Higher Fiber Intake is Associated with Reduced Risk of Related Surgery among Individuals with Inflammatory Bowel Disease in a Prospective Cohort Study

Jun 17, 2023The Journal of nutrition

Higher Fiber Intake Linked to Lower Risk of Surgery in People with Inflammatory Bowel Disease

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Abstract

Higher dietary fiber intake is associated with a 29% reduced risk of IBD-related surgery in individuals with inflammatory bowel disease.

A total of 5580 individuals with inflammatory bowel disease were monitored over a mean follow-up period of 11.2 years.
Individuals in the second to fourth quartiles of dietary fiber intake showed a 23% to 29% reduced risk of undergoing IBD-related surgery compared to those in the lowest quartile.
Similar associations were observed specifically for individuals with Crohn's disease, while no significant association was found for those with ulcerative colitis.
Increased fiber intake from vegetables and fruits was inversely associated with the risk of IBD-related surgery, while fiber from bread showed a positive association.

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BACKGROUND: Evidence for the effects of dietary fiber on adverse outcomes in individuals with inflammatory bowel disease (IBD) is insufficient and controversial.

OBJECTIVES: We aimed to prospectively explore the association between dietary fiber intake and the risk of IBD-related surgery.

METHODS: We identified 5580 individuals with diagnosed IBD [Crohn disease (CD, n = 1908) and ulcerative colitis (UC, n = 3672)] at baseline in the UK Biobank via electronic medical records and self-reported information. Dietary fiber intake was estimated by a partial fiber score derived from a valid food frequency questionnaire. IBD-related surgery (enterotomy, perianal surgery, and others) was ascertained via inpatient data. Cox proportional model was applied to estimate hazard ratios with 95% confidence intervals (CIs) of dietary fiber in quartiles for the risk of IBD-related surgery.

RESULTS: During a mean follow-up period of 11.2 y, we documented 624 IBD-related surgery among 5580 individuals with IBD (mean age, 57.3; 52.8% females). Compared with individuals in the lowest quartiles, those with second to fourth quartiles of fiber intake were associated with 23% (95% CI: 5%, 38%, P = 0.015), 29% (95% CI: 11%, 43%, P = 0.003), and 28% (95% CI: 10%, 43%, P = 0.005) reduced risk (P-trend = 0.002) of IBD-related surgery. Similar associations were observed in CD (P-trend = 0.005) but not UC (P-trend = 0.131). We observed inverse associations of fiber in vegetables and fruits (P-trend = 0.017 and 0.007) but positive associations of fiber in bread (P-trend = 0.046) with the risk of IBD-related surgery.

CONCLUSIONS: Higher intake of fiber is associated with reduced IBD-related surgery risk in patients with IBD with CD but not UC.

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Higher Fiber Intake is Associated with Reduced Risk of Related Surgery among Individuals with Inflammatory Bowel Disease in a Prospective Cohort Study

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