S1092 Journaling About Diet and GI Symptoms Increases GI Symptom Severity, Visceral Hypervigilance, and Perceived Food Intolerance

Introduction: Food journaling is the standard of care to help individuals identify and manage dietary triggers of gastrointestinal (GI) distress. However, heightened awareness and attention to bodily sensations through symptom-focused tracking may subsequently increase anxiety, hypervigilance, and perceived food intolerance, even in healthy populations. This study examined the psychological and psychosomatic effects of food journaling on visceral hypervigilance, perceived food intolerance, and GI symptom awareness in healthy undergraduate students. Methods: Seventy-6 participants were randomly assigned to either the food journaling group or a sleep/exercise journaling control group. Participants completed daily tracking surveys for the 21 days of the study. Participations also completed pre- and post- study questionnaires measuring hypervigilance, GI symptom-specific anxiety, and food-related cognitions, as well as sleepiness, overall wellbeing, and vigor. Results: Participants in the food journaling group reported significantly greater increases in visceral hypervigilance [F(1,75) = 7.5, P = .008], GI symptom severity [F(1,75) = 4.715, P = .03] and perceived food intolerance [F(1,75) = 4.001, P = .049] compared to controls. A significant interaction was also observed between condition and baseline hypervigilance (P = .050), with food journaling having the strongest impact on increasing hypervigilance among those with initially low baseline hypervigilance. Conclusion: These findings suggest that food journaling may inadvertently heighten vigilance toward and distress about GI sensations and foster maladaptive beliefs about food in otherwise healthy individuals. While food journaling is widely recommended in GI symptom management, its use in non-clinical populations may carry unintended psychological risks. Future research should examine whether similar effects occur in patients with GI disorders like irritable bowel syndrome.