Eating Ultra-processed Food Linked to Higher Risk of New-onset Crohn's Disease
Key findings
- This study of 203,516 women and 41,596 men from three ongoing U.S. prospective cohorts examined associations between consumption of ultra-processed foods (UPF) and the risk of new-onset Crohn's disease (CD) or ulcerative colitis (UC)
- Compared with participants in the lowest quartile of UPF consumption on the most recent dietary questionnaire, those in the highest quartile had a greater risk of CD (HR, 1.70; P for trend =0.0008)
- Higher cumulative UPF intake was also associated with a greater risk of CD (highest quartile vs. the lowest, adjusted HR, 1.40; P for trend =0.05)
- The UPF groups most strongly associated with CD risk were ultra-processed breads and breakfast foods; sauces, cheeses, spreads and gravies; and frozen or shelf-stable ready-to-eat/heat meals
- Intake of UPFs was not associated with a significantly greater risk of UC
Over the past few decades, consumption of ultra-processed food (UPF) has increased significantly in several regions of the world, coinciding with a rise in the incidence of inflammatory bowel disease. UPFs are ready-to-eat products that usually incorporate additives such as sweeteners, preservatives, emulsifiers, thickeners and flavors.
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In a very large national sample with long-term follow-up, Chun-Han Lo, MD, postdoctoral research fellow in the Clinical and Translational Epidemiology Unit at Massachusetts General Hospital; Ashwin N. Ananthakrishnan, MBBS, director of the Mass General Crohn's and Colitis Center, and colleagues linked higher consumption of UPFs with significantly increased risk of Crohn's disease (CD), but not ulcerative colitis (UC).
Study Methods
The study included 203,516 women and 41,596 men from three ongoing U.S. prospective cohorts: the Nurses' Health Study, the Nurses' Health Study II and the Health Professionals Follow-up Study. On biennial health questionnaires, 369 participants reported having been diagnosed with CD, and 488 reported a diagnosis of UC.
The researchers validated those diagnoses by obtaining permission from participants to review their medical records.
All participants completed a detailed semiquantitative food frequency questionnaire every four years beginning in 1986 or 1991. Using the NOVA system, which classifies foods according to extent and purpose of processing, the researchers determined each participant's total energy consumption from UPFs.
Recent UPF Consumption
Compared with participants in the lowest quartile of UPF consumption on the most recent dietary questionnaire, those in the highest quartile had:
- Significantly increased risk of CD (adjusted HR, 1.70; P for trend =0.0008)
- No increased risk of UC
Cumulative UPF Consumption
Compared with participants in the lowest quartile of cumulative UPF consumption, those in the highest quartile had:
- Significantly increased risk of CD (adjusted HR, 1.40; P for trend =0.05)
- No increased risk of UC
The UPF groups most strongly associated with CD risk were:
- Ultra-processed breads and breakfast foods—HR, 1.18 per 1 SD increase in intake
- Sauces, cheeses, spreads and gravies—HR, 1.14
- Frozen or shelf-stable ready-to-eat/heat meals—HR, 1.11
Putting the Results in Context
UPFs are already known to have negative effects with regard to obesity and cardiometabolic outcomes. Individuals who avoid UPF consumption may gain other health benefits as well as a substantial reduction in their risk of developing CD.
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