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Impact of gastrointestinal conditions, restrictive diets and mental health on health-related quality of life: cross-sectional population-based study in Australia
  1. Nigel P Stocks1,
  2. David Gonzalez-Chica2,
  3. Phillipa Hay3
  1. 1 General Practice, University of Adelaide, Adelaide, South Australia, Australia
  2. 2 Discipline of General Practice, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
  3. 3 Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
  1. Correspondence to Professor Nigel P Stocks; nigel.stocks{at}


Objectives To assess the relationship between gastrointestinal conditions, restrictive diets, mental health and health-related quality of life (HRQoL).

Design Cross-sectional population-based face-to-face survey.

Setting South Australia.

Participants A representative sample of 2912 consenting adults (48.9±18.1 years; 50.9% females) investigated in 2015.

Primary and secondary outcome measures Participants self-reported diagnosis of gastrointestinal conditions, mental health and current use of restrictive diets. The physical component score (PCS) and mental component score (MCS) of HRQoL were investigated (Study Short Form 12 V.1 questionnaire). Linear regression models were used to test the associations, adjusting for (1) sociodemographic variables, (2) mental health status and (3) lifestyle and body mass index.

Results The prevalence of restrictive diets (36.1%; 95% CI 33.9 to 38.3) was higher among those with any self-reported gastrointestinal condition (60.7% vs 31.3% for those without these conditions; p<0.001). PCS was lower among those with a gastrointestinal condition (mean difference=−3.4; 95% CI −4.5 to −2.4) or on a restrictive diet (mean difference=−1.9; 95% CI −2.7 to −1.1), with a similar pattern, but with a smaller effect, observed for MCS. Being on a restrictive diet did not modify the relationship between having a gastrointestinal condition and reduced HRQoL. However, having a gastrointestinal condition was associated with a 2.4 points lower PCS (95% CI −3.5 to −1.3) among those without a mental health problem, while for those affected by a mental health condition this reduction was greater (mean difference=−5.9; 95% CI −8.7 to −3.1). For MCS, there was no evidence of interaction between mental health and gastrointestinal conditions.

Conclusions One-third of Australian adults are restricting their diet, and this is associated with lower HRQoL. Being on a restrictive diet was not associated with a better HRQoL among individuals with a gastrointestinal condition. Mental health problems were associated with a stronger adverse relationship between gastrointestinal diseases and physical HRQoL. Health professionals should be alert to these associations when trying to improve health outcomes for patients.

  • quality of life
  • epidemiology
  • diet
  • gastrointestinal disease

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  • Contributors NS and DG-C conceived the study, analysed, interpreted the data and wrote the manuscript. PH contributed with additional data necessary to complete the analysis and in writing the manuscript. All authors read and approved the final manuscript.

  • Funding DG-C received a part-fellowship from the NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease to conduct this study.

  • Competing interests None declared.

  • Ethics approval The protocol of this study and the data collection process were approved by the University of Adelaide Human Research Ethics Committee (project H-097-2010).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The datasets used and/or analysed for this study are available from the corresponding author on reasonable request.

  • Patient consent for publication Obtained.

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