Early-life diet and risk of inflammatory bowel disease: a pooled study in two Scandinavian birth cohorts

Gut. 2024 Mar 7;73(4):590-600. doi: 10.1136/gutjnl-2023-330971.


Objective: We assessed whether early-life diet quality and food intake frequencies were associated with subsequent IBD.

Design: Prospectively recorded 1-year and 3-year questionnaires in children from the All Babies in Southeast Sweden and The Norwegian Mother, Father and Child Cohort Study were used to assess diet quality using a Healthy Eating Index and intake frequency of food groups. IBD was defined as >2 diagnoses in national patient registers. Cox regression yielded HRs adjusted (aHRs) for child's sex, parental IBD, origin, education level and maternal comorbidities. Cohort-specific results were pooled using a random-effects model.

Results: During 1 304 433 person-years of follow-up, we followed 81 280 participants from birth through childhood and adolescence, whereof 307 were diagnosed with IBD. Compared with low diet quality, medium and high diet quality at 1 year of age were associated with a reduced risk of IBD (pooled aHR 0.75 (95% CI=0.58 to 0.98) and 0.75 (95% CI=0.56 to 1.00)). The pooled aHR per increase of category was 0.86 (0.74 to 0.99). Pooled aHR for children 1 year old with high versus low fish intake was 0.70 (95% CI=0.49 to 1.00) for IBD, and showed association with reduced risk of UC (pooled aHR=0.46; 95% CI=0.21, 0.99). Higher vegetable intake at 1 year was associated with a risk reduction in IBD. Intake of sugar-sweetened beverages was associated with an increased risk of IBD. Diet quality at 3 years was not associated with IBD.

Conclusion: In this Scandinavian birth cohort, high diet quality and fish intake in early life were associated with a reduced risk of IBD.


MeSH terms

  • Adolescent
  • Animals
  • Birth Cohort*
  • Child
  • Cohort Studies
  • Diet / adverse effects
  • Female
  • Humans
  • Infant
  • Inflammatory Bowel Diseases* / epidemiology
  • Inflammatory Bowel Diseases* / etiology
  • Mothers