Association between ultra-processed food intake and risk of inflammatory bowel disease: a prospective cohort study

BMJ 2021 ; 374 doi: https : //doi.org/10.1136/bmj.n1554

Commentary

This is a prospective cohort study evaluating the risk relationship between intake of ultra-processed foods and inflammatory bowel disease (IBD).

It covered seven geographic regions (Europe and North America, South America, Africa, Middle East, South Asia, Southeast Asia, and China) and 21 low-, middle-, and high-income countries, and included 116 087 adults aged 35-70 years. These participants receive prospective follow-up every three years.

Main Outcome MeasuresThe primary outcome was the development of IBD, including Crohn's disease and ulcerative colitis. The association between ultra-processed food intake and risk of IBD was assessed using Cox proportional hazards multivariable models.

As a result, participants were enrolled in the study between 2003 and 2016, with a median follow-up of 9. During the 7-year period, 467 participants developed incident IBD. (90 with Crohn's disease and 377 with ulcerative colitis)

After adjusting for potential confounders, the higher the intake of ultra-processed foods, the higher the risk of developing IBD. (5 servings/day or more)

 (4 servings/day compared to 1 serving/day, P for trend = .006)

Various subgroups of ultra-processed foods, including soft drinks, refined sweetened foods, salty snacks, and processed meats, each had higher hazard ratios for IBD, consistent with Crohn's disease and less heterogeneous ulcerative colitis.

These results indicate that increased intake of ultra-processed foods was positively correlated with the risk of IBD, but more research is needed to determine what the factors within ultra-processed foods are.