Body composition assessment of Crohn's outpatients and comparison with gender- and age-specific multiple matched control pairs.

BACKGROUND/OBJECTIVES: Routine clinical care for Crohn's disease (CD) outpatients does not cover the assessment of body composition (BC); although this disease (because of inflammation, surgeries, lack of physical activity and appetite) may have a severe impact on lean body mass. The main aims of this prospective research were to assess the nutritional status of the patients and to compare their data with apparently healthy gender- and age-specific matched control pairs. SUBJECTS/METHODS: Overall, 136 CD patients and 1752 apparently healthy people were involved in the study. All participants were measured by the same bioelectrical impedance analyser. RESULTS: Using body mass index (BMI) and fat-free mass index (FFMI) as the markers of nutritional status, we found low BMI for 21% of the patients and low FFMI for 30% of them. Low BMI values were not gender specific, but substantially more females had low FFMI values. Low BMI was diagnosed in the patients' vs the control group for 21 vs 4% for men and 21 vs 2% for women; whereas low FFMI was diagnosed for 25 vs 5% for men and 36 vs 14% for women. Significant differences were found between patients' and control groups (median BMI: 22.0 vs 25.1 kg/m2, P<0.0001; FFMI: 17.3 vs 18.4 kg/m2, P=0.0044). CONCLUSIONS: This study confirmed the higher prevalence of low FFMI than that of low BMI among the subjects. We recommend implementing the assessment of BC into routine clinical care to diagnose low FFMI and to start intervention in time.

Special nutrition intervention is required for muscle protective efficacy of physical exercise in elderly people at highest risk of sarcopenia.

Progressive loss of muscle mass and strength is a physiological consequence of aging, and without interventions, it usually deteriorates into sarcopenia. In this study, the hypothesis that combined special nutritional-physiotherapeutical intervention to prevent or reverse this biological deterioration in elderly people was tested. The effects of the regular resistance muscle training (PT, n = 17) alone and the combined exercise + special nutrition therapy containing whey protein and vitamin D (PT + NT, n = 17) were monitored for 3 months in 34 elderly patients (12 men and 22 women; mean age: 66.47 years) randomly distributed into two groups at a long-term care facility. Physical exercise alone did not result in significant improvement in skeletal muscle mass or strength, whereas combined intervention significantly increased the muscle strength (22.51 ± 2.35 vs. 24.54 ± 2.65, [Formula: see text] ± SEM, kg, p = 0.027). When therapeutic responses to the intervention were compared, a significant advantage of PT + NT over PT was found. The same trend was found when the non-significant post-therapeutic alterations (χ2 test) of the distribution of normal vs. pre-sarcopenic + sarcopenic conditions within the two groups were compared. Combined intervention (PT + NT) is necessary for the efficient protection of the musculature in the high-risk elderly patients.