Paediatric inflammatory bowel disease frequently presents alongside malnutrition, particularly in patients diagnosed with Crohn’s disease, according to a multicentre retrospective cohort study published in the journal Nutrients. Researchers found that nearly a quarter of young patients were underweight at initial diagnosis, though most recovered their nutritional status during longitudinal follow-up despite facing a chronic, relapsing condition.
Nutritional Status and Growth at Diagnosis
The study, led by C. Cesari and colleagues, evaluated 128 paediatric patients across two referral centres. The cohort included 69 patients diagnosed with Crohn’s disease and 59 with ulcerative colitis, with a mean age of 157.2 months. At the time of initial diagnosis, 29 patients—representing 23% of the cohort—were classified as underweight based on a body mass index z-score of less than or equal to -2. Normal body mass index values were recorded in 87 patients, or 68%, while 12 patients were overweight.
Underweight status appeared significantly more often in patients with Crohn’s disease than in those with ulcerative colitis. Specifically, 30% of Crohn’s patients presented as underweight compared with 15% of ulcerative colitis patients, a statistically significant difference. Growth failure, defined as a height-for-age z-score of less than or equal to -2, affected 7.0% of the cohort at diagnosis and also appeared more frequently among individuals with Crohn’s disease.
Clinical Outcomes and Nutritional Recovery
During a mean follow-up period of 29.4 months, nutritional metrics improved for the vast majority of participants who started the study underweight. Overall, 25 of the 29 underweight patients—equal to 86%—achieved a normal or elevated body mass index. Growth failure was documented in 5.3% of patients who had available data at the 36-month mark.
Researchers examined whether baseline malnutrition influenced subsequent disease relapses. The data indicated that being underweight at diagnosis did not independently increase the risk of later relapse. The adjusted odds ratio was 0.52, and the adjusted hazard ratio was 0.60. However, biologic therapy was initiated more frequently in patients who presented as underweight, affecting 41% of that group compared with 17% of patients with normal baseline weight, though this trend did not reach strict statistical significance.
Global Context of Paediatric IBD
The findings arrive as inflammatory bowel disease continues to expand globally, shifting from a condition primarily seen in Western, industrialised societies to an emerging health challenge worldwide. Broader epidemiological reviews published in academic literature note that rising incidence rates in developing nations are linked to rapid modernization and the adoption of Westernized lifestyles. Because childhood-onset IBD is associated with a longer disease duration and an elevated long-term risk of complications such as colorectal cancer, researchers emphasise that early detection and comprehensive management remain critical for pediatric gastroenterology care.
Based on these findings, the study authors highlighted the necessity of assessing nutritional status and linear growth early and continuously as integral components of paediatric inflammatory bowel disease management.