Food processing and risk of Crohn's disease and ulcerative colitis: A European Prospective Cohort Study
Meyer, Antoine; Dong, Catherine; Casagrande, Corinne; Chan, Simon; Huybrechts, Inge; Nicolas, Geneviève; Rauber, Fernanda; Levy, Renata Bertazzi; Millett, Christopher; Oldenburg, Bas; Weiderpass, Elisabete; Heath, Alicia K; Tong, Tammy Yn; Tjønneland, Anne; Kyrø, Cecilie; Kaaks, Rudolf; Katzke, Verena A; Bergman, Manuela M; Palli, Domenico; Masala, Giovanna; Tumino, Rosario; Sacerdote, Carlotta; Colorado-Yohar, Sandra M; Sánchez, Maria-Jose; Grip, Olof; Lindgren, Stefan; Luben, Robert; Gunter, Marc J; Mahamat-Saleh, Yahya; Boutron-Ruault, Marie-Christine; Carbonnel, Franck
(2023) Clinical Gastroenterology and Hepatology, volume 21, issue 6, pp. 1607 - 1616.e6
(Article)
Abstract
BACKGROUND & AIMS: Industrial foods have been associated with increased risks of several chronic conditions. We investigated the relationship between the degree of food processing and risks of Crohn's disease (CD) and ulcerative colitis (UC) in the European Prospective Investigation into Cancer and Nutrition cohort. METHODS: Analyses included 413,590 participants
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(68.6% women; mean baseline age, 51.7 y) from 8 European countries. Dietary data were collected at baseline from validated country-specific dietary questionnaires. Associations between proportions of unprocessed/minimally processed and ultraprocessed food intake and CD and UC risks were estimated using Cox models to obtain hazard ratios (HRs) and 95% CIs. Models were stratified by center, age, and sex, and adjusted for smoking status, body mass index, physical activity, energy intake, educational level, and alcohol consumption. RESULTS: During a mean follow-up period of 13.2 years, 179 incident cases of CD and 431 incident cases of UC were identified. The risk of CD was lower in people consuming high proportions of unprocessed/minimally processed foods (adjusted HR for the highest vs lowest quartile: 0.57; 95% CI, 0.35-0.93; P trend < .01), particularly fruits and vegetables (adjusted HRs, 0.54; 95% CI, 0.34-0.87 and 0.55; 95% CI, 0.34-0.91, respectively). There was no association between unprocessed/minimally processed food intake and the risk of UC. No association was detected between ultraprocessed food consumption and CD or UC risks. CONCLUSIONS: In the European Prospective Investigation into Cancer and Nutrition cohort, consumption of unprocessed/minimally processed foods was associated with a lower risk of CD. No association between UC risk and food processing was found.
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Keywords: Crohn's Disease, EPIC, Food Processing, Ulcerative Colitis, Gastroenterology, Hepatology, Journal Article
ISSN: 1542-3565
Publisher: W.B. Saunders
Note: Funding Information: Funding This work was supported by The Sir Halley Stewart Trust, Crohn's and Colitis UK, and The National Health Service Executive Eastern Region. The coordination of the European Prospective Investigation into Cancer and Nutrition is financially supported by the International Agency for Research on Cancer and also by the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, which has additional infrastructure support provided by the NIHR Imperial Biomedical Research Centre. The national cohorts are supported by the Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l'Education Nationale, and INSERM (France); German Cancer Aid, German Cancer Research Center, German Institute of Human Nutrition Potsdam-Rehbruecke, and Federal Ministry of Education and Research (Germany); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and Compagnia di San Paolo and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports, Netherlands Cancer Registry, LK Research Funds, Dutch Prevention Funds, Dutch Zorg Onderzoek Nederland, World Cancer Research Fund, and Statistics Netherlands (The Netherlands); Health Research Fund–Instituto de Salud Carlos III, Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology (Spain); Swedish Cancer Society, Swedish Research Council, and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to European Prospective Investigation into Cancer and Nutrition–Norfolk; C8221/A29017 to European Prospective Investigation into Cancer and Nutrition–Oxford), and Medical Research Council (1000143 to European Prospective Investigation into Cancer and Nutrition–Norfolk; MR/M012190/1 to European Prospective Investigation into Cancer and Nutrition–Oxford) (United Kingdom). The funders had no role in the study design or in the collection, analysis, interpretation of data, writing of the report, or decision to submit the article for publication. Conflicts of interest These authors disclose the following: Simon S.M. Chan has received travel grants from AbbVie and Takeda; Bas Oldenburg has received grants from Takeda, Pfizer, Ferring, and Celltrion, and participated on advisory boards of Takeda, BMS, Galapagos, Janssen, and Cosmofer; Olof Grip has served as a speaker, consultant, and an advisory board member for Ferring, Janssen, Pfizer, and Takeda; and Franck Carbonnel has received speaker fees from AbbVie, Biogen, Ferring, Janssen, MSD, Pfizer, Pileje, and Takeda, and participated on advisory boards of Amgen, Arena, Celltrion, Enterome, Ferring, Janssen, Medtronic, Pfizer, Pharmacosmos, Roche, and Tillotts. The remaining authors disclose no conflicts. Funding Information: Funding This work was supported by The Sir Halley Stewart Trust , Crohn’s and Colitis UK, and The National Health Service Executive Eastern Region. The coordination of the European Prospective Investigation into Cancer and Nutrition is financially supported by the International Agency for Research on Cancer and also by the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London , which has additional infrastructure support provided by the NIHR Imperial Biomedical Research Centre . The national cohorts are supported by the Danish Cancer Society (Denmark); Ligue Contre le Cancer , Institut Gustave Roussy , Mutuelle Générale de l’Education Nationale, and INSERM (France); German Cancer Aid , German Cancer Research Center , German Institute of Human Nutrition Potsdam-Rehbruecke, and Federal Ministry of Education and Research (Germany); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and Compagnia di San Paolo and National Research Council (Italy); Dutch Ministry of Public Health , Welfare and Sports, Netherlands Cancer Registry, LK Research Funds, Dutch Prevention Funds, Dutch Zorg Onderzoek Nederland, World Cancer Research Fund, and Statistics Netherlands (The Netherlands); Health Research Fund– Instituto de Salud Carlos III , Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology (Spain); Swedish Cancer Society , Swedish Research Council , and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to European Prospective Investigation into Cancer and Nutrition–Norfolk; C8221/A29017 to European Prospective Investigation into Cancer and Nutrition–Oxford), and Medical Research Council (1000143 to European Prospective Investigation into Cancer and Nutrition–Norfolk; MR/M012190/1 to European Prospective Investigation into Cancer and Nutrition–Oxford) (United Kingdom). The funders had no role in the study design or in the collection, analysis, interpretation of data, writing of the report, or decision to submit the article for publication. Publisher Copyright: © 2023
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