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Catamo E, Tornese G, Dovc K, Tinti D, Di Tonno R, Cauvin V, Barbi E, Franceschi R, Bonfanti R, Rabbone I, Battelino T, Robino A. Food Behaviour and Metabolic Characteristics of Children and Adolescents with Type 1 Diabetes: Relationship to Glycaemic Control. Foods 2024; 13:578. [PMID: 38397555 PMCID: PMC10888051 DOI: 10.3390/foods13040578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/07/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024] Open
Abstract
Diet is an essential element of treating and managing type 1 diabetes (T1D). However, limited research has examined food behaviour in children and adolescents with T1D and their relationship to glycaemic control. This study evaluated food behaviour, metabolic characteristics and their impact on the glycaemic control of children and adolescents with T1D. Two hundred and fifty-eight participants with T1D (6-15 years, duration of diabetes >1 year) were recruited. Demographic, anthropometric and clinical data were collected. Questionnaires on food neophobia and food preferences were administered. The Child Food Questionnaire (CFQ) also assessed parental feeding practices. An analysis of food behaviour showed that food neophobia was inversely associated with the liking of vegetables, fruits, fish, sweets and carbohydrates. Moreover, by analysing parental feeding practices, an inverse association of "Pressure to eat", "Monitoring" and "Restriction" with liking for vegetables and carbohydrates emerged. Considering glycaemic control, increased food neophobia and the parent practices "Restriction", "Pressure to eat" and "Concern about weight" were found in participants with glycated haemoglobin (HbA1c) values >8.5%. Finally, higher body mass index (BMI) and total cholesterol values were observed in subjects with HbA1c values >8.5%. These findings contribute to a better understanding of eating behaviour, metabolic status and their complex relationship with glycaemic control.
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Affiliation(s)
- Eulalia Catamo
- Institute for Maternal and Child Health—IRCCS ‘‘Burlo Garofolo”, 34137 Trieste, Italy; (E.C.); (G.T.); (E.B.)
| | - Gianluca Tornese
- Institute for Maternal and Child Health—IRCCS ‘‘Burlo Garofolo”, 34137 Trieste, Italy; (E.C.); (G.T.); (E.B.)
- Department of Medical Sciences, University of Trieste, 34149 Trieste, Italy
| | - Klemen Dovc
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia; (K.D.); (T.B.)
- Department of Endocrinology, Diabetes and Metabolism, University Children’s Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Davide Tinti
- Center for Pediatric Diabetology, A.O.U. Città della Salute e della Scienza, 10126 Torino, Italy;
| | - Raffaella Di Tonno
- Diabetes Research Institute, Department of Pediatrics, IRCCS San Raffaele Hospital, 20132 Milano, Italy; (R.D.T.); (R.B.)
| | - Vittoria Cauvin
- Division of Pediatrics, S. Chiara General Hospital, 38122 Trento, Italy; (V.C.); (R.F.)
| | - Egidio Barbi
- Institute for Maternal and Child Health—IRCCS ‘‘Burlo Garofolo”, 34137 Trieste, Italy; (E.C.); (G.T.); (E.B.)
- Department of Medical Sciences, University of Trieste, 34149 Trieste, Italy
| | - Roberto Franceschi
- Division of Pediatrics, S. Chiara General Hospital, 38122 Trento, Italy; (V.C.); (R.F.)
| | - Riccardo Bonfanti
- Diabetes Research Institute, Department of Pediatrics, IRCCS San Raffaele Hospital, 20132 Milano, Italy; (R.D.T.); (R.B.)
| | - Ivana Rabbone
- Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, 13100 Novara, Italy;
| | - Tadej Battelino
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia; (K.D.); (T.B.)
- Department of Endocrinology, Diabetes and Metabolism, University Children’s Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Antonietta Robino
- Institute for Maternal and Child Health—IRCCS ‘‘Burlo Garofolo”, 34137 Trieste, Italy; (E.C.); (G.T.); (E.B.)
