Association between dietary iron and zinc intake and development of ulcerative colitis: A case–control study in Japan

Abstract

Background and Aim The prevalence of ulcerative colitis (UC) has been increasing in Japan. Trace elements, such as iron, zinc, magnesium, and copper, can cause digestive symptoms where there is a deficiency or excess. We focused on the dietary intake of trace elements and their associations with UC development. Methods A multicenter, hospital‐based case–control study was conducted in Japan. Cases were 127 newly diagnosed UC patients, and 171 age‐matched and sex‐matched hospital controls were recruited. We considered that UC patients had potentially changed their dietary habits due to disease symptoms. The dietary habits were investigated using a self‐administered diet history questionnaire to analyze the dietary intakes and frequencies at two points, the previous 1 month and 1 year before. Results In the assessment of dietary habits 1 year before, the highest intake of iron showed an increased odds ratio (OR) for UC on multivariate analysis (OR = 4.05, 95% confidence interval, 1.46–11.2, P < 0.01). The highest intake of zinc 1 year before showed a decreased OR for UC (OR = 0.39, 95% confidence interval, 0.18–0.85, P = 0.01). Intakes of magnesium and copper had no significant association with UC. Because most UC cases had experienced the first symptom of UC within the previous 11 months, these intakes at 1 year before represented an association with pre‐illness dietary habits. Conclusion A high intake of iron has some effect on the development of UC. In contrast, a high intake of zinc has a protective effect on the development of UC.

Ferroptosis: A Double-Edged Sword in Gastrointestinal Disease

“…First, iron enhances lipid peroxidation (converting PLOOH to the free radicals PLO• and PLOO•) through activation of LOX enzymes [32]. Increasing iron levels in the diet could directly increase cellular iron concentrations and the possibility of having UC [112,113]. Iron overload aggravated intestinal inflammation induced by DSS in rat model [114] In contrast, iron chelators could efficiently inhibit ROS generation and alleviate symptoms in IBD [115,116].…”

Japan’s Practical Guidelines for Zinc Deficiency with a Particular Focus on Taste Disorders, Inflammatory Bowel Disease, and Liver Cirrhosis

“…Zinc deficiency is a very common symptomatic condition. According to a multicenter hospital-based case-control study conducted in Japan, higher doses of zinc taken by patients one year before the study period were associated with a decreased odds ratio for ulcerative colitis (UC), indicating that high zinc intake can protect against UC [43]. In a prospectively collected inflammatory bowel disease (IBD) registry study, zinc deficiency was associated with an increased risk of subsequent hospitalization, surgery, and disease-related complications in patients with IBD, Crohn's disease (CD), and UC [8].…”

Ferroptosis involves in intestinal epithelial cell death in ulcerative colitis

“…Interestingly, in previous studies by different groups, the administration of iron chelator was found to significantly reduce ROS in colonic tissues of UC patients and to ameliorate clinical symptoms and improve endoscopic presentations 9,10 . In contrast, high dietary iron supplements exacerbated UC symptoms in both patients and murine models 11,12 . These findings indicated the important effects of iron and ROS on the pathogenesis of UC.…”