Association Between Inflammatory Potential of the Diet and Ulcerative Colitis: A Case-Control Study

Abstract

Background/Aim: Despite the inflammatory nature of inflammatory bowel disease (IBD), limited data are available on the association of inflammatory potential of the diet and risk of ulcerative colitis (UC). We aimed to investigate the association of inflammatory potential of the diet (IPD) score and odds of UC in a case-control study.Methods: Patients with UC were enrolled from Iranian IBD registry, whose disease was confirmed by a gastroenterologist. Controls were selected randomly from the Study of the Epidemiology of Psycho Alimentary Health and Nutrition (SEPAHAN) study, a large population-based study on more than 8,000 apparently healthy individuals. Dietary intakes of 28 food items obtained from a validated dish-based food frequency questionnaire (FFQ), were used to compute IPD score.Results: This case-control study was carried out among 109 cases and 218 randomly chosen controls. Mean age of cases and controls was 39.5 ± 10.0 and 41.5 ± 11.8 y, respectively. Totally, 52% of study participants were female and 48% were male. After controlling for age, sex, and body mass index (BMI), we found that the patients with UC were more likely to be in the highest quartile of IPD score compared with controls (OR: 2.83; 95% CI: 1.41–5.69, P-trend < 0.001). This association strengthened after additional adjustment for education, smoking, medical history, and physical activity (OR: 3.48; 95% CI: 1.32–9.10, P-trend = 0.003). When we took dietary habits into account, the association was slightly attenuated (OR: 3.33; 95% CI: 1.20–9.20, P-trend = 0.005).Conclusions: We found that adherence to a pro-inflammatory diet was positively associated with greater odds of UC. Further studies are required to confirm these findings.

Inflammatory Potential of the Diet and Incidence of Crohn’s Disease and Ulcerative Colitis in the EPIC-Spain Cohort

“…They performed a pooled analysis of three large US cohorts, using an empirical dietary inflammatory pattern score, and found a positive association between a pro-inflammatory diet and CD risk (51% higher risk for the highest quartile vs. lowest), but no association with UC [ 17 ], results that are in line with ours. In contrast, two Iranian case-control studies, using the DII or a modified version of it, found a positive association between a more inflammatory diet and the risk of UC [ 18 , 19 ]. However, potential limitations of these studies include the possibility of recall and selection biases, which are inherent in most case-control studies.…”

“…However, very few studies have specifically evaluated the relation between the overall diet’s inflammatory potential and IBD risk. In a prospective study, a pro-inflammatory diet was related to an increased risk of CD but not UC [ 17 ], while association with UC has been observed in two case-control studies [ 18 , 19 ].…”

Research advancements and perspectives of inflammatory bowel disease: A comprehensive review

“…50 Although saturated fat is highly recognized a risk factor for IBD, O'Mahony et al 51 report that a lard-based high-fat diet demonstrates the potential to reduce DSS-induced colitis via inducing high level of the secondary bile acid lithocholic acid and activating the vitamin D pathway. Nevertheless, Khademi et al 52 support that there is no significant link between pro-inflammatory diets containing french fries, pizza, snacks, and red and processed meats with UC risk. There is currently no dietary approach that can be successfully applied to all patients with IBD.…”