Food avoidance, restrictive eating behaviour and association with quality of life in adults with inflammatory bowel disease: A systematic scoping review

Day, Alice; Yao, Chu; Andrews, Jane M.; Bryant, Robert V.

doi:10.1016/j.appet.2021.105650

Cited by 29 publications

(32 citation statements)

References 55 publications

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“…• Data are suggesting high prevalence of food avoidance and restrictive dietary behaviors in this patient group 16 FODMAPs: Theorized that due to the efficacy of the diet in reducing symptoms, some patients may be reluctant to reintroduce FODMAPs and could continue to follow the restrictive phase of the diet for longer than is appropriate, especially if not guided by a dietitian, potentially contributing to orthorexia development 99 Gluten-free diet: Similar to the low FODMAP diet, adherence to the gluten-free diet is dependent on level of knowledge and belief in the diet's efficacy in improving health. 116,117 We hypothesize this as an area of potential concern; however, no published studies to date have investigated orthorexia in individuals with coeliac disease.…”

Section: Specific Diets For Inflammatory Bowel Disease Are Increasing...mentioning

confidence: 91%

“…13 The presence of at least one DGBI in individuals with ED has been shown to be as high as 95.5%. 14 Diagnosis of ARFID has been reported to occur frequently in patients with gastroparesis 15 and inflammatory bowel disease, 16 and ARFID symptoms are often related to fear of gastrointestinal symptoms in patients with DGBI. 17 Recent studies investigating ARFID in irritable bowel syndrome (IBS) have shown those with severe food avoidance and restriction have more severe symptoms overall, reduced quality of life and reduced nutrient intake.…”

Section: Introductionmentioning

confidence: 99%

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Orthorexia nervosa is a concern in gastroenterology: A scoping review

Tuck

Sultan

Tonkovic

et al. 2022

Neurogastroenterology Motil

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There is concern that use of restrictive therapeutic diets, such as those used in disorders of the gut‐brain interaction (DGBI), may increase disordered eating. In this issue of Neurogastroenterology and Motility, Burton Murray et al. and Peters et al. both demonstrate a high prevalence of disordered eating in patients with gastrointestinal conditions, particularly those with DGBI. Given these findings, it is likely that orthorexia is common in this patient group, although this was not directly examined in these studies. Orthorexia nervosa is described as an obsessive and unsafe focus on eating foods perceived as healthy. This mini‐review therefore focuses on orthorexia by conducting a scoping review, as per the PRISMA extension for scoping reviews, aimed to assess the prevalence of orthorexia, and associations between orthorexia and restrictive eating practices. While a wide range of orthorexia prevalence has been reported (0%–97%) across the 57 studies included, no studies assessed prevalence specifically in gastrointestinal conditions. Four of eight studies describing diseases associated with specific dietary patterns suggested that participants who followed a diet for “digestive issues” or “food intolerances” were at higher orthorexia risk. These results suggest that dietary modifications may be a factor contributing to orthorexia. Additionally, we provide a commentary on the clinical implications of the findings for gastrointestinal conditions including a clinical flow chart. Clinicians should consider if a restrictive diet is appropriate for individuals with DGBI and include screening for disordered eating prior to implementation of dietary modifications. Future prospective studies should evaluate orthorexia within this patient group.

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Section: Specific Diets For Inflammatory Bowel Disease Are Increasing...mentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Orthorexia nervosa is a concern in gastroenterology: A scoping review

Tuck

Sultan

Tonkovic

et al. 2022

Neurogastroenterology Motil

View full text Add to dashboard Cite

show abstract

“… 16 , 17 There has been some qualitative exploration into the significance of food for people living with IBD, although it is noted that ‘the psychosocial impact of dietary beliefs and behaviours has been a neglected area of IBD research’. 18 To our knowledge, there is also a lack of patient‐led research investigating the relationship between IBD and food.…”

Section: Introductionmentioning

confidence: 99%

“…Patient‐led research can help healthcare professionals understand the depth of patient experiences that are not currently addressed by the medical system, especially as it relates to psychosocial challenges 16,17 . There has been some qualitative exploration into the significance of food for people living with IBD, although it is noted that ‘the psychosocial impact of dietary beliefs and behaviours has been a neglected area of IBD research’ 18 . To our knowledge, there is also a lack of patient‐led research investigating the relationship between IBD and food.…”

