Food Avoidance Research Articles

Effects of Economic Recession on Women’s Preference or Avoidance of High-Calorie Foods

Effects of Economic Recession on Women’s Preference or Avoidance of High-Calorie Foods

A Whole Food Plant-Based Approach to Ulcerative Colitis; A Case Series.

Inflammatory bowel disease (IBD) is a relapsing and remitting condition that requires continuous treatment to reduce the risk of relapse. Alongside genetic factors, diet and lifestyle factors are heavily implicated in the pathogenesis of the disease, with diets high in meat and ultra-processed foods and low in fibre-rich plant foods thought to be central to the disease process. There is considerable interest in using dietary interventions to prevent, treat and IBD, with the hope that this can limit and, in some cases, even eliminate the use of pharmaceutical interventions. A whole food plant-based diet (WFPBD) is an attractive option given its emphasis on foods that promote gut health and reduce inflammation and the avoidance of foods that are associated with dysbiosis and inflammation. Here we describe 3 case histories of patients with ulcerative colitis and the successful use of a WFPBD for remission induction and maintenance with over 2years of follow-up.

Living with food allergies: the experiences of adult patients and caregivers.

Few studies have addressed how food allergy may impact differently on the daily lives of adults with food allergies and caregivers for food-allergic dependents. To explore similarities and differences in life experiences and unmet needs between individuals caring for a child with food allergy and adults with food allergy world-wide. Two multinational, virtual, interactive, moderated discussions of specific questions between respectively people with food allergies and caregivers for people with food allergies, with experienced clinicians participating. Sixteen individuals living with food allergies and nine caregivers took part in the two roundtables. Food avoidance and antihistamines were the most common treatments for food-allergic reactions in both groups. Caregivers reported greater burden of disease on affected individuals and families than did adult patients. Adult panelists considered autoinjectors easy to use but caregivers reported additional emotional stress thinking about autoinjector use. Caregivers described an ever-present fear of inattention and of overlooking a risk factor for a severe reaction, whereas adult panelists showed a determination not to let their food allergies interfere with living their lives. Both groups had safety-conscious attitudes to treatments, but adult patients emphasized convenience while caregivers prioritized reduced severity of reactions and eliminated fear. Both groups confirmed the need for improved, trusted sources of information, and for resources and training programs for any new therapies. The interactive exchange provided insights into differences between adult patients and caregivers, notably in fear and confidence in daily life, severity of disease impact, and unmet needs for treatments.

Reliability and validity of a Korean version of the children's eating behavior questionnaire in anorexia context.

Although childhood anorexia is a common clinical disorder, there is no established tool for evaluating it. The Children's Eating Behavior Questionnaire (CEBQ) is a parent-reported measure designed to assess the eating behavior of children. We aimed to investigate the reliability and validity of the Korean version of the CEBQ (K-CEBQ) for children with anorexia. Parents of children with anorexia aged between 2 and 9 years participated in a survey conducted twice at 1-month intervals. The general characteristics and K-CEBQ scores of the children were recorded. To assess the reliability of the K-CEBQ, the internal consistency and test-retest methods were used. Furthermore, correlation analysis was performed for each item and factor, and the discriminant validity was determined through comparison with the normal group. Optimal cut-off scores, which are based on the maximum area under the curve of the receiver operating characteristic curve, were calculated in two categories. A total of 336 participants responded to the first survey, and the responses from 171 participants from the second survey were included in the analysis. The K-CEBQ showed relatively high internal consistency reliability (Cronbach's alpha = 0.738), and the retest demonstrated sufficient temporal stability. The relationship between each item of the K-CEBQ and the factor to which the item belongs showed a high correlation. There were significant differences between the anorexia and normal groups in two categories of the K-CEBQ: 'food approach' (p = 0.0063) and 'food avoidant' (p < 0.0001). The optimal cut-off values for the 'food approach' and 'food avoidant' category scores were 39.50 and 58.50 points, respectively. This study demonstrated that the K-CEBQ may be a reliable and valid tool for assessing the eating behavior of children with anorexia.

Eating disorders among bariatric surgery patients: The chicken or the egg?

