Despite the fact that current guidelines for managing inflammatory bowel diseases do not devote attention to diet as a central element of treatment, there is an increasing amount of evidence that supports the role of diet in patients with IBD. A new nationwide cohort study shows the association between the level of inflammatory potential in diet and risk of Crohn’s disease.
Environmental factors involving diet may play an important role in the onset and development of inflammatory bowel diseases (IBDs), especially in their early stages. That is because of the involvement of dietary patterns and nutrients in shaping inflammatory responses that become detrimental if they persist over the long term.
A new nationwide cohort study shows the association between the inflammatory potential of diet and risk of Crohn’s disease.
The authors used an empirical dietary inflammatory score, derived by weighting food groups based on their relationship with plasma inflammatory markers (i.e., C-reactive protein, interleukin-6, and tumor necrosis factor a receptor 2), to explore the link between dietary inflammatory potential and risk of incident IBD.
The index assesses the inflammatory potential of diet and is the weighted sum of 18 food groups based on food frequency questionnaire data, with higher scores indicating proinflammatory diets (e.g., processed and red meat, some fish, refined grains, and high-energy beverages) and lower scores indicating anti-inflammatory diets (e.g., dark yellow and green leafy vegetables, tea, coffee, beer, and wine).
The sample under study consisted of 328 cases of incident Crohn’s disease and 428 cases of incident ulcerative colitis from 3 large prospective cohorts in the United States.
Dietary patterns with high inflammatory potential were associated with increased risk of Crohn’s disease, compared with participants who showed a high intake of foods with lower inflammatory potential.
The authors also examined whether change in dietary inflammatory potential could affect the risk of IBD. Participants who shifted from a low to a high inflammatory potential diet and those who usually consumed a proinflammatory diet showed a greater risk of Crohn’s disease, compared with participants who persistently consumed a diet with low inflammatory potential.
In contrast, different levels of dietary inflammatory potential were not linked to risk of ulcerative colitis.
On the whole, the current study highlights the importance of diet in the development of Crohn’s disease by modulating inflammatory mechanisms. Although more mechanistic data and intervention controlled studies are needed, the findings show that what you eat is an important modifiable factor in IBD prevention.