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2
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D'Auria E, Cattaneo C, Panelli S, Pozzi C, Acunzo M, Papaleo S, Comandatore F, Mameli C, Bandi C, Zuccotti G, Pagliarini E. Alteration of taste perception, food neophobia and oral microbiota composition in children with food allergy. Sci Rep 2023; 13:7010. [PMID: 37117251 PMCID: PMC10147366 DOI: 10.1038/s41598-023-34113-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 04/24/2023] [Indexed: 04/30/2023] Open
Abstract
Currently, the mechanisms underlying sensory perception and sensory performance in children with food allergies are far from being understood. As well, only recently, single research afforded the oral host-commensal milieu, addressing oral microbial communities in children with peanut allergies. To bridge the current gaps in knowledge both in the sensory and microbial fields, a psychophysiological case-control study was performed in allergic children (n = 29) and a healthy sex-age-matched control group (n = 30). Taste perception, food neophobia, and liking were compared in allergic and non-allergic children. The same subjects were characterized for their oral microbiota composition by addressing saliva to assess whether specific profiles were associated with the loss of oral tolerance in children with food allergies. Our study evidenced an impaired ability to correctly identify taste qualities in the allergic group compared to controls. These results were also consistent with anatomical data related to the fungiform papillae on the tongue, which are lower in number in the allergic group. Furthermore, distinct oral microbial profiles were associated with allergic disease, with significant down-representations of the phylum Firmicutes and of the genera Veillonella spp., Streptococcus spp., Prevotella spp., and Neisseria spp. For the first time, this study emphasizes the link between sensory perception and food allergy, which is a novel and whole-organism view of this pathology. Our data indicated that an impaired taste perception, as regards both functionality and physiologically, was associated with food allergy, which marginally influences the food neophobia attitude. It is also accompanied by compositional shifts in oral microbiota, which is, in turn, another actor of this complex interplay and is deeply interconnected with mucosal immunity. This multidisciplinary research will likely open exciting new approaches to therapeutic interventions.
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Affiliation(s)
- Enza D'Auria
- Department of Pediatrics, Buzzi Children's Hospital, University of Milan, 20154, Milan, Italy
| | - Camilla Cattaneo
- Sensory & Consumer Science Lab (SCS_Lab), Department of Food, Environmental and Nutritional Sciences, University of Milan, 20133, Milan, Italy.
| | - Simona Panelli
- Pediatric Clinical Research Center "Invernizzi", Department of Biomedical and Clinical Sciences, University of Milan, 20157, Milan, Italy
| | - Carlotta Pozzi
- Department of Pediatrics, Buzzi Children's Hospital, University of Milan, 20154, Milan, Italy
| | - Miriam Acunzo
- Department of Pediatrics, Buzzi Children's Hospital, University of Milan, 20154, Milan, Italy
| | - Stella Papaleo
- Pediatric Clinical Research Center "Invernizzi", Department of Biomedical and Clinical Sciences, University of Milan, 20157, Milan, Italy
| | - Francesco Comandatore
- Pediatric Clinical Research Center "Invernizzi", Department of Biomedical and Clinical Sciences, University of Milan, 20157, Milan, Italy
| | - Chiara Mameli
- Department of Pediatrics, Buzzi Children's Hospital, University of Milan, 20154, Milan, Italy
| | - Claudio Bandi
- Pediatric Clinical Research Center "Invernizzi", Department of Biosciences, University of Milan, 20157, Milan, Italy
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Buzzi Children's Hospital, University of Milan, 20154, Milan, Italy
- Pediatric Clinical Research Center "Invernizzi", Department of Biomedical and Clinical Sciences, University of Milan, 20157, Milan, Italy
| | - Ella Pagliarini
- Sensory & Consumer Science Lab (SCS_Lab), Department of Food, Environmental and Nutritional Sciences, University of Milan, 20133, Milan, Italy
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3
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Alkhiari R, Adler JR. Psychiatric and Neurological Manifestations of Celiac Disease in Adults. Cureus 2023; 15:e35712. [PMID: 36875248 PMCID: PMC9984242 DOI: 10.7759/cureus.35712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2023] [Indexed: 03/06/2023] Open
Abstract
Celiac disease (CD), a chronic inflammatory disorder of the intestines, affects 0.7% to 1.4% of the world's population. CD causes diarrhea, abdominal discomfort, bloating, flatulence, and, in rare cases, constipation in the digestive tract. Since the identification of gluten as the disease-causing antigen, CD patients have been treated with a gluten-free diet, which is advantageous but has limitations for certain patient groups. CD is associated with mood disorders, such as manic-depressive disease, schizophrenia, and bipolar disorder, as well as other disorders such as depression and anxiety. The relationship between CD and psychological issues is not entirely understood. Here, we look at the most recent psychiatric data as they pertain to CD, as well as the relevant psychiatric manifestations that have been associated with this condition. Clinicians should examine mental health factors when a CD diagnosis is established. More research is needed to understand the pathophysiology of CD's psychiatric manifestations.
