S1360 Dietary Disconnect: Low Adherence To Guideline Recommended Dietary Patterns in Inflammatory Bowel Disease Patients
Bibliographic record
Abstract
Introduction: Recently, the American Gastroenterological Association (AGA) published their “Practice Update on Diet and Nutritional Therapies in Patients With Inflammatory Bowel Disease (IBD)”, in which experts recommend IBD patients to follow the Mediterranean Diet (MD) if there are no contraindications. As this guideline is directed at practitioners and not patients, we aimed to assess dietary habits in the IBD patient population to determine whether guideline recommendations are translated to the patient population. Methods: Adult (age >18) IBD patients presenting to the Gastroenterology Clinic at a single tertiary care center were included between 04/01/2024 and 05/31/2024. We developed an anonymous survey including 1) questions about dietary habits and whether patients received information about diet in IBD, 2) Nine Item Avoidant/Restrictive Food Intake disorder screen (NIAS) to assess for food avoidant behavior and 3) The Saskatchewan Inflammatory Bowel Disease-Nutrition Risk Tool (SaskIBD-NR) to assess nutrition risk in IBD patients based on symptoms, food restriction and weight loss. Results: A total of 98 IBD patients completed the survey. 70.4% of patients was unaware of the risk of malnutrition in IBD. 41.8% did not previously receive information about diet in IBD and 80.4% expressed interest in receiving (more) dietary education. Only 2.1% followed the MD, and 53.1% did not follow a diet. 70.4% of patients restricted their eating. Based on NIAS, 14.3% has avoidant behavior. Based on SaskIBD-NR, 53% are low risk, 26% are medium risk and 21% are high risk for malnutrition. Conclusion: We show that despite national guidelines recommending that IBD patients to follow the Mediterranean diet, only a very small subgroup of patients is doing so. This is in part due to lack of education as evidenced by >40% not receiving dietary information, but we believe that food avoidance behaviors are involved as well, as demonstrated by nearly 15% with avoidant behavior and 1 in 5 patients at high risk for malnutrition. Therefore, we should 1) emphasize education on the MD in IBD patients and 2) evaluate for food avoidance behaviors that may limit implementation of the MD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".