Postoperative eating behaviors and unhealthy weight control measures are leading causes of bariatric surgery complications. Candidates for bariatric surgery and individuals with eating disorders may share common risk factors, such as a history of dieting, and/or being bullied or teased for their weight. Binge-eating disorder, night eating syndrome, and bulimia nervosa are the most common eating disorders among candidates for bariatric surgery before the operation. Malnutrition, stress, and intense fear of weight gain can lead to the development of an eating disorder after surgery as well. Plugging, grazing, loss of control eating, dumping, and food avoidance are specific disordered behaviors that may present after bariatric surgery. To improve physical and psychological outcomes for individuals under their care, clinicians can screen for these disordered behaviors and distinguish them from a healthy diet and the expected postsurgical course.

Cultural Intolerance, in Practice: Social Variation in Food and Drink Avoidances in Italy, 2003–2016

Sociological literature on cultural practices seeking to understand the social differentiation of taste pays limited attention to what people avoid consuming, despite its potential as a strategic indicator of taste. Avoidance has special relevance for the understanding of eating and drinking practices which are often characterized by exclusion of items for health, hedonic, reputational, or spiritual reasons. Making use of rich data on twenty-three items commonly consumed by Italian adults, this paper investigates how avoidances—i.e. what people claim never to eat or drink—are clustered, socially patterned and have evolved over time. Methodologically, we propose the novel use and integration of two machine learning techniques—Self-Organizing Maps (SOM) and Boosted Regression Trees (BRT)— to identify nine highly homogeneous avoidance clusters and examine the power of social variables in predicting the probability of individuals’ belonging to various clusters and to further characterize them. We conclude by discussing possible rationales behind avoidance.

The effects of lifestyle changes like diet, toilet habits, physical activity and others in children with functional constipation

Background: Functional constipation is common in pediatric age group. Our aim is to evaluate the effects of lifestyle changes (diet, toilet habits, physical activity and others) in children with functional constipation, and to assess the risk factors of functional constipation in Indian children. Methods: This was an observational, prospective, questionnaire and proforma based (pretested and predesigned) follow-up study. Duration was from January 2016 to December 2017. Study was conducted at, department of paediatrics, Mahatma Gandhi Medical College, Jaipur. Results: On regular follow-up, stool frequency was improved after changing the lifestyle factors like adequate physical activity (p&lt;0.05, CI: 0.27) and regular toilet habits (p&lt;0.05, CI:0.93), blood/mucus, straining, painful defecation and pain abdomen, all are showing significant improvement (p&lt;0.05) after relieving constipation. On regular follow-up Need of disimpaction (polyethylene glycol or proctoclys enema) reduced significantly (p=0.001), number of cases with adequate fiber diet improved significantly (p=0.001), Number of children consuming frequent junk food decreased significantly (p=0.001). Conclusions: Initial disimpaction, if needed and maintenance laxative therapy (1-3 months as per need) along with major lifestyle changes like fibers rich diet, avoidance of junk food, adequate physical activity, optimal sleep hygiene, and daily regular toilet habits have significantly positive correlation with improvement in functional constipation and its symptoms.

A scoping review of psychological interventions and outcomes for avoidant and restrictive food intake disorder (ARFID).

This scoping review identifies and describes psychological interventions for avoidant restrictive food intake disorder (ARFID) and summarizes how outcomes are measured across such interventions. Five databases (Cochrane, Embase, Medline, PsycInfo, Web of Science) were searched up to December 22, 2022. Studies were included if they reported on psychological interventions for ARFID. Studies were excluded if participants did not have an ARFID diagnosis and if psychological interventions were not delivered or detailed. Fifty studies met inclusion criteria; almost half were single-case study designs (23 studies) and most studies reported on psychological interventions for children and adolescents with ARFID (42 studies). Behavioral interventions (16 studies), cognitive-behavioral therapy (10 studies), and family therapy (5 studies), or combinations of these therapeutic approaches (19 studies) were delivered to support patients with ARFID. Many studies lacked validated measures, with outcomes most commonly assessed via physical health metrics such as weight. This review provides a comprehensive summary of psychological interventions for ARFID since its introduction to the DSM-5. Across a range of psychological interventions and modalities for ARFID, there were common treatment components such as food exposure, psychoeducation, anxiety management, and family involvement. Currently, studies reporting on psychological interventions for ARFID are characterized by small samples and high levels of heterogeneity, including in how outcomes are measured. Based on reviewed studies, we outline suggestions for clinical practice and future research. Avoidant restrictive food intake disorder (ARFID) is an eating disorder characterized by avoidance or restriction of food due to fear, sensory sensitivities, and/or a lack of interest in food. We reviewed the literature on psychological interventions for ARFID and the outcomes used to measure change. Several psychological interventions have been developed and applied to patients with ARFID. Outcome measurement varies widely and requires further development and greater consensus.

