ULTRA-PROCESSED FOOD INTAKE AND INFLAMMATORY BOWEL DISEASE (IBD)

Nov 17, 2021
Sébastien Bouley

The results of the PURE cohort study showed a positive association between ultra-processed food intake and risk of IBD.

On 14 July 2021, the British Medical Journal published a prospective study investigating the relationship between Inflammatory Bowel Disease (IBD), meaning disorders characterized by a chronical inflammation of the intestine as Crohn’s Disease or Ulcerative Colitis, and the consumption of ultra-processed food, referring to food products that, because of formulation or packaging needs, contain additive ingredients.

THE STUDY:

The work was coordinated by three centers in Canada; its most remarkable characteristics were its size and its geographical extent, as it focused on 116 087 subjects from 21 countries of different income status from around the world, including Sweden and Poland for Europe. The participants were aged between 35 and 70 years old, and belonged to the Prospective Urban and Rural Epidemiological (PURE) cohort, a project that started in 2002; they were selected after having completed at least one baseline food frequency questionnaire to assess their usual diet.

THE FINDINGS:

The study showed a statistically significant association between the intake of ultra-processed food and the development of IBD; the connection was still present after adjustment for confounders, and was also present when considering sub-categories of ultra-processed food, as processed meat, soft drinks, refined sweetened food, as well as salty foods and snacks.

No association with IBD was found when investigating non-highly-processed food categories, as white meat, unprocessed red meat, fruit, vegetables, and dairy or starchy food; this seems to indicate that what could play a role in IBD genesis is more the transformation process and consequences rather than the food itself.

Researchers hypothesize that food could be an environmental cofactor in IBD development, because of its possible impact on gut microbiota and on the intestinal milieu in general.

It is important to remember, however, that associations observed through prospective studies cannot be interpreted as proof of a cause-effect relationship, and that further studies are needed to clarify the results of this and other similar publications.

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