Correlation between Food Literacy and Avoidant/Restrictive Food Intake Disorder in Patients with Inflammatory Bowel Disease

Abstract

Background Dietary over-restriction is common in patients with inflammatory bowel disease (IBD) and can lead to avoidant/restrictive food intake disorder (ARFID) in severe cases. Studies have shown that food literacy may influence patients' eating behavior to some extent, but whether it can directly affect ARFID in IBD patients has not been reported. Objective To understand the current status of food literacy and ARFID in patients with IBD, and analyse the correlation between the two. Methods This was a cross-sectional study, and convenience sampling method was used to select IBD patients who attended or were hospitalized in the outpatient clinics of gastroenterology and anorectal medicine in four general hospitals in Nanjing, including Jiangsu Province Hospital of Chinese Medicine (Affiliated Hospital of Nanjing University of Chinese Medicine), Nanjing Hospital of Chinese Medicine (Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine), Nanjing Drum Tower Hospital and Zhongda Hospital, Southeast University, from October 2022 to June 2023 as the study subjects. A self-made general information questionnaire, 9-item Avoidant/Restrictive Food Intake Disorder Screen (NIAS), and Food Literacy Scale were used to investigate the study subjects, to compare the NIAS and food literacy scores of IBD patients with different characteristics, and Pearson correlation analysis was used to explore the relationship. Results A total of 438 questionnaires were distributed and 429 valid questionnaires were recovered, with a valid recovery rate of 97.95%. The NIAS score of IBD patients was (20.82±8.65), and the incidence of ARFID was 18.41% (79/429) ; the food literacy score was (32.72±9.68). Comparison of NIAS scores of patients with different disease types and disease activity showed statistically significant differences (P<0.05). Pearson correlation analysis showed that food literacy scores, planning and management dimensions of food literacy scale and the attitude towards making scores were negatively correlated with NIAS scores in patients with IBD (P<0.05) . Conclusion The level of food literacy in IBD patients needs to be improved. ARFID was common (18.41%), and food literacy was negatively associated with ARFID. Clinical medical staff should regularly evaluate patients' food literacy, monitor their eating behavior, and develop precise health education intervention paths to improve the level of food literacy, and reduce the incidence of ARFID.

Keywords

• inflammatory bowel diseases|dietary restriction|avoidant/restrictive food intake disorder|food literacy|correlation