{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T18:27:39Z","timestamp":1793212059905,"version":"4.5.0"},"reference-count":44,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Nestl\u00e9 Health Sciences for an investigator-initiated study into nutritional status in colonic IBD","award":["Nestl\u00e9-AMC-31403"],"award-info":[{"award-number":["Nestl\u00e9-AMC-31403"]}]},{"name":"Health Holland TKI grant in partnership with Nestl\u00e9 Health Sciences","award":["TKI-LSH-ADT-2021-AMC-26344"],"award-info":[{"award-number":["TKI-LSH-ADT-2021-AMC-26344"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Growth impairment and poor nutritional status are recognized complications of pediatric inflammatory bowel disease (IBD), yet data specific to ulcerative colitis (UC) are limited. This systematic review aims to provide an overview of current knowledge on growth, nutritional status, and body composition in children and adolescents with UC. Methods: A systematic literature search was performed up to August 2025. Studies including patients aged 5\u201322 years with confirmed UC were reviewed. Results related to growth, nutritional status, and body composition were narratively synthesized to summarize findings. Results: Fifteen studies with 1575 patients with UC met inclusion criteria, comprising 5 prospective, 5 cross-sectional, and 5 retrospective designs. Although the included studies were conducted in broader IBD cohorts, only UC-specific outcomes were reported. The data were limited by sample size, heterogeneity in patient characteristics, outcome definitions, and assessment methods. The majority of patients had prolonged disease with remission or mild activity. Growth failure prevalence ranged from 7% to 36%, with weight deficits being more common than height deficits. Undernutrition affected up to 25% of patients, with variability across studies. Overweight and obesity were also observed, though most studies showed no significant differences between UC patients and controls. Only five very small studies assessed body composition, reporting inconsistent findings regarding reductions in lean body mass. Conclusions: Growth impairment and poor nutritional status can occur in children and adolescents with UC. Larger, standardized, high-quality studies focused specifically on UC are needed to better characterize its impact on growth and nutritional status, including the essential integration of body composition assessment.<\/jats:p>","DOI":"10.3390\/nu18010169","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T10:03:48Z","timestamp":1767607428000},"page":"169","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Nutritional Status, Body Composition and Growth in Paediatric-Onset Ulcerative Colitis: A Systematic Review"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2397-7581","authenticated-orcid":false,"given":"Chen","family":"Sarbagili-Shabat","sequence":"first","affiliation":[{"name":"Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Amsterdam University Medical Centers, Emma Children\u2019s Hospital, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floor","family":"Timmer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Amsterdam University Medical Centers, Emma Children\u2019s Hospital, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3730-3262","authenticated-orcid":false,"given":"Konstantina","family":"Morogianni","sequence":"additional","affiliation":[{"name":"Department of Food Science and Human Nutrition, Agricultural University of Athens, 118 55 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2075-7495","authenticated-orcid":false,"given":"Ralph","family":"de Vries","sequence":"additional","affiliation":[{"name":"Medical Library, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"de Meij","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Amsterdam University Medical Centers, Emma Children\u2019s Hospital, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8426-0316","authenticated-orcid":false,"given":"Nikki","family":"van der Kruk","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Amsterdam University Medical Centers, Emma Children\u2019s Hospital, 1105 AZ Amsterdam, The Netherlands"},{"name":"Tytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology Endocrinology and Metabolism, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5478-6705","authenticated-orcid":false,"given":"Lana","family":"Verstoep","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Amsterdam University Medical Centers, Emma Children\u2019s Hospital, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0125-0680","authenticated-orcid":false,"given":"Nicolette","family":"Wierdsma","sequence":"additional","affiliation":[{"name":"Tytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology Endocrinology and Metabolism, 1105 AZ Amsterdam, The Netherlands"},{"name":"Department of Nutrition and Dietetics, Amsterdam University Medical Centers, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5822-4371","authenticated-orcid":false,"given":"Johan","family":"Van Limbergen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Amsterdam University Medical Centers, Emma Children\u2019s Hospital, 1105 AZ Amsterdam, The Netherlands"},{"name":"Tytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology Endocrinology and Metabolism, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3191","DOI":"10.3748\/wjg.v20.i12.3191","article-title":"Update on nutritional status, body composition and growth in paediatric inflammatory bowel disease","volume":"20","author":"Hill","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.clnu.2022.12.004","article-title":"ESPEN guideline on Clinical Nutrition in inflammatory bowel disease","volume":"42","author":"Bischoff","year":"2023","journal-title":"Clin. Nutr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"367","DOI":"10.21037\/atm-22-1126","article-title":"Sarcopenia is associated with poor clinical outcomes in patients with inflammatory bowel disease: A prospective cohort study","volume":"10","author":"Liu","year":"2022","journal-title":"Ann. Transl. