Food-related Quality Of Life Research Articles

Food-related quality of life in adults with inflammatory bowel disease is associated with restrictive eating behaviour, disease activity and surgery: A prospective multicentre observational study.

Measuring food-related quality of life (FRQoL) quantifies the psychosocial impact of eating and drinking. FRQoL and associated factors are not well explored in people with inflammatory bowel disease (IBD), despite IBD being a chronic disease affecting the digestive tract. The present study aimed to characterise and identify any patient or disease-related predictors of FRQoL in individuals with IBD. Adults with a formal diagnosis of IBD were recruited to a prospective multicentre cross-sectional study between April 2018 and December 2019. Participants completed questionnaires measuring FRQoL (FRQoL-29), clinical disease activity (Harvey Bradshaw Index and Simple Clinical Colitis Activity Index), restrictive eating behaviour (Nine-Item Avoidant/Restrictive Food Intake Disorder Screen), mental health (Depression Anxiety Stress Scale-21) and other patient and disease-related variables. A multivariable regression was performed to identify factors associated with FRQoL. One hundred and eight participants completed the questionnaires (n=39, Crohn's disease; n=69, ulcerative colitis). The mean FRQoL was 79 (95% confidence interval=75-84) (poor, 0; superior, 145). Poorer FRQoL was observed in those with restrictive eating behaviour associated with fear of a negative consequence from eating (p<0.0001) and reduced appetite (p<0.030). Greater FRQoL was observed in those with lower disease activity (p<0.0001) and previous IBD surgery (p=0.024). FRQoL was not associated either way by IBD phenotype, duration, or gender. The majority of participants obtained their dietary information from the internet (60%) or gastroenterologist (46%). FRQoL in people with IBD is poorer in those with restrictive eating behaviours and clinically active disease. Interestingly, it was greater in those with previous IBD surgery. Further research is required to validate these associations and explore longitudinal effects of poor FRQoL on patient outcomes and potential strategies for prevention or management of impaired FRQoL in IBD.

The low FODMAP diet for IBS; A multicentre UK study assessing long term follow up

BackgroundThe low FODMAP diet (LFD) is effective in managing irritable bowel syndrome (IBS) in the short term. This study assessed the long-term effect of the LFD on symptoms, nutritional composition and socialising. MethodsPatients with IBS who received dietetic-led LFD advice were approached at long term follow up (>6 months post LFD advice) from six centres across the United Kingdom. Participants completed questionnaires assessing gastrointestinal symptoms, adherence, nutritional intake, dietary acceptability and food related quality of life (QOL). Results205 participants completed the study, with a mean follow up of 44 months (3.7 years). Adequate symptom relief was noted in 60% of individuals at long term follow up, with 76% being on the personalisation phase of the LFD (pLFD). Mean nutritional intake did not differ between individuals on the pLFD versus habitual diet, with no difference in fructan intake (2.9 g/d vs 2.9 g/d, p = 0.96). The majority (80%) of individuals on the pLFD consumed specific ‘free-from’ products at the long term, with the purchase of gluten or wheat free products being the commonest (68%). ConclusionThe majority of patients follow the pLFD in the long term, with a large proportion purchasing gluten or wheat free products to manage their symptoms.

P345 Food-related quality of life in adults with Inflammatory Bowel Disease is influenced by restrictive eating behaviour, disease activity and surgery: a prospective multi-centre study

