Nutritional and metabolic advances in inflammatory bowel disease

Crude measurements of nutritional status, such as body weight, are inadequate to assess the severity and consequence of malnutrition among inflammatory bowel disease patients. Functional deficiency resulting in osteopenia and muscle weakness have been demonstrated in these patients when compared to controls. Manipulating micronutrient and essential fatty acid intake may affect the degree of inflammation and functional status in these patients. Despite evidence that colonocyte oxidation of butyrate is impaired, pharmacologic doses of butyrate have been disappointing. Much of the general population fails to achieve the recommended daily allowance of lipid, micronutrients and fibre. Even in the absence of specific dietary manipulation, patient education regarding a prudent diet is sorely needed.