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3380","DOI":"10.3748\/wjg.v12.i21.3380","article-title":"Malnutrition affects quality of life in gastroenterology patients","volume":"12","author":"Norman","year":"2006","journal-title":"World J. Gastroenterol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2501","DOI":"10.1111\/hex.12219","article-title":"Variable access to quality nutrition information regarding inflammatory bowel disease: A survey of patients and health professionals and objective examination of written information","volume":"18","author":"Prince","year":"2015","journal-title":"Health Expect."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1002\/jpn3.70096","article-title":"Management of paediatric ulcerative colitis, part 2: Acute severe colitis-An updated evidence-based consensus guideline from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition and the European Crohn\u2019s and Colitis Organization","volume":"81","author":"Assa","year":"2025","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1093\/ecco-jcc\/jjaa161","article-title":"The Medical Management of Paediatric Crohn\u2019s Disease: An ECCO-ESPGHAN Guideline Update","volume":"15","author":"Aloi","year":"2021","journal-title":"J. Crohns. Colitis"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1111\/apt.13218","article-title":"Systematic review: Body composition in children with inflammatory bowel disease","volume":"42","author":"Thangarajah","year":"2015","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2647","DOI":"10.1016\/j.clnu.2019.12.027","article-title":"Body composition in children with chronic inflammatory diseases: A systematic review","volume":"39","author":"Houttu","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Swirkosz, G., Szczygiel, A., Logon, K., Wrzesniewska, M., and Gomulka, K. (2023). The Role of the Microbiome in the Pathogenesis and Treatment of Ulcerative Colitis\u2014A Literature Review. Biomedicines, 11.","DOI":"10.3390\/biomedicines11123144"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1136\/gutjnl-2014-307198","article-title":"Abnormal fibre usage in UC in remission","volume":"64","author":"James","year":"2015","journal-title":"Gut"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"682","DOI":"10.3748\/wjg.v29.i4.682","article-title":"Gaseous metabolites as therapeutic targets in ulcerative colitis","volume":"29","author":"Yao","year":"2023","journal-title":"World J. Gastroenterol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1053\/j.gastro.2008.06.081","article-title":"Definition of phenotypic characteristics of childhood-onset inflammatory bowel disease","volume":"135","author":"Russell","year":"2008","journal-title":"Gastroenterology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1002\/jpn3.70097","article-title":"Management of paediatric ulcerative colitis, part 1: Ambulatory care-An updated evidence-based consensus guideline from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition and the European Crohn\u2019s and Colitis Organisation","volume":"81","author":"Wine","year":"2025","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1007\/s10620-020-06759-5","article-title":"Growth Delay in Inflammatory Bowel Diseases: Significance, Causes, and Management","volume":"66","author":"Wong","year":"2021","journal-title":"Dig. Dis. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"jjaf122","DOI":"10.1093\/ecco-jcc\/jjaf122","article-title":"European Crohn\u2019s and Colitis Organisation consensus on dietary management of inflammatory bowel disease","volume":"19","author":"Svolos","year":"2025","journal-title":"J. Crohns. Colitis"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1097\/MIB.0000000000001128","article-title":"Sarcopenia Is Common in Overweight Patients with Inflammatory Bowel Disease and May Predict Need for Surgery","volume":"23","author":"Adams","year":"2017","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Abd-El-Aziz, M.A., Hubner, M., Demartines, N., Larson, D.W., and Grass, F. (2022). Simple Clinical Screening Underestimates Malnutrition in Surgical Patients with Inflammatory Bowel Disease-An ACS NSQIP Analysis. Nutrients, 14.","DOI":"10.3390\/nu14050932"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1111\/apt.13156","article-title":"Low muscle mass and sarcopenia: Common and predictive of osteopenia in inflammatory bowel disease","volume":"41","author":"Bryant","year":"2015","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_21","unstructured":"(2025, December 27). PROSPERO: International Prospective Register of Systematic Reviews. University of York. Available online: https:\/\/www.crd.york.ac.uk\/prospero\/."},{"key":"ref_22","unstructured":"Otten, R., de Vries, R., and Schoonmade, L. (2025, December 27). Amsterdam Efficient Deduplication (AED) method\u2014Manual. Zenodo.org. Available online: https:\/\/zenodo.org\/records\/4544315."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"240","DOI":"10.3163\/1536-5050.104.3.014","article-title":"De-duplication of database search results for systematic reviews in EndNote","volume":"104","author":"Bramer","year":"2016","journal-title":"J. Med. Libr. Assoc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"16","DOI":"10.21037\/tp.2018.12.04","article-title":"Growth failure in pediatric onset inflammatory bowel disease: Mechanisms, epidemiology, and management","volume":"8","author":"Ishige","year":"2019","journal-title":"Transl. Pediatr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1002\/jcsm.12383","article-title":"GLIM criteria for the diagnosis of malnutrition\u2014A consensus report from the global clinical nutrition community","volume":"10","author":"Cederholm","year":"2019","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1093\/ecco-jcc\/jjac041","article-title":"Systematic