Abstract Background Measuring food-related quality of life (FRQoL) quantifies the psychosocial impact of eating and drinking.1 The influences on FRQoL in people with inflammatory bowel disease (IBD) are not well explored, despite IBD being a chronic disease affecting the digestive tract. This study aimed to characterise and identify any patient or disease-related predictors of FRQoL in individuals with IBD. Methods Adults with a formal diagnosis of IBD were recruited to a prospective multi-centre cross-sectional study between April 2018 and December 2019. Participants completed questionnaires measuring FRQoL (IBD-FRQoL-29: minimum/poor 29, maximum/greatest 145), clinical disease activity (active disease: Harvey Bradshaw Index &amp;gt;4 active disease, Simple Clinical Colitis Activity Index &amp;gt;2, restrictive eating behaviour (Nine Item Avoidant/Restrictive Screen: minimum 0, maximum 45), mental health (DASS-21: minimum 0, maximum 126) and other patient and disease-related variables. Results One hundred and eight participants completed the questionnaires. The majority of the cohort had UC (69/108, 64%) and there was almost equal distribution of those with quiescent (48%) and active (52%) disease The mean FRQoL of individuals with IBD was 79 (95% CI 75, 84) (see Figure 1). Poorer FRQoL was seen in those with restrictive eating behaviour associated with fear of a negative consequence from eating (p&amp;lt;0.0001) and reduced appetite (p&amp;lt;0.030). Greater FRQoL was seen in those with lower disease activity (p&amp;lt;0.0001) and previous IBD surgery (p=0.240). FRQoL was not influenced either way by IBD phenotype, duration, or gender. The majority of participants obtained their dietary information from the internet (60%) or gastroenterologist (46%). Conclusion FRQoL in people with IBD is poorer in those with restrictive eating behaviours and clinically active disease. Interestingly, it was greater in those with previous IBD surgery. Further research is required to validate these associations and explore longitudinal effects of poor FRQoL on patient outcomes and potential strategies for prevention or management of impaired FRQoL in IBD. Reference

Food-related quality of life is impaired in inflammatory bowel disease and associated with reduced intake of key nutrients

Inflammatory bowel disease (IBD) may impact the extent to which food, eating, and drinking bring satisfaction and enjoyment to peoples' lives, and this may impact dietary intake. The prevalence of an impaired food-related quality of life (FR-QoL), its associated factors, and its impact on diet have not been explored. To measure the prevalence and nature of the burden of impaired FR-QoL in people with IBD, the factors associated with these, and their associations with nutrient intake. We recruited 1576 outpatients with IBD (≥16 years old) in person from 7 IBD centers across the United Kingdom. Patients completed validated questionnaires to measure their FR-QoL, quality of life (QoL), distress, fatigue, anxiety, and depression. Dietary intake was recorded using the European Prospective Investigation into Cancer FFQ. A health professional recorded disease activity, Montreal classification, blood results, BMI, and malnutrition risk. FR-QoL was regressed onto explanatory variables using univariable and multivariable analyses. Data from 1221 patients were available (77.4% response; Crohn's disease, 65%; ulcerative colitis, 35%). The FR-QoL mean (± SD) score was 80.8 ± 26.9, with wide ranges (minimum, 29; maximum, 145). Following multivariable regression, the strongest associations with FR-QoL were the number of recent disease flares (5 flares β = -12.7; P<0.001), the IBD-specific QoL (β = 0.33; P<0.001), and IBD-related distress (β = -0.26; P<0.001). Patients with poorer FR-QoL had lower intakes of fiber (nonstarch polysaccharide; Q1 to Q5 difference=2.1 g/d; 95% CI: 0.4-3.8; P=0.048), calcium (192.6 mg/d; 95% CI: 112.5-272.6; P<0.001), phosphorus (167 mg/d; 95% CI: 58-276; P=0.041), and magnesium (34.4 mg/d; 95% CI: 9.3-59.4; P=0.041). Impaired FR-QoL is prevalent in IBD and is associated with recurrent disease flares, a reduced IBD-specific QoL, and greater IBD-related distress. A poorer FR-QoL was associated with lower intakes of key nutrients of importance to IBD, including those relating to gut health and bone mineralization.

Orthorexia nervosa is associated with positive body image and life satisfaction in Chinese elderly: Evidence for a positive psychology perspective.

Obsessive attention to healthy eating might paradoxically lead to physical and psychosocial impairments, a potential eating disorder termed orthorexia nervosa (ON). An ongoing debate concerns whether ON should be categorized as an eating disorder, an obsessive-compulsive disorder, or a mental disorder at all. A missing voice in this debate is ON in the elderly, which remains unknown, despite health being a more central issue in everyday life during old age. Similarly missing is ON in East Asia, which remains largely unexplored. The current study investigated ON in 313 Chinese elderly (M = 67.90, SD = 7.94) using the Chinese version of the Düsseldorf Orthorexia Scale (C-DOS). Questionnaires were used to measure traditional eating disorder symptomatology, body image (body dissatisfaction, body appreciation, and functionality appreciation), lifestyle behaviors (fruit and vegetable consumption and time spent on physical activity), and indexes of well-being (psychological distress, food-related quality of life, and life satisfaction). ON symptoms were positively related to physical activity, fruit and vegetable (F&V) consumption, body appreciation, functionality appreciation, and life satisfaction, but negatively related to body dissatisfaction. Compared with those without ON, the elderly with ON scored higher on positive psychological/lifestyle measures but lower on negative psychological measures. Contrary to the dominant characterization of ON as a variant of disordered eating, in Chinese elderly ON was associated with several positive lifestyle and psychological measures. Thus, ON in the elderly might not be viewed as a form of disordered eating but can be protective and beneficial.

