Dietary Patterns and Risk of Inflammatory Bowel Disease in Europe: Results from the EPIC Study

Background:Specific nutrients or foods have been inconsistently associated with ulcerative colitis (UC) or Crohn's disease (CD) risks. Thus, we investigated associations between diet as a whole, as dietary patterns, and UC and CD risks. Methods:Within the prospective EPIC (European Prospective Investigation into Cancer) study, we set up a nested matched case–control study among 366,351 participants with inflammatory bowel disease data, including 256 incident cases of UC and 117 of CD, and 4 matched controls per case. Dietary intake was recorded at baseline from validated food frequency questionnaires. Incidence rate ratios of developing UC and CD were calculated for quintiles of the Mediterranean diet score and a posteriori dietary patterns produced by factor analysis. Results:No dietary pattern was associated with either UC or CD risks. However, when excluding cases occurring within the first 2 years after dietary assessment, there was a positive association between a “high sugar and soft drinks” pattern and UC risk (incidence rate ratios for the fifth versus first quintile, 1.68 [1.00–2.82]; Ptrend = 0.02). When considering the foods most associated with the pattern, high consumers of sugar and soft drinks were at higher UC risk only if they had low vegetables intakes. Conclusions:A diet imbalance with high consumption of sugar and soft drinks and low consumption of vegetables was associated with UC risk. Further studies are needed to investigate whether microbiota alterations or other mechanisms mediate this association.

[1]  E. Segal,et al.  Artificial sweeteners induce glucose intolerance by altering the gut microbiota , 2014, Nature.

[2]  A. Tjønneland,et al.  Carbohydrate Intake in the Etiology of Crohn's Disease and Ulcerative Colitis , 2014, Inflammatory bowel diseases.

[3]  E. Riboli,et al.  Association between high dietary intake of the n−3 polyunsaturated fatty acid docosahexaenoic acid and reduced risk of Crohn's disease , 2014, Alimentary pharmacology & therapeutics.

[4]  Jan Verhaegen,et al.  A decrease of the butyrate-producing species Roseburia hominis and Faecalibacterium prausnitzii defines dysbiosis in patients with ulcerative colitis , 2013, Gut.

[5]  G. Young,et al.  Dietary Red Meat Aggravates Dextran Sulfate Sodium-Induced Colitis in Mice Whereas Resistant Starch Attenuates Inflammation , 2013, Digestive Diseases and Sciences.

[6]  W. Garrett,et al.  The Microbial Metabolites, Short-Chain Fatty Acids, Regulate Colonic Treg Cell Homeostasis , 2013, Science.

[7]  W. Willett,et al.  Long-term intake of dietary fat and risk of ulcerative colitis and Crohn's disease , 2013, Gut.

[8]  N. Barnich,et al.  Western diet induces dysbiosis with increased E coli in CEABAC10 mice, alters host barrier function favouring AIEC colonisation , 2013, Gut.

[9]  A. Tjønneland,et al.  Mediterranean diet and colorectal cancer risk: results from a European cohort , 2013, European Journal of Epidemiology.

[10]  J. Guzman,et al.  Diet, Microbiome, and the Intestinal Epithelium: An Essential Triumvirate? , 2013, BioMed research international.

[11]  L. Powell,et al.  Beverage consumption and individual-level associations in South Korea , 2013, BMC Public Health.

[12]  M. Woods,et al.  Dietary patterns and colorectal cancer recurrence and survival: a cohort study , 2013, BMJ Open.

[13]  S. Ng,et al.  Geographical variability and environmental risk factors in inflammatory bowel disease , 2013, Gut.

[14]  C. McDonald,et al.  Crohn's Disease-Associated Adherent-Invasive Escherichia coli Adhesion Is Enhanced by Exposure to the Ubiquitous Dietary Polysaccharide Maltodextrin , 2012, PloS one.

[15]  U. Ekelund,et al.  Combined Impact of Lifestyle Factors on Prospective Change in Body Weight and Waist Circumference in Participants of the EPIC-PANACEA Study , 2012, PloS one.

[16]  Francisco Guarner,et al.  The gut microbiota in IBD , 2012, Nature Reviews Gastroenterology &Hepatology.

[17]  C. Chassard,et al.  Gut microbial adaptation to dietary consumption of fructose, artificial sweeteners and sugar alcohols: implications for host–microbe interactions contributing to obesity , 2012, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[18]  S. Ng,et al.  Inflammatory bowel disease in Asia: A systematic review , 2012, Journal of gastroenterology and hepatology.

