The inflammatory bowel diseases (IBDs) are chronic inflammatory processes affecting the gastrointestinal tract. When diagnosed in childhood and adolescence, IBD almost always impacts adversely upon the nutritional state of the patient. Weight loss and impaired linear growth may be present at diagnosis or subsequently. Further potential nutritional consequences in childhood IBD include malnutrition, anaemia, osteopaenia, and delayed puberty. Understanding the nutritional aspects of IBD is paramount in growing children, especially those entering and advancing through puberty. This paper focuses upon the nutritional impacts of IBD in children and adolescents. 1. Introduction The inflammatory bowel diseases (IBDs) are chronic illnesses affecting the gastrointestinal tract: they predominantly comprise Crohn’s disease (CD) and ulcerative colitis (UC). Although CD and UC share some features, they have distinctive endoscopic and histological characteristics and disease patterns [1]. Furthermore, the clinical manifestations and outcomes of these two conditions vary. At present, there are no specific medical cures for CD and UC: current therapies aim to control the disease and prevent adverse outcomes [1]. CD and UC may present at any age. Although IBD is uncommon in the first decade of life, presentation in infancy is well recognized. IBD is more common in the second decade, particularly in adolescence [2, 3]. There are clear demonstrations of increasing incidence of IBD around the world over the last decades, with increased rates also noted in areas with previous very low rates [3–8]. The changing incidence of IBD has also been noted in paediatric populations, with particular increases in CD [9, 10]. A history of weight loss or poor weight gain is commonly recorded at the time of diagnosis with IBD in children and adolescents. Poor linear growth may also be evident at the initial assessment, leading to growth failure in some. Growth impairment is typically more prominent in CD than UC [1]. Impaired nutrition may lead onto short- and long-term consequences that include delayed puberty, micronutrient deficiencies, impaired adult height, and bone disease. Regular monitoring and detailed attention to nutritional support remains a central facet of the management of children and adolescents with IBD. This paper will focus on the impact of IBD upon the nutritional state of children and adolescents and will highlight recent advances in this area. 2. Altered Growth Patterns in Paediatric IBD 2.1. Weight in Children with IBD Numerous cohort studies have demonstrated
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