Food-Related Behavioral Patterns in Patients with Inflammatory Bowel Diseases: The Role of Food Involvement and Health Engagement
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Measures
2.2.1. Sociodemographic and Disease-Related Characteristics
2.2.2. Food Involvement
2.2.3. Health Engagement
2.2.4. Food Choice Motives
2.2.5. Emotional States
2.2.6. Food-Related Quality of Life
2.3. Statistical Analysis
- (i)
- Interpretability of the final clusters’ averages and ANOVA’s p-values;
- (ii)
- Number of participants in each cluster (closer to homogeneity is better);
- (iii)
- Pseudo-F values, calculated according to the procedure described by Calinski and Harabasz [43]: higher pseudo-Fs are an indication of a better solution;
- (iv)
- Finally, to address the stability of the identified best solution, the Rand index [44] was calculated; the Rand index is considered acceptable above the 0.70 threshold.
3. Results
3.1. Participant Characteristics
3.2. Scale Scoring and Descriptive Statistics
3.3. Cluster Analysis
- (i)
- A cluster comprising patients with higher PHE-s® scores and lower FIS scores is labeled as the “Health-conscious” group.
- (ii)
- Another group characterized by higher scores on PHE-s® and FIS is the “Balanced” group.
- (iii)
- A cluster with higher FIS scores and lower PHE-s® scores is identified as the “Hedonist” group.
- (iv)
- Lastly, a cluster of patients with lower scores on both PHE-s® and FIS is called the “Careless” group.
3.3.1. Differences between Clusters
Sociodemographic and Disease-Related Characteristics
Food-Related Quality of Life
Motives behind Food Choices
4. Discussion
4.1. Limitations
4.2. Relevance for Clinical Practice
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Participant Characteristics | n | % |
---|---|---|
Gender | ||
Male | 355 | 39.9 |
Female | 535 | 60.1 |
Diagnosis | ||
Colitis (ulcerative or indeterminate) | 445 | 50.0 |
Crohn’s disease | 445 | 50.0 |
Level of education | ||
Middle school or lower | 87 | 9.8 |
High school | 422 | 47.4 |
University or higher | 381 | 42.8 |
Existing comorbidities | ||
Yes | 197 | 22.1 |
No | 693 | 77.9 |
IBD relapses/hospitalizations in the last year | ||
Yes | 352 | 39.6 |
No | 538 | 60.4 |
Ever undergone surgery for IBD | ||
Yes | 336 | 37.8 |
No | 554 | 62.2 |
Currently taking drugs/medications for IBD | ||
Yes | 784 | 88.1 |
No | 106 | 11.9 |
Variables | Min | Max | Mean | SD | Skewness | Kurtosis |
---|---|---|---|---|---|---|
Food-related quality of life (Fr-QoL-29) | 1.00 | 4.97 | 3.10 | 0.85 | −0.344 | −0.443 |
Food choice motives (FCQ) (It is important to me that the food I eat on a typical day…) | ||||||
is healthy | 1 | 7 | 5.96 | 1.02 | −1.275 | 2.645 |
is a way of monitoring my mood | 1 | 7 | 5.03 | 1.50 | −0.810 | 0.329 |
is convenient | 1 | 7 | 4.99 | 1.42 | −0.835 | 0.568 |
provides me with pleasurable sensations | 1 | 7 | 5.57 | 1.11 | −1.105 | 1.987 |
is natural | 1 | 7 | 5.58 | 1.18 | −0.878 | 1.023 |
is affordable | 1 | 7 | 4.93 | 1.39 | −0.618 | 0.322 |
helps me control my weight | 1 | 7 | 4.75 | 1.66 | −0.696 | −0.154 |
is familiar | 1 | 7 | 4.47 | 1.41 | −0.502 | 0.134 |
is environmentally friendly | 1 | 7 | 5.28 | 1.29 | −0.755 | 0.626 |
is animal friendly | 1 | 7 | 5.18 | 1.42 | −0.628 | −0.027 |