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Affiliation(s)
| | - John R Adler
- Department of Medicine, Qassim University, Qassim, SAU
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de Almeida PC, Zandonadi RP, Nakano EY, Vasconcelos IAL, Botelho RBA. Food Neophobia in Children with Autistic Spectrum Disorder (ASD): A Nationwide Study in Brazil. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121907. [PMID: 36553350 PMCID: PMC9776952 DOI: 10.3390/children9121907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
Food neophobia (FN) is common among children with autistic spectrum disorder (ASD), potentially impairing their health and diet quality. This study aimed to investigate and classify the prevalence of FN among 4-to-11-year-old Brazilian children with ASD. This descriptive cross-sectional study was performed by applying online a validated instrument to identify FN in Brazilian children with ASD through their caregivers' responses for a national prevalence of FN in this group. The final sample included 593 children with ASD, 80.1% of boys, with a mean age of 6.72 ± 2.31 years, and 83% having only ASD. Almost 75% (n = 436) of the children with ASD had high food neophobia scores. The fruit neophobia domain had the lowest prevalence of high neophobia (63.7%). No significant difference in FN (total, fruit, and vegetable domains) was found, considering gender and age. There was no statistical difference in FN (all domains) by the number of residents in the same household, income, or the caregivers' educational level. FN did not decrease in older children with ASD. FN is a more complex problem, requiring a multidisciplinary trained team to face the problem.
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Affiliation(s)
- Priscila Claudino de Almeida
- Graduate Program in Human Nutrition, University of Brasília, Brasília 70910-900, Brazil
- Correspondence: ; Tel.: +55-61-98220-2078
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Coburn S, Germone M, McGarva J, Taft T. Psychological Considerations for Food Intolerances: Celiac Sprue, Eosinophilic Esophagitis, and Non-Celiac Gluten Sensitivity. Gastroenterol Clin North Am 2022; 51:753-764. [PMID: 36375994 PMCID: PMC10581356 DOI: 10.1016/j.gtc.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Several chronic digestive conditions are physiologically based on food intolerance, including celiac disease, nonceliac gluten sensitivity, and eosinophilic esophagitis. Patients are expected to follow medically prescribed diets to eliminate identified food triggers to control symptoms. However, the psychological impacts of these dietary approaches are largely unaddressed in clinical practice. Hypervigilance and anxiety regarding food and symptoms, and disordered eating, may emerge and negatively affect outcomes. Clinicians working with pediatric and adult populations with food intolerances should be aware of these psychological comorbidities, and equally emphasize effective ways to help patients manage the mental and physical aspects of their condition.
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Affiliation(s)
- Shayna Coburn
- Children's National Hospital 111 Michigan Avenue NW, Center for Translational Research, 6th Flr Main, Washington, DC 20010, USA
| | - Monique Germone
- Departments of Psychiatry and Pediatrics, University of Colorado Anschutz Medical Campus, Digestive Health Institute, Children's Hospital Colorado, 13123 E. 16th Ave., B130, Aurora, CO 80045, USA
| | - Josie McGarva
- Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street Suite 1400, Chicago, IL 60611, USA
| | - Tiffany Taft
- Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street Suite 1400, Chicago, IL 60611, USA.
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6
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Mikocka-Walus A, Skvarc D, de Acosta MB, Evertsz FB, Bernstein CN, Burisch J, Ferreira N, Gearry RB, Graff LA, Jedel S, Mokrowiecka A, Stengel A, Trindade IA, van Tilburg MAL, Knowles SR. Exploring the Relationship Between Self-Isolation and Distress Among People with Gastrointestinal Disorders During the COVID-19 Pandemic. J Clin Psychol Med Settings 2022; 29:654-665. [PMID: 34494184 PMCID: PMC8423336 DOI: 10.1007/s10880-021-09818-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 12/17/2022]
Abstract
This study aimed to explore the association between perceived isolation and symptoms of distress in people with GI disorders at the time of the pandemic; and to examine factors which moderate this relationship. This online cross-sectional survey was advertised in May-September 2020 via patient organisations and associated social media. Overall, 831 people (82% female, mean age 49 years) from 27 countries participated. A significant relationship between social isolation and psychological distress was noted (r = .525, p < .001). GI symptoms moderated the association between isolation and distress (B = .047, t = 2.47, p = .015). Interventions targeting these factors may help to reduce distress in people with GI disorders at the time of major stressors such as the COVID-19 pandemic.
