Dairy Products, Dietary Calcium, and Risk of Inflammatory Bowel Disease: Results From a European Prospective Cohort Investigation

Background:Dairy products may be involved in the etiology of inflammatory bowel disease by modulating gut microbiota and immune responses, but data from epidemiological studies examining this relationship are limited. We investigated the association between prediagnostic intake of these foods and dietary calcium, and the subsequent development of Crohn's disease (CD) and ulcerative colitis (UC). Methods:In total, 401,326 participants were enrolled in the European Prospective Investigation into Cancer and Nutrition cohort. At recruitment, consumption of total and specific dairy products (milk, yogurt, and cheese) and dietary calcium was measured using validated food frequency questionnaires. Cases developing incident CD (n = 110) or UC (n = 244) during follow-up were matched with 4 controls. Conditional logistic regression analyses were used to calculate odds ratios (ORs) with 95% confidence intervals (CIs), adjusted for total energy intake and smoking. Results:Compared with the lowest quartile, the ORs for the highest quartile of total dairy products and dietary calcium intake were 0.61 (95% CI, 0.32–1.19, p trend = 0.19) and 0.63 (95% CI, 0.28–1.42, p trend = 0.23) for CD, and 0.80 (95% CI, 0.50–1.30, p trend = 0.40) and 0.81 (95% CI, 0.49–1.34, p trend = 0.60) for UC, respectively. Compared with nonconsumers, individuals consuming milk had significantly reduced odds of CD (OR 0.30, 95% CI, 0.13–0.65) and nonsignificantly reduced odds of UC (OR 0.85, 95% CI, 0.49–1.47). Conclusions:Milk consumption may be associated with a decreased risk of developing CD, although a clear dose-response relationship was not established. Further studies are warranted to confirm this possible protective effect.

[1]  G. Constantinescu,et al.  Diagnostic Delay in Romanian Patients with Inflammatory Bowel Disease: Risk Factors and Impact on the Disease Course and Need for Surgery. , 2016, Journal of Crohn's & colitis.

[2]  I. Rudkowska,et al.  Dairy nutrients and their effect on inflammatory profile in molecular studies. , 2015, Molecular nutrition & food research.

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

[4]  C. Poupardin,et al.  Diagnostic delay in a French cohort of Crohn's disease patients. , 2014, Journal of Crohn's & colitis.

[5]  C. Weaver,et al.  Linking Vitamin D Deficiency to Inflammatory Bowel Disease , 2013, Inflammatory bowel diseases.

[6]  B. Lamarche,et al.  Impact of dairy products on biomarkers of inflammation: a systematic review of randomized controlled nutritional intervention studies in overweight and obese adults. , 2013, The American journal of clinical nutrition.

[7]  M. Kleerebezem,et al.  Influence of fermented milk products, prebiotics and probiotics on microbiota composition and health. , 2013, Best practice & research. Clinical gastroenterology.

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

[9]  David C. Wilson,et al.  Host-microbe interactions have shaped the genetic architecture of inflammatory bowel disease , 2012, Nature.

[10]  G. Rogler,et al.  Inflammatory bowel disease pathogenesis: what is new? , 2012, Current opinion in gastroenterology.

[11]  J. Doré,et al.  Anti‐inflammatory properties of dairy lactobacilli , 2012, Inflammatory bowel diseases.

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

[13]  G. Rogler,et al.  Systematic evaluation of risk factors for diagnostic delay in inflammatory bowel disease , 2012, Inflammatory bowel diseases.

[14]  E. Giovannucci,et al.  Higher predicted vitamin D status is associated with reduced risk of Crohn's disease. , 2012, Gastroenterology.

[15]  R. Cross,et al.  Association of Age at Diagnosis and Ulcerative Colitis Phenotype , 2012, Digestive Diseases and Sciences.

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

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

[18]  R. Kaaks,et al.  Dietary calcium and magnesium intake in relation to cancer incidence and mortality in a German prospective cohort (EPIC-Heidelberg) , 2011, Cancer Causes & Control.

[19]  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.

