Food Insecurity, Diet and Health Outcomes in Pediatric Inflammatory Bowel Disease: A Pilot Study.

BACKGROUND/OBJECTIVES: Food insecurity (FI) is a well-defined factor in pediatric health outcomes and has been associated with lower diet quality. While poor diet quality has been linked to the rising prevalence of inflammatory bowel disease (IBD), little is known about the impact of FI on pediatric IBD. This pilot study explores the feasibility and potential impact of FI on dietary intake and clinical outcomes in children with newly diagnosed IBD.

METHODS

This pilot study included newly diagnosed IBD patients aged 5 to 18. FI screening was completed using the USDA 6-item and AAP 2-item screeners at diagnosis and 6 months. Dietary intake was classified according to their degree of processing (NOVA classification). Clinical data, anthropometrics, and healthcare utilization were collected over 6 months.

RESULTS

Among 20 patients, FI was identified in 40% of families. Food-insecure patients had significantly lower weight and BMI z-scores at diagnosis compared to food-secure peers ( = 0.002 and = 0.0013, respectively). Food-insecure patients consumed more ultra-processed foods (UPFs, 70.6% vs. 66.7%, = 0.473). However, most patients consumed diets high in ultra-processed foods. FI status was dynamic over the study period. Hospitalizations were more frequent among food-insecure patients.

CONCLUSIONS

FI is common in pediatric IBD and associated with poorer nutritional status. FI was associated with higher consumption of UPFs, although diet quality was poor among most patients. Future studies should validate these findings in large cohorts and evaluate longitudinal interventions.