Researchers in Australia studied 64 children with inflammatory bowel disease (IBD)—a condition that causes stomach and intestinal problems—to understand how they change their eating habits. More than half of the kids changed what they ate after being diagnosed, and over one-third regularly skipped meals. The study found that kids who avoided certain foods and those with active disease symptoms were more likely to skip meals. Interestingly, girls were more likely to avoid foods than boys. While doctors and nutrition experts were trusted for advice, some kids were making food choices based on what friends or family suggested instead. The researchers say kids with IBD need better guidance from medical professionals about what’s safe to eat.

The Quick Take

  • What they studied: How children with inflammatory bowel disease (IBD) change their eating habits, what foods they avoid, and whether they skip meals
  • Who participated: 64 Australian children (34 boys and 30 girls) with an average age of 13.4 years who have IBD. About half had Crohn’s disease and half had ulcerative colitis—both types of IBD that affect the digestive system
  • Key finding: More than half the children changed their diet after diagnosis, and over one-third regularly skipped meals. Kids who avoided foods and those with active disease symptoms were 13-12 times more likely to skip meals. Girls were about 3 times more likely to avoid foods than boys
  • What it means for you: If you’re a parent of a child with IBD, your child may naturally want to avoid certain foods or skip meals. This is common, but it’s important to talk with a doctor or dietitian about safe eating choices rather than letting your child decide alone. Getting professional guidance may help prevent nutritional problems and better manage symptoms

The Research Details

Researchers used a cross-sectional study design, which means they looked at a group of children at one point in time rather than following them over months or years. The 64 children with IBD who visited Perth Children’s Hospital completed a detailed questionnaire about their eating habits, food choices, and where they got advice about what to eat. On the same day, doctors measured how active each child’s disease was using standard scoring systems. The researchers then analyzed the answers using statistics to find patterns and connections between different factors.

This type of study is useful for understanding what’s happening right now in a group of people and finding patterns. By collecting information directly from children and their medical records on the same day, researchers could see real connections between disease activity, eating habits, and meal skipping. This helps doctors understand what problems kids with IBD commonly face with food

The study used a validated questionnaire, meaning the questions were tested and proven to be reliable. The researchers measured disease activity using standard medical scoring systems that doctors use regularly. However, because this is a snapshot study of just 64 children in one hospital in Australia, the results may not apply to all children with IBD everywhere. The study would be stronger if it included more children from different hospitals and countries

What the Results Show

Just over half of the 64 children (52%) reported changing their diet after being diagnosed with IBD, with food avoidance being the most common change. More than one-third (38%) regularly skipped meals. When researchers looked at what predicted meal skipping, they found two main factors: children who avoided certain foods were about 14 times more likely to skip meals, and children whose disease was actively causing symptoms were about 12 times more likely to skip meals. These two factors were the strongest predictors of meal skipping, even when accounting for other differences between children.

Girls showed different patterns than boys. Girls were about 3 times more likely to avoid foods compared to boys, and they were also about 3.5 times more likely to report that specific foods made their symptoms worse. This suggests that girls may be more sensitive to food-related symptoms or more likely to notice and report them.

When asked where they got advice about food, most children trusted their gastroenterologist (stomach doctor) and dietitian. However, about 20% of the children who were modifying their diet were doing so based on advice from people who weren’t medical experts—like friends, family, or internet sources. This is concerning because non-expert advice might not be safe or helpful for children with IBD.

The study found that dietary modification was very common in this group of Australian children with IBD. The fact that meal skipping was so strongly connected to both food avoidance and active disease suggests these behaviors are related—kids may be skipping meals because they’re avoiding foods due to symptoms. The gender differences are interesting and suggest that girls may need extra support and education about managing food and symptoms

Previous research has shown that children with IBD often change their eating habits, but this study provides new information about Australian children specifically. The finding that meal skipping is linked to active disease makes sense because when symptoms are worse, kids naturally want to avoid foods that might trigger problems. The gender differences found here haven’t been as clearly documented in previous studies, suggesting this is an area that needs more research

This study only included 64 children from one hospital in Perth, Australia, so the results may not apply to all children with IBD in other places. The study was done at one point in time, so researchers couldn’t see how eating habits changed over time. The study relied on children and parents remembering and reporting their eating habits, which might not be completely accurate. The researchers didn’t have detailed information about why children were avoiding specific foods or skipping meals, so they couldn’t fully understand the reasons behind these behaviors

The Bottom Line

If your child has IBD, work with a gastroenterologist and registered dietitian to create a safe eating plan rather than letting your child avoid foods on their own (high confidence). Don’t rely on advice from non-medical sources like social media or friends when making food decisions for your child with IBD (high confidence). Monitor whether your child is skipping meals, as this may indicate their disease is not well-controlled or they need better support with food choices (moderate confidence). Pay special attention if you have a daughter with IBD, as girls may be more likely to avoid foods and experience food-related symptoms (moderate confidence)

Parents and caregivers of children with IBD should pay close attention to these findings. Children with IBD themselves should understand that avoiding foods without professional guidance might not help and could lead to nutritional problems. Healthcare providers caring for children with IBD should use these findings to start conversations about eating habits and provide better guidance. This research is less relevant for children without IBD or adults with IBD, though some principles may apply

Changes in eating habits and meal skipping patterns may develop gradually over weeks to months after IBD diagnosis. If you work with a dietitian to create a better eating plan, you might notice improvements in your child’s nutrition and symptoms within 2-4 weeks. However, managing food and IBD is an ongoing process that requires regular check-ins with your healthcare team

Want to Apply This Research?

  • Track daily meal completion (breakfast, lunch, dinner eaten yes/no) and note any meals skipped, along with disease symptom severity that day on a 1-10 scale. This helps identify patterns between symptom flare-ups and meal skipping behavior
  • Set a daily reminder to eat three meals and use the app to log each meal completed. If your child skips a meal, note the reason (not hungry, worried about symptoms, too busy, etc.) to discuss with their doctor or dietitian at the next appointment
  • Review weekly meal-skipping patterns and symptom severity trends. Share this data with your child’s healthcare team monthly to identify whether disease control is improving and whether eating habits are becoming more consistent. Adjust the eating plan based on patterns you observe

This research describes patterns observed in one group of Australian children with IBD and should not be used to diagnose or treat any condition. Every child with IBD is different, and eating needs vary greatly. Always consult with your child’s gastroenterologist and a registered dietitian before making significant changes to your child’s diet or eating patterns. This information is educational and not a substitute for professional medical advice. If your child is skipping meals or avoiding foods, discuss this with their healthcare team to ensure they’re getting proper nutrition and that their disease is well-controlled.