Dietary Gluten Intake Is Not Associated With Risk of Inflammatory Bowel Disease in US Adults Without Celiac Disease

Mar 29, 2021Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

Gluten in the diet is not linked to risk of inflammatory bowel disease in US adults without celiac disease

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Abstract

Over 5 million person-years of follow-up revealed that gluten intake was not associated with risk of inflammatory bowel disease.

A total of 337 cases of Crohn's disease and 447 cases of ulcerative colitis were documented.
Participants consuming the highest levels of gluten did not show a significantly increased risk for Crohn's disease compared to those with the lowest intake.
The hazard ratio for Crohn's disease in the highest gluten intake group was 1.16, indicating no strong association.
For ulcerative colitis, the hazard ratio for the highest gluten intake group was 1.04, also suggesting no significant link.
Adjustments for primary sources of gluten intake did not change the risk estimates materially.

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BACKGROUND & AIMS: Diet is thought to play a role in the development of inflammatory bowel disease (IBD), though it is unknown whether gluten intake confers risk of IBD. The aim of this study was to determine the relationship between gluten intake and risk of incident Crohn's disease (CD) and ulcerative colitis (UC).

METHODS: We performed a prospective cohort study of 208,280 US participants from the Nurses' Health Study (1986-2016), Nurses' Health Study II (1991-2017), and the Health Professionals Follow-up Study (1986-2016) who did not have IBD at baseline or celiac disease, and who completed semiquantitative food frequency questionnaires. We used Cox proportional hazards modeling to estimate the risk of IBD according to quintiles of cumulative average energy-adjusted dietary gluten intake over the follow-up period.

RESULTS: We documented 337 CD cases and 447 UC cases over 5,115,265 person-years of follow-up evaluation. Dietary gluten intake was not associated with risk of IBD. Compared with participants in the lowest quintile of gluten intake, the adjusted hazard ratios and 95% CIs for participants in the highest quintile of gluten intake were 1.16 (95% CI, 0.82-1.64; P = .41) for CD and 1.04 (95% CI, 0.75-1.44; P = .64) for UC. Adjusting for primary sources of gluten intake did not materially change our estimates. trend trend

CONCLUSIONS: In 3 large adult US prospective cohorts, gluten intake was not associated with risk of CD or UC. Our findings are reassuring at a time when consumption of gluten has been increasingly perceived as a trigger for chronic gastrointestinal diseases.

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Dietary Gluten Intake Is Not Associated With Risk of Inflammatory Bowel Disease in US Adults Without Celiac Disease

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