Comparative assessment of nutritional status and energy expenditure in relation to dietary intake in hospitalized and...

Malnutrition is a common problem in inflammatory bowel diseases (IBD) and is associated with poorer outcomes and reduced quality of life. Body mass index (BMI) is commonly used to assess nutritional status but does not reflect body composition. Data on nutritional status and energy requirements in IBD are limited. The aim of our study was to evaluate nutritional status and energy requirements in hospitalized and outpatient patients with active IBD, and in patients with IBD in remission, in relation to caloric and protein intake.

This single-center prospective cohort study assessed nutritional status using the fat-free mass index (FFMI), derived from bioelectrical impedance vector analysis (BIVA). Energy requirements were measured by indirect calorimetry (Q-NRG). Protein requirements and caloric and protein intake were evaluated. Active IBD patients were evaluated longitudinally at baseline and 12 weeks and compared cross-sectionally with patients in remission.

Following remission, FFMI increased by 1.1 kg/m² in hospitalized patients (n = 14), significantly greater than the 0.4 kg/m² increase in outpatients (n = 12) (P = .026). No significant differences were observed between groups in BMI change (P = .45) or resting energy expenditure reduction (P = .53). Once in remission, the caloric balance of hospitalized and outpatient patients were comparable to patients with IBD in remission (n = 11) (P = .66).

Hospitalized patients with active IBD showed greater improvement in BIVA-derived nutritional status during remission than outpatients, despite similar BMI changes and stable energy expenditure. BIVA-derived FFMI may be useful for nutritional assessment of patients with IBD. Given the small sample size and exploratory design, these results should be interpreted as hypothesis-generating.