Dietary Avoidance Behaviors in a Clinical Sample of Adults with Inflammatory Bowel Disease

Abstract

Background: Inflammatory Bowel Disease (IBD) presents a significant clinical challenge due to its chronic nature and the unpredictable cycle of remission and relapse. Medical treatment often fails to fully control the disease leaving patients to endure debilitating gastrointestinal symptoms. Therefore, patients tend to seek dietary approaches to manage and prevent symptoms. Specifically, most of the patients prefer avoiding foods they perceive as problematic over following a special diet. However, there is a lack in understanding the rationale behind food avoidance and how food avoidance behaviors impact nutritional status and disease activity in IBD patients.

Objectives: To qualitatively identify the factors influencing food avoidance in IBD patients and to examine the association between these avoidance behaviors and both malnutrition risk and inflammatory biomarkers.

Methods: A secondary analysis was conducted using data from a multicenter cross- sectional study of adults diagnosed with IBD. Participants completed questionnaires assessing food avoidance and malnutrition risk, while inflammatory biomarkers were collected from health records. Qualitative thematic analysis was applied to identify the reasons behind food avoidance.

Results: The study included 137 participants with a median age of 35 years. The thematic analysis revealed eight key themes for habitual food avoidance and nine themes for avoidance during flare-ups, with symptom management and advice from others and personal preference being prominent factors. Correlation analysis showed no significant association between food avoidance and the risk of malnutrition or inflammatory biomarkers.

Conclusions: Among a clinical cohort of adult patients, food avoidance was influenced by a combination of past experiences, anticipatory fears, and external advice. These findings highlight the need for personalized dietary counseling to addresses individual differences and prevent unnecessary dietary avoidance.