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Affiliation(s)
| | - David Skvarc
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Manuel Barreiro de Acosta
- Department of Gastroenterology, IBD Unit, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Floor Bennebroek Evertsz
- Department of Medical Psychology, Amsterdam University Medical Centres, Amsterdam, the Netherlands
| | | | - Johan Burisch
- Medical Division, Hvidovre Hospital, University of Copenhagen, GastrounitHvidovre, Denmark
| | - Nuno Ferreira
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Richard B Gearry
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Lesley A Graff
- Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Sharon Jedel
- Division of Digestive Diseases, Rush University Medical Center, Chicago, IL, USA
| | - Anna Mokrowiecka
- Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité Universitätsmedizin Berlin and Berlin Institute of Health, Berlin, Germany
| | - Inês A Trindade
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
| | - Miranda A L van Tilburg
- College of Pharmacy & Health Sciences, Campbell University, Buies Creek, NC, USA
- Division of Gastroenterology, University of North Carolina, Chapel Hill, NC, USA
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Simon R Knowles
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
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7
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Food Habits and Lifestyle in Hyperphenylalaninemia Patients: Should These Be Monitored? CHILDREN 2022; 9:children9081164. [PMID: 36010054 PMCID: PMC9406895 DOI: 10.3390/children9081164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 11/17/2022]
Abstract
Studies on Hyperphenylalaninemia (HPA) patients are scarce and primarily focused on neurocognitive outcomes compared to PKU patients. In this study, we characterized the food habits and lifestyle of HPA patients compared with healthy peers. We performed a cross-sectional survey of a cohort of 30 patients (13 males, median age/range: 7.9; 2.2–16.7 years) and 28 controls (8 males, median age/range: 7.9; 2.1–16.7 years). Anthropometric parameters, food and nutrient intakes, and level of physical activity were assessed. Food neophobia, eating disorders, and body image perception was investigated by specific tests. Patients showed greater selectivity in the choice of foods than controls, preferring products with lower protein content (p-value: 0.03) and avoiding associating multiple protein and carbohydrate sources. A comparable tendency to distrust new foods emerged without elements suggestive of eating disorders. Patients had higher image dissatisfaction than peers (p-value: 0.01). This group of patients manifested more selective eating habits and worse body image acceptance. A regular evaluation of these aspects in these patients may result in a more effective follow-up of this disorder. More studies are needed to confirm these findings.
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8
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Peters JE, Basnayake C, Hebbard GS, Salzberg MR, Kamm MA. Prevalence of disordered eating in adults with gastrointestinal disorders: A systematic review. Neurogastroenterol Motil 2022; 34:e14278. [PMID: 34618988 DOI: 10.1111/nmo.14278] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/16/2021] [Accepted: 09/19/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Patients with gastrointestinal disorders are prone to heightened awareness of dietary intake. When diet-related thoughts or behaviors are excessive, they may lead to psychological distress, nutritional compromise, and impair medical treatment. Identification of disordered eating behavior and eating disorders is crucial for effective management, but data on their prevalence within this population remain scarce. We conducted a systematic review of the prevalence of disordered eating behavior and eating disorders in adults with gastrointestinal disorders. METHODS MEDLINE, PubMed, and PsycInfo databases were searched up to June 2021. Studies examining disordered eating in adult patients with a primary gastrointestinal diagnosis were included. KEY RESULTS A total of 17 studies met the inclusion criteria for the review. The range of gastrointestinal disorders examined included disorders of gut-brain interaction (DGBI), coeliac disease, and inflammatory bowel disease (IBD). The methods for examining disordered eating were highly variable. The prevalence of disordered eating ranged from 13-55%. The prevalence was higher in patients with disorders of gut-brain interaction (DGBI) than in those with organic gastrointestinal disorders. Factors associated with disordered eating included female sex, younger age, gastrointestinal symptom severity, anxiety and depression, and lower quality of life. CONCLUSIONS & INFERENCES Disordered eating is highly prevalent in adult patients with gastrointestinal illness, particularly those with DGBI. Understanding whether a patient's primary underlying diagnosis is that of an eating disorder or gastroenterological disorder remains a challenge for clinicians. There is an unmet need to identify at-risk patients so that psychological intervention can be included in the therapeutic strategy.
