The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Nutrients. 2024 Oct 31;16(21):3736. doi: 10.3390/nu16213736.
BACKGROUND/OBJECTIVES: Food insecurity (FI) is defined as the lack of consistent access to enough food for an active and healthy life. FI affects over 30 million Americans and is associated with poor clinical outcomes and impaired quality of life and drives significant health inequities. Despite the rising prevalence of FI and the federal focus on improving access to healthy food, there is a paucity of research on FI in patients with inflammatory bowel disease (IBD). Therefore, the goal of this study was to define FI in a cohort of IBD patients and determine whether FI was associated with changes in dietary patterns, including specifically an increase in ultra-processed food (UPF) consumption in this high-risk patient population.
This was a single-center, retrospective cohort study of patients with a diagnosis of IBD who were 18 years of age or older and who were seen in a nutrition focused clinic. Patients were screened for FI using the Hunger Vital Sign™, a 2-question validated FI screening tool and underwent a 24-h dietary recall. The degree of food processing was assessed using the NOVA Food Classification System.
Among 128 patients with IBD, we observed that FI is increasingly prevalent, with 45% of patients reporting difficulty with sufficient grocery access at least "sometimes" in the last 12 months and 10% reporting decreased food access "often" in the prior year. In addition, the patients at high-risk for FI were significantly more likely to eat NOVA 4 UPFs (54% vs. 27%, = 0.001) and were significantly less likely to eat NOVA 1 unprocessed foods (32% vs. 61%, = 0.001) as compared to those not at risk for FI. Finally, only a small percentage of those at highest risk for FI were enrolled in a federal food assistance program for grocery support.
The prevalence of FI is increasing in patients with IBD and is associated with reduced dietary quality.
背景/目的：食物不安全（FI）被定义为缺乏稳定获得足够食物以维持积极健康生活的能力。FI 影响超过 3000 万美国人，与不良临床结局和生活质量受损有关，并导致严重的健康不平等。尽管 FI 的患病率不断上升，联邦政府也专注于改善获得健康食品的机会，但在炎症性肠病（IBD）患者中，FI 的研究相对较少。因此，本研究的目的是在 IBD 患者队列中定义 FI，并确定 FI 是否与饮食模式的变化相关，特别是在这一高风险患者群体中，FI 是否与超加工食品（UPF）消费的增加有关。
这是一项单中心、回顾性队列研究，纳入了年龄在 18 岁及以上、在营养重点诊所就诊的 IBD 患者。使用 Hunger Vital SignTM，一种 2 个问题的验证性 FI 筛查工具，对患者进行 FI 筛查，该工具是一种 2 个问题的验证性 FI 筛查工具。通过 24 小时膳食回顾评估食物加工程度。NOVA 食品分类系统用于评估食物加工程度。
在 128 名 IBD 患者中，我们观察到 FI 的患病率不断上升，45%的患者报告在过去 12 个月中至少“有时”难以获得足够的食品杂货，10%的患者报告在过去一年中“经常”减少食品获取。此外，FI 高风险患者明显更有可能食用 NOVA 4 类 UPF（54%比 27%， = 0.001），而不太可能食用 NOVA 1 类未加工食品（32%比 61%， = 0.001）。最后，只有一小部分 FI 高风险患者参加了联邦食品援助计划以获得食品杂货支持。
IBD 患者的 FI 患病率不断上升，与膳食质量下降有关。
