Excessive Weight – Muscle Depletion Paradox and Cardiovascular Risk Factors in Outpatients With Inflammatory Bowel Disease

Abstract

-Background -Evidence suggests a nutritional transition process in patients with inflammatory bowel disease. Obesity, which was once an uncommon occurrence in such patients, has grown in this population at the same prevalence rate as that found in the general population, bringing with it an increased risk of cardiovascular disease. Objective -The aim of the present study was to determine the nutritional status and occurrence of cardiovascular risk factors in patients with inflammatory bowel disease. Methods -A case-series cross-sectional study was conducted involving male and female adult outpatients with inflammatory bowel disease. Data were collected on demographic, socioeconomic, clinical and anthropometric variables as well as the following cardiovascular risk factors: sedentary lifestyle, excess weight, abdominal obesity, medications in use, comorbidities, alcohol intake and smoking habits. The significance level for all statistical tests was set to 5% (P < 0.05). Results -The sample comprised 80 patients with inflammatory bowel disease, 56 of whom (70.0%) had ulcerative colitis and 24 of whom (30.0%) had Crohn's disease. Mean age was 40.3±11 years and the female genre accounted for 66.2% of the sample. High frequencies of excess weight (48.8%) and abdominal obesity (52.5%) were identified based on the body mass index and waist circumference, respectively, in both groups, especially among those with ulcerative colitis. Muscle depletion was found in 52.5% of the sample based on arm muscle circumference, with greater depletion among patients with Crohn's disease (P=0.008). The most frequent risk factors for cardiovascular disease were a sedentary lifestyle (83.8%), abdominal obesity (52.5%) and excess weight (48.8%). Conclusion -The results of the complete anthropometric evaluation draw one's attention to a nutritional paradox, with high frequencies of both -muscle depletion, as well as excess weight and abdominal obesity. HEADINGS -Inflammatory bowel disease. Overweight. Malnutrition. Risk factors. Cardiovascular disease.

Body Composition in Patients With Crohn’s Disease and Ulcerative Colitis

“…Obesity, once considered a rare condition in IBD, has become increasingly prevalent, mainly in the last two decades (2,7) . It is believed that this is related to increased number of comorbidities, such as diabetes, hypertension, thromboembolic disease, infections, cancer (7) .…”

Impact of biological therapy on body composition of patients with Chron's disease

“…13,14 In addition to malnutrition, changes in body composition such as the occurrence of sarcopenia have been described in patients with CD. [15][16][17][18] Schneider et al describe the occurrence of sarcopenia in 60% of patients with CD even during clinical remission. 18 Loss of lean mass (LM) has been associated with worsening of bone mineral density, increased morbidity, loss of muscle strength, and increased risk of infectious complications.…”

Systematic review of nutrition screening and assessment in inflammatory bowel disease

“…Over-nourishment and obesity affects up to 55% of patients with IBD in the Western hemisphere[23,54]. In spite of this, decreased muscle mass and micronutrient deficiencies remain prevalent even among the obese population with IBD ( i.e ., sarcopenic obesity), and are not accurately assessed by traditional nutrition assessment methods[33,55-57]. Although there is conflicting data on the association of obesity itself with IBD related clinical outcomes[58-61], the syndrome of “sarcopenic-obesity” likely does have implications in predicting relevant clinical outcomes, and warrants further in-vestigation[33].…”