Higher consumption of ultra-processed foods increases risk for Crohn’s
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Rising rates of ultra-processed food consumption correlated with an increased risk for Crohn’s disease, according to a presentation at Digestive Disease Week.
“The pathophysiology of IBD is related to an inappropriate host-immune response to commensal bacteria in genetically susceptible individuals. Environmental factors, especially diet, play an important role on the development of IBD,” Chun-Han Lo, MD, MPH, Massachusetts General Hospital, said. “Compared with the Mediterranean diet, the Western diet is widely thought to increase the risk of IBD, potentially through changes in the gut microbiome and epithelial barrier function and seem to have direct influence on immune function.”
To evaluate the association between UPF consumption and the risk for CD and ulcerative colitis, researchers analyzed 241,252 patients from the Nurses’ Health Study and the Nurses’ Health Study II. They used validated semi-quantitative food frequency questionnaires to assess dietary intake and medical records to confirm diagnoses.
According to study results, there were 368 incident cases of CD and 488 incident cases of UC; the median age at diagnosis was 56 years. Participants in the highest quartile of UPF consumption and emulsifier/thickener-rich food intake had an increased risk for CD compared with participants in the lowest quartile (HR = 1.72; 95% CI, 1.24-2.38; HR = 1.4; 95% CI, 1.03-1.88, respectively). Researchers noted no association between consumption of UPFs and emulsifier and risk for UC.
“A higher consumption of UPS products especially ultra-processed grain foods, fat, sauces and emulsifier/thickener-containing foods was associated with increased risk of CD,” Lo concluded. “Further studies on the factor of ultra-processed food intake in patients with established diseases may be warranted.”
Perspective
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Digestive Disease Week 2021 had several presentations regarding westernization and the increasing incidence and prevalence of IBD; diet certainly was a focus. However, there are numerous aspects of western diets that add complexity to the question of individual factors. The presentation by Kamm (Session: Predicting and Preventing the Development of IBD) provided an outstanding summary of the interactions between dietary components including ultra-processed grain foods, fat, sauces and emulsifiers and extended to other food additives and colorings, titanium dioxide in toothpaste, antibiotics in the food source, increased intestinal permeability and impacts on the microbiome, metabolome and immune system.
Additionally, in the same session (Role of Diet, Lifestyle, and Environment in Inflammatory Bowel Disease) that Lo presented the data from the Nurses’ Health Studies, Narula presented data from the Prospective Urban Rural Epidemiology [PURE] cohort of over 100,000 individuals from 21 countries identifying higher processed food intake with an increased risk for developing IBD.
Further potential environmental/dietary interactions also impact the development of obesity and visceral fat that are potential contributors to the increasing incidence of IBD and Crohn’s disease, in particular, around the world. The complexity of these interactions is exemplified by presentations from Lopes and Khakoo in the same session regarding composite environmental and modifiable risk factors to predict development or even age of onset for developing IBD.
Adding in genetics, the complexity of factors contributing to IBD continues to grow and will require ongoing studies to home in on specific factors in individual patients.
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Lo C, et al. Abstract 389. Presented at: Digestive Disease Week; May 21-23, 2021 (virtual meeting).
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