背景:避免性/限制性食物摄入障碍(ARFID)是一种新描述的进食障碍。足够的食物素养水平允许个人有足够的食物选择。本研究旨在评估炎症性肠病(IBD)患者ARFID的患病率和食物素养水平,并分析ARFID与食物素养之间的相关性。
方法:这项横断面研究筛选了ARFID,并评估了在中国四家三级医院就诊的IBD患者的食物素养水平。使用九项回避/限制性食品摄入障碍筛查(NIAS)测量ARFID风险。食物素养使用食物素养评估问卷(中文版,FLEQ-Ch).分析了各个NIAS评分与食物素养变量之间的关系,以评估哪些食物素养方面与NIAS评分呈正相关或负相关。进行逐步线性回归分析以确定IBD患者NIAS评分的可能预测因子。
结果:总共372名IBD受试者完成了NIAS和FLEQ-Ch。IBD队列的总体平均NIAS评分为28.16±8.03(p<0.01),在372名参与者中,123(32.5%)的ARFID风险评分为阳性(≥10NIAS挑食,≥9NIAS-食欲不振,和≥10NIAS-担心负面后果)。NIAS评分与食品素养水平呈负相关(β=-0.299;p<0.01)。疾病表型,疾病活动,IBD患者的食物素养为避免ARFID的积极结果提供了有价值的预测性见解。
结论:这项研究表明,IBD患者队列中ARFID的风险与他们的食物素养水平不足有关。因此,这项研究支持以下观点:无论IBD患者目前是否被诊断为ARFID,都应评估他们的食物素养.具体来说,为了早期识别IBD中存在ARFID风险的人,疾病表型,疾病活动,和食物素养应在临床实践中常规考虑。必须调查和提高患者的食品素养意识,以预测ARFID的风险发生并鼓励健康的饮食行为。
过度的饮食限制在炎症性肠病(IBD)患者中很常见,在严重的情况下会导致避免性/限制性食物摄入障碍(ARFID)。ARFID是近年来提出的一种新的饮食失调。研究表明,食物素养可以在一定程度上影响患者的饮食行为。有必要研究与ARFID相关的风险因素,以更好地了解IBD患者为何发展ARFID,并为旨在减少这些风险因素的计划提供信息。在我们的研究中,我们发现疾病表型,疾病活动,IBD患者的食物素养为避免ARFID的积极结果提供了有价值的预测性见解。这些因素可以在疾病饮食管理过程的这个关键时刻为医疗保健提供者和患者提供有价值的观点。因此,这项研究支持以下观点:无论IBD患者目前是否被诊断为ARFID,都应评估他们的食物素养.具体来说,为了早期识别IBD中存在ARFID风险的人,疾病表型,疾病活动,和食物素养应在临床实践中常规考虑。
BACKGROUND: Avoidant/Restrictive Food Intake Disorder (ARFID) is a newly described eating disorder. Adequate levels of food literacy allow individuals to have adequate food choices. This study aimed to assess the prevalence of ARFID and the level of food literacy in patients with inflammatory bowel disease (IBD) and to analyse the correlation between ARFID and food literacy.
METHODS: This cross-sectional study screened for ARFID and assessed food literacy levels in patients with IBD attending four tertiary hospitals in
China. ARFID risk was measured using the Nine Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS). Food literacy was assessed using the Food Literacy Evaluation Questionnaire (Chinese version, FLEQ-Ch).The relationship between individual NIAS scores and food literacy variables was analysed to assess which food literacy aspect is positively or negatively associated with NIAS scores. Stepwise linear regression analysis was performed to identify the possible predictors of NIAS scores in patients with IBD.
RESULTS: A total of 372 IBD subjects completed the NIAS and FLEQ-Ch. The overall mean NIAS scores for the IBD cohort was 28.16 ± 8.03 (p < 0.01), and of the 372 participants, 123 (32.5%) had positive ARFID risk scores (≥ 10 NIAS-picky eating, ≥ 9 NIAS-poor appetite, and ≥ 10 NIAS-fear of negative consequences).The NIAS scores were inversely associated with food literacy levels (β = - 0.299; p < 0.01).Disease phenotype, disease activity, and food literacy in patients with IBD provided valuable predictive insights for avoiding positive outcomes in ARFID.
CONCLUSIONS: This study shows that the risk of ARFID in the cohort of patients with IBD is associated with their inadequate food literacy levels. Therefore, this study supports the notion that patients with IBD should be assessed for food literacy regardless of whether they are currently diagnosed with ARFID. Specifically, for early identification of those at risk for ARFID in IBD, disease phenotype, disease activity, and food literacy should be routinely considered in clinical practice.The food literacy awareness of patients must be investigated and improved to predict the risk occurrence of ARFID and encourage healthy eating behaviour.
Excessive dietary restriction is common in patients with inflammatory bowel disease (IBD) and in severe cases can lead to Avoidant/Restrictive Food Intake Disorder (ARFID).ARFID is a new eating disorder that has been proposed in recent years. Studies have shown that food literacy can influence patients’ eating behaviour to some extent. Research on the risk factors associated with ARFID is necessary to better understand why people with IBD develop ARFID and to inform programmes aimed at reducing these risk factors. In our study, we found that disease phenotype, disease activity, and food literacy in patients with IBD provided valuable predictive insights for avoiding positive outcomes in ARFID. These factors can provide valuable perspectives for healthcare providers and patients at this critical juncture in the disease dietary management process. Therefore, this study supports the notion that patients with IBD should be assessed for food literacy regardless of whether they are currently diagnosed with ARFID. Specifically, for early identification of those at risk for ARFID in IBD, disease phenotype, disease activity, and food literacy should be routinely considered in clinical practice.