Section: Introductionmentioning

confidence: 99%

A patient‐led, peer‐to‐peer qualitative study on the psychosocial relationship between young adults with inflammatory bowel disease and food

Rines

Daley

Loo

et al. 2022

Health Expectations

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Background: Inflammatory bowel diseases (IBDs) are chronic gastrointestinal diseases that negatively affect the enjoyment of food and engagement in social and cultural gatherings. Such experiences may promote psychosocial challenges, an aspect of IBD often overlooked and under-supported in clinical settings and research.Objectives: This study explored the psychosocial experiences that young adults with IBD have with food via a qualitative patient-led research process.Methods: Trained patient researchers conducted this study by engaging peers via semi-structured interviews and focus groups in a three-step co-design process.Participants (n = 9) identified the research topic (SET), explored the topic and identified emerging themes (COLLECT), refined themes and made recommendations for healthcare system change (REFLECT).Results: Themes that emerged included: 'Experimenting with Food', 'Evolution Over Time', 'Diet Changes are Emotional' and 'Role of Stigma'. Participants identified the significance and frustrations of repeated testing and experimenting with food compatibility, and noted nuances in food relationships as they gain knowledge and experience over time. They emphasized the importance of maintaining a sense of hope throughout and wished to impart this to newly diagnosed patients.

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“…Dietary behaviours and intake are known to be impacted by inflammatory bowel disease (IBD), with a recent analysis showing around three quarters of patients restrict food and drink perceived to trigger gut symptoms [ 1 ]. Indeed, a recent systematic review of 29 studies reported 41–93% of patients engage in restrictive dietary behaviours [ 2 ]. Therefore, unsurprisingly, impaired nutrient intakes and suboptimal nutritional status are common in IBD [ 3 , 4 ], with a systematic review showing intakes of energy, fibre, folate and calcium are lower than recommended intakes, and fibre intakes are lower in IBD than healthy controls [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Improving Food-Related Quality of Life in Inflammatory Bowel Disease through a Novel Web Resource: A Feasibility Randomised Controlled Trial

et al. 2022

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Food-related quality of life (FR-QoL) is impaired in inflammatory bowel disease (IBD) and education and support on food-related issues in IBD is needed. This feasibility trial aimed to investigate the effectiveness and acceptability of a web resource in enhancing FR-QoL in newly diagnosed IBD. Patients diagnosed with Crohn’s disease or ulcerative colitis in the preceding 12 months, with an impaired FR-QoL, were recruited and randomised to either receive access to the web resource (covering IBD-specific diet concerns) or no access (control group) for 12 weeks, while receiving usual clinical care. FR-QoL, health-related quality of life, psychological outcomes, and clinical disease activity were assessed. Web resource usage was assessed, and patients’ experiences of the web resource were investigated in semi-structured interviews. Of 81 patients screened, 50 participants were randomised, 30 to the web resource and 20 to control. FR-QoL increased more in the web resource (+11.7 SD 18.2) than control group (+1.4 SD 20.4) (p = 0.067), while IBD distress reduced in the web resource (−6.8 SD 26.6) and increased in the control group (+8.3 SD 25.5) (p = 0.052), albeit not statistically significantly. End of trial Crohn’s disease clinical activity (PRO-2) was significantly lower in the web resource than control group (p = 0.046). Participants most frequently accessed web resource content discussing dietary management of gut symptoms and in semi-structured interviews, reported the website to contain relevant information. This feasibility study demonstrates potential effectiveness of the web resource on improving FR-QoL and psychological outcomes in IBD. An adequately powered effectiveness RCT is feasible to conduct and is now warranted. NCT03884686.

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Food avoidance, restrictive eating behaviour and association with quality of life in adults with inflammatory bowel disease: A systematic scoping review

Cited by 29 publications

References 55 publications

Orthorexia nervosa is a concern in gastroenterology: A scoping review

Orthorexia nervosa is a concern in gastroenterology: A scoping review

A patient‐led, peer‐to‐peer qualitative study on the psychosocial relationship between young adults with inflammatory bowel disease and food

Improving Food-Related Quality of Life in Inflammatory Bowel Disease through a Novel Web Resource: A Feasibility Randomised Controlled Trial

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