Association between avoidant/restrictive food intake disorder risk, dietary attitudes and behaviors among Chinese patients with inflammatory bowel disease: a cross-sectional study
Wenjing Tu, Yiting Li, Tingting Yin, Sumin Zhang, Ping Zhang, Guihua Xu
Abstract
Restrictive eating behaviors are common among patients with inflammatory bowel disease (IBD), which may may develop nutritional and/or quality of life impairments into avoidant/restrictive food intake disorder (ARFID). The objective of this study is to estimate the prevalence and characteristics of ARFID in Chinese patients with IBD, and to investigate the current perceptions and dietary behaviors of patients with and without ARFID. A cross-sectional study was conducted in gastroenterology clinics of four tertiary hospitals in China. Patients with IBD were asked to complete a structured questionnaire including demographic characteristics, dietary attitudes and behaviors. The diagnosis of ARFID was established using Chinese version of the Nine-Item Avoidant/Restrictive Food Intake Disorder Screen questionnaire. A total of 483 patients with IBD completed the questionnaires, and 20.3% met clinical criteria for ARFID. The average score of ARFID was 21.9 (interquartile range = 17.0–26.0). Multivariable binary logistic regression results showed that patients with Crohn’s disease (OR = 0.483, 95%CI = 0.280–0.835; p = 0.009), being in an active disease state (OR = 0.220, 95%CI = 0.123–0.392; p < 0.001), holding dietary attitudes regarding symptom control (OR = 2.431, 95%CI = 1.299–4.548; p = 0.005), and reporting a specific dietary history (OR = 27.158, 95%CI = 3.679-200.456; p = 0.001) were significant more likely to suffer from ARFID. ARFID is a common problem among patients with IBD. The incidence of ARFID is particularly high among patients with Crohn’s disease, during relapse, and those who hold restrictive dietary attitudes or have a history of specific diets. Therefore, it is imperative to prioritize routine screening and early identification of ARFID, especially among high-risk populations, in future research and clinical practice. ChiCTR2100051539, on 26 September 2021. Restrictive eating behaviors are common among patients with inflammatory bowel disease (IBD), which may may develop nutritional and/or quality of life impairments into avoidant/restrictive food intake disorder (ARFID). This study aimed to estimate the prevalence and characteristics of ARFID in Chinese patients with IBD, and to investigate the current attitudes and dietary behaviors of patients with and without ARFID. Participants comprised 483 patients with IBD from gastroenterology clinics of four tertiary hospitals in China. Participants completed a comprehensive questionnaire that encompassed demographic characteristics, dietary attitudes, and behaviors. Following screening with the Chinese version of the Nine-Item Avoidant/Restrictive Food Intake Disorder Screen questionnaire, it was found that 20.3% of participants met the clinical criteria for ARFID. The findings suggest that individuals with IBDmay exhibit a heightened vulnerability to ARFID. Moreover, the likelihood of ARFID was found to be significantly associated with four factors among patients with IBD, namely having Crohn’s disease, being in an active disease state, holding attitudes towards symptom management, and reporting a specific dietary history. Therefore, it is imperative to prioritize routine screening and early identification of ARFID, especially among high-risk populations, in future research and clinical practice.