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J Crohns Colitis. 2018 Jan 24;12(2):129-136. doi: 10.1093/ecco-jcc/jjx136.

Fibre intake and the development of inflammatory bowel disease: A European prospective multi-centre cohort study (EPIC-IBD).

Author information

1
Laboratory Center, Hospital of Southern Jutland, Denmark.
2
Institute of Regional Health Research - Center Sønderjylland, University of Southern Denmark, Denmark.
3
Institute of Molecular Medicine, University of Southern Denmark, Denmark.
4
Department of Medicine, Norwich Medical School University of East Anglia, UK.
5
Norfolk & Norwich University Hospitals NHS Trust, UK.
6
Strangeways Research Laboratory, Institute of Public Health, University of Cambridge, UK.
7
Danish Cancer Society Research Center, Danish Cancer Society, Denmark.
8
Division of Clinical Epidemiology, DKFZ - German Cancer Research Centre, Germany.
9
Department of Clinical Sciences, University Hospital, Sweden.
10
Department of Epidemiology, German Institute of Human Nutrition, Germany.
11
Department of Medical Biosciences, Clinical Chemistry, Umeå University, Sweden.
12
Department of Public Health and Clinical Medicine, Umeå University, Sweden.
13
Department of Public Health, Section for Epidemiology, Aarhus University, Denmark.
14
Department of Gastroenterology and Hepatology, University Medical Center Utrecht, The Netherlands.
15
INSERM, Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, France.
16
Universite Paris Sud, UMRS 1018, France.
17
Department of Gastroenterology, Bicetre University Hospital, Assistance Publique des Hopitaux, France.
18
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK.
19
Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Italy.
20
Cancer Registry and Histopathology Department, 'Civic - M.P.Arezzo' Hospital, Italy.
21
WHO Collaborating Centre for Food and Nutrition Polices, Greece.
22
Division of Epidemiology, Imperial College London, UK.

Abstract

Background and Aims:

Population-based prospective cohort studies investigating fibre intake and development of inflammatory bowel disease are lacking. Our aim was to investigate the association between fibre intake and the development of Crohn's disease [CD] and ulcerative colitis [UC] in a large European population.

Methods:

In total, 401326 participants, aged 20-80 years, were recruited in eight countries in Europe between 1991 and 1998. At baseline, fibre intake [total fibres, fibres from fruit, vegetables and cereals] was recorded using food frequency questionnaires. The cohort was monitored for the development of inflammatory bowel disease. Each case was matched with four controls and odds ratios [ORs] for the exposures were calculated using conditional logistic regression. Sensitivity analyses according to smoking status were computed.

Results:

In total, 104 and 221 participants developed incident CD and UC, respectively. For both CD and UC, there were no statistically significant associations with either quartiles, or trends across quartiles, for total fibre or any of the individual sources. The associations were not affected by adjusting for smoking and energy intake. Stratification according to smoking status showed null findings apart from an inverse association with cereal fibre and CD in non-smokers [Quartile 4 vs 1 OR = 0.12, 95% confidence interval = 0.02-0.75, p = 0.023, OR trend across quartiles = 0.50, 95% confidence interval = 0.29-0.86, p = 0.017].

Conclusion:

The results do not support the hypothesis that dietary fibre is involved in the aetiology of UC, although future work should investigate whether there may be a protective effect of specific types of fibre according to smoking status in CD.

KEYWORDS:

Dietary fibre; diet; epidemiology; fibre food; inflammatory bowel disease; prospective study

PMID:
29373726
PMCID:
PMC5881771
DOI:
10.1093/ecco-jcc/jjx136
[Indexed for MEDLINE]
Free PMC Article

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