Dietary Beliefs, Food Avoidance and Meal Skipping in Australian Children With Inflammatory Bowel Disease

OBJECTIVES: To determine the frequency and patterns of dietary modification, sources of dietary advice and associated behaviours in Australian children with inflammatory bowel disease (IBD). METHODS: Mixed-methods cross-sectional study was conducted with IBD patients attending Perth Children's Hospital. Participants completed a validated questionnaire and clinical disease activity (PUCAI/PCDAI) was recorded on the day of consultation. Descriptive statistics, t-tests, chi-square tests, and multivariable logistic regressions were performed using Jamovi. RESULTS: Sixty-four children participated (34 males; mean age 13.4 ± 2.8 years; 28 Crohn's disease, 36 ulcerative colitis). Over half (33/64, 51.6%) reported dietary modification post diagnosis, most commonly food avoidance. One-third (24/64, 37.5%) regularly skipped meals. On multivariable logistics regression food avoidance (aOR 13.8, 95% CI 2.17-87) and disease activity (aOR 12.4, 95% CI 2.80-55.1) were independently associated with meal skipping. Females were 3.17 (95% CI 1.14-8.80) times more likely to practice food avoidance and 3.56 (95% CI 1.14-8.80) times more likely to report symptom exacerbation with specific foods on univariable analysis. Although gastroenterologists and dietitians were the most trusted sources of dietary advice, over 20% (7/33) of patients were modifying their diet based on non-expert recommendation. CONCLUSIONS: Dietary modification post diagnosis is prevalent among Australian paediatric IBD patients. Meal skipping is independently associated with active disease and self-directed food avoidance; females report higher rates of food avoidance and symptoms exacerbation with foods. These findings highlight the need for proactive, consistent dietary counselling and underscore the importance of further multicentre studies to corroborate these findings.