[19]  Yunwei Wang,et al.  Dietary fat-induced taurocholic acid production promotes pathobiont and colitis in IL-10−/− mice , 2012, Nature.

[20]  B. Peleteiro,et al.  Dietary patterns and colorectal cancer: systematic review and meta-analysis , 2012, European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation.

[21]  Yunwei Wang,et al.  Dietary-fat-induced taurocholic acid promotes pathobiont expansion and colitis in Il 10 2 / 2 mice , 2012 .

[22]  Subrata Ghosh,et al.  Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. , 2012, Gastroenterology.

[23]  Ateequr Rehman,et al.  Twin study indicates loss of interaction between microbiota and mucosa of patients with ulcerative colitis. , 2011, Gastroenterology.

[24]  Philippe Seksik,et al.  Epidemiology and natural history of inflammatory bowel diseases. , 2011, Gastroenterology.

[25]  H. El‐Serag,et al.  Dietary Intake and Risk of Developing Inflammatory Bowel Disease: A Systematic Review of the Literature , 2011, The American Journal of Gastroenterology.

[26]  V. Chouraki,et al.  The changing pattern of Crohn’s disease incidence in northern France: a continuing increase in the 10‐ to 19‐year‐old age bracket (1988–2007) , 2011, Alimentary pharmacology & therapeutics.

[27]  A. Griffiths,et al.  Epidemiology of pediatric inflammatory bowel disease: A systematic review of international trends , 2011, Inflammatory bowel diseases.

[28]  L. Tappy,et al.  Fructose and metabolic diseases: new findings, new questions. , 2010, Nutrition.

[29]  F. Clavel-Chapelon,et al.  Animal Protein Intake and Risk of Inflammatory Bowel Disease: The E3N Prospective Study , 2010, The American Journal of Gastroenterology.

[30]  S. Ardizzone,et al.  Pre-illness changes in dietary habits and diet as a risk factor for inflammatory bowel disease: a case-control study. , 2010, World journal of gastroenterology.

[31]  C. R. Carvalho,et al.  Fructose alters adiponectin, haptoglobin and angiotensinogen gene expression in 3T3-L1 adipocytes. , 2010, Nutrition research.

[32]  R. Luben,et al.  Dietary n-3 polyunsaturated fatty acids and the aetiology of ulcerative colitis: a UK prospective cohort study , 2010, European journal of gastroenterology & hepatology.

[33]  G. Radford-Smith,et al.  Role of diet in the development of inflammatory bowel disease , 2010, Inflammatory bowel diseases.

[34]  S. Bischoff,et al.  Toll‐like receptor 4 is involved in the development of fructose‐induced hepatic steatosis in mice , 2009, Hepatology.

[35]  Gennaro Miele,et al.  Transitions at CpG Dinucleotides, Geographic Clustering of TP53 Mutations and Food Availability Patterns in Colorectal Cancer , 2009, PloS one.

[36]  E. Riboli,et al.  Linoleic acid, a dietary n-6 polyunsaturated fatty acid, and the aetiology of ulcerative colitis: a nested case–control study within a European prospective cohort study , 2009, Gut.

[37]  W. Sandborn,et al.  An Update on the Epidemiology of Inflammatory Bowel Disease in Asia , 2008, The American Journal of Gastroenterology.

[38]  E. Riboli,et al.  Diet in the Aetiology of Ulcerative Colitis: A European Prospective Cohort Study , 2008, Digestion.

[39]  E. Levy,et al.  Dietary patterns and risk for Crohn's disease in children , 2008, Inflammatory bowel diseases.

[40]  H. Inskip,et al.  Stability of dietary patterns in young women over a 2-year period , 2008, European Journal of Clinical Nutrition.

[41]  N Slimani,et al.  The EPIC nutrient database project (ENDB): a first attempt to standardize nutrient databases across the 10 European countries participating in the EPIC study , 2007, European Journal of Clinical Nutrition.

[42]  F. Hu,et al.  Association of dietary patterns with cancer recurrence and survival in patients with stage III colon cancer. , 2007, JAMA.

[43]  F. Clavel-Chapelon,et al.  Dietary patterns and risk of colorectal tumors: a cohort of French women of the National Education System (E3N). , 2006, American journal of epidemiology.

[44]  F. Hu,et al.  Intake of sugar-sweetened beverages and weight gain: a systematic review. , 2006, The American journal of clinical nutrition.

