Intake of ultra-processed foods is associated with an increased risk of Crohn's disease: a cross-sectional and prospective analysis of 187,154 participants in the UK Biobank.

Abstract

Ultra-processed food (UPF) consumption has been linked to globally increasing incidence and prevalence in chronic diseases including inflammatory bowel diseases (IBD). We aimed to investigate the association between UPF consumption and IBD incidence, prevalence, and IBD-relevant outcomes. We performed a cross-sectional and prospective cohort study in 187,854 individuals included in the national UK Biobank using 24-hour dietary recall questionnaires. Multivariable logistic regression and Cox proportional hazard regression were used to examine the association between UPFs and the prevalent, and incidence risk of IBD, respectively. 185,849 participants with a mean age of 56.2 were included with a mean follow-up of 9.84 years. During follow-up, 841 developed IBD (251 Crohn's disease (CD), and 590 ulcerative colitis (UC)). UPF intake in IBD patients was significantly higher (CD: OR 1.94 (95%CI: 1.52 - 2.49, p<0.001); UC: OR 1.39 (95%CI: 1.17 - 1.65, p<0.001)). Compared to low consumption, higher UPF consumption was significantly associated with incident CD (HR 2.00 (95%CI: 1.32 - 3.03, p=0.001), but not UC. We also found a significant association between UPF intake and need of IBD-related surgery (HR 4.06 (95%CI: 1.52 - 10.86, p= 0.005)). Higher intake of UPFs was associated with higher incidence of CD, but not UC. In individuals with a pre-existing diagnosis of IBD, consumption of UPFs was significantly higher compared to controls, and was associated with an increased need for IBD-related surgery. Further studies are needed to address the impact of UPF intake on disease pathogenesis, and outcomes.