Western and Carnivorous Dietary Patterns are Associated with Greater Likelihood of IBD Development in a Large Prospective Population-based Cohort

Abstract

Objective Nutrition plays a role in the development of Crohn’s disease (CD) and ulcerative colitis (UC). However, prospective data on nutrition and disease-onset is limited. Here, we analysed dietary patterns and scores to IBD-development in a prospective population-based cohort. Design We analysed 125,445 participants of whom 224 individuals developed de novo UC and 97 CD over a maximum 14-year follow-up period. Participants answered health-related (also prospectively) and dietary questionnaires (FFQ) at baseline. Principal Component Analysis (PCA) was conducted deriving a-posteriori dietary patterns. Hypotheses-based a-priori dietary scores were also calculated, including the protein score, Healthy Eating Index, LifeLines Diet Score (LLDS) and alternate Mediterranean Diet Score. Logistic regression models were performed between dietary patterns, scores, and IBD-development. Results PCA identified five dietary patterns. A pattern characterized by high intake of snacks, prepared meals, non-alcoholic beverages, sauces along with low vegetables and fruit consumption was associated with higher likelihood of CD-development (OR: 1.16, 95% CI: 1.03-1.30, p=0.013). A pattern comprising red meat, poultry, and processed meat, was associated with increased likelihood of UC-development (OR: 1.11, 95% CI: 1.01-1.20, p=0.023). A high diet quality score (LLDS) was associated with decreased risk of CD (OR: 0.95, 95% CI: 0.92-0.99, p=0.009). Conclusions A Western dietary pattern was associated with a greater likelihood of CD-development and a carnivorous pattern with UC-development, while a relatively high diet quality (LLDS) was protective for CD-development. Our study strengthens the importance of evaluating dietary patterns to aid prevention of IBD in the general population.

Where Do We Stand in the Behavioral Pathogenesis of Inflammatory Bowel Disease? The Western Dietary Pattern and Microbiota—A Narrative Review

“…In the study of Khalili et al, a greater adherence to MD was associated with a significantly lower risk of later-onset CD (age, gender, education level, body mass index and smoking did not modify these associations), but not UC [12]. On the other hand, WD was associated with a greater likelihood of CD development and a carnivorous pattern with UC development [223]. Additionally, adherence to MD was associated with an improvement in quality of life among individuals suffering from CD (IBDQ score) [224].…”

Long-Term Dietary Patterns Are Reflected in the Plasma Inflammatory Proteome of Patients with Inflammatory Bowel Disease

“…The fourth dietary pattern was characterised by a high intake of coffee and alcohol, in contrast to a low intake of tea and moderate consumption of spreads and dairy [6]. This pattern was strongly associated with higher levels of plasma CCL11, but with lower levels of plasma IL12B.…”

“…Previous studies observed that dietary patterns are strongly associated with a greater likelihood of IBD development [6], pro-inflammatory gut microbial signatures [7], intestinal inflammation and disease exacerbations in established IBD [8][9][10][11]. A myriad of studies linked specific dietary components to inflammatory markers such as CRP or FCal or used various in vitro and in vivo approaches to uncover pro-inflammatory or anti-inflammatory effects [12,13].…”

“…A myriad of studies linked specific dietary components to inflammatory markers such as CRP or FCal or used various in vitro and in vivo approaches to uncover pro-inflammatory or anti-inflammatory effects [12,13]. While the pro-inflammatory and anti-inflammatory role of specific nutrients is well described, studies on the overall dietary composition are important to generate food-based dietary recommendations [6,14].…”

Dietary Beliefs in Children and Adolescents with Inflammatory Bowel Disease and their Parents

“…• More than one-third of young patients with IBD and their parents believe that diet has a significant role in the course of IBD. To date, even if no single food substance has been identified as causative of IBD onset or relapse, a high intake of snacks, prepared meals, carbonated beverages, and sauces with low vegetables and fruit has been associated with a greater likelihood of CD development and a carnivorous pattern with UC development (4).…”