Lean body mass, physical activity and quality of life in paediatric patients with inflammatory bowel disease and in healthy controls

Background and aims: Physical activity is important for muscle and bone strength in the growing child and may be impaired in paediatric patients with inflammatory bowel disease (IBD) even during quiescent disease. The SenseWearPro(2) armband allows to measure physical activity under everyday life conditions. Methods: Thirty-nine IBD patients (27 Crohn's disease, 12 ulcerative colitis, 24 boys) in remission (n = 26) or with only mild disease activity (n = 13) were compared to 39 healthy age and sex-matched controls. Body weight, height, body mass index (BMI), lean body mass as phase angle alpha (determined by bioelectrical impedance analysis), and dynamometric grip force were expressed as age- and sex-related Z-scores. SenseWearPro(2) armbands were applied for three consecutive days to record number of steps, duration of physical activity and sleeping time. Quality of life was assessed with the German KINDL and IMPACT III questionnaires, energy intake with prospective food protocols. Differences between patients and pair-matched controls were analysed by paired t-test. Results: Patients showed lower Z-scores for phase angle alpha (difference -0.72; 95% CI [-1.10; -0.34]) and lower grip strength (-1.02 [-1.58; -0.47]) than controls. They tended towards lesser number of steps per day (-1339 [-2760; 83]) and shorter duration of physical activity (-0.44 h [-0.94; 0.06]), particularly in females and patients with mild disease. Quality of life and energy intake did not differ between patients and controls. Conclusion: In spite of quiescent disease lean body mass and physical activity were reduced. Interventions to encourage physical activity may be beneficial in this lifelong disease. (C) 2011 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.