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Affiliation(s)
- Jessica E Peters
- The University of Melbourne, Melbourne, Vic., Australia.,Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, Vic., Australia
| | - Chamara Basnayake
- The University of Melbourne, Melbourne, Vic., Australia.,Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, Vic., Australia
| | - Geoffrey S Hebbard
- The University of Melbourne, Melbourne, Vic., Australia.,Department of Gastroenterology, The Royal Melbourne Hospital, Melbourne, Vic., Australia
| | - Michael R Salzberg
- The University of Melbourne, Melbourne, Vic., Australia.,Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, Vic., Australia
| | - Michael A Kamm
- The University of Melbourne, Melbourne, Vic., Australia.,Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, Vic., Australia
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9
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Dietary Behavior and Risk of Orthorexia in Women with Celiac Disease. Nutrients 2022; 14:nu14040904. [PMID: 35215554 PMCID: PMC8879910 DOI: 10.3390/nu14040904] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/17/2022] [Accepted: 02/19/2022] [Indexed: 02/04/2023] Open
Abstract
Evidence points to a link between celiac disease and eating disorders. Although with the current limited knowledge, orthorexia cannot be formally recognized as an eating disorder, some features are similar. This study is the first to examine individuals with celiac disease in terms of the prevalence of risk of orthorexia. Participants were 123 females diagnosed with celiac disease. The standardized ORTO-15 questionnaire was used to assess the risk of orthorexia. In this study, eating habits and physical activity were assessed. The effect of celiac disease on diet was self-assessed on a 5-point scale. Taking a score of 40 on the ORTO-15 test as the cut-off point, a risk of orthorexia was found in 71% of individuals with celiac disease, but only in 32% when the cut-off point was set at 35. There was a positive correlation between age and ORTO-15 test scores (rho = 0.30). In the group with orthorexia risk, meals were more often self-prepared (94%) compared to those without risk of orthorexia (78%) (p = 0.006). Individuals at risk for orthorexia were less likely to pay attention to the caloric content of food (46%) relative to those without risk of orthorexia (69%) (p = 0.001). For 64% of those at risk for orthorexia vs. 8% without risk had the thought of food that worried them (p = 0.001). Given the survey instrument for assessing the prevalence of orthorexia and the overlap between eating behaviors in celiac disease and orthorexia, the prevalence of orthorexia in celiac disease cannot be clearly established. Therefore, future research should focus on using other research tools to confirm the presence of orthorexia in celiac disease.
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10
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Satherley RM, Lerigo F, Higgs S, Howard R. An interpretative phenomenological analysis of the development and maintenance of gluten-related distress and unhelpful eating and lifestyle patterns in coeliac disease. Br J Health Psychol 2022; 27:1026-1042. [PMID: 35170152 PMCID: PMC9544439 DOI: 10.1111/bjhp.12588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 02/03/2022] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Estimates indicate that individuals with coeliac disease are more likely to experience disordered eating and impaired well-being than healthy controls, but less is known about the mechanisms by which these factors are related. The aim of this study was to understand experiences of coeliac disease and influence on subsequent unhelpful eating and lifestyle patterns. METHODS An online focus group discussion, hosted through a synchronous chat log, with adults living with coeliac disease was conducted. Seven individuals discussed their condition, lifestyle, and dietary changes post-diagnosis. Discussions were analysed using an interpretative phenomenological approach, a technique that enables new practical or research insight into health conditions based upon participants' experiences of their condition. RESULTS Three themes were identified: (i) Nobody knew what was happening to my body; (ii) I am so afraid of being 'glutened' that it is central to my thoughts and anxieties; and (iii) I am frightened but I can keep myself safe by being a 'good' coeliac. These appeared to contribute to participant distress or unhelpful eating or lifestyle behaviours. Participants appeared to develop severe anxiety around gluten, and implausible beliefs around diet and lifestyle management that appear to initiate and maintain unhelpful eating behaviours and maladaptive lifestyles changes, that contribute to distress. CONCLUSIONS Extending current knowledge, we propose a novel cognitive perspective on the development and maintenance of disordered eating in coeliac disease. Implications for how health providers can better support individuals with coeliac disease, and the role of dietary management, anxiety, and gastrointestinal symptoms in the development of disordered eating are discussed.
