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Background <p>Avoidant/Restrictive Food Intake Disorder (ARFID) is a possible comorbidity in patients with Inflammatory Bowel Disease (IBD). Early detection and intervention are crucial to prevent malnutrition and related complications. However, ARFID often remains undiagnosed due to its subtle presentation. Methods: This multicenter study enrolled 235 patients with IBD at German tertiary referral centers between March and September 2025. The Nine Item Avoidant/Restrictive Food Intake disorder screen (NIAS), a screening tool for ARFID, was translated into German and administered at baseline and follow-up. The validity and reliability of the NIAS German were assessed via hypothesis testing and Cronbach’s α coefficient.</p> Results <p>The NIAS German demonstrated excellent internal consistency (Cronbach’s α = 0.810) and test-retest reliability (<i>p</i> &lt; 0.001). A significant correlation was found between the initial and follow-up NIAS scores for all items (<i>p</i> &lt; 0.001). Furthermore, the intraclass correlation coefficient of 0.896 (95% CI: 0.846–0.931) confirmed the reliability of the German questionnaire version. Notably, women with IBD scored significantly higher on the NIAS and its subscales, indicating a greater likelihood and severity of ARFID symptoms, as screened by the NIAS (Md [IQR]: women = 13 [7–17]; men = 10 [6–15]; <i>p</i> = 0.007).</p> Conclusions <p>The German version of the NIAS demonstrated good reliability and initial evidence supporting its use as a screening instrument in German-speaking men and women with IBD. The findings of this study highlight the importance of sex-specific assessment and suggest that IBD women may be at higher risk of developing ARFID. Early detection and targeted interventions are essential to prevent malnutrition and related complications in this vulnerable population.</p>

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Sex-specific patterns of avoidant and restrictive eating in inflammatory bowel disease: validation of the German version of the Nine Item Avoidant/Restrictive Food Intake disorder screen (NIAS)

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月3日

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  • Lea Pueschel,
  • Stefanie Claire Fuhrberg,
  • Leonie Kuhn,
  • Josephine Conrad,
  • Marina Florea,
  • Navid Pueschel,
  • Linda Schemann,
  • Yilmaz Rohat Kala,
  • Konstantina Atanasova,
  • Laura-Louise Knoedler,
  • Wolfgang Reindl,
  • Eva Lina Wilke,
  • Moritz Middelhoff,
  • Anne Kerstin Thomann,
  • Miriam Wiestler

摘要

Background

Avoidant/Restrictive Food Intake Disorder (ARFID) is a possible comorbidity in patients with Inflammatory Bowel Disease (IBD). Early detection and intervention are crucial to prevent malnutrition and related complications. However, ARFID often remains undiagnosed due to its subtle presentation. Methods: This multicenter study enrolled 235 patients with IBD at German tertiary referral centers between March and September 2025. The Nine Item Avoidant/Restrictive Food Intake disorder screen (NIAS), a screening tool for ARFID, was translated into German and administered at baseline and follow-up. The validity and reliability of the NIAS German were assessed via hypothesis testing and Cronbach’s α coefficient.

Results

The NIAS German demonstrated excellent internal consistency (Cronbach’s α = 0.810) and test-retest reliability (p < 0.001). A significant correlation was found between the initial and follow-up NIAS scores for all items (p < 0.001). Furthermore, the intraclass correlation coefficient of 0.896 (95% CI: 0.846–0.931) confirmed the reliability of the German questionnaire version. Notably, women with IBD scored significantly higher on the NIAS and its subscales, indicating a greater likelihood and severity of ARFID symptoms, as screened by the NIAS (Md [IQR]: women = 13 [7–17]; men = 10 [6–15]; p = 0.007).

Conclusions

The German version of the NIAS demonstrated good reliability and initial evidence supporting its use as a screening instrument in German-speaking men and women with IBD. The findings of this study highlight the importance of sex-specific assessment and suggest that IBD women may be at higher risk of developing ARFID. Early detection and targeted interventions are essential to prevent malnutrition and related complications in this vulnerable population.