Nutritional Risk in Patients with IBD: Results from a National Survey

Background: Malnutrition is a clinically relevant yet often under-recognized complication of inflammatory bowel diseases (IBD). Evidence from non-hospitalized patients remains limited. This study provides a descriptive analysis of indicators of nutritional risk among members of the Italian IBD patients' association and explores the association with symptoms, clinical characteristics, and access to nutritional care. Methods: A cross-sectional survey was conducted on 705 IBD patients. The questionnaire incorporated all the items required to assess nutritional risk included in the Malnutrition Universal Screening Tool (MUST) and its association with other clinical parameters. Results: Overall, 43.0% of respondents were found to be at moderate or high risk of malnutrition based on the MUST. A low BMI was observed in 25.6% of patients with CD and 22.1% of those with UC. Additionally, unintentional weight loss (UWL) occurred in 24.5% and 23.7% of CD and UC patients, respectively. In total, 30% of patients reported restricting their diet because they were afraid certain foods would worsen their symptoms. Gastrointestinal symptoms were significantly associated with MUST ≥ 2. Only 21.7% of participants reported receiving nutritional counselling. A total of 67.3% of subjects already at high nutritional risk (MUST ≥ 2) have never received any dietary recommendations. Conclusions: In this community sample of IBD patients, a considerable proportion reported indicators compatible with nutritional risk. These findings are not generalized to the general IBD population due to the dissemination through a patient association, but highlight gaps in outpatient nutritional assessment and patient education. Structured, accessible nutritional support may help address these unmet needs.