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Affiliation(s)
- Rose-Marie Satherley
- Department of Psychological Interventions, School of Psychology, University of Surrey, Guildford, UK
| | - Fiona Lerigo
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, UK
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Edgbaston, UK
| | - Ruth Howard
- School of Psychology, University of Birmingham, Edgbaston, UK
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11
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Rabadán A, Bernabéu R. A systematic review of studies using the Food Neophobia Scale: Conclusions from thirty years of studies. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2021.104241] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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12
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Nutritional implications of dietary gluten avoidance among Canadians: results from the 2015 Canadian Community Health Survey. Br J Nutr 2021; 126:738-746. [PMID: 33172514 DOI: 10.1017/s000711452000450x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Adherence to a gluten-free diet (GFD) is the only available treatment for gluten-related disorders, although a GFD may also be followed for discretionary reasons. The main objectives of the present study were to (1) describe and test for differences in key nutrient intakes among Canadians who follow a GFD compared with Canadians with no dietary exclusions and (2) describe additional dietary avoidances adhered to by Canadians who avoid gluten. We conducted a secondary analysis of the cross-sectional 2015 Canadian Community Health Survey-Nutrition Survey, which included a general health survey and 24-h dietary recall (n 20 487). Participants were categorised as those who avoid dietary gluten and those who reported no avoidances. Key nutrient intakes were assessed, as a percentage of Dietary Recommended Intakes, including fibre, B vitamins, vitamin D, Ca, Fe, Na and Zn, and compared between the two groups using t tests. Canadians who avoided gluten had significantly lower intakes of folate, vitamin B12, vitamin D, Fe, Na and Ca compared with those who did not avoid any food groups. However, Canadians who reported following a GFD were significantly more likely to use vitamin or mineral supplements in the past 30 d. More than 20 % of those who avoided gluten also avoided dairy products. Findings suggest that following a GFD places Canadians at risk for nutrient inadequacies, particularly folate, Ca and vitamin D. Further research is required to further examine how multiple dietary avoidances among those who avoid gluten may contribute to dietary inadequacies.
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13
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Gibson D, Watters A, Mehler PS. The intersect of gastrointestinal symptoms and malnutrition associated with anorexia nervosa and avoidant/restrictive food intake disorder: Functional or pathophysiologic?-A systematic review. Int J Eat Disord 2021; 54:1019-1054. [PMID: 34042203 DOI: 10.1002/eat.23553] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/22/2021] [Accepted: 05/08/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Although multiple pathophysiologic changes develop within the gastrointestinal (GI) system in the setting of malnutrition, the etiology of the reported multitude of symptoms in those with anorexia nervosa and avoidant restrictive intake disorder, as well as their contribution toward disordered eating, remain poorly understood. This systematic review seeks to better understand how these physiologic changes of malnutrition of the esophagus, stomach, intestines, and pancreas contribute toward the reported GI symptoms, as well as better understand how celiac disease, inflammatory bowel disease, pelvic floor dysfunction, and Ehlers-Danlos syndrome contribute toward disordered eating. METHODS Studies of any design exploring the pathogenesis of complications and treatment strategies were included. Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used to structure and complete the review. RESULTS A total of 146 articles were used for the review. The majority of studies were observational or case reports/case series. DISCUSSION Pathophysiologic changes of the esophagus, stomach, and intestines develop with malnutrition, although these changes do not consistently correlate with expressed GI symptoms in patients with restrictive eating disorders. Celiac disease and inflammatory bowel disease also contribute to disordered eating through the associated somatic GI complaints, while pelvic floor dysfunction and Ehlers-Danlos syndrome contribute through both somatic symptoms and functional symptoms. Indeed, functional GI symptoms remain problematic during the course of treatment, and further research is required to better understand the extent to which these symptoms are functional in nature and remit or remain as treatment ensues.
