Carbohydrate intake in the etiology of Crohn's disease and ulcerative colitis

Simon Chan (Lead Author), Robert Luben, Fiona van Schaik, Bas Oldenburg, H. Bas Bueno-de-Mesquita, Göran Hallmans, Pontus Karling, Stefan Lindgren, Olof Grip, Timothy Key, Francesca L. Crowe, Manuela M. Bergmann, Kim Overvad, Domenico Palli, Giovanna Masala, Kay-Tee Khaw, Antoine Racine, Franck Carbonnel, Marie-Christine Boutron-Ruault, Anja OlsenAnne Tjonneland, Rudolf Kaaks, Rosario Tumino, Antonia Trichopoulou, Andrew R. Hart

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Background: Diet may have a role in the etiology of inflammatory bowel disease. In previous studies, the associations between increased intakes of carbohydrates, sugar, starch, and inflammatory bowel disease are inconsistent. However, few prospective studies have investigated the associations between these macronutrients and incident Crohn's disease (CD) or ulcerative colitis (UC).

Methods: A total of 401,326 men and women were recruited between 1991 and 1998. At recruitment, dietary intakes of carbohydrate, sugar, and starch were measured using validated food frequency questionnaires. The cohort was monitored identifying participants who developed incident CD or UC. Cases were matched with 4 controls, and odds ratios were calculated for quintiles of total carbohydrate, sugar, and starch intakes adjusted for total energy intake, body mass index, and smoking.

Results: One hundred ten participants developed CD, and 244 participants developed UC during follow-up. The adjusted odds ratio for the highest versus the lowest quintiles of total carbohydrate intake for CD was 0.87, 95% CI = 0.24 to 3.12 and for UC 1.46, 95% CI = 0.62 to 3.46, with no significant trends across quintiles for either (CD, Ptrend = 0.70; UC, Ptrend = 0.41). Similarly, no associations were observed with intakes of total sugar (CD, Ptrend = 0.50; UC, Ptrend = 0.71) or starch (CD, Ptrend = 0.69; UC, Ptrend = 0.17).

Conclusions: The lack of associations with these nutrients is in agreement with many case–control studies that have not identified associations with CD or UC. As there is biological plausibility for how specific carbohydrates could have an etiological role in inflammatory bowel disease, future epidemiological work should assess individual carbohydrates, although there does not seem to be a macronutrient effect.
Original languageEnglish
Pages (from-to)2013-2021
Number of pages9
JournalInflammatory Bowel Diseases
Issue number11
Early online date26 Sep 2014
Publication statusPublished - Nov 2014

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