Food-Related Quality of Life Is an Important Consideration in the Nutritional Status of Inflammatory Bowel Disease (IBD) Patients With More Severe Disease

Abstract

Introduction: The role of diet in IBD course is evolving. In parallel, greater credence is given to psychosocial factors, including self-management behaviors. At the intersection of these constructs is Food Related Quality of Life (FQOL), or impacts of modified eating behaviors and food-related anxiety on life quality. We aim to evaluate FQOL in IBD patients (pts), and determine how FQOL relates to disease severity, psychological function, diet treatment, and nutrition intake. Methods: Adult IBD pts recruited from 2 university-based GE clinics, researchmatch.org, and social media completed: Food Related Quality of Life Scale, Diet History Questionnaire II (adjusted for BMI), PROMIS Anxiety/Depression, diet treatment, symptom severity (Harvey Bradshaw or Ulcerative Colitis Symptom Severity converted to standard z-score), clinical and demographic information. Pts are dichotomized for severity by treatment (Severe, Biologic or Corticosteroids vs. Non-Severe, No Biologic or Corticosteroids). Spearman Rho correlation evaluated relationships between variables due to nonnormal data. Results: 95 participants: Mean(SD) age is 41.9(14.2) yrs, 77% female, 90% Non-Hispanic white. 48% clinic recruit, 53% severe IBD, diagnosis duration 13.7(10.3) yrs. 62% using diet treatment with 1.1(1.0; Range 0-4) diets for median time of 5.5 months (Range 0-150). Diet efficacy and adherence are 5.6(2.8) and 6.7(2.7) / 10. Severe IBD pts report more symptoms (p=.002) and poorer FQOL (p=.04) than non-severe; no significant differences exist by group for anxiety, depression, diet use or efficacy, or nutrition variables. Symptom severity negatively correlates with FQOL (r = -0.45, p <.01). In pts with severe IBD, FQOL correlates with greater diet efficacy (r = 0.35, p <.05), fewer diet treatments (r = -0.35, p <.05), and reduced intake across several nutrients (Table); these relationships do not exist for non-severe IBD pts. Anxiety, depression, IBD symptom severity, and diet treatment variables do not significantly correlate with nutrition intake in either group.Table: Table. Spearman Rho Correlation Between FQOL and Adjusted Dietary Intake by IBD SeverityConclusion: IBD pts with more severe disease demonstrate poorer FQOL, which is associated with decreases in dietary intake of fat, fatty acids, vitamins E and K, and alcohol. Symptom severity and psychological function do not relate to diet intake, suggesting FQOL plays a unique role. Using fewer dietary treatments or viewing diet as effective is associated with better FQOL. Further inquiry into the role FQOL has in IBD outcomes is warranted.