Emulsifiers Impact Colonic Length in Mice and Emulsifier Restriction is Feasible in People with Crohn's Disease.

There is an association between food additive emulsifiers and the prevalence of Crohn’s disease. This study aimed to investigate: (i) the effect of different classes of emulsifiers on markers of intestinal inflammation in mice and (ii) the feasibility, nutritional adequacy and symptom impact of restricting all emulsifier classes in Crohn’s disease. Mice were exposed to different classes of emulsifiers (carboxymethycellose, polysorbate-80, soy lecithin, gum arabic) in drinking water for 12-weeks, after which markers of inflammation and metabolism were measured. A low emulsifier diet was developed to restrict all classes of emulsifiers and its feasibility measured over 14-days in 20 participants with stable Crohn’s disease. Crohn’s disease-related symptoms, disease control, body weight and composition, nutrient intake and food-related quality of life (QoL) were measured. All emulsifiers resulted in lower murine colonic length compared with control (mean 9.5 cm (SEM 0.20)), but this only reached significance for polysorbate-80 (8.2 cm (0.34), p = 0.024) and carboxymethylcellulose (8.0 cm (0.35), p = 0.013). All 20 participants completed the feasibility study. The frequency of consuming emulsifier-containing foods decreased by 94.6% (SD 10.3%). Food-related QoL improved between habitual (median 81.5 (IQR 25.0)) and low emulsifier diet (90.0 (24.0), p = 0.028). Crohn’s disease-related symptoms reduced (median 3.0 (IQR 5.3) vs. 1.4 (3.9), p = 0.006), and disease control scores improved (13.5 (IQR 6.0) vs. 15.5 (IQR 3.0), p = 0.026). A range of emulsifiers may influence intestinal inflammation in mice, and dietary restriction of emulsifiers is feasible. Trials investigating the efficacy of a low emulsifier diet in Crohn’s disease are warranted.

Perceptions and psychosocial impact of food, nutrition, eating and drinking in people with inflammatory bowel disease: a qualitative investigation of food-related quality of life.

Extensive research has provided an important understanding of the impact of inflammatory bowel disease (IBD) on nutrient intake, requirements and metabolism. By contrast, there has been limited research examining the psychosocial aspects of food, eating and drinking in IBD. The present study aimed to address this unmet need. Qualitative semi-structured interviews regarding the perceptions and psychosocial impact of food, eating and drinking were undertaken with 28 purposively selected people with IBD. Interviews were audio-recorded and transcribed verbatim. Colaizzi's framework was used to structure the data analysis. Five major themes were identified. IBD symptoms and both surgical and medical treatments were described as having a direct impact on eating and drinking, with participants also using different food-related strategies to control IBD symptoms. These included a process of experimentation to identify trigger foods, following a severely restricted and limited diet, eating small portions, and eating more frequently. However, their limited knowledge about if, and how, food affected their symptoms, often resulted in negative coping strategies that impacted on psychosocial functioning, including a lack of enjoyment of eating, being afraid to eat and finding social occasions stressful. Managing food and drinking also made food shopping and preparation more burdensome, creating problems with families, at work and for social life, as well as the need for careful preparation and advanced planning of activities. Inflammatory bowel disease has a profound impact on psychosocial aspects of food and nutrition, which impacts on 'food-related quality of life' (FRQoL). Further research is required to identify interventions that will improve FRQoL in patients with IBD.

Food-related quality of life in patients with inflammatory bowel disease and irritable bowel syndrome.

