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Dietary Intake and Risk of Developing Inflammatory Bowel Disease: A Systematic Review of the Literature
Abstract
OBJECTIVES: The incidence of inflammatory bowel disease (IBD) is increasing. Dietary factors such as the spread of the "Western" diet, high in fat and protein but low in fruits and vegetables, may be associated with the increase. Although many studies have evaluated the association between diet and IBD risk, there has been no systematic review. METHODS: We performed a systematic review using guideline-recommended methodology to evaluate the association between pre-illness intake of nutrients (fats, carbohydrates, protein) and food groups (fruits, vegetables, meats) and the risk of subsequent IBD diagnosis. Eligible studies were identified via structured keyword searches in PubMed and Google Scholar and manual searches. RESULTS: Nineteen studies were included, encompassing 2,609 IBD patients (1,269 Crohn's disease (CD) and 1,340 ulcerative colitis (UC) patients) and over 4,000 controls. Studies reported a positive association between high intake of saturated fats, monounsaturated fatty acids, total polyunsaturated fatty acids (PUFAs), total omega-3 fatty acids, omega-6 fatty acids, mono- and disaccharides, and meat and increased subsequent CD risk. Studies reported a negative association between dietary fiber and fruits and subsequent CD risk. High intakes of total fats, total PUFAs, omega-6 fatty acids, and meat were associated with an increased risk of UC. High vegetable intake was associated with a decreased risk of UC. CONCLUSIONS: High dietary intakes of total fats, PUFAs, omega-6 fatty acids, and meat were associated with an increased risk of CD and UC. High fiber and fruit intakes were associated with decreased CD risk, and high vegetable intake was associated with decreased UC risk.
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“A systematic review concluded that diets with high levels of total fats, polyunsaturated fatty acids, omega-6 fatty acids, and meat were associated with an increased risk of CD and UC; high fiber and high fruit intake were associated with a decreased risk of CD, whereas high vegetable intake was associated with a decreased for UC65.”
From Diet and the Intestinal Microbiome: Associations, Functions, and Implications for Health and Disease (2014) · cites this paper as [65]
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Environmental Risk Factors for Inflammatory Bowel Diseases: A Review
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“established from the more rigorous cohort studies [34, 35].”
BackgroundMicrobiome, Metabolome and Inflammatory Bowel Disease
Ahmed, I., Roy, B. C., Khan, S., Septer, S. S., & Umar, S. (2016) · Microorganisms · doi:10.3390/microorganisms4020020 · Cited by 199
“Several studies have examined the association between dietary patterns and the incidence of IBD [106,107].”
BackgroundDietary cellulose prevents gut inflammation by modulating lipid metabolism and gut microbiota
Kim, Y., Hwang, S. W., Kim, S., Lee, Y., Kim, T., Lee, S.-H., Kim, S. J., Yoo, H. J., Kim, E. N., & Kweon, M. (2020) · Gut Microbes · doi:10.1080/19490976.2020.1730149 · Cited by 197
“Epidemiologic and basic researchers have identified the Western diet, which is characterized by high fat, high carbohydrate, and low fiber content, as a risk factor for colitis.(2,3) Based on these studies, dietary education is usually recommended for colitis patients, and the exclusion of Western diet by exclusive en…”
BackgroundMiele, E., Shamir, R., Aloi, M., Assa, A., Braegger, C., Bronsky, J., de Ridder, L., Escher, J. C., Hojsak, I., Kolaček, S., et al. (2018) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000001896 · Cited by 191
“Several epidemiological studies discuss a positive correlation between western life style (western diet with high amounts of unsaturated fatty acids, of proteins, a high sugar loads and low vegetables and fruits intake) and the risk of developing IBD (291,292).”
BackgroundLeaky Gut and the Ingredients That Help Treat It: A Review
Alemán, R. S., Moncada, M. L., & Aryana, K. J. (2023) · Molecules · doi:10.3390/molecules28020619 · Cited by 185
“Diets high in sucrose, refined carbohydrates, polyunsaturated fatty acids, and omega-6 and low in fiber are associated with an increased risk of presenting these intestinal disorders [9].”
Backgroundvon Martels, J. Z. H., Sadabad, M. S., Bourgonje, A. R., Blokzijl, T., Dijkstra, G. D. H., Faber, K. N., & Harmsen, H. J. M. (2017) · Anaerobe · doi:10.1016/j.anaerobe.2017.01.001 · Cited by 186
Dietary interventions for induction and maintenance of remission in inflammatory bowel disease
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“Some studies have associated an increased fat intake with CD risk (Hou 2011; Reif 1997; Sakamoto 2005).”
BackgroundThe epidemiology and risk factors of inflammatory bowel disease.
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“Although diet is not a causative factor in IBD it is thought to be a potential trigger for IBD flares, and it is believed that the Westernised diet rich in processed foods is a factor in the increased incidence of the disease in these regions (82).”
