Quantitative assessment of nutrition and nutritional status of patients with Crohn’s disease aged 13–18
Authors: Konecka Nina , Kikut Justyna , Szczuko Małgorzata 
Published: September 2020

Abstract

Introduction: Crohn’s disease (CD) is classified as an inflammatory bowel disease, with a recent increased incidence in developed countries. Treatment is based on pharmacotherapy and nutritional support. Patients in the exacerbation phase are particularly exposed to the development of malnutrition, which in the case of children may result in the inhibition of growth or delay in puberty. For these reasons, nutrition is very important in the treatment process. In the remission phase of the disease, the diet should be consistent with the recommendations for the population of healthy people in order to prevent the formation of vitamin and mineral deficiencies.
The aim of the study was to determine the nutritional status of adolescent CD patients and to analyze their diet.

Materials and methods: The study was conducted on 14 children with CD, 6 girls and 8 boys with an average age of 16.25 ±1.65 years. Their nutrition was analyzed based on information obtained from a nutritional history collected over 3 days. The collected information was entered into the Diet 5 software. The results of the menus were compared to current dietary norms. The nutritional status of the children was based on a body mass index (BMI) analysis with reference to OLA and OLAF percentiles. The additional results of morphology and the levels of sodium, potassium, total calcium and 25(OH)D from their blood were compared. All obtained results were analysed statistically using Statistica v12.0 software.

Results: The nutritional status of both the boys and the girls was normal, however the energy consumption was low (2274.83 ±475.93 kcal and 1843.33 ±258.4 kcal). Protein consumption was high, at 86.44 ±29.57 g and 62.36 ±26.51 g. In both groups, the levels of saturated fatty acids were too high (30.38 ±14.45, 23.02 ±13.53 mg), and in the boys’ group cholesterol was too high (427.41 ±278.3 mg). Both sexes consumed insufficient amounts of fiber (17.32 ±7.63 g, 19.84 ±4.85 g) and omega-3 (1.8 ±0.99 g, 1.74 ±0.89 g). Iron, copper, iodine and zinc were consumed at the appropriate level. Both sexes consumed too little calcium (586.44 ±458.11 mg, 742.47 ±515.37 mg), potassium (2892.96 ±1223.79 mg, 2901.62 ±1028.56 mg) and magnesium (283.45 ±145.26 mg, 276.71 ±163.32 mg). Folate consumption was too low (256.44 ±81.02 μg, 231.07 ±81.03 μg), vitamin D (2.85 ±1.00 μg, 0.96 ±0.68 μg) and also vitamin E in the group of girls (7.02 mg ±1.46 mg). The blood parameters did not differ significantly between the sexes, and the concentration of 25(OH)D was within the lower limit of the norm (28.17 ±5.91 ng/dL, 22.60 ±3.38 ng/dL).

Conclusions: Low energy intake may adversely affect the nutritional status of CD patients. A deficiency in the diet of n-3 acids may promote the development of inflammation. Insufficient intake of calcium and vitamin D can disrupt the development of the skeletal system. The insufficient intake of dietary fiber can lead to constipation. A too low vitamin D intake and low blood levels of its metabolite indicate the need for supplementation. Additional supplementation of potassium and magnesium should be taken into consideration in the nutrition of CD patients.