The University of Southampton
University of Southampton Institutional Repository

Nutritional perspectives of children with Crohn's disease: a single-centre cohort observation of disease activity, energy expenditure and dietary intake

Nutritional perspectives of children with Crohn's disease: a single-centre cohort observation of disease activity, energy expenditure and dietary intake
Nutritional perspectives of children with Crohn's disease: a single-centre cohort observation of disease activity, energy expenditure and dietary intake

Background/Objectives: Children with Crohn’s disease often demonstrate nutritional recovery during primary therapy at diagnosis, but long-term nutritional support is sometimes necessary. Evidence to inform best nutritional practice including energy and micronutrient requirements is limited. The principal objective of this study was to determine how energy expenditure and physical activity vary with disease activity over the first year following diagnosis.

Subjects/Methods: Twenty children were studied at diagnosis with Crohn’s disease and were followed up over 1 year while receiving treatment according to national guidelines. The majority of children (13) were treated with exclusive enteral nutrition. At study visits, height, weight, bioelectrical impedance, resting energy expenditure by indirect calorimetry, tri-axial accelerometer and blood investigations were performed alongside clinical assessment.

Results: There was no significant effect of disease activity on resting energy expenditure (REE). Physical activity was greater after primary therapy (Z=3.31, P<0.01). Median wPCDAI fell from 58 at diagnosis to 7.5 after primary therapy and was 7.5 at 1 year. Weight s.d.s increased from −1.67 to −0.86 and lean index s.d.s increased from −2.93 to −1.64, although the increase was mostly in the first 2 months. Median height s.d.s was unchanged throughout this study. There was a significant association between dietary intake and weight gain (r=0.8 P<0.01) but not height gain. Persistent micronutrient deficits beyond diagnosis were seen for both iron and vitamin D.Conclusions: This study has demonstrated that REE does not change significantly through different phases of disease activity, but physical activity is low at diagnosis. Children with Crohn's disease should be screened for deficiencies of iron and vitamin D.

Conclusions: This study has demonstrated that REE does not change significantly through different phases of disease activity, but physical activity is low at diagnosis. Children with Crohn's disease should be screened for deficiencies of iron and vitamin D.
0954-3007
1132-1137
Wiskin, A.E.
ec8cc41c-16a7-4fac-ac28-208ca26311ab
Haggarty, R.
1d1c6226-90d8-4846-98f6-72cee114bbd6
Afzal, N.A.
a379b32e-b837-4b56-a7fc-31ae91665122
Wootton, S.A.
bf47ef35-0b33-4edb-a2b0-ceda5c475c0c
Beattie, Robert
9a66af0b-f81c-485c-b01d-519403f0038a
Wiskin, A.E.
ec8cc41c-16a7-4fac-ac28-208ca26311ab
Haggarty, R.
1d1c6226-90d8-4846-98f6-72cee114bbd6
Afzal, N.A.
a379b32e-b837-4b56-a7fc-31ae91665122
Wootton, S.A.
bf47ef35-0b33-4edb-a2b0-ceda5c475c0c
Beattie, Robert
9a66af0b-f81c-485c-b01d-519403f0038a

Wiskin, A.E., Haggarty, R., Afzal, N.A., Wootton, S.A. and Beattie, Robert (2016) Nutritional perspectives of children with Crohn's disease: a single-centre cohort observation of disease activity, energy expenditure and dietary intake. European Journal of Clinical Nutrition, 70 (10), 1132-1137. (doi:10.1038/ejcn.2016.107).

Record type: Article

Abstract

Background/Objectives: Children with Crohn’s disease often demonstrate nutritional recovery during primary therapy at diagnosis, but long-term nutritional support is sometimes necessary. Evidence to inform best nutritional practice including energy and micronutrient requirements is limited. The principal objective of this study was to determine how energy expenditure and physical activity vary with disease activity over the first year following diagnosis.

Subjects/Methods: Twenty children were studied at diagnosis with Crohn’s disease and were followed up over 1 year while receiving treatment according to national guidelines. The majority of children (13) were treated with exclusive enteral nutrition. At study visits, height, weight, bioelectrical impedance, resting energy expenditure by indirect calorimetry, tri-axial accelerometer and blood investigations were performed alongside clinical assessment.

Results: There was no significant effect of disease activity on resting energy expenditure (REE). Physical activity was greater after primary therapy (Z=3.31, P<0.01). Median wPCDAI fell from 58 at diagnosis to 7.5 after primary therapy and was 7.5 at 1 year. Weight s.d.s increased from −1.67 to −0.86 and lean index s.d.s increased from −2.93 to −1.64, although the increase was mostly in the first 2 months. Median height s.d.s was unchanged throughout this study. There was a significant association between dietary intake and weight gain (r=0.8 P<0.01) but not height gain. Persistent micronutrient deficits beyond diagnosis were seen for both iron and vitamin D.Conclusions: This study has demonstrated that REE does not change significantly through different phases of disease activity, but physical activity is low at diagnosis. Children with Crohn's disease should be screened for deficiencies of iron and vitamin D.

Conclusions: This study has demonstrated that REE does not change significantly through different phases of disease activity, but physical activity is low at diagnosis. Children with Crohn's disease should be screened for deficiencies of iron and vitamin D.

Full text not available from this repository.

More information

Accepted/In Press date: 19 May 2016
e-pub ahead of print date: 22 June 2016
Published date: October 2016
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 411057
URI: http://eprints.soton.ac.uk/id/eprint/411057
ISSN: 0954-3007
PURE UUID: 5202b60b-77b2-4d2f-b41f-e4205af38d25

Catalogue record

Date deposited: 13 Jun 2017 16:32
Last modified: 06 Oct 2020 19:38

Export record

Altmetrics

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×