# Internet Dietary Guidance for Pediatric Inflammatory Bowel Disease: A Quality and Readability Crisis

## TL;DR

This study finds that online dietary advice for children with inflammatory bowel disease is of low quality and hard to understand.

## Contribution

The study evaluates the quality and readability of dietary guidance for pediatric IBD found on the internet.

## Key findings

- Websites had moderate reliability but poor information quality and overall quality scores.
- The average readability level was around 11th grade, exceeding recommended standards for patient education.
- Dietary recommendations across websites were inconsistent and highly variable.

## Abstract

Background: Diet and nutritional therapy are treatment options for children with inflammatory bowel disease (IBD). Parents of children with medical conditions often turn to the internet for medical guidance. However, the quality and readability of internet dietary information for pediatric IBD are currently unknown. The objective of this study was to evaluate the quality and readability of websites about diet for pediatric IBD.

Methods: Top internet websites for the searches “IBD, diet, children,” “Crohn’s disease, diet, children,” and “ulcerative colitis, diet, children” were rated using the DISCERN instrument, a validated tool for rating consumer health information, on a scale of 1-5 to assess reliability, information quality, and overall quality (5 = highest reliability or quality). The Flesch-Kincaid grade level (FKGL) was used to determine website readability.

Results: The mean reliability scores were 3.1 for searches on “IBD, diet, children,” 3.0 for “Crohn’s disease, diet, children,” and 3.1 for “ulcerative colitis, diet, children.” The corresponding mean information quality scores were 2.5, 2.5, and 2.4, and the mean overall quality scores were 2.8, 2.7, and 2.9. The mean reading grade levels required to understand the content per FKGL were 11.9, 10.8, and 11.1. Across the websites, 23 highly variable dietary recommendations were made.

Conclusions: For internet search results about diet and pediatric IBD, mean scores indicated moderate website reliability but poor information quality and overall quality. Websites were written at approximately an 11th-grade reading level, above the recommended standard for patient education. Dietary recommendations were numerous and inconsistent.