[20]  Xiao-Ming Ye,et al.  Risk factors and gene polymorphisms of inflammatory bowel disease in population of Zhejiang, China. , 2011, World journal of gastroenterology.

[21]  J. Halfvarson.  Genetics in twins with Crohn's disease: Less pronounced than previously believed? , 2011, Inflammatory bowel diseases.

[22]  E. Szigethy,et al.  Inflammatory bowel disease. , 2011, Pediatric clinics of North America.

[23]  Wendy S. Garrett,et al.  Bifidobacterium animalis subsp. lactis fermented milk product reduces inflammation by altering a niche for colitogenic microbes , 2010, Proceedings of the National Academy of Sciences.

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

[25]  P. Dagnelie,et al.  Inflammatory Bowel Disease in South Limburg (the Netherlands) 1991-2002: Incidence, diagnostic delay, and seasonal variations in onset of symptoms. , 2009, Journal of Crohn's & colitis.

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

[27]  M. Vatn,et al.  Geographic distribution and ecological studies of inflammatory bowel disease in southeastern Norway in 1990–1993 , 2008, Inflammatory bowel diseases.

[28]  C. Bernstein,et al.  Disorders of a modern lifestyle: reconciling the epidemiology of inflammatory bowel diseases , 2008, Gut.

[29]  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.

[30]  A. Lobo,et al.  A case-control study of drinking water and dairy products in Crohn's Disease--further investigation of the possible role of Mycobacterium avium paratuberculosis. , 2007, American journal of epidemiology.

[31]  S. Galandiuk,et al.  Smoking and inflammatory bowel disease: a meta-analysis. , 2006, Mayo Clinic proceedings.

[32]  M. Cheang,et al.  A Population-Based Case Control Study of Potential Risk Factors for IBD , 2006, The American Journal of Gastroenterology.

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

[34]  L. Hougs,et al.  Disease Concordance, Zygosity, and NOD2/CARD15 Status: Follow-Up of a Population-Based Cohort of Danish Twins with Inflammatory Bowel Disease , 2005, The American Journal of Gastroenterology.

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

[36]  D. Heresbach,et al.  Crohn's disease in the over-60 age group: a population based study , 2004, European journal of gastroenterology & hepatology.

[37]  J. Martínez,et al.  ORIGINAL COMMUNICATION A systematic review of socioeconomic differences in food habits in Europe: consumption of cheese and milk , 2003 .

[38]  G. Roos,et al.  Use of butter and cheese in 10 European countries: a case of contrasting educational differences. , 2003, European journal of public health.

[39]  E. Lindberg,et al.  Inflammatory bowel disease in a Swedish twin cohort: a long-term follow-up of concordance and clinical characteristics. , 2003, Gastroenterology.

[40]  F. Clavel-Chapelon,et al.  Consumption of dairy products in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort: data from 35955 24-hour dietary recalls in 10 European countries , 2002, Public Health Nutrition.

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

[42]  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.

[43]  W C Willett,et al.  Adjustment for total energy intake in epidemiologic studies. , 1997, The American journal of clinical nutrition.

[44]  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.

[45]  S. Yamato,et al.  Epidemiologic analysis of Crohn disease in Japan: increased dietary intake of n-6 polyunsaturated fatty acids and animal protein relates to the increased incidence of Crohn disease in Japan. , 1996, The American journal of clinical nutrition.

[46]  R A Goldbohm,et al.  Reproducibility of a food frequency questionnaire and stability of dietary habits determined from five annually repeated measurements. , 1995, European journal of clinical nutrition.

[47]  J. Kurata.  Dietary and other risk factors of ulcerative colitis. A case-control study in Japan. Epidemiology Group of the Research Committee of Inflammatory Bowel Disease in Japan. , 1994, Journal of clinical gastroenterology.

[48]  A. Sonnenberg.  Disability from inflammatory bowel disease among employees in West Germany. , 1989, Gut.

[49]  H. Belshaw,et al.  The Food and Agriculture Organization of the United Nations , 1947, International Organization.