Diet and anthropometrics of children with inflammatory bowel disease: A comparison with the general population
Open accessAbstract
Background: There is a lack of knowledge regarding the diet of children with inflammatory bowel disease (IBD). Therefore, we investigated dietary intake in pediatric IBD compared to the general population and assessed anthropometrics and food avoidance. Methods: In this cross-sectional cohort study, patients younger than 18 years with IBD were included (2014-2017). Dietary intake (total energy, macro nutrients, food types) was assessed using a Food Frequency Questionnaire (FFQ) and compared with a matched reference population (n = 306). Results: There were 102 patients included (55% male, median age 15.0 years). Median height Z-score was -0.39 (interquartile range [IQR]: -1.17 to 0.26). Growth failure (height Z-scores<-1.64) was present in 11% of patients. Median BMI Z-score was 0.36 (IQR: -0.70 to 0.96). Acute malnutrition (weight-for-height Z-score<-2) was present in 3% of patients. Energy intake was lower in pediatric IBD compared to the reference population (mean kilojoule/day: 8286 vs 9794, P < 0.001). Protein intake did not differ, while fat intake was higher in pediatric IBD (mean gram/day: 101 vs 91, P < 0.001), with higher intake of vegetable oils/fats. Carbohydrate intake was lower in pediatric IBD (mean gram/day: 267 vs 305, P < 0.001), with lower intake of food types high in sugar. Food avoidance was reported in 53% of patients, with frequent avoidance of spicy (46%), high-fat food (30%), and dairy (30%). Conclusions: The diet of children with IBD differs from the general pediatric population, with lower energy intake and high rates of food avoidance. Evaluation of the dietary intake alongside anthropometrics may be important to prevent nutrition deficiencies and promote health.
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Identification of specific foods that influence symptoms or trigger flare-ups can lead to food avoidance or exclusion diets in children and adolescents with IBD.
“This can lead to food avoidance or exclusion diets in children and adolescents with IBD, which may or may not be necessary and can negatively impact nutritional status [27].”
From Online Acceptance and Commitment Therapy and Nutrition Workshop for Parents of Children with Inflammatory Bowel Disease: Feasibility, Acceptability, and Initial Effectiveness. (2021) · cites this paper as [27]
The Food avoidance section reports that 53% of children with IBD avoided foods because of worsening abdominal symptoms, and the Discussion says patients may adopt diets excluding those foods (page numbers unavailable). The paper warns about inadequate intake and nutritional deficiencies, but does not establish that the avoided foods trigger flare-ups or that avoidance itself worsened nutritional status; it also does not assess whether particular exclusions were necessary. (LLM, conf=0.84)
Experimental — accuracy not yet measuredFood avoidance or exclusion diets in children and adolescents with IBD may or may not be necessary and can negatively impact nutritional status.
“This can lead to food avoidance or exclusion diets in children and adolescents with IBD, which may or may not be necessary and can negatively impact nutritional status [27].”
From Online Acceptance and Commitment Therapy and Nutrition Workshop for Parents of Children with Inflammatory Bowel Disease: Feasibility, Acceptability, and Initial Effectiveness. (2021) · cites this paper as [27]
The Food avoidance section reports that 53% of the children avoided foods because of abdominal symptoms. The Discussion describes exclusion diets, lower energy intake, and a possible effect of insufficient intake on growth; it also recommends balanced-diet counseling to prevent nutritional deficiencies. It does not assess whether the exclusions were necessary or establish that food avoidance itself worsened nutritional status. (LLM, conf=0.84)
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BackgroundSila, S., Trivić, I., Pavić, A. M., Niseteo, T., Kolaček, S., & Hojsak, I. (2019) · European Journal of Pediatrics · doi:10.1007/s00431-019-03443-3 · Cited by 13 · see citing works
Godin, J., Martin, F., Breton, I., Schoepfer, A. M., & Nydegger, A. (2020) · Clinical Nutrition · doi:10.1016/j.clnu.2020.02.003 · Cited by 11 · see citing works
Brown, S., Wall, C. L., Frampton, C., Gearry, R. B., & Day, A. S. (2022) · Nutrients · doi:10.3390/nu14163425 · Cited by 8 · see citing works
Dietary habits in Italian children with inflammatory bowel disease: A case‐control multicenter study
Gatti, S., Vallorani, M., Quattrini, S., Aloi, M., Bramuzzo, M., Felici, E., Zuin, G., Catassi, G. N., Grazian, F., Ciacchini, B., et al. (2024) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1002/jpn3.12344 · Cited by 7 · see citing works
Ivković, L., Hojsak, I., Trivić, I., Sila, S., Hrabač, P., Konjik, V., Senečić-Čala, I., Palčevski, G., Despot, R., Žaja, O., et al. (2020) · Pediatric Research · doi:10.1038/s41390-020-0853-2 · Cited by 7 · see citing works
Matran, E. R., Diaconu, A.-M., Vlad, A. M., Păcurar, D., & Becheanu, C. A. (2024) · Nutrients · doi:10.3390/nu17010051 · Cited by 5 · see citing works
Rogler, G., Scharl, M. M., Spalinger, M. R., Yılmaz, B., Zaugg, M., Hersberger, M., Schreiner, P., Biedermann, L., & Herfarth, H. H. (2021) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.202000514 · Cited by 5 · see citing works
Koopman, N., Jaspers, Y. R. J., van Leeuwen, P. T., Chronas, K., Yim, A. Y. F. L., Diederen, K., Velde, A. A. T., Roseboom, W., Kindermann, A., Benninga, M. A., et al. (2025) · Communications Medicine · doi:10.1038/s43856-025-00984-7 · Cited by 4 · see citing works
“Apartialdescriptionwaspublishedinthe study of Diederen et al. 19 .”