Food-related quality of life (FRQoL) evaluates the impact of diet, eating behaviors, and food-related anxiety on a person's quality of life. This is the first study to evaluate FRQoL in inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS), two illnesses where food and diet are of importance. One hundred seventy-five participants (80 IBS, 95 IBD) participated in the study by completing measures evaluating FRQoL, psychological distress, and health-related quality of life. Primary analyses evaluated differences in FRQoL between IBD and IBS patients. Secondary analyses compared differences based on remission status, dietary use, and dietary consultation, as well as evaluated potential predictors of FRQoL. IBD patients in remission report the highest FRQoL (IBD-remission: 91.2 (26.5) vs. IBD-active: 67.7 (19.6) and IBS-active: 67.6 (18.3), p < .001). Using more dietary treatments is associated with decreased FRQoL for IBS (r = - 0.23, p < .05) and IBD patients (r = - 0.31, p < .01). IBS patients are more likely to use dietary treatments than IBD (IBS = 81% vs. IBD = 64%, p < .01), with self-directed diets being the most commonly used approach. Symptom severity is the strongest predictor of FRQoL in both groups (IBD: R2 = .27, p < .01; IBS: R2 = .23, p < .001). FRQoL is a unique construct for IBD and IBS patients that can be influenced by several clinical and dietary factors, including number of diets and type of diet used, depending on the diagnosis. Thus, FRQoL should be considered when working with both IBD and IBS patients.

Promote Food. Improving Food-related Quality of Life in Inflammatory Bowel Disease

Promote Food. Improving Food-related Quality of Life in Inflammatory Bowel Disease

P192 Prevalence and factors associated with impaired food-related quality of life: a cross-sectional survey of 1223 people with inflammatory bowel disease

P192 Prevalence and factors associated with impaired food-related quality of life: a cross-sectional survey of 1223 people with inflammatory bowel disease

Treatment-related dietary changes and management of nutrition-related treatment side effects: Experiences and perspectives of individuals with cancer and their caregivers.

e22058Background: Treatment-related changes in taste perception, food preferences, and food-related quality of life are significant challenges among individuals with cancer and their caregivers, bu...

Altered eating: a definition and framework for assessment and intervention

BackgroundEating can be a significant challenge for cancer survivors; however, to date there is no systematic way of assessing and addressing food related quality of life in this group. The purpose of our study was to develop a framework for doing so.MethodsOver the course of 6 years in participant-led food workshops, we worked alongside 25 head and neck cancer (HNC) survivors and their partners, employing video-reflexive ethnographic (VRE) methods. The current study reports on data from the two summative workshops of this series where we worked with participants to cohere the emergent themes. Video and transcripts were reviewed and coded with participants and stakeholders according to domains of life that were affected by food. Three of the authors, one of whom is both survivor and researcher, arrived at the consensus framework.ResultsSeven areas of life were identified as affecting, or being affected by, altered eating. Three were physiological: anatomical, functional and sensory. Two captured the cognitive and behavioural labour of eating. Social life and identity were altered. The foregoing had an enduring emotional impact.ConclusionsAltered eating has physical, emotional and social consequences. The altered eating framework provides a systematic way of exploring those consequences with individual survivors. This framework has the potential to improve both the assessment and treatment of altered eating, to benefit food-related quality of life.

P121 Characterising and managing issues with food-related quality of life in inflammatory bowel disease: a qualitative study of patients and healthcare professionals

P121 Characterising and managing issues with food-related quality of life in inflammatory bowel disease: a qualitative study of patients and healthcare professionals

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

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.

Long-term impact of the low-FODMAP diet on gastrointestinal symptoms, dietary intake, patient acceptability, and healthcare utilization in irritable bowel syndrome.

