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Inflamm Bowel Dis. 2017 Dec;23(12):2072-2082. doi: 10.1097/MIB.0000000000001108.

Dietary Polyphenols in the Aetiology of Crohn's Disease and Ulcerative Colitis-A Multicenter European Prospective Cohort Study (EPIC).

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1Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom; 2Program in Public Health, College of Health Sciences, University of California, Irvine, California; 3Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; 4Biomarker Group, Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), Lyon, France; 5Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; 6Department of Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom; 7Norfolk and Norwich University Hospital NHS Trust, Norwich, United Kingdom; 8Strangeways Research Laboratory, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom; 9Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands; 10Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden; 11Department of Public Health and Clinical Medicine, GI Unit, Umeå University, Umeå, Sweden; 12Department of Clinical Sciences, University Hospital, Malmö, Sweden; 13Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; 14Department of Epidemiology, German Institute of Human Nutrition, Potsdam, Germany; 15Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark; 16Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Centre, Florence, Italy; 17INSERM, Centre for Research in Epidemiology and Population Health, U1018, Team 9, Institut Gustave Roussy, Villejuif, France; 18Université Paris Sud, UMRS 1018, Villejuif, France; 19Department of Gastroenterology, Bicêtre University Hospital, Assistance Publique des Hôpitaux de Paris, Le Kremlin Bicêtre, France; 20Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark; 21Focused Research Unit for Molecular and Clinical Research, Institute of Regional Research- Center Sønderjylland, University of Southern Denmark, Odense, Denmark; 22Laboratory Center, Hospital of Southern Jutland, Aabenraa, Denmark; 23Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark; 24Division of Clinical Epidemiology, DKFZ-German Cancer Research Centre, Heidelberg, Germany; 25Cancer Registry and Histopathology Unit, "Civic-M.P.Arezzo" Hospital, ASP Ragusa, Italy; and 26WHO Collaborating Center for Food and Nutrition Policies, Athens, Greece.



Oxidative stress may be involved in the aetiology of inflammatory bowel disease and whether dietary polyphenols, which possess antioxidants properties, prevent its development is unknown.


A total of 401,326 men and women aged 20 to 80 years from 8 countries were recruited between 1991 and 1998 and at baseline completed validated food frequency questionnaires. Dietary polyphenol intake was measured using Phenol-Explorer, a database with information on the content of 502 polyphenols. Incident cases of Crohn's diseases (CD) and ulcerative colitis (UC) were identified during the follow-up period of up to December 2010. A nested case-control study using conditional logistic regression estimated the odds ratios (ORs), and 95% confidence intervals, for polyphenol intake (categories based on quartiles) and developing CD or UC.


In total, 110 CD (73% women) and 244 UC (57% women) cases were identified and matched to 440 and 976 controls, respectively. Total polyphenol intake was not associated with CD (P trend = 0.17) or UC (P trend = 0.16). For flavones and CD, there were reduced odds for all quartiles, which were statistically significant for the third (OR3rd versus 1st quartile = 0.33; 95% confidence interval, 0.15-0.69) and there was an inverse trend across quartiles (P = 0.03). Similarly, for resveratrol, there was an inverse association with CD (OR4th versus 1st quartile = 0.40; 95% confidence interval, 0.20-0.82) with an inverse trend across quartiles (P = 0.02). No significant associations between subtypes of polyphenols and UC were found. Effect modification by smoking in CD was documented with borderline statistical significance.


The data supports a potential role of flavones and resveratrol in the risk of developing CD; future aetiological studies should investigate these dietary components and further examine the potential for residual confounding.

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