Association between Maternal and Toddler Appetitive Traits in a Mexican Population.

The Child Eating Behaviour Questionnaire for toddlers (CEBQ-T-Mex) and the Adult Eating Behaviour Questionnaire (AEBQ-Esp) measure appetitive traits (ATs) in children and adults, respectively, both validated for use in Spanish. ATs are inherited variations in appetite, present from birth, that are reasonably stable throughout childhood and can explain why some infants over- or undereat in response to environmental exposures. "Food approach" traits predispose to overweight while "food avoidance" traits provide protection, but little is known about the relationships between parents' and their toddler's ATs. The aim was to examine the associations between maternal and toddler appetitive traits, using the AEBQ-Esp and CEBQ-T-Mex, and to examine the associations between ATs and Body Mass Index z-scores (BMIz). Sociodemographic data and the weights and heights of mothers and toddlers (aged 12-36 months) were collected from a teaching hospital in Guadalajara, Mexico. Mothers completed both the AEBQ-Esp and the CEBQ-T-Mex. Direct correlations were found between the ATs of toddlers and their mother (p < 0.005), except for "Slowness in Eating" (SE), and only an inverse correlation was found between the "Satiety Responsiveness" (SR) of toddlers and their BMIz (r = -0.147; p = 0.007). These results suggest that ATs could potentially run in families. These may be useful targets for family-wide interventions to support the development and maintenance of healthy eating behaviours in childhood.

Distinct Food Triggers for Migraine, Medication Overuse Headache and Irritable Bowel Syndrome.

Irritable bowel syndrome (IBS) is an under-diagnosed common health problem that impairs quality of life. Migraine and IBS are comorbid disorders that are triggered by foods. We aim to investigate IBS frequency in medication overuse headache (MOH) patients and identify food triggers and food avoidance behavior. Participants who completed the cross-sectional, observational and online survey were included (n = 1118). Demographic data, comorbid disorders, medications used, presence of headache, the diagnostic features of headache and IBS, migraine related subjective cognitive symptoms scale (MigSCog), consumption behavior of patients regarding 125 food/food additives and food triggers were asked about in the questionnaire. Migraine and MOH diagnoses were made in 88% and 30.7% of the participants, respectively. Non-steroidal anti-inflammatory drugs (NSAIDs) were the main overused drug (89%) in MOH patients. IBS symptoms were present in 35.8% of non-headache sufferers, 52% of migraine patients and 65% of MOH patients. Specific food triggers for MOH patients were dopaminergic and frequently consumed as healthy foods such as banana, apple, cherry, apricot, watermelon, olive, ice cream and yogurt. MigSCog scores were significantly higher in episodic migraine and MOH patients when IBS symptoms coexisted. The frequency of IBS was higher in MOH patients compared to migraine patients. Coexistence of IBS seems to be a confounding factor for cognitive functions. MOH specific triggers were mostly dopaminergic foods, whereas migraine specific food triggers were mostly histaminergic and processed foods. Personalized diets focusing on food triggers and interference with leaky gut must be integrated to MOH and migraine treatment to achieve sustainable management of these disorders.

Freshwater and Marine eels in the Pacific and New Zealand: Food Avoidance Behaviour and Prohibitions

