Combined patient-generated subjective global assessment and body composition facilitates nutritional support in inflammatory bowel disease : an ambulatory study in Shanghai / Dongsheng Bian, Yongmei Shi, Yongmei Jiang, Jie Zhong, Jing Sun, Yubei Gu

Background and objectives: Malnutrition is commonly diagnosed in patients with inflammatory bowel disease (IBD). However, only few clinical studies have adequately explored the importance of body composition in the nutritional assessment of Chinese patients with IBD. Methods and study design: A total of 78 IBD patients were enrolled, and Patient-Generated Subjective Global Assessment (PG-SGA) was used to assess malnutrition. Bioelectrical impedance analysis was used to analyze the body composition of IBD patients and their fat free mass indexes (FFMI) were also calculated. FFMI values <17 kg/m2 in men and <15 kg/m2 in women were considered low. Food consumption data were collected using the semi-quantitative food frequency questionnaire. Results: Of the 78 patients, 49 (62.8%) had low-FFMI. Among the patients with PG-SGA <4, 12 (41.4%) had altered body composition with low-FFMI. FFMI negatively correlated with the PG-SGA scores and disease activity. No statistically significant differences in fat free mass (FFM) and skeletal muscle mass were observed between patients in the active phase and patients in remission (p>0.05). However, the fat mass and visceral fat area of patients in remission were higher than those of patients in the active phase (p<0.05). The average energy derived from fat, proteins and carbohydrates was 29.6±8.45%, 10.4±1.97% and 60.3±9.33%, respectively. Conclusions: Our study shows that 41.4% of IBD patients had altered body composition despite being well-nourished according to the PG-SGA. Patients in the remission phase presented with fat accumulation and their FFM remained low. The dietary pattern was not adequate among the IBD patients, especially regarding protein intake.

Nutrition.