Conceptual Model of Lean Body Mass in Pediatric Inflammatory Bowel Disease

Youth with Inflammatory Bowel Disease (IBD) demonstrate deficits in lean body mass (LM) placing them at increased risk for future health problems, including reduction of bone mass and impaired bone architecture. Research suggests that deficits in LM are multifactorial, including influences from the disease and its treatment, as well as health behaviors such as diet and physical activity. Based on a systematic literature review examining factors related to LM deficits in IBD, this paper presents a conceptual model to explain the development of LM in youth with IBD. The model considers predictors of LM across four domains: (1) demographic; (2) medical; (3) diet; and (4) physical activity. Much existing research is cross-sectional, but suggests multiple factors work together to promote or inhibit LM accrual in youth with IBD. The conceptual model, developed based on empirical findings to date, can be used to understand and further elucidate the process through which LM is developed and maintained, to inform the development of empirically-supported clinical interventions, and to guide future research objectives and priorities. Address correspondence and reprint requests to Margaux J. Barnes, Department of Pediatrics, University of Alabama at Birmingham, 1600 7th Avenue South, McWane Suite 5604, Birmingham, AL 35294 (e-mail: mbarnes@peds.uab.edu). Received 11 June, 2018 Accepted 14 October, 2018 This work has been supported in part by the Nutrition and Obesity Research Center Pilot and Feasibility Program as well as the Kaul Pediatric Research Institute. No competing interests, personal or financial, exist for any authors. © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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