Unveiling Food Avoidance Among Patients With Inflammatory Bowel Disease: Patterns and Pathways to Better Dietary...

To investigate potential types of food avoidance among patients with inflammatory bowel disease (IBD) and identify the contributing factors.

Food avoidance may be an important risk factor for poor physical and mental health in patients with IBD. However, there is limited research on food avoidance within the Chinese context.

Between July 2022 and December 2023, patients with IBD during appointment at the First Affiliated Hospital with Nanjing Medical University was investigated with paper questionnaires to assess food avoidance, food category avoidance, fear of disease progression, negative illness perception, IBD-related self-efficacy, and social support. Demographic and disease-related characteristics were also collected. Latent profile analysis (LPA) was used to examine food avoidance in patients with IBD, and the correlates were investigated using regression analysis.

LPA showed that respondents could be classified into three groups in terms of food avoidance, namely, the mild-food avoidance adaptation group (n = 72, 22.29%), the moderate-food pleasure deficiency group (n = 163, 50.46%), and the severe-food avoidance impairment group (n = 88, 27.24%). The total number of avoided foods in the three groups was 2.78 ± 2.37, 3.59 ± 2.49, and 3.89 ± 2.51, respectively (p = 0.02). In the multinomial logistic regression analysis, higher levels of fear of disease progression and negative perceptions were associated with the severe avoidance group. In contrast, patients in remission were more likely to fall into the mild and moderate avoidance groups.

Patients with IBD may exhibit long-term, spontaneous food avoidance, which often presents at high levels. Furthermore, patients with IBD exhibit considerable heterogeneity in their food avoidance patterns, categorizing them into three distinct categories. Future dietary management strategies should be tailored based on the specific characteristics and predictive factors of these food avoidance patterns.

Given the prevalence and heterogeneity of food avoidance in patients with IBD, nurse managers should implement stratified interventions tailored to patient characteristics. Training nurses in culturally sensitive dietary education and emotional regulation strategies may improve the management of food-related behaviors and support patients' adaptive coping with the disease.