ABSTRACT
Introduction
The effectiveness of low-fats diet for managing bile acid diarrhoea (BAD) is unclear, yet many individuals may restrict fat intake. This study aims to explore factors associated with reducing fat intake.
Methods
Cross-sectional survey using convenience sampling recruited adults from the United Kingdom with a self-reported diagnosis of BAD via online platforms (April to May 2021). Demographics, clinical characteristics, and low-fat diet follower status data were collected. Potential predictors of intention to reduce fat intake were assessed using a modified validated questionnaire framed on the Theory of Planned Behaviour. Multinomial logistic regression was performed.
Results
Of 434 respondents, current, past and non-followers of low-fat diets were 49%, 34% and 17%, whilst 79%, 83% and 78% reported chronic diarrhoea, respectively. Intention to reduce fat intake was associated with higher odds for six out of 20 predictor variables: current versus past-followers, for its necessity for health (odds ratio [OR] = 1.4, 95% confidence interval [CI] 1.2 to 1.7), improving diarrhoea (OR = 1.5, 95% CI 1.3 to 1.7), abdominal pain (OR = 1.4, 95% CI: 1.3 to 1.7), bloating (OR = 1.4, 95% CI 1.2 to 1.6), flatulence (OR = 1.4, 95% CI 1.4 to 1.7), controlling gut symptoms (OR = 1.3, 95% CI 1.2 to 1.5); current versus non-followers, for its necessary for health (OR = 1.3, 95% CI 1.1 to 1.5).
Conclusion
Addressing the association between fat intake and an individual’s attitude about its necessity for health and beliefs about controlling diarrhoeal symptoms may improve BAD management. For developing new therapies for symptom and body weight management, dietary behaviour components additional to fat intake warrant investigation.
Journal of Human Nutrition and Dietetics, Volume 39, Issue 1, February 2026. Read More