title: Systematic review: Body composition in children with inflammatory bowel disease.
abstract: BACKGROUND
  Paediatric inflammatory bowel disease (IBD) is associated with weight loss, growth restriction and malnutrition. Bone mass deficits are well described, little is known about other body composition compartments.
  
  
  OBJECTIVE
  To define the alterations in non-bone tissue compartments in children with IBD, and explore the effects of demographic and disease parameters.
  
  
  METHODS
  A systematic search was carried out in the PubMed (www.ncbi.nlm.nih.gov/pubmed) and Web of Science databases in May 2014 (limitations age <17 years, and composition measurements compared with a defined control population).
  
  
  RESULTS
  Twenty-one studies were included in this systematic review, reporting on a total of 1479 children with IBD [1123 Crohn's disease, 243 ulcerative colitis], pooled mean age 13.1 ± 3.2 years, and 34.9% female. Data were highly heterogeneous, in terms of methodology and patients. Deficits in protein-related compartments were reported. Lean mass deficits were documented in 93.6% of Crohn's disease and 47.7% of ulcerative colitis patients when compared with healthy control populations. Lower lean mass was common to both sexes in Crohn's disease and ulcerative colitis, deficits in females with persisted for longer. Fat-related compartment findings were inconsistent, some studies report reductions in body fat in new diagnosis/active Crohn's disease.
  
  
  CONCLUSIONS
  It is clear that almost all children with Crohn's disease and half with ulcerative colitis have reduced lean mass, however, body fat alterations are not well defined. To understand what impact this may have on health and disease in children with IBD, further studies are needed to identify in which tissues these deficits lie, and to quantify body fat and its distribution.
authors.affiliation: Section of Neonatal Medicine, Department of Medicine, Imperial College London, UK.
authors.forename: D
authors.initials: D
authors.lastname: Thangarajah
authors.affiliation: Section of Neonatal Medicine, Department of Medicine, Imperial College London, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Hyde
authors.affiliation: Section of Neonatal Medicine, Department of Medicine, Imperial College London, UK.
authors.forename: V K S
authors.initials: VK
authors.lastname: Konteti
authors.affiliation: Section of Neonatal Medicine, Department of Medicine, Imperial College London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Santhakumaran
authors.affiliation: Nutrition and Dietetic Research Group, Faculty of Medicine, Imperial College, London, UK.
authors.forename: G
authors.initials: G
authors.lastname: Frost
authors.affiliation: Paediatric Gastroenterology Department, Chelsea Children's Hospital, Chelsea and Westminster NHS Foundation Trust, London, UK.
authors.forename: J M E
authors.initials: JM
authors.lastname: Fell
mesh_terms: D000293:Adolescent; D001823:Body Composition; D001837:Body Weights and Measures; D015519:Bone Density; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000150:complications; D003424:Crohn Disease / Q000150:complications; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D008297:Male