Multidimensional nutritional assessment in Crohn’s disease: a cross-sectional comparison of active disease and remission

Abstract

Background: Malnutrition is a clinically important but frequently underrecognized complication of Crohn’s disease (CD), and contributes to poorer outcomes, impaired functional status, and increased care burden. We evaluated the nutritional status of adults with CD and compared the burden of nutritional impairment between active disease and remission

Methods: This cross-sectional study included 127 adults with CD: 63 with active disease and 64 in remission. Disease activity was established using the Crohn’s Disease Activity Index, Simple Endoscopic Score for Crohn’s Disease, and magnetic resonance enterography. Nutritional assessment included body mass index (BMI), mid-upper arm circumference, calf circumference, triceps skinfold thickness, mid-arm muscle circumference, Mini Nutritional Assessment-Short Form (MNA-SF), and biochemical indices, including hemoglobin, serum iron, folate, vitamin B12, albumin, and zinc. Malnutrition was defined according to the Global Leadership Initiative on Malnutrition (GLIM) criteria.

Results: Overall, 47.2% of patients were malnourished. Malnutrition was substantially more prevalent in active disease than in remission (81.0% vs 14.1%, p < 0.001). Compared with patients in remission, those with active CD had significantly lower BMI, anthropometric measures, MNA-SF scores, hemoglobin, serum iron, albumin, and zinc (all p <0.001). Folate and vitamin B12 were not significantly different between groups. BMI correlated strongly with other anthropometric parameters and MNA-SF score (r=0.854-0.914; all p <0.001), whereas associations with biochemical markers were weaker and attenuated after subgroup analysis.

Conclusion: Malnutrition is highly prevalent among people with CD. A multidimensional nutritional assessment combining anthropometry, biochemical markers, and structured clinical screening appears more informative than reliance on any single marker.

Bangladesh J Medicine 2026; Vol. 37, No. 2(1): pp. 239