Review: The Impact and Importance of Body Composition in Inflammatory Bowel Disease","volume":"16","author":"Ding","year":"2022","journal-title":"J. Crohns. Colitis"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Moola, S., Munn, Z., Tufanaru, C., Aromataris, E., Sears, K., Sfetcu, R., Currie, M., Lisy, K., Qureshi, R., and Mattis, P. (2020). Systematic reviews of etiology and risk. JBI Manual for Evidence Synthesis, JBI.","DOI":"10.46658\/JBIRM-17-06"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1097\/MPG.0000000000003072","article-title":"Pediatric-onset Inflammatory Bowel Disease Has Only a Modest Effect on Final Growth: A Report From the epi-IIRN","volume":"73","author":"Assa","year":"2021","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1016\/0016-5085(93)90883-E","article-title":"Growth failure in children with inflammatory bowel disease: A prospective study","volume":"105","author":"Motil","year":"1993","journal-title":"Gastroenterology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1038\/s41430-019-0555-1","article-title":"Nutritional status and body composition in children with inflammatory bowel disease: A prospective, controlled, and longitudinal study","volume":"74","author":"Selbuz","year":"2020","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1038\/ejcn.2013.286","article-title":"Detailed assessment of nutritional status and eating patterns in children with gastrointestinal diseases attending an outpatients clinic and contemporary healthy controls","volume":"68","author":"Tsiountsioura","year":"2014","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_32","first-page":"e26562","article-title":"Linear Growth Impairment in Patients with Pediatric Inflammatory Bowel Disease","volume":"14","author":"Isa","year":"2022","journal-title":"Cureus"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"21300","DOI":"10.1038\/s41598-023-48504-8","article-title":"Nutritional status of pediatric patients with inflammatory bowel diseases is related to disease duration and clinical picture at diagnosis","volume":"13","author":"Akutko","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1007\/s00431-019-03443-3","article-title":"Nutritional status and food intake in pediatric patients with inflammatory bowel disease at diagnosis significantly differs from healthy controls","volume":"178","author":"Sila","year":"2019","journal-title":"Eur. J. Pediatr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/j.crohns.2011.11.017","article-title":"Lean body mass, physical activity and quality of life in paediatric patients with inflammatory bowel disease and in healthy controls","volume":"6","author":"Werkstetter","year":"2012","journal-title":"J. Crohns. Colitis"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Zhou, X., Kern, I., Rothe, U., Schoffer, O., Weidner, J., Richter, T., Laass, M.W., Kugler, J., and Manuwald, U. (2024). Growth development of children and adolescents with inflammatory bowel disease in the period 2000\u20132014 based on data of the Saxon pediatric IBD registry: A population-based study. BMC Gastroenterol., 24.","DOI":"10.1186\/s12876-023-03088-5"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2541","DOI":"10.1002\/ibd.21654","article-title":"Pediatric inflammatory bowel disease: Increasing incidence, decreasing surgery rate, and compromised nutritional status: A prospective population-based cohort study 2007\u20132009","volume":"17","author":"Jakobsen","year":"2011","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1111\/apa.15383","article-title":"Growth failure is rare in a contemporary cohort of paediatric inflammatory bowel disease patients","volume":"110","author":"Ashton","year":"2021","journal-title":"Acta Paediatr."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1159\/000501924","article-title":"Prevalence and Predictors of Growth Impairment and Short Stature in Pediatric-Onset Inflammatory Bowel Disease","volume":"101","author":"Rinawi","year":"2020","journal-title":"Digestion"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.ajg.2020.07.002","article-title":"Prevalence of nutritional disorders in Saudi children with inflammatory bowel disease based on the national growth reference","volume":"21","author":"Alahmadi","year":"2020","journal-title":"Arab. J. Gastroenterol."},{"key":"ref_41","first-page":"55","article-title":"Body composition as an indicator of the nutritional status in children with newly diagnosed ulcerative colitis and Crohn\u2019s disease\u2014A prospective study","volume":"12","author":"Korczowski","year":"2017","journal-title":"Prz. Gastroenterol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1002\/ibd.21214","article-title":"Final adult height of children with inflammatory bowel disease is predicted by parental height and patient minimum height Z-score","volume":"16","author":"Lee","year":"2010","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1093\/ecco-jcc\/jjaa197","article-title":"Diagnostic Delay Is Associated With Complicated Disease and Growth Impairment in Paediatric Crohn\u2019s Disease","volume":"15","author":"Ricciuto","year":"2021","journal-title":"J. Crohns. Colitis"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Alhusseini, N., Alsinan, N., Almutahhar, S., Khader, M., Tamimi, R., Elsarrag, M.I., Warar, R., Alnasser, S., Ramadan, M., and Omair, A. (2023). Dietary trends and obesity in Saudi Arabia. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1326418"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/1\/169\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T10:11:04Z","timestamp":1767607864000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/1\/169"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,5]]},"references-count":44,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["nu18010169"],"URL":"https:\/\/doi.org\/10.3390\/nu18010169","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,5]]}}}