Abstract Background Nutritional assessment is a key component of inflammatory bowel disease (IBD) care. The 2025 D-ECCO consensus¹ highlighted the need for studies combining BMI with measures of body composition and muscle function to better define nutritional risk. Reduced handgrip strength (HGS) has been associated with poor recovery and increased morbidity and mortality². HGS is a simple inexpensive marker reflecting both nutritional and inflammatory status. This study evaluated HGS as a tool to enhance nutritional assessment in a dietitian-led IBD clinic in a London teaching hospital. Methods Adults attending an IBD dietitian clinic (Aug–Oct 2025) were assessed for demographics, BMI, IBD type, disease activity, Malnutrition Universal Screening Tool (MUST) score, medications, and oral nutrition supplement (ONS) use. Disease activity was defined by C-reactive protein (CRP) and clinical indices like the Harvey–Bradshaw Index for Crohn’s disease and the Simple Clinical Colitis Activity Index for ulcerative colitis. HGS was measured by dynamometer; low HGS 27kg (men) or 16kg (women) per EWGSOP2³. Analyses used non-parametric tests and Spearman’s ρ. Results Eighty-two patients (19–92 years) were included. Fifteen percent were at malnutrition risk (MUST≥2), and 21% had low HGS. Mean BMI was 26kg/m² and mean HGS 28kg (35kg men, 22kg women). HGS correlated positively with BMI (ρ = 0.36, p 0.001) (graph 1) and declined with age (ρ = -0.23, p = 0.037) (graph 2). The BMI-HGS relationship remained significant after adjusting for age (partial ρ = 0.41, p 0.001), showing body mass contributes independently to muscle strength. HGS did not differ significantly across disease activity categories, and no correlation was observed with CRP, suggesting systemic inflammation does not directly reflect muscle function, although larger longitudinal studies may clarify this trend. Among obese patients (BMI ≥ 30kg/m²) 50% had below-mean HGS suggesting that higher body weight does not preclude reduced muscle strength and may indicate sarcopenic obesity in IBD. ONS users had lower HGS (22kg vs 27kg, p = 0.24), though the association was not independent of BMI or age. Half showed below-average HGS, supporting nutritional monitoring in this higher-risk group. Conclusion HGS is a simple, objective, and cost-effective measure of muscle function in IBD. Lower HGS was common and associated with poorer nutritional status, higher age but not with inflammatory activity, although larger studies are needed to clarify this relationship. The coexistence of high BMI with reduced strength highlights sarcopenic-obesity phenotypes and the limitations of BMI alone. Integrating HGS into dietitian-led IBD care may improve early identification of at-risk patients and inform targeted nutritional intervention. References: Svolis V, et al. ECCO Consensus on Dietary Management of Inflammatory Bowel Disease. J Crohns Colitis. 2025. doi:10.1093/ecco-jcc/jjae099. Celis-Morales CA, et al. Associations of grip strength with cardiovascular, respiratory, and cancer outcomes and all-cause mortality: prospective cohort study of half a million UK adults. BMJ. 2018;361:k1651. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: Revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31. Conflict of interest: Ms. Ayton, Darcy: No conflict of interest Hoque, Syed Samiul: No conflict of interest
Ayton et al. (2026) studied this question.