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

Nutrients. 2021 Jun 26;13(7):2201. doi: 10.3390/nu13072201.


Diet may influence the development of inflammatory bowel disease through the modulation of inflammation. We investigated whether the inflammatory potential of the diet is associated with the risk of Crohn's disease (CD) and ulcerative colitis (UC) in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain). The study included 32,633 participants aged 29-69 years. The inflammatory potential of the diet was measured by using an inflammatory score of the diet (ISD) based on a baseline dietary history questionnaire. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During 21 years (674,547 person-years) of follow-up, 32 and 57 participants developed CD and UC, respectively. In multivariable analysis, a one-standard deviation (SD) increment in the ISD (two-unit increase) was associated with a higher risk of CD (HR of 1.71; 95% CI: 1.05-2.80; p = 0.031). By contrast, ISD was not associated with UC (HR for one-SD increment of 0.89; 95% CI: 0.66-1.19; p = 0.436). Our results suggest that consuming a more pro-inflammatory diet may contribute to the risk of CD, supporting that a healthy diet might be beneficial in its prevention. Further, larger studies are needed to verify these findings.

Keywords: Crohn’s disease; inflammation; inflammatory bowel disease; inflammatory potential of the diet; prospective cohort study; ulcerative colitis.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Colitis, Ulcerative / epidemiology*
  • Crohn Disease / epidemiology*
  • Diet*
  • Female
  • Humans
  • Incidence
  • Inflammation
  • Inflammatory Bowel Diseases
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Nutrition Assessment
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Spain
  • Surveys and Questionnaires