[45]  A. Wolk,et al.  Long-term stability of food patterns identified by use of factor analysis among Swedish women. , 2006, The Journal of nutrition.

[46]  D. Greenberg,et al.  Changes in intake of key nutrients over 17 years during adult life of a British birth cohort , 2005, British Journal of Nutrition.

[47]  K. Wakai,et al.  Dietary Risk Factors for Inflammatory Bowel Disease: A Multicenter Case‐Control Study in Japan , 2005, Inflammatory bowel diseases.

[48]  B. Popkin,et al.  The nutrition transition: worldwide obesity dynamics and their determinants , 2004, International Journal of Obesity.

[49]  G. Bray,et al.  Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity. , 2004, The American journal of clinical nutrition.

[50]  Tina Costacou,et al.  Adherence to a Mediterranean diet and survival in a Greek population. , 2003, The New England journal of medicine.

[51]  F. Clavel-Chapelon,et al.  Physical activity of subjects aged 50–64 years involved in the European Prospective Investigation into Cancer and Nutrition (EPIC) , 2002, Public Health Nutrition.

[52]  N E Day,et al.  European Prospective Investigation into Cancer and Nutrition (EPIC): study populations and data collection , 2002, Public Health Nutrition.

[53]  M. Schulze,et al.  Diversity of dietary patterns observed in the European Prospective Investigation into Cancer and Nutrition (EPIC) project , 2002, Public Health Nutrition.

[54]  Frank B. Hu,et al.  Dietary pattern analysis: a new direction in nutritional epidemiology , 2002, Current opinion in lipidology.

[55]  K. Tucker,et al.  Are dietary patterns useful for understanding the role of diet in chronic disease? , 2001, The American journal of clinical nutrition.

[56]  P. Dagnelie,et al.  Diet as a risk factor for the development of ulcerative colitis , 2000, American Journal of Gastroenterology.

[57]  D Feskanich,et al.  Reproducibility and validity of dietary patterns assessed with a food-frequency questionnaire. , 1999, The American journal of clinical nutrition.

[58]  R. Mackie,et al.  Continuous culture selection of bifidobacteria and lactobacilli from human faecal samples using fructooligosaccharide as selective substrate , 1998, Journal of applied microbiology.

[59]  L. Sechrest,et al.  Invited commentary: Factor analysis and the search for objectivity. , 1998, American journal of epidemiology.

[60]  S. Reif,et al.  Pre-illness dietary factors in inflammatory bowel disease. , 1997, Gut.

[61]  N Slimani,et al.  Pilot phase studies on the accuracy of dietary intake measurements in the EPIC project: overall evaluation of results. European Prospective Investigation into Cancer and Nutrition. , 1997, International journal of epidemiology.

[62]  P. Pietinen,et al.  European Prospective Investigation into Cancer and Nutrition: validity studies on dietary assessment methods. , 1997, International journal of epidemiology.

[63]  E Riboli,et al.  Validation and calibration of dietary intake measurements in the EPIC project: methodological considerations. European Prospective Investigation into Cancer and Nutrition. , 1997, International journal of epidemiology.

[64]  J. Lennard-jones,et al.  Incidence of inflammatory bowel disease across Europe: is there a difference between north and south? Results of the European Collaborative Study on Inflammatory Bowel Disease (EC-IBD). , 1996, Gut.

[65]  L. Lipworth,et al.  Diet and overall survival in elderly people , 1995, BMJ.

[66]  A case-control study of ulcerative colitis in relation to dietary and other factors in Japan. The Epidemiology Group of the Research Committee of Inflammatory Bowel Disease in Japan. , 1995, Journal of gastroenterology.

[67]  F. Miglio,et al.  Dietary habits as risk factors for inflammatory bowel disease. , 1995, European journal of gastroenterology & hepatology.

[68]  P. Mortensen,et al.  The dependence of the in vitro fermentation of dietary fibre to short-chain fatty acids on the contents of soluble non-starch polysaccharides. , 1993, Scandinavian journal of gastroenterology.

[69]  B. Ruparelia.  Do locum duties help or hinder acquisition of clinical knowledge by final year medical students? , 1985 .

[70]  M. Elstein,et al.  Smoking, sugar, and inflammatory bowel disease. , 1985, British medical journal.

[71]  P. Emmett,et al.  Smoking, sugar, and inflammatory bowel disease. , 1985, British medical journal.

[72]  K. Lewis,et al.  Fermentation of Sugar Acids by Bacteria , 1940, Journal of bacteriology.