Prevalence of Avoidant/Restrictive Food Intake Disorder and Association with Nutrition Status in Patients with Inflammatory Bowel Diseases

There is a large body of research on the relationship between inflammatory bowel disease (IBD) and diet; however, few conclusive, generalizable recommendations have been determined. Regardless, IBD patients often alter their normal dietary intake, which is concerning considering the prevalence of malnutrition in the IBD population. Avoidant/restrictive food intake disorder (ARFID) is a feeding disorder that was recently added to the Diagnostic and Statistical Manual of Mental Disorders and its prevalence and impact on the nutritional status of IBD patients has not previously been described. In this study ARFID risk was measured using the Nine-Item ARFID Screen and in the 161 outpatient, adult IBD participants 17% were at ARFID risk. Participants who avoid food, regardless of disease status, had significantly higher ARFID risk scores than those who do not avoid food. Participants who reported symptoms of diarrhea, pain, no appetite, and fullness were significantly more likely to be at ARFID risk than those who did not. Nutritional risk was measured using the Patient Generated-Subjective Global Assessment (PG-SGA). ARFID risk score and nutritional risk score were positively correlated (rs= 0.196, P = 0.024), indicating that participants with a higher ARFID risk score were also at risk for malnutrition. These results demonstrate that IBD patients should be regularly screened for malnutrition and food avoidance, endorsing the critical role of a registered dietitian as part of the IBD patient care team