Eels are ubiquitous throughout the Pacific and New Zealand, and offer a rich source of protein and fat. However, bones of eels are rare in archaeological sites. This contrast has been noted several times in archaeological literature, not just in the Pacific, but also in Europe. Explanations for the dearth of bones range from taphonomic processes, the bones are too small, or too fragile, or they preferentially self-destruct because they are rich with oil. We show that each of these reasons is false. We review the presence and absence of eel bones in 144 archaeological sites in the Pacific region, finding only 1,151 eel bones of a total NISP of 188,351 (0.61%). Allometric equations are established for estimating live length and weight from cranial bone measurements of freshwater eels. Prehistoric catches were mostly in the range of 430 to 500 mm, length with only 5 greater than 800 mm, with no sign of the huge eels about 1800 mm long recorded in historic episodes of mass harvesting by M?ori. A review of myths and oral traditions in the Pacific about eels revealed some common themes. Eels represent the incarnation of a male deity, symbolising the penis, and that the personified eel tempts and defiles a woman sexually. A male, often an heroic ancestral figure, punishes the eel by cutting him up into pieces. We found that there is often a strong association of eels with danger, and that eels are either venerated or feared, but seldom considered food. In some Pacific societies, the arrival of Europeans resulted in the lifting of the prohibition of eels as food. We also found two historic instances in among M?ori that eels were tapu, requiring an elaborate tapu removal ceremony before they could be eaten by people who were starving. We conclude that mass harvesting of eels in New Zealand, so evident in the historic era, was a post-European development with important implications for M?ori settlement patterns, making it possible to establish permanent villages in the interior of major river systems in Central New Zealand.

Relationship between growth and food avoidance with food allergy at age 3 years: The Japan Environment and Children's Study (JECS)

BackgroundBasic management for food allergy (FA) is eliminating causative food from the diet, which can impact normal growth. This study examined the association between food avoidance and growth failure among children with FA aged 0–3 years using the Japan Environment and Children's Study (JECS) data. MethodsData on height, weight, and FA history registered were collected using self-administered questionnaires at age 1, 1.5, 2, and 3 years. A general linear model was used to examine whether dietary restriction affected body size. Height, weight, and body mass index (BMI) were adjusted for age in months using standard deviation (SD) scores for each age group by month of measurement. Presence of FA or dietary restriction was used as a binary variable. ResultsOf the 38 477 participants included in this analysis, 4070 with FAs had significantly lower SD scores for height and weight at age 3 years. With milk avoidance, significantly lower SD scores for height (male: β = −0.097 [95%CI: 0.175, −0.019], female: β = −0.103 [95%CI: 0.204, −0.002]), a significantly lower SD score for weight (male: β = −0.115[95%CI: 0.187, −0.043], female β = −0.114[95%CI: 0.203, −0.026]) were observed. Soy avoidance in males marked a lower SD score for height (β = −0.307 [95%CI: 0.474, −0.140]). Continued food avoidance until age 3 resulted in significantly lower SD score for height and weight regardless of gender. ConclusionGrowth impairment was observed with food avoidance at age 3 years. Growth impairment were more obvious in males than in females. With regards food items, the impact of milk and soy was more significant.

Evolution of Food Protein-Induced Enterocolitis Syndrome (FPIES) Index Trigger Foods and Subsequent Reactions After Initial Diagnosis.

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy treated by trigger food avoidance and supportive care. Whether the prevalence of different trigger foods is changing with evolving food introduction patterns is unknown. The rate and nature of subsequent reactions after initial diagnosis have not been fully studied. We sought to characterize how trigger foods have changed over time and investigate the nature of subsequent reactions after initial diagnosis. We collected data regarding patients' FPIES reactions from 347 patients seen in the University of Michigan Allergy and Immunology clinic for FPIES from 2010 to 2022. Inclusion criteria consisted of pediatric patients diagnosed with FPIES by an allergist based on international consensus guidelines. Most foods including less commonly cited FPIES triggers increased in frequency over time. The most common index trigger was oat. A total of 32.9% (114 of 347) patients experienced a subsequent reaction after education on trigger avoidance and safe home introduction of new foods, with 34.2% (41 of 120) of subsequent reactions to new triggers at home and 45% (54 of 120) to known triggers at home. Of patients reacting subsequently, 28% (32 of 114) experienced a subsequent reaction necessitating an emergency department visit. The most common new subsequent reaction triggers were egg and potato, whereas peanut most commonly triggered reactions on oral food challenge. The risk profile of FPIES triggers may be evolving over time, though high-risk FPIES foods remain common. The subsequent reaction rate after counseling indicates that home food introduction poses risk. This study highlights the need for improved safety of new food introduction and/or prediction methods for FPIES to help prevent potentially dangerous home FPIES reactions.

