Age and Body Satisfaction Predict Diet Adherence in Adolescents with Inflammatory Bowel Disease

Abstract

The aim of the current study was to determine whether age and body satisfaction predict dietary adherence in adolescents with Inflammatory Bowel Disease (IBD), and whether older females are less adherent than younger males and females. Forty-four participants aged 10-21 with IBD were recruited. Participants provided informed consent and demographics. Body satisfaction was measured by a questionnaire and a task in which participants selected their current and ideal body image out of silhouettes depicting bodies ranging from underweight to obese. Adherence was measured by marking a 100mm visual analog scale, the 1-week completion of a dietary log, and a questionnaire evaluating coping strategies used for overcoming obstacles to dietary Further, oral intake might be adjusted related to abdominal pain or "flare-ups." Thus, dietary recommendations contribute to the treatment regimen of IBD (Booth, 1991;Powers, 1997;Woolner et al., 1998). Research examining diet adherence in children with IBD (Booth, 1991;Woolner et al., 1998) and other pediatric chronic illness (Mackner, McGrath, & Stark, 2001;Stark, 2000), suggests that it is poor. It is important to note that there are no general recommendations that apply to all patients with IBD; patients usually resort to a combination of physician/dietician recommendations and personal trial and error in order to identify diet guidelines appropriate for them.A critical variable to consider when examining adherence in chronic illness is the developmental level of the patients (La Greca & Bearman, 2003;Manne, 1998;Rapoff, 1999 Greca & Bearman, 2003;Manne, 1998;Rapoff, 1999). In fact, there are data suggesting that dietary adherence is particularly poor in adolescent patients with IBD (Booth, 1991).Given that both IBD and treatment for IBD (e.g., corticosteroids, diet recommendations) can impact a patients' body size, weight, and shape, body satisfaction is a central concern with this population (Dunker et al., 1998;Casati et al., 2000;De Rooy et al., 2001). Body satisfaction or body image can be defined as both the personal perception of one's body and the cognitions and emotions associated with one's body, in addition to the degree to which one is satisfied with one's physical appearance (Kelsay, Hazel, & Wamboldt, 2005). No research to date has examined whether body satisfaction impacts IBD diet adherence, although body satisfaction has been found to adversely impact adherence in other chronic illness populations (Abbott et al., 2000;Joyce, 2002;Walters, 2001). However, it is important to note that an association between poor body image and poor adherence might not be present for both genders as it is well established that eating disorders are more prevalent in females in mid to late adolescence (DSM-IV-TR, 2000). Furthermore, body dissatisfaction manifests differently in males and females such that girls tend to focus on a lower overall body weight whereas boys tend to desire an increase in muscle mass in concordance with low body fat (Pope, Phillips, & Olivardia, 2000...

Body image dissatisfaction in patients with inflammatory bowel disease: a systematic review

“…Database searches identified 587 records and 5712 14 22–76 studies were included, with some studies eligible for multiple questions (see figure 1 for selection process and reasons for exclusion). All 57 papers reported using BI tools, 3114 22–26 30 31 33–39 42 47 50 51 53 54 58 60–65 67 69 71 72 reported prevalence or mean/median BI scores, 1614 23 24 30 34–36 47 54 58 60 61 63 65 67 71 studies presented factors associated with BID and 814 22–24 34 61 65 71 studies reported correlations between QoL and BI.…”

“…Thirty-one studies including a total of 3634 patients reported on prevalence or severity of BID (see table 3 for study characteristics). Seventeen studies14 22 23 25 30 31 38 42 53 54 58 60 61 65 69 71 72 included both patients with ulcerative colitis (UC) and Crohn’s disease (CD). Ages ranged from 2 to 71, and 18 studies22 30 38 40–42 51–53 57 59–62 69 70 72 75 included only children/adolescents.…”

“…Seventeen studies14 22 23 25 30 31 38 42 53 54 58 60 61 65 69 71 72 included both patients with ulcerative colitis (UC) and Crohn’s disease (CD). Ages ranged from 2 to 71, and 18 studies22 30 38 40–42 51–53 57 59–62 69 70 72 75 included only children/adolescents. Fourteen studies24–26 33–37 39 47 50 63 64 67 included surgery patients and one study included only women 71…”

“…Eight studies14 22–24 34 62 65 71 explored a potential association between BID and QoL across a total of 1371 patients, with seven presenting a significant association. Three studies22 24 61 (table 4) focused on younger populations with the rest including adults only.…”

“…The others used non-validated tools. Twelve studies14 35 50 51 58 64 65 72 adjusted for potential confounders such as age, gender, BMI and previous surgery often using multiple regression models. Several studies reported limited demographic data.…”