is fairly traded | 1 | 7 | 4.47 | 1.14 | −0.410 | 0.038 |
helps me control my symptoms | 1 | 7 | 6.18 | 0.96 | −1.224 | 1.753 |
Emotional states | ||||||
Happiness | 0 | 100 | 58.66 | 26.37 | −0.571 | −0.331 |
Sadness | 0 | 100 | 36.46 | 27.68 | 0.514 | −0.694 |
Hopefulness | 0 | 100 | 54.93 | 29.13 | −0.235 | −0.865 |
Fear | 0 | 100 | 28.72 | 27.95 | 0.868 | −0.239 |
Satisfaction | 0 | 100 | 52.49 | 27.60 | −0.180 | −0.860 |
Anger | 0 | 100 | 33.49 | 30.43 | 0.670 | −0.776 |
Disgust | 0 | 100 | 19.44 | 25.92 | 1.56 | 1.550 |
Anxiety | 0 | 100 | 37.37 | 30.19 | 0.423 | −0.977 |
Distress | 0 | 100 | 46.65 | 31.28 | 0.090 | −1.170 |
Boredom | 0 | 100 | 29.65 | 29.30 | 0.778 | −0.524 |
Food involvement (FIS) | 2.75 | 6.33 | 4.57 | 0.64 | −0.76 | −0.308 |
Health engagement (PHE-s®) | −5.52 | 8.28 | 2.40 | 2.86 | −0.148 | −0.337 |
Variables | Clusters | Welch’s F | p | η2 | |||
---|---|---|---|---|---|---|---|
1: Health-Conscious (n = 261) | 2: Balanced (n = 241) | 3: Hedonist (n = 187) | 4: Careless (n = 201) | ||||
PHE-s® cluster mean | 0.75 a | 0.71 a | −0.90 b | −0.94 b | 626.597 | <0.001 | 0.681 |
FIS cluster mean | −0.80 c | 0.77 b | 0.92 a | −0.73 c | 594.238 | <0.001 | 0.667 |
Variables | Clusters | χ2 | p | Cramer’s V | |||
---|---|---|---|---|---|---|---|
1: Health-Conscious | 2: Balanced | 3: Hedonist | 4: Careless | ||||
Gender | 39.529 | <0.001 | 0.21 | ||||
Male | 53.3% (5.2) | 33.2% (−2.5) | 26.2% (−4.3) | 43.3% (1.1) | |||
Female | 46.7% (−5.2) | 66.8% (2.5) | 73.8% (4.3) | 56.7% (−1.1) | |||
Diagnosis | |||||||
Colitis | 48.7% (−0.5) | 48.5% (−0.5) | 47.1% (−0.9) | 56.2% (2.0) | |||
Crohn’s disease | 51.3% (0.5) | 51.5% (0.5) | 53.9% (0.9) | 43.8% (−2.0) | 4.418 | n. s. | |
Level of education | 7.525 | n. s. | - | ||||
Middle school or lower | 11.5% (1.1) | 8.7% (−0.6) | 5.9% (−2.0) | 12.4% (1.4) | |||
High school | 47.9% (0.2) | 46.9% (−0.2) | 46.5% (−0.3) | 48.3% (0.3) | |||
University or higher | 40.6% (−0.9) | 44.4% (0.6) | 47.6% (1.5) | 39.3% (−1.1) | |||
Comorbidities | 0.132 | n. s. | - | ||||
Yes | 22.2% (0.0) | 21.6% (−0.2) | 23.0% (0.3) | 21.9% (−0.1) | |||
No | 77.8% (0.0) | 78.4% (0.2) | 77.0% (−0.3) | 78.1% (0.1) | |||
Hospitalizations | 24.616 | <0.001 | 0.16 | ||||
Yes | 4.6% (−4.1) | 10.8% (−0.4) | 19.3% (3.8) | 13.9% (1.2) | |||
No | 95.4% (4.1) | 89.2% (0.4) | 80.7% (−3.8) | 86.1% (−1.2) | |||
Relapses | 92.681 | <0.001 | 0.32 | ||||
Yes | 21.8% (−7.0) | 31.1% (−3.1) | 61.5% (6.9) | 52.2% (4.2) | |||
No | 78.2% (7.0) | 68.9% (3.1) | 38.5% (−6.9) | 47.8% (−4.2) |
Variables | Clusters | Welch’s F | p | η2 | |||
---|---|---|---|---|---|---|---|
1: Health-Conscious | 2: Balanced | 3: Hedonist | 4: Careless | ||||
Food-related quality of life | 2.66 c | 2.81 c | 3.68 a | 3.49 b | 104.161 | <0.001 | 0.257 |
Food choice motives (It is important to me that the food I eat on a typical day…) | |||||||
is healthy | 5.84 b | 6.16 a | 6.02 a | 5.81 b | 6.749 | <0.001 | 0.020 |
is a way of monitoring my mood | 4.64 | 4.98 b | 5.42 a | 5.24 | 12.476 | <0.001 | 0.038 |
is convenient | - | - | - | - | 1.776 | n. s. | - |
provides me with pleasurable sensations | 5.38 b | 5.70 | 5.73 a | 5.52 a,b | 5.193 | 0.002 | 0.017 |
is natural | - | - | - | - | 2.344 | n. s. | - |
is affordable | 4.75 b | 5.03 a,b | 5.13 a | 4.87 a,b | 3.668 | 0.012 | 0.011 |