1.42 Food Avoidance Behavior Patterns in Children and Adolescents With Eating Disorders

1.42 Food Avoidance Behavior Patterns in Children and Adolescents With Eating Disorders

Food Immunotherapy: Dissecting Current Guidelines and Navigating the Gray Zone.

Food allergy is a common, chronic disease that is burdensome for patients and families, with multiple dietary and social limitations and a significant psychological impact stemming from the fear of accidental exposures and potentially severe, life-threatening reactions. Until recently, the only management option consisted of strict food avoidance. Food allergen immunotherapy (food AIT) has emerged as an alternative, active intervention to strict food avoidance, with a multitude of research studies supporting its efficacy and good safety profile. Food AIT results in a raise of allergenic threshold, which provides several benefits to food-allergic patients, including protection from accidental exposures, potentially decreased severity of allergic reactions on unintentional exposures, and improvement in quality of life. In the last few years, multiple independent reports have been published proposing strategies to implement food oral immunotherapy in U.S. clinics, although formal guidelines are currently lacking. Because food immunotherapy is gaining traction, popularity, and interest among both patients and health care providers, many physicians look for guidance on how to implement this intervention in their daily practice. In other parts of the world, use of this treatment has prompted the development of various guidelines from allergy societies. This rostrum discusses currently available guidelines on food AIT from different areas of the world, describes and comments on their similarities and differences, and highlights unmet needs in this area of therapy.

Assessing Dietary Practices of Children with Avoidant Restrictive Food Intake Disorder (ARFID) - A Cross-Sectional Study

OBJECTIVE: The current study aimed to find children's dietary patterns with Avoidant Restrictive Food Intake Disorder (ARFID) and its characteristics in children. METHODOLOGY: This mixed-method cross-sectional study was conducted in April 2021 among children with Avoidant Restrictive Food Intake Disorder. Thirty participants of the age group (5-12 years) were selected from the Pediatrics and Children Ward of Ittefaq Hospital, Lahore, with a purposive sampling technique. Outpatient children aged between 5 and 12 years were included, whereas the children who had any congenital disabilities and were diagnosed with any other eating disorder were excluded. A focus group discussion was held for the formulation of the questionnaire. A diagnostic criteria questionnaire for ARFID was taken from the Canadian Pediatric Surveillance Program 2017, including anthropometric data and general characteristics/behavioral features. A self-structured food frequency questionnaire was used. Informed consent was taken from all participants. Qualitative interviews were reported as thematic analysis, and Quantitative data were analyzed using SPSS version 25 as statistical analysis for data visualization, simple statistics to generate summary charts, and customized graphs. RESULTS: Patients with ARFID were primarily female and relatively young, with a mean age of 8.35±0.46. Most of the participants were underweight (77%). The mean BMI (kg/m2) of the children was 13.7±0.26. Most patients with ARFID also reported a lack of interest in eating, loss of appetite, aversion due to sensory characteristics and avoidance of certain foods. CONCLUSION: ARFID is prevalent in all populations, but the lack of awareness among healthcare professionals and the general population makes the diagnosis difficult. KEYWORDS: ARFID, Eating Disorders, Food aversions, Food Frequency Questionnaire, Loss of appetite, Underweight

Food intolerance related to gastrointestinal symptoms amongst adults living with bile acid diarrhoea: A cross-sectional study.

The role of food in managing bile acid diarrhoea (BAD) is poorly understood. The present study explored the prevalence of food intolerance amongst adults with BAD. The study comprised a cross-sectional survey of adults with BAD determined by the 75 selenium homotaurocholic acid test (SeHCAT) living in the UK. Participants anonymously completed an online questionnaire on 39 food items. Frequency of food in general affecting BAD symptoms, as well as frequencies of diarrhoea, abdominal pain, bloating, flatulence and consequential food avoidance after food item ingestion, were assessed. Food group avoidance was also assessed. There were 434 participants who completed the questionnaire between April and May 2021 of whom 80% reported moderate to severe chronic diarrhoea. Food intolerances were reported by 88.0% (95% confidence interval [CI] = 84.6-90.9) of participants. Diarrhoea was reported most frequently after take-away food, fish and chips, creamy sauces, cream and large quantities of fruit (range 41.0%-33.6%). Lowest frequencies were for potato, avocado, mango, watermelon and pear (range 3.7%-7.4%) for the foods listed in the questionnaire. Similar trends were found for abdominal pain, bloating, flatulence and consequential food avoidance. Symptom-triggering within 30 min of ingestion was more prevalence than after 30 min for almost all foods. Food group avoidance was highest for fatty foods (81.2%; 95% CI = 77.8-85.3) followed by dairy (53.9%; 95% CI = 49.1-58.7). Perceived food intolerance amongst adults with BAD and persisting diarrhoeal symptoms is high. Important triggers were meals with a higher fat content and higher-fat dairy products. Diets amongst those with persisting diarrhoeal symptoms may be overly restrictive.

