Ultra-Processed Food Intake in Children with Inflammatory Bowel Disease: A Pilot Case-Control Study

Background: The consumption of ultra-processed foods (UPFs) has increased globally, particularly in developed countries. UPFs are energy-dense and nutrient-poor, and they often contain additives that can disrupt gut flora and increase intestinal permeability. There is evidence to suggest that processed foods may contribute to the onset of IBD and also impact its progression and response to treatment. This study investigated whether children with IBD consume more UPFs than healthy controls and examined the association between UPF intake and disease activity. Methods: This pilot cross-sectional case-control study recruited children with IBD from the Gastroenterology Outpatient Clinic at the Heim Pál National Pediatric Institute in Budapest, Hungary, between December 2023 and February 2025. Age- and sex-matched healthy controls (HCs) were also enrolled. Dietary intake was assessed using two days of 24 h recalls. UPF intake was categorized using the NOVA system and expressed as a percentage of total daily energy intake. Results: A total of 47 children with IBD were matched with HCs. There was no difference in total energy intake between the two groups. Children with UC had a significantly higher intake of UPFs than HCs (MD: 10.5%, p = 0.02), whereas no difference was observed in children with CD after excluding oral nutritional support. No difference in UPF intake was observed between children with active or inactive disease. However, children receiving biological therapy consumed significantly fewer UPFs than those receiving other treatments (MD: 8%, p = 0.04). Conclusions: Children with IBD consume more UPFs compared to HC. The UPF intake of children with CD was not lower than healthy children despite the recommended Crohn's Disease Exclusion Diet (CDED).