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May 29, 2020
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Dietary gluten does not increase Crohn’s, UC in women without celiac disease

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No correlation was seen between dietary gluten intake and the risk for incidence Crohn’s disease or ulcerative colitis among women without celiac disease, according to data from Digestive Disease Week.

“Gluten, a protein found in wheat, barley and rye, has received increased attention by both the general public and medical community for its potential role in a multitude of patient symptoms and diseases,” Emily W. Lopes, MD, from Massachusetts General Hospital in Boston, told Healio Gastroenterology. “Our results suggest that eating gluten does not increase a person's chance of being diagnosed with IBD. We found that dietary gluten intake was not associated with increased risk for ulcerative colitis or Crohn's disease.”

Lopes and colleagues performed a prospective study of more than 208,000 women from the Nurses' Health Study, Nurses' Health Study II, and Health Professionals Follow-up Study for over 20 years, without prior diagnosis of celiac disease or IBD at baseline. They estimated the cumulative average of dietary intake over the follow-up with semiquantitative food frequency questionnaires given at baseline and every 4 years. They also reviewed medical records to confirm self-reported cases of Crohn’s disease and ulcerative colitis. Investigators estimated multivariable-adjusted hazard ratio and 95% confidence intervals for risk for CD and UC according to quintile categories of gluten intake with Cox proportional hazard modeling, with adjustment for age, BMI, smoking, total caloric intake, dietary pattern, physical activity, appendectomy and medications correlated with risk for IBD.

emily walsh lopes headshot
Emily W. Lopez

Results showed 272 CD cases and 359 UC cases over a total of 2,026,573 person-years. Investigators noted dietary gluten was not linked to a risk for CD or UC incident. The multivariable-adjusted HRs for women in the highest quintile of energy-adjusted gluten intake (baseline mean = 8.5 grams/day) were 1.04 (95% CI, 0.72-1.5) for CD and 1.06 (95% CI, 0.74-1.51) for UC, compared with women in the lowest quintile of energy-adjusted gluten intake (baseline mean = 3.1 grams/day). Effect estimates were not materially altered after the refined or whole grains as primary sources of gluten intake were adjusted.

According to stratified analysis, baseline age, BMI or smoking status did not modify the correlation between gluten intake and risk for CD or UC.

“It is important to note that we did not study the impact of gluten intake on those already diagnosed with IBD, thus we cannot expand our results to this population,” she said. – by Monica Jaramillo

Reference: Lopes EW, et al. Abstract 847. Presented at: Digestive Disease Week; May 2-5, 2020; Chicago (meeting canceled).