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. 2020 Sep;159(3):873-883.e1.
doi: 10.1053/j.gastro.2020.05.011. Epub 2020 May 7.

Dietary Inflammatory Potential and Risk of Crohn's Disease and Ulcerative Colitis

Chun-Han Lo  1 , Paul Lochhead  2 , Hamed Khalili  2 , Mingyang Song  3 , Fred K Tabung  4 , Kristin E Burke  2 , James M Richter  5 , Edward L Giovannucci  6 , Andrew T Chan  7 , Ashwin N Ananthakrishnan  8
Affiliations

Dietary Inflammatory Potential and Risk of Crohn's Disease and Ulcerative Colitis

Chun-Han Lo et al. Gastroenterology. 2020 Sep.

Abstract

Background & aims: Inflammation is a potential mechanism through which diet modulates the onset of inflammatory bowel disease. We analyzed data from 3 large prospective cohorts to determine the effects of dietary inflammatory potential on the risk of developing Crohn's disease (CD) and ulcerative colitis (UC).

Methods: We collected data from 166,903 women and 41,931 men in the Nurses' Health Study (1984-2014), Nurses' Health Study II (1991-2015), and Health Professionals Follow-up Study (1986-2012). Empirical dietary inflammatory pattern (EDIP) scores were calculated based on the weighted sums of 18 food groups obtained via food frequency questionnaires. Self-reported CD and UC were confirmed by medical record review. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).

Results: We documented 328 cases of CD and 428 cases of UC over 4,949,938 person-years of follow-up. The median age at IBD diagnosis was 55 years (range 29-85 years). Compared with participants in the lowest quartile of cumulative average EDIP score, those in the highest quartile (highest dietary inflammatory potential) had a 51% higher risk of CD (HR 1.51; 95% CI 1.10-2.07; Ptrend = .01). Compared with participants with persistently low EDIP scores (at 2 time points, separated by 8 years), those with a shift from a low to high inflammatory potential of diet or persistently consumed a proinflammatory diet had greater risk of CD (HR 2.05; 95% CI 1.10-3.79 and HR 1.77; 95% CI 1.10-2.84). In contrast, dietary inflammatory potential was not associated with the risk of developing UC (Ptrend = .62).

Conclusions: In an analysis of 3 large prospective cohorts, we found dietary patterns with high inflammatory potential to be associated with increased risk of CD but not UC.

Keywords: Food; Inflammatory Bowel Disease; Lifestyle Factor; Nutrition.

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Conflict of interest statement

Disclosures: J.M.R. is a consultant to Policy Analysis Inc. and Takeda Pharmaceuticals. A.T.C. serves as a consultant for Janssen Pharmaceuticals, Pfizer Inc., and Bayer Pharma AG, and Boehringer Ingelheim for work unrelated to the topic of this manuscript. A.N.A. has served as a Scientific Advisory Board member for Abbvie, Gilead, Kyn therapeutics and received research grants from Pfizer and Merck. No other conflict of interest exists.

Figures

Figure 1.
Figure 1.. Multivariable associations of cumulative average empirical dietary inflammatory pattern score and risk of Crohn’s disease according to disease location.
Disease location was categorized according the Montréal classification. P for trend was calculated using cumulative average EDIP score as a continuous variable.
Figure 2.
Figure 2.. Multivariable associations of 8-year change in EDIP score with risk of Crohn’s disease and ulcerative colitis.
Participants’ 8-year change in EDIP score was calculated by subtracting the baseline EDIP score from the updated EDIP score 8 years after baseline.
See this image and copyright information in PMC

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