High consumption of ultra-processed foods (UPFs) may increase risk for Crohn disease (CD), according to results of a study published in the Journal of Crohn’s and Colitis.
Investigators sourced data for this cross-sectional and prospective analysis from the UK Biobank. Individuals (N=187,154) with 24-hour dietary recall and energy record data were evaluated for inflammatory bowel disease (IBD) risk on the basis of UPF consumption.
The study population comprised individuals with a mean age [SD] of 56.2[7.9] years, 54.8% were women, 95.9% were White, average BMI was26.9 (SD, 4.6) kg/m2, and patients had a daily intake of 8666.4[2453.5] KJ. Among the study cohort, 1325 had a diagnosis of ulcerative colitis (UC) and 680 of CD at baseline.
In the fully adjusted model, IBD was significantly assoicated with UPF intake (odds ratio [OR], 1.56; 95% CI, 1.35-1.79; P <.001), in which for every SD increase in UPF intake, risk for IBD increased by an OR of 1.17 (95% CI, 1.12-1.22; P <.001).
In the disease-specific analysis, both CD (OR, 1.94; 95% CI, 1.54-2.49; P <.001) and UC (OR, 1.39; 95% CI, 1.17-1.65; P <.001) associated with UPF intake.
In the prospective analysis, at an average follow-up of 9.84 years among a cohort of 185,849 study participants who did not have an IBD diagnosis at baseline, 841 were diagnosed with UC and 251 with CD. Risk for an IBD diagnosis increased with every SD increase in UPF energy intake (hazard ratio [HR], 1.09; 95% CI, 1.02-1.16; P =.009).
Risk for a CD diagnosis was associated with UPF intake, in which the individuals in the highest quintile of UPF consumption were assoicated with a HR of 2.00 (95% CI, 1.32-3.03; P =.001) for being diagnosed with CD. No association between UPF and UC were observed in this analysis.
Among an IBD prospective cohort, 1325 patients with UC and 680 with CD were observed to have a dose-response relationship between UPF consumption and risk for IBD surgery among the highest UPF consumers (HR, 4.06; 95% CI, 1.52-10.86; P =.005) and for benign colorectal neoplasm among the subset of high-UPF consumers with CD (HR, 3.21; 95% CI, 1.15-8.98; P =.026).
In a subgroup analysis, the association between UPF and CD risk was stronger among patients with ileocolonic or undefined disease compared with ileal or colonic disease. In a sensitivity analysis, similar trends were observed when liquid-based UPFs were excluded.
The major limitation of this study was that many participants only responded to a single 24-hour dietary recall assessment.
“Taken together, we provide further evidence to implicate UPFs in the development and disease course of IBD, which might represent a promising strategy in tackling its globally increasing incidence,” the study authors wrote.
Chen J, Wellens J, Kalla R, et al. Intake of ultra-processed foods is associated with an increased risk of Crohn’s disease: a cross-sectional and prospective analysis of 187,154 participants in the UK Biobank. J Crohns Colitis. 2022;jjac167. doi:10.1093/ecco-jcc/jjac167