Vernon‐Roberts, A., Musto, F., Aloi, M., & Day, A. S. (2023) · Gastrointestinal Disorders · doi:10.3390/gidisord5020016 · Cited by 3 · see citing works
“Previous surveys have shown that up to 53% of children with IBD practice food avoidance due to symptom exacerbation [27], while, in an Italian cohort, 48% of children with IBD agreed that food may exacerbate symptoms but only 36% had modified their diet to exclude foods [28].”
BackgroundKarlsson, N. V., Boneh, R. S., Mårild, K., & Segerstad, E. M. H. A. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1590847 · Cited by 2 · see citing works
Nutritional intake and body composition in children with inflammatory bowel disease
Pintér, H. K., Boros, K. K., Pálfi, E., & Veres, G. (2020) · Developments in Health Sciences · doi:10.1556/2066.2019.00004 · Cited by 1 · see citing works
“While most studies are focused on the role of diet in the aetiology of the disease rather than the current nutrition of the patients, recent research has shown that paediatric IBD patients have a higher fat intake than healthy subjects [8].”
BackgroundMaćków, M., Kozioł-Kozakowska, A., Szeląg, M., Pytrus, T., Raczkowska, E., Neubauer, K., Zawiślak, I., Gajda, R., Habánová, M., & Stawarski, A. (2024) · Nutrients · doi:10.3390/nu16162762 · Cited by 1 · see citing works
“There is a risk of malnutrition among children with IBD [13], and it may occur as often as in adults with IBD due to disease activity, low albumin levels [14] or an improperly balanced diet [15].”
BackgroundBreton, J., Quinn, R., Conrad, M. A., Kachelries, K., Schwab, E., Baldassano, R., Albenberg, L., & Compher, C. (2026) · British Journal Of Nutrition · doi:10.1017/s0007114526107004 · Cited by 1 · see citing works
“Notably, some of these studies (14,15) estimated dietary intake using FFQ, while we obtained three 24-hour recalls prompted by a research bionutritionist, a method recognised to be more accurate and less prone to recall bias (38) .”
Impact of Diet, Psychological Factors, and Psychological Care on Pediatric IBD Outcomes
Brown, S., & Day, A. S. (2024) · Springer eBooks · doi:10.1007/978-3-031-32046-0_123-1 · Cited by 1 · see citing works
The Role of the Vitamins in the Inflammatory Bowel Diseases
Barbalho, S. M., Guiguer, É. L., Rubira, C. J., Araújo, A. C., & Goulart, R. D. Á. (2019) · Elsevier eBooks · doi:10.1016/b978-0-08-100596-5.22889-8
Parental knowledge of chronic inflammatory bowel diseases in a child
Cilar, L., Polak, Š., & Kegl, B. (2021) · Sestrinski glasnik · doi:10.11608/sgnj.26.1.5
Silva, A. P. F. D., Mello, L. D. A., da Fonseca, E. M. S., de Lima, L. E., Maranhão, L. J. A., Alves, N. M. L. C., Nascimento, E. F. R., & Júnior, M. R. D. M. (2021) · Brazilian Journal of Health Review · doi:10.34119/bjhrv4n4-230
Impact of Diet, Psychological Factors, and Psychological Care on Pediatric IBD Outcomes
Brown, S., & Day, A. S. (2025) · Springer eBooks · doi:10.1007/978-3-031-73363-5_123
Nutritional Monitoring and Intervention in Paediatric Inflammatory Bowel Disease
Arpe, L., Jackman, L., Jones, K. D. J., Wells, E., Kiparissi, F., Gaynor, E., & Borrelli, O. (2026) · Nutrients · doi:10.3390/nu18172786
“Children with PIBD have been reported to have a lower calorie intake compared to healthy controls, particularly during active disease [5].”
Influential
- Authors
- Diederen, K., Krom, H., Koole, J. C. D., Benninga, M. A., & Kindermann, A.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Corresponding author
- Diederen, Kay
- Venue
- Inflammatory Bowel Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-04-25
- Volume
- 24
- Issue
- 8
- Pages
- 1632-1640
- ISSN
- 1078-0998 (ISSN-L)
- 1536-4844
- OpenAlex
- W2801018157
- Cited by
- 31
- References
- 66
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 1 · 2022: 3 · 2021: 5 · 2020: 7 · 2019: 6
- FWCI
- 2.75
- Type
- journal article
- Language
- en
- Open access
- green
- pure.amsterdamumc.nl
- Licence
- Locations
- Inflammatory Bowel Diseases (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Keywords
- inflammatory bowel disease, pediatric inflammatory bowel disease
- MeSH terms
- Adolescent, Body Height, Body Weight, Energy Intake, Cross-Sectional Studies, Diet, Diet Surveys, Feeding Behavior, Female, Humans, Male, Netherlands, Inflammatory Bowel Diseases, Cohort Studies, Nutrition Assessment, Linear Models, Dietary Supplements, Malnutrition
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