu, Barcelona, Spain, 4Hospital Sant Joan de Déu, Barcelona, Spain, 5Hospital Sant Joan de Déu, Barcelona, Spain, 6Hospital Sant Joan de Deu, Barcelona, Suriname, 7Hospital Sant Joan de Deu, Barcelona, Spain

Background

The aim of the study was to evaluate the nutritional status and assess the eating habits in a cohort of paediatric inflammatory bowel disease (PIBD) patients at diagnosis, to establish an individualised nutritional recovery plan.

Methods

Data of 84 patients (48 boys; 44 Crohn’s disease [CD] and 40 ulcerative colitis [UC]) diagnosed with PIBD in our hospital (July 2012 - November 2015) were collected. Mean age at diagnosis: 12 years (range 18 months-17 years). Collected data were: anthropometric parameters (weight, height, and skin folds), nutritional index (Muscle Mass Index [MMI] and Waterlow Index [WI]) and scans to determine nutritional status such us bioelectrical impedance. Likewise, eating habits were assessed by a food frequency questionnaire (FFQ) and according to the validated EnKid study.

Results

In total, 73.7% of patients had lost weight before diagnosis. Of these, 33.3% had less than 10% weight loss; 22.6% lost between 10%–15%; and 17.8% of patients lost more than 15% of their previous weight. According to the WI, 26% presented with a normal nutritional status; 26% were overweight or obese; and 47% had some kind of malnutrition (27% mild, 18% moderate, and 2% severe). We observed a greater percentage of undernourished CD patients as compared with UC ones (60/40). Further, 13% of the patients followed at the time of diagnosis a low-quality nutritional diet; 50% of patients needed to improve the eating pattern to suit the Mediterranean diet; and 37% maintained good dietetic habits.

Conclusion

More than a half of our patients present with weight loss at the time of diagnosis, with malnutrition being more frequent in CD patients as compared with UC patients. Regarding the eating habits, more than a half of the patients should improve some aspects of their diet and strengthen guidelines of a balanced diet. A small percentage of the patients have wrong eating habits that should be modified. Nutritional status assessment at the time of diagnosis is quite helpful to establish an individualised nutritional treatment and to give dietetic recommendations, either with traditional food or enteral nutrition. A close dietetic control during the follow-up should influence the re-education of eating habits and reinforce a balanced diet of PIBD patients.