Abstract
Diet may influence the development of inflammatory bowel disease through the modulation of inflammation. We investigated whether the inflammatory potential of the diet is associated with the risk of Crohn’s disease (CD) and ulcerative colitis (UC) in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain). The study included 32,633 participants aged 29–69 years. The inflammatory potential of the diet was measured by using an inflammatory score of the diet (ISD) based on a baseline dietary history questionnaire. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During 21 years (674,547 person-years) of follow-up, 32 and 57 participants developed CD and UC, respectively. In multivariable analysis, a one-standard deviation (SD) increment in the ISD (two-unit increase) was associated with a higher risk of CD (HR of 1.71; 95% CI: 1.05–2.80; p = 0.031). By contrast, ISD was not associated with UC (HR for one-SD increment of 0.89; 95% CI: 0.66–1.19; p = 0.436). Our results suggest that consuming a more pro-inflammatory diet may contribute to the risk of CD, supporting that a healthy diet might be beneficial in its prevention. Further, larger studies are needed to verify these findings.
Highlights
Inflammatory bowel disease (IBD) denotes a group of idiopathic immune-mediated disorders, characterized by chronic relapsing-remitting inflammation of the digestive tract.The two main types of IBD are ulcerative colitis (UC), which is a non-transmural disease limited to the colonic mucosa, and Crohn’s disease (CD), which is transmural and can cause inflammation throughout the entire gastrointestinal tract [1]
In multivariable Cox regression analysis, after adjustment by age, sex and energy intake and stratified by centre, one-standard deviation (SD) increment in the inflammatory score of the diet (ISD) was associated with a higher risk of CD with hazard ratio (HR) of 1.71
No interactions were found with sex or age group. In this prospective cohort study in Spanish adults, we found that higher ISD values were associated with an increased risk of CD, independently of age, sex, energy intake, and centre when ISD was examined as a continuous measure
Summary
Inflammatory bowel disease (IBD) denotes a group of idiopathic immune-mediated disorders, characterized by chronic relapsing-remitting inflammation of the digestive tract.The two main types of IBD are ulcerative colitis (UC), which is a non-transmural disease limited to the colonic mucosa, and Crohn’s disease (CD), which is transmural and can cause inflammation throughout the entire gastrointestinal tract [1]. Inflammatory bowel disease (IBD) denotes a group of idiopathic immune-mediated disorders, characterized by chronic relapsing-remitting inflammation of the digestive tract. In Europe, the incidence of UC ranges between 0.9 and 24.3 per 100,000 person-years, and the estimates for CD range from 0.5 to 10.6 cases per 100,000 person-years [2]. These lifelong diseases often impose a meaningful impact on the quality of life for the affected individuals, leading to substantive costs to the health care systems and society [3]. IBD has been regarded as a disease of industrialized societies. The worldwide spread of the disease is believed to be associated with the Westernization of diets and other environmental factors, which raise the risk of IBD in persons with genetic susceptibility [4,5]
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