Ultra-processed Foods and Risk of Crohn’s Disease and Ulcerative Colitis: A Prospective Cohort Study

Aug 30, 2021Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

Eating Ultra-Processed Foods and the Risk of Crohn's Disease and Ulcerative Colitis Over Time

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Abstract

In a study of 245,112 participants, higher consumption of ultra-processed foods is associated with a 70% increased risk of Crohn's disease.

Over 5,468,444 person-years of follow-up, 369 cases of Crohn's disease and 488 cases of ulcerative colitis were documented.
Participants in the highest quartile of ultra-processed food consumption had a hazard ratio of 1.70 for developing Crohn's disease compared to those in the lowest quartile.
Specific types of ultra-processed foods, such as breads, ready-to-eat meals, and sauces, showed the strongest positive associations with Crohn's disease risk.
No consistent association was found between ultra-processed food intake and the risk of ulcerative colitis.
Further studies are needed to determine the specific dietary components that may contribute to the increased risk of Crohn's disease.

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BACKGROUND & AIMS: The rising incidence of inflammatory bowel disease in regions undergoing Westernization has coincided with the increase in ultra-processed food (UPF) consumption over the past few decades. We aimed to examine the association between consumption of UPFs and the risk of Crohn's disease (CD) and ulcerative colitis (UC).

METHODS: We performed a prospective cohort study of 3 nationwide cohorts of health professionals in the United States-the Nurses' Health Study (1986-2014), the Nurses' Health Study II (1991-2017), and the Health Professionals Follow-up Study (1986-2012). We employed Cox proportional hazards models with adjustment for confounders to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for CD and UC according to self-reported consumption of UPFs.

RESULTS: The study included 245,112 participants. Over 5,468,444 person-years of follow-up, we documented 369 incident cases of CD and 488 incident cases of UC. The median age at diagnosis was 56 years (range, 29-85 years). Compared with participants in the lowest quartile of simple updated UPF consumption, those in the highest quartile had a significantly increased risk of CD (HR, 1.70; 95% CI, 1.23-2.35; P = .0008). Among different UPF subgroups, ultra-processed breads and breakfast foods; frozen or shelf-stable ready-to-eat/heat meals; and sauces, cheeses, spreads, and gravies showed the strongest positive associations with CD risk (HR per 1 standard deviation increase in intake, 1.18 [95% CI, 1.07-1.29], 1.11 [95% CI, 1.01-1.22], and 1.14 [95% CI, 1.02-1.27], respectively). There was no consistent association between UPF intake and UC risk. trend

CONCLUSIONS: Higher UPF intake was associated with an increased risk of incident CD. Further studies are needed to identify specific contributory dietary components.

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Ultra-processed Foods and Risk of Crohn’s Disease and Ulcerative Colitis: A Prospective Cohort Study

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