Association between avoidant/restrictive food intake disorder risk, dietary attitudes and behaviors among Chinese patients with inflammatory bowel disease: A cross-sectional study

Abstract

Abstract Background: Restrictive eating behaviors are common among patients with inflammatory bowel disease (IBD), which may may develop nutritional and/or quality of life impairments into avoidant/restrictive food intake disorder (ARFID). The objective of this study is to estimate the prevalence and characteristics of ARFID in Chinese patients with IBD, and to investigate the current perceptions and dietary behaviors of patients with and without ARFID. Methods: A cross-sectional study was conducted in gastroenterology clinics of four tertiary hospitals in China. Patients with IBD were asked to complete a structuredquestionnaire including demographic characteristics, dietary attitudes and behaviors. The diagnosis of ARFID was established using Chinese version of the Nine-Item Avoidant/Restrictive Food Intake Disorder Screen questionnaire. Results: A total of 483 patients with IBD completed the questionnaires, and 20.3% met clinical criteria for ARFID. The average score of ARFID was 21.9 (interquartile range=17.0-26.0). Binary logistic regression results showed that patients with Crohn's disease (OR=0.483, 95%CI=0.280-0.835; p=0.009), being in an active disease state (OR=0.220, 95%CI=0.123-0.392; p<0.001), holding dietary attitudes regarding symptom control (OR=2.431, 95%CI=1.299-4.548; p=0.005), and reporting a specific dietary history (OR=27.158, 95%CI=3.679-200.456; p=0.001) were significant more likely to suffer from ARFID. Conclusions: ARFID is a common problem among patients with IBD. The incidence of ARFID is particularly high among patients with Crohn's disease, during relapse, and those who hold restrictive dietary attitudes or have a history of specific diets. Therefore, it is imperative to prioritize routine screening and early identification of ARFID, especially among high-risk populations, in future research and clinical practice. Trial registration: ChiCTR2100051539, on 26 September 2021.