helps me control my weight | - | - | - | - | 0.636 | n. s. | - |
is familiar | - | - | - | - | 0.626 | n. s. | - |
is environmentally friendly | 5.33 a,b | 5.40 a | 5.28 a,b | 5.05 b | 2.604 | 0.051 | 0.010 |
is animal friendly | - | - | - | - | 1.013 | n. s. | - |
is fairly traded | - | - | - | - | 1.854 | n. s. | - |
helps me control my symptoms | 5.90 c | 6.18 b | 6.43 a | 6.31 a,b | 13.054 | <0.001 | 0.044 |
Variables | Clusters | |||
---|---|---|---|---|
1: Health-Conscious | 2: Balanced | 3: Hedonist | 4: Careless | |
Defining variables | High health engagement and low food involvement | High health engagement and high food involvement | Low health engagement and high food involvement | Low health engagement and low food involvement |
Sociodemographic and clinical characteristics | Males, with no hospitalization or relapses in the last year, higher average age | Females, with no relapses in the last year | Females with relapses and/or hospitalizations in the previous year | Diagnosis of colitis, with relapses in the last year and no surgical treatment in the past |
Food-related quality of life and emotional state | High food-related quality of life | High food-related quality of life | Reported food-related quality of life is the lowest among groups | Reported food-related quality of life is low |
Food choice drivers | This group does not show a particular driver regarding food. Compared to the other groups, these participants reported less interest in healthiness, mood modulation, sensations, affordability, and friendliness toward the environment. Food is not deemed essential for symptom management either | More interest in food’s healthiness and its pleasurable sensations. However, seeking pleasure is unrelated to mood modulation, as they reported this driver as less critical. Attention toward the environment and symptom management are also present (the latter is not as high as for other clusters) | Higher interest in food’s healthiness and its pleasurable sensations. In this case, however, there is also a reported use of food as a means to regulate mood, which is an essential driver for this group. Affordability and symptom control are also important drivers | This group shows a low interest in the healthiness of food and a high use of food for mood regulation. Inconsistently, they also report the importance of managing symptoms through food. Environmental friendliness is not essential |
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Share and Cite
Palamenghi, L.; Usta, D.; Leone, S.; Graffigna, G. Food-Related Behavioral Patterns in Patients with Inflammatory Bowel Diseases: The Role of Food Involvement and Health Engagement. Nutrients 2024, 16, 1185. https://doi.org/10.3390/nu16081185
Palamenghi L, Usta D, Leone S, Graffigna G. Food-Related Behavioral Patterns in Patients with Inflammatory Bowel Diseases: The Role of Food Involvement and Health Engagement. Nutrients. 2024; 16(8):1185. https://doi.org/10.3390/nu16081185
Chicago/Turabian StylePalamenghi, Lorenzo, Dilara Usta, Salvo Leone, and Guendalina Graffigna. 2024. "Food-Related Behavioral Patterns in Patients with Inflammatory Bowel Diseases: The Role of Food Involvement and Health Engagement" Nutrients 16, no. 8: 1185. https://doi.org/10.3390/nu16081185