title: A snapshot of the nutritional status of Crohn's disease among adolescents in Brazil: a prospective cross-sectional study.
abstract: BACKGROUND
  The relationship between nutrition and Crohn's disease (CD) is complex and involves several therapeutic possibilities including: nutrition treatment for malnourished patients, optimization of growth and development, prevention of osteoporosis, first-line therapy for active disease, and maintenance of disease remission. In children and adolescents with CD, malnutrition is a common problem that adversely affects the prognosis. In at-risk adolescent CD patients, it is important to assess body composition, food intake, energy expenditure, nutrient balance and serum levels of nutrients before planning interventions for this population. The aim of this study was to provide a snapshot of the nutritional status of adolescents with CD in Brazil.
  
  
  METHODS
  We prospectively selected 22 patients with mildly to moderately active CD, 29 patients with inactive CD and 35 controls (first-degree relatives of and in the same age bracket as the CD patients). The age range of participants was between 13.2 and 19.4 years old. We collected anthropometric data including weight, height, and body mass index (BMI), which were expressed as Z scores: weight-for-age, height-for-age and BMI-for-age, respectively, as well as using bioimpedance to determine body composition and assessing the Tanner stage. We also assessed macronutrients and micronutrients (serum levels and dietary intake of both). We used the chi-square test to determine whether any of the studied variables were associated with inactive or active CD. The level of significance was set at 5 % (p < 0.05). We have written informed parental consent for participation for any minors and written informed consent for any participants that were adults.
  
  
  RESULTS
  The mean values for lean body mass, Tanner stage, height-for-age Z score and BMI-for-age Z score were lower in the active CD group than in the inactive CD and control groups (p < 0.05 for both). Compared with the controls, the CD patients showed significant differences in terms of the quality of dietary intake (particularly in caloric intake, dietary protein intake, dietary fiber intake, and micronutrient intake), which were reflected in the serum levels of nutrients, mainly vitamins A and E (p < 0.05).
  
  
  CONCLUSIONS
  Adolescents with CD (including those with mildly to moderately active or inactive disease) have a nutritional risk, which makes it important to conduct nutritional assessments in such patients.
authors.affiliation: Department of Gastroenterology, University of Sao Paulo School of Medicine Hospital das Clínicas, Av. Dr. Eneas de Carvalho Aguiar 255, 05403-000, Sao Paulo, Brazil. caprospero@gmail.com.
authors.forename: Camila Ortiz Prospero Cavalcante
authors.initials: CO
authors.lastname: Costa
authors.affiliation: Department of Gastroenterology, University of Sao Paulo School of Medicine Hospital das Clínicas, Av. Dr. Eneas de Carvalho Aguiar 255, 05403-000, Sao Paulo, Brazil. fjcarril@usp.br.
authors.forename: Flair José
authors.initials: FJ
authors.lastname: Carrilho
authors.affiliation: Lipids Laboratory (LIM-10), Endocrinology and Metabolism Division of University of Sao Paulo School of Medicine Hospital das Clinicas, Av.Dr.Eneas de Carvalho Aguiar 255, 05403-000, Sao Paulo, Brazil. valeriasutti@gmail.com.
authors.forename: Valeria Sutti
authors.initials: VS
authors.lastname: Nunes
authors.affiliation: Department of Gastroenterology, University of Sao Paulo School of Medicine Hospital das Clínicas, Av. Dr. Eneas de Carvalho Aguiar 255, 05403-000, Sao Paulo, Brazil. aytan@usp.br.
authors.forename: Aytan Miranda
authors.initials: AM
authors.lastname: Sipahi
authors.affiliation: Department of Gastroenterology, University of Sao Paulo School of Medicine Hospital das Clínicas, Av. Dr. Eneas de Carvalho Aguiar 255, 05403-000, Sao Paulo, Brazil. maraci@uol.com.br.
authors.forename: Maraci
authors.initials: M
authors.lastname: Rodrigues
mesh_terms: D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D000886:Anthropometry; D001823:Body Composition; D015992:Body Mass Index; D001938:Brazil; D016009:Chi-Square Distribution; D003424:Crohn Disease / Q000097:blood / Q000150:complications*; D003430:Cross-Sectional Studies; D004034:Diet Surveys; D004435:Eating; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D018977:Micronutrients / Q000097:blood; D009748:Nutrition Disorders / Q000097:blood / Q000209:etiology*; D009752:Nutritional Status; D011446:Prospective Studies; D014801:Vitamin A / Q000097:blood; D014810:Vitamin E / Q000097:blood; D014815:Vitamins / Q000097:blood; D055815:Young Adult
chemical_list: D018977:Micronutrients; D014815:Vitamins; D014801:Vitamin A; D014810:Vitamin E