From the Guidelines
Return to sport after weight loss from an IBD flare should be gradual and individualized, beginning only when the flare is under control and with your physician's approval, with a focus on endurance training and appropriate physical activity, such as resistance training, to improve muscle mass and performance, as recommended by the most recent ESPEN guideline on clinical nutrition in inflammatory bowel disease 1. When considering return to sport, it's essential to prioritize the patient's overall health, physical well-being, and quality of life, as exercise can have beneficial effects on these aspects, but also potentially exacerbate IBD symptoms if not managed properly 1. Key considerations for return to sport include:
- Starting with low-intensity activities, such as walking for 15-20 minutes daily, and gradually increasing duration and intensity over several weeks as tolerated
- Focusing on proper nutrition during recovery, aiming for small, frequent meals rich in protein, complex carbohydrates, and adequate hydration
- Monitoring the body's response closely, watching for symptoms like unusual fatigue, abdominal pain, or dizziness, which may indicate the need to slow down
- Reintroducing strength training once some endurance has been regained, starting with light weights and gradually progressing The timeline for return to pre-flare activity levels can vary significantly between individuals, but most patients can expect to return to their previous activity levels within 4-12 weeks, depending on the severity of the flare, as supported by the ECCO Topical Review on peri-operative physical rehabilitation in IBD 1. It's crucial to note that while regular exercise can exert anti-inflammatory effects, intense or strenuous exercise can induce transient mild systemic inflammation, potentially exacerbating IBD, highlighting the need for a cautious and individualized approach to return to sport, as emphasized in the ESPEN practical guideline on clinical nutrition in inflammatory bowel disease 1.
From the Research
Guidelines for Return to Sport
There are no specific guidelines provided in the studies for return to sport following weight loss from an Inflammatory Bowel Disease (IBD) flare. However, the studies provide information on the importance of nutritional management and weight loss in IBD patients.
Nutritional Management
- IBD patients are at risk of impaired nutritional status, which can increase the risk of disease flares 2
- Nutritional requirements may vary according to disease type, extension, and activity 3
- A healthy diet, such as a plant-based or Mediterranean diet, can help with weight loss and reduce the risk of disease flares 3, 4
Weight Loss and IBD
- Obesity and IBD are both increasing in prevalence, and many IBD patients are overweight or obese 3
- Weight loss diets, such as low-carb, intermittent fasting, and paleolithic diets, can be effective for weight loss in IBD patients, but their safety and efficacy are still being studied 3, 5
- Antiobesity medications can be effective and safe for IBD patients with obesity, but more research is needed 5