Making good of a tricky start: How IgE and mast cells manage a protective sway in food allergy

The immune and nervous systems respond to dangerous stimuli to maintain homeostasis. In a recent issue of Nature, Florsheim etal. and Plum etal. uncover the crosstalk between immunoglobulin E (IgE)-mast-cell-mediated immune activation and neural responses driving behavioral avoidance of allergenic food.

Validity and reliability of Turkish version of the Adult Eating Behaviour Questionnaire for adult participants.

The aim of this study is to assess the validity and reliability of the Adult Eating Behaviour Questionnaire (AEBQ-TR) for adults. Hunot et al. (2016) developed the original questionnaire, which was modified and translated into Turkish. On data collected from adults, construct validity was assessed using exploratory factor analysis and confirmatory factor analysis. Pearson's and Cronbach's correlation coefficients were used to evaluate reliability and validity (P < 0·05). This research was carried out in Ankara, Turkey. A total of 311 adults from Ankara (148 men and 163 women) took part in the study. Seventy-two of these adults take the retest. In the present study, 311 adults with a mean age of 29·3 ± 11·3 years participated. Factor loadings ranged from 0·404 to 0·907. In general, food approach and food avoidance scales showed a positive correlation within themselves. According to the results of confirmatory factor analysis and goodness-of-fit indicators, the seven-factor model showed a better model fit in the Turkish data (chi-square/degrees of freedom = 2·137, root mean error of approximation: 0·061, comparative fit index: 0·884, and normed fit index: 0·850). Higher BMI was associated with higher Emotional Over-eating, higher Enjoyment of the Food, lower Food Satiety and lower Emotional Under-eating. The Turkish AEBQ is a valid and reliable tool for 20- to 65-year adults to determine appetitive properties related to the aetiology of weight change and especially obesity risk. Besides, AEBQ testing is required for validation in early and late adulthood.

Pediatric Phagophobia: A Systematic Review and a Case Report of Pharmacological Interventions

Background: Phagophobia is characterized by conditioned excessive fear of swallowing or choking that is usually triggered by an incident. It usually leads to avoidance of certain types of food or, in severe forms, a complete refusal to eat solid food and/or liquids. The condition is commonly associated with physical and psychological symptoms impacting the health condition of the individual due to deprivation of essential nutrients. Case Presentation: A 12-year-old boy developed acute onset fear of swallowing (Phagophobia) following a dream he had of someone choking. This was exacerbated by watching an online video of a person choking. This has led to an avoidance of solid food and dependence on soft food and liquids. Fear of swallowing along with food avoidance has led to malnutrition, weight loss, and several physical complaints for which the patient was admitted under pediatric care. A course of Cognitive Behavioral Therapy (CBT) resulted in limited response and was augmented with fluoxetine. Full remission was achieved within six weeks. Methods: A systematic review of all peer-reviewed English literature was performed for articles related to the pharmacological treatment of pediatric phagophobia (0-18 years) following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results: A total of 17 case reports were identified describing 17 children with phagophobia (females = 70 %). The mean age was 9.3 and the average was between 2 and 15 years who were diagnosed with choking phobia/ phagophobia or different but equivalent diagnoses like Avoidant/Restrictive Food Intake Disorder or Post Traumatic Feeding Disorder. Different classes of medications were used in variable doses for different durations which were associated with significant improvement in eating patterns and reduction in fear and anxiety associated with eating. Conclusion: Phagophobia is a serious and potentially life-threatening illness that can cause physical complications and functional impairment in the psychosocial aspect. Pharmacological treatment can be a beneficial and safe option either alone or in combination with therapeutic interventions for children presenting with phagophobia.