Food habits in 10–11-year-old children with functional gastrointestinal disorders

Abstract

Objective: To evaluate the role of food habits and nutrient intake in children with functional gastrointestinal disorders (FGIDs) considering their association with psychosocial factors. Design: Cross-sectional. Setting: A rural town in Mid-Western Finland. Subjects: After excluding organic gastrointestinal (GI) disorders, a total of 49 children with FGID and 78 control children without GI symptoms from a cohort of 422 children were studied. Methods: Food frequency questionnaire, GI-symptoms questionnaire and the Child Behaviour Check List (CBCL) filled in by parents together with their child, and 24-h dietary recall and anthropometric and haematological measurements. Results: Compared to control children, fewer children with FGID had daily family dinner (77 vs 91%, P ¼ 0.030) and they used less often vegetables (P ¼ 0.023), fruits (P ¼ 0.027) and berries (P ¼ 0.011), but more often ice cream (P ¼ 0.018) and soft drinks (P ¼ 0.027) and had a higher sucrose intake (9 vs 7E%, P ¼ 0.032) and lower lactose intake (27 vs 36 g, P ¼ 0.001). Reported food-related symptoms were more common among FGID group (69 vs 11%), as well as restricted milk use (31 vs 0%). Children with FGID had higher total problem scores in CBCL (P ¼ 0.002), and the behavioural/emotional problems associated with occurrence of FGID (OR 1.04, 95% CI 1.07-1.076) as did the sugar intake (OR 1.1, 95% CI 1.004-1.215).Conclusions: This population-based study suggests that school-aged children with FGIDs have less-organized food habits and higher milk avoidance, and they display internalizing psychological characteristics. IntroductionFunctional gastrointestinal disorders (FGIDs) are defined as a combination of chronic or recurrent gastrointestinal (GI) symptoms in the absence of diagnosed disease. A number of common paediatric disorders falls into this category, for example, infant regurgitation, chronic nonspecific diarrhoea, irritable bowel syndrome (IBS), nonulcer dyspepsia, infant dyschezia, and functional constipation (Hyams, 1999;Rasquin-Weber et al, 1999;Thompson et al, 1999).It is well known that psychopathology plays an important role in FGIDs. Gut function is controlled by a complex neural network and the current understanding is that FGIDs result from dysregulation of the bidirectional communication between the brain and the gut (ie the brain-gut axis), modulated by various psychosocial factors. Recently, instead of searching unidirectional relationship between psychosocial events and GI function, research has shifted to evaluate the reciprocal interaction between physiologic and psychosocial processes in these disorders Ringel and Drossman, 1999). More psychological problems and stressors have been found in children with recurrent abdominal pain (RAP) and in those with organic GI disorder as compared to GI patients without symptoms or healthy control children (Sawyer et al, 1987;Walker and Greene, 1989;Robinson et al, 1990;Walker et al, 2001). There is also some evidence that FGIDs may be more common in children coming from low social class ...

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