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A prospective study of long-term intake of dietary fiber and risk of Crohn's disease and ulcerative colitis.

Abstract

BACKGROUND & AIMS

Increased intake of dietary fiber has been proposed to reduce the risk of inflammatory bowel disease (Crohn's disease [CD] and ulcerative colitis [UC]). However, few prospective studies have examined associations between long-term intake of dietary fiber and risk of incident CD or UC.

METHODS

We collected and analyzed data from 170,776 women, followed up over 26 years, who participated in the Nurses' Health Study, followed up for 3,317,425 person-years. Dietary information was prospectively ascertained via administration of a validated semiquantitative food frequency questionnaire every 4 years. Self-reported CD and UC were confirmed through review of medical records. Cox proportional hazards models, adjusting for potential confounders, were used to calculate hazard ratios (HRs).

RESULTS

We confirmed 269 incident cases of CD (incidence, 8/100,000 person-years) and 338 cases of UC (incidence, 10/100,000 person-years). Compared with the lowest quintile of energy-adjusted cumulative average intake of dietary fiber, intake of the highest quintile (median of 24.3 g/day) was associated with a 40% reduction in risk of CD (multivariate HR for CD, 0.59; 95% confidence interval, 0.39-0.90). This apparent reduction appeared to be greatest for fiber derived from fruits; fiber from cereals, whole grains, or legumes did not modify risk. In contrast, neither total intake of dietary fiber (multivariate HR, 0.82; 95% confidence interval, 0.58-1.17) nor intake of fiber from specific sources appeared to be significantly associated with risk of UC.

CONCLUSIONS

Based on data from the Nurses' Health Study, long-term intake of dietary fiber, particularly from fruit, is associated with lower risk of CD but not UC. Further studies are needed to determine the mechanisms that mediate this association.

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  • Authors+Show Affiliations

    ,

    Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. Electronic address: aananthakrishnan@partners.org.

    , , , , , , , ,

    Source

    Gastroenterology 145:5 2013 Nov pg 970-7

    MeSH

    Adult
    Colitis, Ulcerative
    Crohn Disease
    Dietary Fiber
    Eating
    Female
    Follow-Up Studies
    Humans
    Incidence
    Longitudinal Studies
    Middle Aged
    Proportional Hazards Models
    Prospective Studies
    Risk Factors
    Self Report

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    23912083

    Citation

    Ananthakrishnan, Ashwin N., et al. "A Prospective Study of Long-term Intake of Dietary Fiber and Risk of Crohn's Disease and Ulcerative Colitis." Gastroenterology, vol. 145, no. 5, 2013, pp. 970-7.
    Ananthakrishnan AN, Khalili H, Konijeti GG, et al. A prospective study of long-term intake of dietary fiber and risk of Crohn's disease and ulcerative colitis. Gastroenterology. 2013;145(5):970-7.
    Ananthakrishnan, A. N., Khalili, H., Konijeti, G. G., Higuchi, L. M., de Silva, P., Korzenik, J. R., ... Chan, A. T. (2013). A prospective study of long-term intake of dietary fiber and risk of Crohn's disease and ulcerative colitis. Gastroenterology, 145(5), pp. 970-7. doi:10.1053/j.gastro.2013.07.050.
    Ananthakrishnan AN, et al. A Prospective Study of Long-term Intake of Dietary Fiber and Risk of Crohn's Disease and Ulcerative Colitis. Gastroenterology. 2013;145(5):970-7. PubMed PMID: 23912083.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - A prospective study of long-term intake of dietary fiber and risk of Crohn's disease and ulcerative colitis. AU - Ananthakrishnan,Ashwin N, AU - Khalili,Hamed, AU - Konijeti,Gauree G, AU - Higuchi,Leslie M, AU - de Silva,Punyanganie, AU - Korzenik,Joshua R, AU - Fuchs,Charles S, AU - Willett,Walter C, AU - Richter,James M, AU - Chan,Andrew T, Y1 - 2013/08/02/ PY - 2013/05/14/received PY - 2013/07/08/revised PY - 2013/07/29/accepted PY - 2013/8/6/entrez PY - 2013/8/6/pubmed PY - 2014/2/15/medline KW - AhR KW - CD KW - CI KW - Crohn's disease KW - Diet KW - FFQ KW - Fruits KW - HR KW - IBD KW - IQR KW - NHS KW - NSAID KW - Nurses' Health Study KW - Population-Based Study KW - UC KW - Vegetables KW - aryl hydrocarbon receptor KW - confidence interval KW - food frequency questionnaire KW - hazard ratio KW - inflammatory bowel disease KW - interquartile range KW - nonsteroidal anti-inflammatory drug KW - ulcerative colitis SP - 970 EP - 7 JF - Gastroenterology JO - Gastroenterology VL - 145 IS - 5 N2 - BACKGROUND & AIMS: Increased intake of dietary fiber has been proposed to reduce the risk of inflammatory bowel disease (Crohn's disease [CD] and ulcerative colitis [UC]). However, few prospective studies have examined associations between long-term intake of dietary fiber and risk of incident CD or UC. METHODS: We collected and analyzed data from 170,776 women, followed up over 26 years, who participated in the Nurses' Health Study, followed up for 3,317,425 person-years. Dietary information was prospectively ascertained via administration of a validated semiquantitative food frequency questionnaire every 4 years. Self-reported CD and UC were confirmed through review of medical records. Cox proportional hazards models, adjusting for potential confounders, were used to calculate hazard ratios (HRs). RESULTS: We confirmed 269 incident cases of CD (incidence, 8/100,000 person-years) and 338 cases of UC (incidence, 10/100,000 person-years). Compared with the lowest quintile of energy-adjusted cumulative average intake of dietary fiber, intake of the highest quintile (median of 24.3 g/day) was associated with a 40% reduction in risk of CD (multivariate HR for CD, 0.59; 95% confidence interval, 0.39-0.90). This apparent reduction appeared to be greatest for fiber derived from fruits; fiber from cereals, whole grains, or legumes did not modify risk. In contrast, neither total intake of dietary fiber (multivariate HR, 0.82; 95% confidence interval, 0.58-1.17) nor intake of fiber from specific sources appeared to be significantly associated with risk of UC. CONCLUSIONS: Based on data from the Nurses' Health Study, long-term intake of dietary fiber, particularly from fruit, is associated with lower risk of CD but not UC. Further studies are needed to determine the mechanisms that mediate this association. SN - 1528-0012 UR - https://www.unboundmedicine.com/medline/citation/23912083/A_prospective_study_of_long_term_intake_of_dietary_fiber_and_risk_of_Crohn's_disease_and_ulcerative_colitis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(13)01140-2 DB - PRIME DP - Unbound Medicine ER -