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Affiliation(s)
- Dennis Gibson
- ACUTE at Denver Health, Denver, Colorado, USA.,Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Ashlie Watters
- ACUTE at Denver Health, Denver, Colorado, USA.,Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Philip S Mehler
- ACUTE at Denver Health, Denver, Colorado, USA.,Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.,Eating Recovery Center, Denver, Colorado, USA
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Food Neophobia among Adults: Differences in Dietary Patterns, Food Choice Motives, and Food Labels Reading in Poles. Nutrients 2021; 13:nu13051590. [PMID: 34068662 PMCID: PMC8151374 DOI: 10.3390/nu13051590] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 11/17/2022] Open
Abstract
Food neophobia (FN) is associated with reduced quality of diet in adults; thus, the understanding of the relationship between FN and food consumption in more depth appears to be a key issue. The aim of the study was to assess the relationship between food neophobia, dietary patterns, food choice motives, and food label reading in the group of adults. Data were collected using the computer-assisted personal interviewing technique (CAPI). A cross-sectional quantitative survey was carried out in November-December 2017 in a sample of 1017 Polish adults. The questionnaire used in the study included the Food Neophobia Scale (FNS), the Beliefs and Eating Habits Questionnaire (KomPAN), and questions regarding food choice motives, reading food labels, and sociodemographic characteristics. The food neophobics were older, had a lower level of education, and had higher BMI compared to others. Compared to others, among the food neophobics, there were more people who often consumed vegetables, fruit, meat, and meat products and who rarely consumed functional and convenience food, sweets, and sweetened beverages. When choosing food, more food neophobics chose healthy and tasteless food products, while more food neophilics chose unhealthy and tasty products. More food neophobics declared not reading price and shelf-life information on food labels compared to the other two groups. Although food neophobia may make adaptation to dietary recommendations difficult, health-promoting features of the diet were observed within the food neophobics. Actions focusing on food choice motives may help even more to limit the effects of food neophobia in adults. Further research is recommended to confirm the observed relationships under different sociocultural conditions.
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15
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Guzek D, Pęska J, Głąbska D. Role of Food Neophobia and Allergen Content in Food Choices for a Polish Cohort of Young Women. Nutrients 2019; 11:nu11112622. [PMID: 31683942 PMCID: PMC6893445 DOI: 10.3390/nu11112622] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 10/23/2019] [Accepted: 10/28/2019] [Indexed: 12/11/2022] Open
Abstract
Young women are vulnerable to a number of factors which influence their food choices, including beliefs about food products, or information about nutritional value, while information, that product is free from specific component generates consumer perceptions of its healthfulness. Among the factors which may influence such perception, there is food neophobia (FN). The aim of this study was to determine the influence of FN and information about allergens on the food product choices in the Polish cohort of young women, in the choice experiment when given a model restaurant menu. The web-based choice experiment, in a group of 600 women, aged 18-30 years, with no food allergies diagnosed, was conducted using a mock Italian-style restaurant menu. For 2 starters, 2 soups, 3 main courses and 3 desserts that were included, the allergen content, neophobic potential and perceived lack of healthiness, for a Polish population, were defined. Each respondent randomly received the version containing only a description of dishes, or a description accompanied by the allergens listed. The FN was assessed using the Food Neophobia Scale (FNS). The type of menu (with or without allergens listed) did not influence the choices of dishes. The highest FN level was observed for the women being inhabitants of villages (median of 32). The respondents characterized by a high level of FN less commonly chose dishes characterized by neophobic potential as a starter (Carpaccio), main course (Risotto ai frutti di mare) and dessert (Zabaglione). At the same time, the highest FN level was observed for respondents who chose dishes with no neophobic potential (median of 34.5). However, for allergen content and perceived lack of healthiness, no association with FN was observed, so it may be stated that for neophobic respondents, only neophobic potential is a factor limiting the choice of dishes. It may be concluded that food neophobia in young women may limit the consumption of dishes with unknown food products, and the influence is observed independently of other features of a dish, such as allergen content or perceived healthiness. The problem may appear especially for inhabitants of villages, who are characterized by the highest level of FN.
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Affiliation(s)
- Dominika Guzek
- Department of Organization and Consumption Economics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland.
| | - Joanna Pęska
- Department of Organization and Consumption Economics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland.
| | - Dominika Głąbska
- Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland.
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