P1066Ultra-processed food intake independently predicts pre-sarcopenia in patients with inflammatory bowel disease in remission

Abstract Background Sarcopenia is associated with worse clinical outcomes in inflammatory bowel disease (IBD). This study aimed to investigate clinical, nutritional, and lifestyle factors associated with sarcopenia in patients with IBD during the remission phase. Methods In this cross-sectional observational study, we enrolled adult IBD patients in stable clinical and endoscopic remission. Exclusion criteria included eating disorders, major surgery, severe comorbidities, use of medications with effects on metabolic functions, alcohol abuse, pregnancy or breastfeeding, and competitive physical activity. Demographic, clinical, and lifestyle data were collected. Dietary intake was assessed using validated food frequency questionnaires, categorizing foods according to the NOVA classification into minimally processed foods (MPF), processed foods (PF), and ultra-processed foods (UPF). The percentage of UPF consumption was divided into three tertiles (T1=low; T3=high). Body composition was assessed by bioimpedance analysis to estimate fat-free mass (FFM), fat mass (FM) and appendicular skeletal muscle mass/height² (ASM/height²). Muscle strength and function were assessed with Grip strength test, and Timed Up and Go (TUG) test, respectively. The International Physical Activity Questionnaire (IPAQ)-short form was used to assess level of physical activity. Sarcopenia was diagnosed according to EWGSOP2 criteria. Results We included 104 patients, 50 with Crohn’s disease (CD), and 54 with ulcerative colitis (UC), 60% of whom were male, with a mean age of 41.4±15.6 years. The mean disease duration was 23.2±37.6 years. Overall, 17.3% had extra-intestinal manifestations, 57.7% of patients received biologic therapy. Mean daily intake was 1,690.3±814.2 g for MPF, 883.4±528.4 g for PF, and 617.9±322.2 g for UPF, accounting for 19.95±7.9% of total food intake. Overall, 36.5% of participants were in the highest UPF tertile. Mean FFM and FM were 50.4±9.5 kg and 20.4±8.0 kg, respectively. Sarcopenia was diagnosed in 16% of patients, and no variables were significantly associated with this outcome. Nevertheless, the mean ASM/height² was 7.01±1.26 kg/m², with 32 patients (31%) classified as pre-sarcopenic. Muscle strength and physical function were within expected ranges. Average physical activity level was moderate (IPAQ score 2,655±2,633). In hierarchical logistic regression, higher UPF intake was the only independent predictor of pre-sarcopenia (OR = 3.40, 95% CI: 1.06–10.9, p = 0.039). Conclusion The highest UPF consumption was associated with pre-sarcopenia in IBD patients in remission, underscoring the importance of dietary counselling to preserve muscle mass and improve outcomes. Prospective studies are warranted to confirm these findings. References: Narula N, Wong ECL, Dehghan M, et al. Association of ultra-processed food intake with risk of inflammatory bowel disease: Prospective cohort study. BMJ 374:n1554 Kathy Vagianos, Casandra Dolovich, KelcieWitges, Lesley A.Graff, Charles N. Bernstei ; Ultra-Processed Food, Disease Activity, and Inflammation in Ulcerative Colitis: The Manitoba Living With IBD Study. The American College of Gastroenterology 2024. 119(6):1102-1109. Carlos A Monteiro, Geoffrey Cannon, Renata B Levy; Jean-Claude Moubarac, Maria LC Louzada, Fernanda Rauber; Ultra-processed foods: what they are and how to identify them. Public health nutrition 2018. 936-941 Bezzio C, Brinch D, Ribaldone DG, et al. Prevalence, Risk Factors and Association with Clinical Outcomes of Malnutrition and Sarcopenia in Inflammatory Bowel Disease: A Prospective Study. Nutrients. 2024 Nov 21;16(23):3983. Conflict of interest: Compare, Debora: No conflict of interest Sgamato, Costantino: No conflict of interest Nardone, Gerardo: No conflict of interest Dr. Ambrosio, Carmen: No conflict of interest Zerella, Giovanni: No conflict of interest Monaco, Marco: No conflict of interest Rea, Carmine: No conflict of interest Torriero, Aurora: No conflict of interest Sarnataro, Miriam: No conflict of interest Esposito, Paola: No conflict of interest