Nutritional impact of inflammatory bowel diseases on children and adolescents

OBJECTIVE: To perform a sistematiy review of the literature about the nutritional impact of inflammatory bowel diseases in children and adolescents.DATA SOURCES: A systematic review was performed using PubMed/MEDLINE, LILACS and SciELO databases, with inclusion of articles in Portuguese and in English with original data, that analyzed nutritional aspects of inflammatory bowel diseases in children and adolescents. The initial search used the terms "inflammatory bowel diseases" and "children" or "adolescents" and "nutritional evaluation" or "nutrition deficiency". The selection of studies was initially performed by reading the titles and abstracts. Review studies and those withouth data for pediatric patients were excluded. Subsequently, the full reading of the articles considered relevant was performed.RESULTS: 237 studies were identified, and 12 of them were selected according to the inclusion criteria. None of them was performed in South America. During the analysis of the studies, it was observed that nutritional characteristics of patients with inflammatory bowel disease may be altered; the main reports were related to malnutrition, growth stunting, delayed puberty and vitamin D deficiency.CONCLUSION: There are nutritional consequences of inflammatory bowel diseases in children and adolescents, mainly growth stunting, slower pubertal development, underweight and vitamin deficiencies. Nutritional impairments were more significant in patients with Crohn's disease; overweight and obesity were more common in patients with ulcerative rectocolitis. A detailed nutritional assessment should be performed periodically in children and adolescents with inflammatory bowel disease.研究目的：针对儿童青少年炎症性肠病（inflammatory bowel diseases）的营养影响开展系统性文献综述。 数据来源：本研究通过PubMed/MEDLINE、LILACS及SciELO数据库完成系统性综述检索，纳入葡萄牙语、英语原创性研究文献，分析儿童青少年炎症性肠病的营养相关特征。初始检索采用“炎症性肠病”与“儿童”或“青少年”，以及“营养评估”或“营养缺乏”作为检索词组合。研究初选阶段通过阅读标题与摘要完成筛选，排除综述类文献及未涉及儿科患者的研究。随后对判定为相关的文献进行全文阅读。 结果：本次检索共识别出237篇相关文献，最终依据纳入标准筛选出12篇，其中无研究在南美洲开展。经文献分析可见，炎症性肠病患者的营养状态可出现异常，现有报道主要涉及营养不良、生长迟缓、青春期发育延迟及维生素D缺乏。 结论：儿童青少年炎症性肠病可引发多种营养相关不良结局，主要包括生长迟缓、青春期发育迟缓、体质量不足及维生素缺乏。克罗恩病（Crohn's disease）患者的营养损伤更为显著；而溃疡性直肠结肠炎（ulcerative rectocolitis）患者则更易出现超重与肥胖。因此，针对炎症性肠病儿童青少年患者，应定期开展细致的营养评估。