Researchers studied 68 children with Crohn’s disease in China to understand how muscle loss affects their treatment. They found that children with Crohn’s disease were much more likely to have muscle loss (34%) compared to healthy children (10%). Kids who lost muscle were also more likely to stop responding well to their biologic medicine. However, when doctors combined medicine with special nutrition plans, muscle loss improved significantly. This research shows that checking for muscle loss early and treating it might help kids with Crohn’s disease get better results from their medications.

The Quick Take

  • What they studied: Whether children with Crohn’s disease have more muscle loss than healthy kids, and whether muscle loss affects how well their medicine works
  • Who participated: 68 Chinese children with Crohn’s disease (average age 12 years) who received a specific biologic medicine called infliximab, plus 136 healthy children without Crohn’s disease as a comparison group
  • Key finding: Children with Crohn’s disease had muscle loss three times more often than healthy children (34% vs. 10%). Kids whose medicine stopped working well had even more muscle loss (50% vs. 24%). When kids received medicine plus special nutrition support, muscle loss decreased from 48% to 25%
  • What it means for you: If your child has Crohn’s disease, doctors should check for muscle loss early. Adding nutrition support to medicine treatment may help the medicine work better and reduce muscle loss. This is especially important because muscle loss can make treatment less effective

The Research Details

Researchers looked at 68 children with Crohn’s disease who received a biologic medicine called infliximab between 2022 and 2025. They used special CT scans (a type of detailed X-ray) to measure how much muscle and fat each child had in their body. They compared these children to 136 healthy children without Crohn’s disease to see if there was a difference in muscle loss.

The doctors collected information about each child’s health, blood tests, and scan results. They looked at whether children responded well to their medicine or stopped responding. Then they followed some children (44 of them) who received medicine combined with special nutrition plans (either complete nutrition through a tube or partial tube feeding) and took new scans to see if their muscle loss improved.

This type of study is called an observational study because researchers watched what happened rather than randomly assigning kids to different treatments.

Understanding muscle loss in children with Crohn’s disease is important because kids are still growing and developing. Losing muscle during childhood can affect their growth, strength, and how well their bodies fight disease. By using CT scans to measure muscle directly, researchers can see the real problem instead of just guessing based on weight. This helps doctors understand why some kids don’t respond well to medicine and what they can do about it.

This study has several strengths: it used actual CT scans to measure muscle (very accurate), it compared sick children to healthy children, and it followed some children over time to see if treatment helped. However, the study only included 68 children from China, so results might be different in other countries or larger groups. The study didn’t randomly assign kids to different treatments, so we can’t be completely sure the nutrition support caused the improvement. The researchers did collect detailed medical information, which makes the findings more reliable.

What the Results Show

The main finding was that muscle loss was much more common in children with Crohn’s disease than in healthy children. About one-third of children with Crohn’s disease (34%) had muscle loss, while only one-tenth of healthy children (10%) had it. This difference was statistically significant, meaning it’s very unlikely to have happened by chance.

Among the children with Crohn’s disease, those whose medicine stopped working well had even worse muscle loss. Half of the kids who stopped responding to their medicine (50%) had muscle loss, compared to only about one-quarter (24%) of kids whose disease went into remission (got better).

When researchers looked at what protected children from muscle loss, they found that having a higher body mass index (BMI) was the only protective factor. For every unit increase in BMI, the risk of muscle loss decreased by about 27%.

When 44 children received their medicine combined with special nutrition support (either complete tube feeding or partial tube feeding), follow-up scans showed improvement. The percentage of children with muscle loss dropped from 48% to 25%, which was a significant improvement.

The study showed that CT scans are a reliable way to measure muscle loss in children with Crohn’s disease. This is important because doctors can now use this tool to identify which children are at risk for treatment failure. The research also suggests that nutrition support is an important part of treatment, not just the medicine alone. Children who received combined treatment (medicine plus nutrition) did better than those who might have received medicine alone.

Previous research in adults with Crohn’s disease showed that muscle loss affects treatment outcomes, but very little research existed in children. This study fills that gap by showing that the same problem happens in kids. The findings support the idea that muscle loss is an important factor across all ages with Crohn’s disease. The improvement seen with combined medicine and nutrition treatment aligns with current medical recommendations that emphasize treating the whole person, not just the disease.

This study only included 68 children from China, so the results might be different in other countries or larger groups of children. The study didn’t randomly assign children to receive different treatments, so we can’t be completely certain that the nutrition support caused the improvement in muscle loss—other factors might have helped too. The study only followed children for a few years, so we don’t know if the benefits last long-term. The study only looked at one type of biologic medicine (infliximab), so results might be different with other medicines. Finally, CT scans expose children to radiation, so this test wouldn’t be done just to check for muscle loss—it’s only done when doctors already need to scan the abdomen for other reasons.

The Bottom Line

For children with Crohn’s disease: Ask your doctor to check for muscle loss, especially if your child isn’t responding well to medicine. Consider adding nutrition support (tube feeding if recommended) along with biologic medicine. Make sure your child gets enough protein and calories to support muscle growth. For doctors: Screen children with Crohn’s disease for muscle loss using CT scans when they’re already being done for other reasons. Consider combining biologic therapy with nutritional support rather than medicine alone. These recommendations are based on solid evidence from this study, though more research in larger groups would strengthen them.

This research is most relevant for children with Crohn’s disease, especially those who aren’t responding well to medicine. Parents of children with Crohn’s disease should discuss muscle loss screening with their doctors. Gastroenterologists (digestive doctors) and nutritionists treating children with Crohn’s disease should pay special attention to these findings. This may be less relevant for adults with Crohn’s disease or children with other digestive conditions, though similar principles might apply.

Muscle loss develops gradually over months to years in children with Crohn’s disease. Improvements from combined medicine and nutrition support may take several weeks to months to become noticeable on scans. Parents should expect to see changes in follow-up scans done 2-3 months after starting combined treatment. Long-term benefits would need to be tracked over 6-12 months or longer.

Want to Apply This Research?

  • Track weekly protein intake (grams per day) and compare it to recommended amounts for your child’s age and weight. Also track appetite, energy levels, and any changes in how well medicine is working on a weekly basis
  • Work with your child’s nutritionist to set a specific protein goal for each day (for example, 1.2 grams per kilogram of body weight). Use the app to log meals and snacks that contain protein, and get reminders to eat protein-rich foods at each meal
  • Monthly check-ins to review protein intake trends, energy levels, and disease activity. Set reminders for scheduled doctor visits where CT scans or other muscle assessments might happen. Track any changes in how well medicine is working and share this data with your medical team

This research is informational only and should not replace professional medical advice. If your child has Crohn’s disease or you suspect muscle loss, consult with your pediatric gastroenterologist or healthcare provider. Treatment decisions should be made with your medical team based on your child’s individual situation. CT scans involve radiation exposure and should only be done when medically necessary. This study was conducted in Chinese children and results may vary in other populations.