P1213 The role of stress in dietary choices and disease outcomes in Inflammatory Bowel Disease
M Acampora, D Usta, A Costa Pereira, M Savarese, L Avedano, M S De Rocchis, S Leone, G GraffignaAbstract
Background
The role of nutrition in managing Inflammatory Bowel Disease (IBD) is widely discussed, yet its interplay with stress-related factors influencing eating behaviour and disease management remains complex. Stress-induced eating behaviours, such as increased comfort foods consumption, may exacerbate symptoms and hinder effective disease management, impacting clinical outcomes and quality of life. This study, part of EU-funded MiGut-Health project, assesses the relationship between stress, eating behaviours, and disease management in IBD patients, focusing on comfort food consumption, psychological food involvement, and disease-related factors, including health engagement, stool consistency, and disease activity.
Methods
In August 2024, a cross-sectional study was conducted applying an online survey to a cohort of 2,276 adult IBD patients across Italy. The survey included validated scales: the Patient Health Engagement Scale (PHE-s), Psychological Food Involvement Scale (PFIS), Perceived Stress Scale (PSS-10), Salzburg Stress Eating Scale, Inflammatory Bowel Disease Symptom Inventory (IBDSI-SF), and Bristol Stool Chart, along with items on Comfort Food Consumption. Data analysis involved descriptive analysis and independent samples t-test.
Results
Participants reported moderate perceived stress (mean=17.3 ± 7.75), with 35.5% indicating increased comfort food consumption when stressed, primarily chocolate (23.2%), sweet snacks (22.0%), and savoury snacks (21.0%). Individuals with high stress (32.6%) were more likely to consume fast food (mean=0.4 ± 0.66, p < 0.001) and sweetened beverages (mean=0.7 ± 1.21, p < 0.001). They placed greater importance on comfort food groups for managing stress (mean=2.7 ± 1.17 vs 2.5 ± 1.14, p < 0.001). Disease activity was notably higher in the high-stress group (mean=29.2 ± 15.61 vs. 16.8 ± 11.66, p < 0.001), alongside looser stool consistency (mean=4.8 ± 1.59 vs. 4.3 ± 1.45, p < 0.001). High-stress patients also demonstrated lower health engagement (mean=2.1 ± 0.68 vs. 2.6 ± 0.74, p < 0.001) and reduced psychological food involvement (mean=4.1 ± 1.17 vs. 4.4 ± 1.09, p < 0.001).
Conclusion
Stress significantly shapes eating behaviours and disease management in IBD patients. High stress correlates with increased comfort foods consumption, reduced psychological food involvement, and poorer disease outcomes, including heightened symptoms, looser stool consistency, and diminished health engagement. These findings highlight the complex relationship between stress and disease-related factors, suggesting the need for integrated interventions targeting stress management to improve dietary behaviours and overall disease management in IBD.