Avoidant Restrictive Food Intake Disorder Prevalent Among Patients With Inflammatory Bowel Disease

Authors

Emily Yelencich, San Jose State University
Emily Truong, The University of California, Los Angeles
Adrianne M. Widaman, San Jose State UniversityFollow
Giselle Pignotti, San Jose State UniversityFollow
Liu Yang, The University of California, Los Angeles
Yejoo Jeon, The University of California, Los Angeles
Andrew T. Weber, The University of California, Los Angeles
Rishabh Shah, The University of California, Los Angeles
Janelle Smith, The University of California, Los Angeles
Jenny S. Sauk, The University of California, Los Angeles
Berkeley N. Limketkai, The University of California, Los Angeles

Publication Date

8-10-2021

Document Type

Article

Publication Title

Clinical Gastroenterology and Hepatology

DOI

10.1016/j.cgh.2021.08.009

Abstract

Background & Aims
Inflammatory bowel disease (IBD) patients alter their dietary behaviors to reduce disease-related symptoms, avoid feared food triggers, and control inflammation. This study aimed to estimate the prevalence of avoidant/restrictive food intake disorder (ARFID), evaluate risk factors, and examine the association with risk of malnutrition in patients with IBD.
Methods
This cross-sectional study recruited adult patients with IBD from an ambulatory clinic. ARFID risk was measured using the Nine-Item ARFID Screen. Nutritional risk was measured with the Patient Generated-Subjective Global Assessment. Logistic regression models were used to evaluate the association between clinical characteristics and a positive ARFID risk screen. Patient demographics, disease characteristics, and medical history were abstracted from medical records.
Results
Of the 161 participants (Crohn’s disease, 45.3%; ulcerative colitis, 51.6%; IBD-unclassified, 3.1%), 28 (17%) had a positive ARFID risk score (≥24). Most participants (92%) reported avoiding 1 or more foods while having active symptoms, and 74% continued to avoid 1 or more foods even in the absence of symptoms. Active symptoms (odds ratio, 5.35; 95% confidence interval, 1.91–15.01) and inflammation (odds ratio, 3.31; 95% confidence interval, 1.06–10.29) were significantly associated with positive ARFID risk. Patients with a positive ARFID risk screen were significantly more likely to be at risk for malnutrition (60.7% vs 15.8%; P < .01).
Conclusions
Avoidant eating behaviors are common in IBD patients, even when in clinical remission. Patients who exhibit active symptoms and/or inflammation should be screened for ARFID risk, with referrals to registered dietitians to help monitor and address disordered eating behaviors and malnutrition risk.

Keywords

Inflammatory Bowel Disease, Ulcerative Colitis, Crohn’s Disease, Avoidant/Restrictive Food Intake Disorder

Comments

This is the Version of Record and can also be read online here.

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Department

Nutrition, Food Science and Packaging

Recommended Citation

Emily Yelencich, Emily Truong, Adrianne M. Widaman, Giselle Pignotti, Liu Yang, Yejoo Jeon, Andrew T. Weber, Rishabh Shah, Janelle Smith, Jenny S. Sauk, and Berkeley N. Limketkai. "Avoidant Restrictive Food Intake Disorder Prevalent Among Patients With Inflammatory Bowel Disease" Clinical Gastroenterology and Hepatology (2021). https://doi.org/10.1016/j.cgh.2021.08.009