Usefulness of Nutritional Intervention Through New Digital Technologies in Patients with Inflammatory Bowel Disease

Background: Malnutrition and suboptimal diet quality are common, yet under-recognized, in inflammatory bowel disease (IBD) and are associated with worse clinical outcomes and lower quality of life. Digital tools may facilitate continuous, personalized nutritional support, but evidence in IBD remains limited. The aim of this study was to evaluate the impact of a nutritional intervention based on a mobile application (Nootric^®) on nutritional status, diet quality, and malnutrition risk in patients with IBD undergoing stable follow-up. Methods: We conducted a prospective longitudinal cohort study without a control group including 151 adult patients with Crohn's disease or ulcerative colitis under stable follow-up in a tertiary IBD unit. Participants used a structured digital nutritional support program through the Nootric^® app for 24 weeks, supervised by dietitians and the IBD team. Clinical activity, biochemical markers (C-reactive protein, fecal calprotectin), nutritional biomarkers (albumin, prealbumin, micronutrients), body mass index (BMI), malnutrition risk (self-administered Malnutrition Universal Screening Tool, MUST), and diet quality (PREDIMED and an expanded "Nootric score") were assessed at baseline, 12 weeks, and 24 weeks. Analyses focused on patients with adequate adherence. Results: Of the 151 included IBD patients, 110 maintained stable app use. Mean albumin increased from 4.38 to 4.49 g/dL at 24 weeks (p = 0.003), and prealbumin from 24.9 to 26.1 mg/dL (p = 0.047), despite the absence of overt protein-calorie malnutrition at baseline. Patients with obesity achieved a mean weight loss of approximately 6% of baseline body weight. Diet quality improved significantly, with higher Nootric score and a positive correlation between app use intensity and increased score. Malnutrition risk according to the MUST scale improved in more adherent patients, while clinical and biochemical disease activity remained stable overall. Conclusions: A mobile app-based nutritional program supervised by dietitians was feasible, well accepted, and associated with improved nutritional markers, diet quality, and malnutrition risk, supporting its role as a complementary component of IBD care.