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Conceptual Model of Lean Body Mass in Pediatric Inflammatory Bowel Disease

Barnes, Margaux J.*; Lynch, Mary K.*; Lisenby, Molly D.*; Jester, Traci*; Maclin, Jeanine*; Knight, Taylor; Fisher, Gordon; Gower, Barbara§

Journal of Pediatric Gastroenterology and Nutrition: March 2019 - Volume 68 - Issue 3 - p 301–305
doi: 10.1097/MPG.0000000000002212
Review Article

ABSTRACT Youth with inflammatory bowel disease (IBD) demonstrate deficits in lean 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, and health behaviors such as diet and physical activity. Based on a systematic literature review examining factors related to LM deficits in IBD, this article presents a conceptual model to explain the development of LM in youth with IBD. The model considers predictors of LM across 4 domains: demographic; medical; diet; and 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.

*Department of Pediatrics, University of Alabama at Birmingham

Children's of Alabama

Department of Human Studies

§Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL.

Address correspondence and reprint requests to Margaux J. Barnes, PhD, Department of Pediatrics, University of Alabama at Birmingham, 1600 7th Ave South, McWane Suite 5604, Birmingham, AL 35233 (e-mail:

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 and the Kaul Pediatric Research Institute.

The authors report no conflicts of interest.

© 2019 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,