Nutrition assessment of patients with inflammatory bowel disease.
BACKGROUND
Malnutrition among inflammatory bowel disease (IBD) subjects is well documented in the literature and may arise from factors including inadequate dietary intake, malabsorption, and disease activity. The aims of this present study were to complete a comprehensive nutrition assessment of IBD subjects.


METHODS
One hundred twenty-six consecutive adults with IBD completed anthropometric measures, 4-day food-record assessments, and biochemical markers of nutrition.


RESULTS
A high prevalence of inadequate nutrient consumption was observed: vitamin E (63%), vitamin D (36%), vitamin A (26%), calcium (23%), folate (19%), iron (13%), and vitamin C (11%). Several biochemical deficiencies were also observed. The prevalence of subnormal serum levels was hemoglobin (40%), ferritin (39.2%), vitamin B(6) (29%), carotene (23.4%), vitamin B(12) (18.4%), vitamin D (17.6%), albumin (17.6%), and zinc (15.2%). Dietary intake was not correlated with serum levels in all instances; there was a highly significant correlation between diet and serum values of vitamin B(12), folate, and vitamin B(6) for all IBD subjects, independent of disease activity, and for vitamin D among all IBD subjects in remission.


CONCLUSIONS
Subjects with IBD have a high rate of iron deficiency and anemia, which are most likely not secondary to diet. Supplementing with iron should be warranted only if a true iron deficiency exists. The routine evaluation of serum vitamin B(6) and vitamin D levels is recommended. Routine multivitamin supplementation is warranted in IBD in view of numerous dietary and biochemical deficiencies observed among adult IBD subjects. Even if subjects with IBD seem to be well nourished, they may harbor vitamin/mineral deficiencies.
Vagianos
Kathy
K
Department of Nutrition, University of Manitoba IBD Clinical and Research Centre, Winnipeg, Manitoba, Canada.
Bector
Savita
S
McConnell
Joseph
J
Bernstein
Charles N
CN
D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology / Q000209:etiology; D000886:Anthropometry; D001361:Avitaminosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D001481:Basal Metabolism / Q000502:physiology; D001774:Blood Chemical Analysis; D015930:Diet Records; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000628:therapy; D000090463:Iron Deficiencies; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D015596:Nutrition Assessment; D009751:Nutritional Requirements; D009752:Nutritional Status; D015995:Prevalence