An examination of appetite and disordered eating in active Crohn’s disease

Wardle, Richard; Thapaliya, Gita; Nowak, Adam; Radford, Shellie; Dalton, Michelle; Finlayson, Graham; Moran, Gordon W.

Abstract

Background: Crohn’s disease (CD) patients suffer from nutritional deficiencies when in active disease. We aim to examine calorific intake, macronutrient choice and disordered eating behaviour in patients with active CD.
Methods: CD patients with matched healthy volunteers (HV) were recruited. Active disease was defined by faecal calprotectin >250ug/g, C-reactive protein >5mg/dl, or active disease seen on endoscopy or imaging. Symptoms were quantified by Harvey-Bradshaw Index (HBI). Calorific intake was assessed by 24-h dietary recall. Disordered eating was assessed using validated questionnaires [Binge Eating Scale (BES); Power of Food Scale (PFS); Control of Eating Questionnaire (CoEQ); Dutch Eating Behaviour Questionnaire (DEBQ); Three Factor Eating Questionnaire (TFEQ)].
Results: 30 CD (18M:12F, Age:32.3±2.19, BMI:24.9±0.8) and 31 matched HV (19M:12F, Age:32.8±2.0, BMI:24.7±0.5) were recruited. Mean faecal calprotectin was 1032.5±176µg/g,C-reactive protein 83.8±47.1mg/L and HBI 4.8±1. There were no significant differences in calorific intake between groups. Protein intake was lower in the CD cohort (p=0.03). Hospital Anxiety and Depression score was higher (p=0.01) and CoEQ-Positive Mood (p=0.001) lower in CD. CD were characterised by higher BES (p=0.01) and lower CoEQ Craving Control (p=0.027) with greater craving for Sweet (p=0.043), Savoury (p=0.021) foods. PFS food present (p=0.005), DEBQ Emotional (p=<0.001) and External Eating (p=0.022) were significantly higher than HV.
Conclusions: Reduced protein consumption and more prevalent disordered eating behaviour traits were present in CD. Greater binge eating and decreased control of cravings may be attributed to lower mood and higher anxiety observed. Patients may benefit from stronger psychological support with firm dietetic advice for healthy eating.

Citation

Wardle, R., Thapaliya, G., Nowak, A., Radford, S., Dalton, M., Finlayson, G., & Moran, G. W. (2018). An examination of appetite and disordered eating in active Crohn’s disease. Journal of Crohn's and Colitis, 12(7), 819-825. https://doi.org/10.1093/ecco-jcc/jjy041

• Journal Article Type: Article
• Acceptance Date: Mar 5, 2018
• Online Publication Date: Apr 3, 2018
• Publication Date: Jun 28, 2018
• Deposit Date: Mar 8, 2018
• Publicly Available Date: Apr 4, 2019
• Journal: Journal of Crohn's and Colitis
• Print ISSN: 1873-9946
• Electronic ISSN: 1876-4479
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 12
• Issue: 7
• Pages: 819-825
• DOI: https://doi.org/10.1093/ecco-jcc/jjy041
• Keywords: Inflammatory Bowel Disease, Crohn’s disease, eating behaviour, nutrition
• Public URL: https://nottingham-repository.worktribe.com/output/943018
• Publisher URL: https://academic.oup.com/ecco-jcc/advance-article/doi/10.1093/ecco-jcc/jjy041/4959791
• Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in Journal of Crohn's and Colitis following peer review. The version of record Richard Anthony Wardle, Gita Thapaliya, Adam Nowak, Shellie Radford, Michelle Dalton, Graham Finlayson, Gordon W Moran; An examination of appetite and disordered eating in active Crohn’s disease, Journal of Crohn's and Colitis, , jjy041, https://doi.org/10.1093/ecco-jcc/jjy041 is available online at:https://academic.oup.com/ecco-jcc/advance-article/doi/10.1093/ecco-jcc/jjy041/4959791
• Contract Date: Mar 8, 2018