The low-FODMAP diet is a frequently used treatment for irritable bowel syndrome (IBS). Most research has focused on short-term FODMAP restriction; however, guidelines recommend that high-FODMAP foods are reintroduced to individual tolerance. This study aimed to assess the long-term effectiveness of the low-FODMAP diet following FODMAP reintroduction in IBS patients. Patients with IBS were prospectively recruited to a questionnaire study following completion of dietitian-led low-FODMAP education. At baseline and following FODMAP restriction (short term) only, gastrointestinal symptoms were measured as part of routine clinical care. Following FODMAP reintroduction, (long term), symptoms, dietary intake, acceptability, food-related quality of life (QOL), and healthcare utilization were assessed. Data were reported for patients who continued long-term FODMAP restriction (adapted FODMAP) and/or returned to a habitual diet (habitual). Of 103 patients, satisfactory relief of symptoms was reported in 12% at baseline, 61% at short-term follow-up, and 57% at long-term follow-up. At long-term follow-up, 84 (82%) patients continued an 'adapted FODMAP' diet (total FODMAP intake mean 20.6, SD 14.9g/d) compared with 19 (18%) of patients following a 'habitual' diet (29.4, SD 22.9g/d, P=.039). Nutritional adequacy was not compromised for either group. The 'adapted FODMAP' group reported the diet cost significantly more than the 'habitual' group (P<.001) and affected social eating (P<.01) but there was no effect on food-related QOL. Healthcare utilization was similar between both groups. Low-FODMAP education is effective for long-term IBS management, enables a nutritionally adequate diet, and is broadly acceptable to patients.

외식관련 SNS 이용 속성이 소비자의 외식동기, 외식만족도 및 삶의 질에 미치는 영향

The object of this study was to employ effective marketing methods using SNS by determining how food-related SNS usage characteristics have influence on dine-out motivation and restaurant satisfaction and how this affects people's quality of lie. Survey respondents were men and women who have had used some kinds of food-related SNS. The survey included general characteristics of respondents, food-related SNS usage characteristics, dine-out motivation, restaurant satisfaction, and food-related quality of life. Food-related SNS usage characteristics were divided into convenience, effective time-spending, and informative; Dine-out motivation was sorted into entertainment motivation and social motivation by factor analysis. Analysis of the connections between the variables by AMOS showed that among food-related SNS usage characteristics, convenience did not have a significant influence on either entertainment or social motivation. Informative had a positive effect on entertainment motivation (p<0.05), but not on social motivation. On the other hand, effective time-spending through food-related SNS had an impact on both entertainment (p<0.001) and social (p<0.05) motivation. Moreover, the effect of dine-out motivation on restaurant satisfaction showed that entertainment motivation (p<0.05) and social motivation (p<0.01) both have significant influences on restaurant satisfaction. Also, restaurant satisfaction turned out to affect quality of life (p<0.05). As a result of this study, the usage of food-related SNS did not directly influence customers' restaurant satisfaction and quality of life; (p<0.05). As a result of this study, the usage of food-related SNS did not directly influence customers' restaurant satisfaction and quality of life; however, it had an impact on dine-out motivation and gain pleasure of dining out and help improve the quality of life in the long run; thus, it is believed that marketing strategies thorough SNS by restaurant industry are required.

PTU-102 Development Of A Food Related Quality Of Life Questionnaire For People With Ibd

IntroductionThe role of diet as a therapy for Inflammatory Bowel Disease (IBD) is well established and has improved treatment and prognosis for patients. However, little is understood about how IBD...

Nutritional status and food-related quality of life in hospitalised older adults

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Nutritional status and food-related quality of life in free-living older adults

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Assessing alterations in taste and their impact on cancer care

As the discipline of supportive and palliative cancer care grows, there is increasing acknowledgement of taste and smell alterations (TSAs) as barriers to nutrient intake and detriments to the food-related quality of life and well being of the population. The focus of this brief review is to summarize the recent advances regarding the cause and nature of TSAs and patients' perceptions of TSAs and to identify promising approaches for the alleviation of TSAs. Individual variations in the nature of TSAs exist and chemosensory changes have been established as an important quality of life issue associated with prognosis. The development and partial recovery of radiation therapy induced TSAs have been observed in longitudinal studies. Flavor enhancement has been found to improve patient-reported taste and smell capabilities. Patient-reported tools and qualitative methodologies have provided insight into the impact of TSAs on food-related quality of life and have been used with clinical measures to relate patient's perception to objective outcomes. A variety of approaches to the assessment of TSAs continue to generate a description of the development, duration and recovery of distorted chemosensory perception in cancer patients. Attention to individual variation in the nature and severity of TSAs as well as nutritional support and focus on flavorful foods can enhance patients' well being and food-related quality of life.