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Nutritional status of children with inflammatory bowel disease in Saudi Arabia
Mohammad Issa El Mouzan1, Mohammed Hadi Al Edreesi1, Abdulrahman Abdullah Al-Hussaini1
1Mohammad Issa El Mouzan, Department of Pediatrics, Head, Pediatric IBD Research Group, Member of Prince Abdullah Bin Khalid Celiac Disease Research Chair, King Saud University, Riyadh 11461, Saudi Arabia.
Insights
Nutritional disorders are common in Saudi children with inflammatory bowel disease (IBD). Overweight was more prevalent than underweight, particularly in older children with ulcerative colitis (UC) and Crohn's disease (CD).
Area of Science:
- Pediatric Gastroenterology
- Nutritional Science
- Public Health
Background:
- Inflammatory bowel disease (IBD) encompasses Crohn's disease (CD) and ulcerative colitis (UC).
- Nutritional status is a critical concern in pediatric IBD management.
- Prevalence of nutritional disorders in Saudi children with IBD requires investigation.
Purpose of the Study:
- To determine the prevalence of nutritional disorders, including thinness and overweight, in a Saudi national cohort of children diagnosed with IBD.
- To analyze age-related variations in nutritional status among children with IBD.
Main Methods:
- Analysis of a national cohort of 374 children newly diagnosed with IBD (2003-2012).
- Diagnosis confirmed by gastroenterologists using standard criteria.
- Body Mass Index (BMI) for age calculated using WHO standards; overweight defined as BMI-SDS > +1, thinness as BMI-SDS < -2.
Main Results:
- Prevalence of thinness was 31% (IBD), 35% (CD), and 24% (UC), significantly higher in CD than UC in 10-17 year olds (P=0.030).
- Prevalence of overweight was 16% (IBD), 15% (CD), and 20% (UC), significantly higher in UC than CD in 10-17 year olds (P=0.020).
- Anorexia was reported in 25% of UC and 39% of CD patients at diagnosis.
Conclusions:
- A significant proportion of Saudi children with IBD present with overweight, contrary to the classical expectation of underweight.
- Nutritional assessment should consider both thinness and overweight in pediatric IBD patients.
- Increased awareness of these nutritional patterns is crucial for effective patient care and management strategies.
Aim:
To assess the prevalence of nutritional disorders in children with inflammatory bowel disease (IBD) in Saudi Arabia.
Methods:
The data from a national cohort of children newly diagnosed with IBD between 2003 and 2012 were analyzed. The diagnosis of IBD and the differentiation between Crohn's disease (CD) and ulcerative colitis (UC) were confirmed by gastroenterologists according to the standard criteria. The body mass index (BMI) of each child [weight (kg)/height(2) (m)] was calculated at the time of diagnosis. The World Health Organization standards and references were used and the BMI for age > +1 and < -2 standard deviation score were used to define overweight and thinness, respectively. Age stratification analysis was performed to investigate any age-related variation in the prevalence of nutritional status between children < 10 years of age and older.
Results:
There were 374 children from 0.33 to 17 years of age, including 119 (32%) children with UC and 255 (68%) with CD. All of the children were Saudi nationals, and 68 (57%) of the UC and 150 (59%) of the CD children were males. A positive history of anorexia at the time of diagnosis was found in 30 (25%) patients with UC and 99 (39%) patients with CD. The prevalence of thinness was 31%, 35% and 24% in children with IBD, CD and UC, respectively, with a significantly higher prevalence of thinness in children with CD than in children with UC (P = 0.037) only in the age group of 10-17 years (P = 0.030). The prevalence of overweight was 16 %, 15% and 20 % in the children with IBD, CD and UC, respectively, indicating a higher prevalence in UC that was statistically significant only in the age group of 10-17 years (P = 0.020).
Conclusion:
A high proportion of children with IBD presented with overweight instead of the classical underweight. Awareness of this finding is important for patient care.
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