Handgrip strength as a marker of nutritional and inflammatory status in IBD: A cross-sectional analysis from a dietitian-led clinic

Abstract

Background: Nutritional assessment is a key component of inflammatory bowel disease (IBD) care. The 2025 D-ECCO consensus 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 mortality . 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. Method(s): 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 =2), and 21% had low HGS. Mean BMI was 26kg/m and mean HGS 28kg (35kg men, 22kg women). HGS correlated positively with BMI (p = 0.36, p =2), and 21% had low HGS. Mean BMI was 26kg/m and mean HGS 28kg (35kg men, 22kg women). HGS correlated positively with BMI (p = 0.36, p = 30kg/m ) 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(s): 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.