BackgroundZhang, S., Nie, Q., Sun, Y., Zuo, S., Chen, C., Li, S., Yang, J., Hu, J., Zhou, X., Yu, Y., et al. (2024) · Microbiome · doi:10.1186/s40168-024-01896-9 · Cited by 192
“Research has established a link between Western diet and the onset of IBD [53], while a high-fiber diet can reduce the risk of IBD or improve the quality of life in IBD patients by reshaping the gut microbiota [54, 55].”
BackgroundNguyen, L. H., Ma, W., Wang, D. D., Cao, Y., Mallick, H., Gerbaba, T. K., Lloyd‐Price, J., Abu-Ali, G., Hall, A. B., Sikavi, D. R., et al. (2020) · Gastroenterology · doi:10.1053/j.gastro.2019.12.029 · Cited by 186
The Role of Environmental Factors in the Pathogenesis of Inflammatory Bowel Diseases
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“Despite dietary exposures having been associated with the development of IBD and disease course [2,3], the primary therapies for IBD are medications that suppress the immune system or possess direct anti-inflammatory effects.”
BackgroundZeng, H., Ishaq, S. L., Zhao, F., & Wright, A. G. (2016) · The Journal of Nutritional Biochemistry · doi:10.1016/j.jnutbio.2016.05.015 · Cited by 173
“There is compelling evidence to includediets and the composition of the gut microbiota as key risk factors [3,18,28].”
BackgroundInfluentialFree Fatty Acid (FFA) and Hydroxy Carboxylic Acid (HCA) Receptors
Offermanns, S. (2013) · The Annual Review of Pharmacology and Toxicology · doi:10.1146/annurev-pharmtox-011613-135945 · Cited by 178
Tavakoli, P., Vollmer-Conna, U. S., Hadzi-Pavlovic, D., & Grimm, M. (2021) · Public health reviews · doi:10.3389/phrs.2021.1603990 · Cited by 173
The Role of Dietary Nutrients in Inflammatory Bowel Disease
Sugihara, K., Morhardt, T. L., & Kamada, N. (2019) · Frontiers in Immunology · doi:10.3389/fimmu.2018.03183 · Cited by 172
“A recent systematic literature review of epidemiological data has shown that high dietary intakes of total fats, SFAs, omega-6 (n-6) and PUFAs are associated with an increased risk of both CD and UC (133).”
BackgroundLi, M., Ding, Y., Wei, J., Dong, Y., Wang, J., Dai, X., Yan, J., Chu, F., Zhang, K., Meng, F., et al. (2024) · Gut Microbes · doi:10.1080/19490976.2024.2377576 · Cited by 169
“37,38 In our study, we also demonstrated that a HFD could aggravate the severity of colitis and disrupt gut barrier function in DSS-induced colitis model.”
BackgroundDietary influences on intestinal immunity
Veldhoen, M., & Brucklacher-Waldert, V. (2012) · Nature reviews. Immunology · doi:10.1038/nri3299 · Cited by 167
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“[44] carried out a systematic review of the literature on dietary intake and the risk of developing IBD.”
BackgroundAdipose-Tissue and Intestinal Inflammation – Visceral Obesity and Creeping Fat
Kredel, L. I., & Siegmund, B. (2014) · Frontiers in Immunology · doi:10.3389/fimmu.2014.00462 · Cited by 166
Keshteli, A. H., Madsen, K. L., & Dieleman, L. A. (2019) · Nutrients · doi:10.3390/nu11071498 · Cited by 157
“The relationship between diet and UC development has been indicated in several epidemiological studies [4].”
BackgroundKaulmann, A., & Bohn, T. (2016) · Oxidative Medicine and Cellular Longevity · doi:10.1155/2016/9346470 · Cited by 154
“Positive influences on the gut microbiota and the aryl-hydrocarbon receptor (AhR), mediating protection against xenobiotics, were discussed.”
BackgroundThe Role of Carrageenan and Carboxymethylcellulose in the Development of Intestinal Inflammation
Martino, J. V., Limbergen, J. V., & Cahill, L. E. (2017) · Frontiers in Pediatrics · doi:10.3389/fped.2017.00096 · Cited by 163
Diet as a Therapeutic Option for Adult Inflammatory Bowel Disease
Kakodkar, S., & Mutlu, E. (2017) · Gastroenterology Clinics of North America · doi:10.1016/j.gtc.2017.08.016 · Cited by 158
“There is suspicion that the pathogenesis of inflammatory bowel disease (IBD) may involve the Western diet which is known to be low in fruits and vegetables and high in fat, n-6 polyunsaturated fatty acids (PUFA) and red/processed foods.(1) Westernization has become a global phenomenon, this may explain why there is an…”
The Impact of Inflammatory Bowel Disease in Canada 2018: Children and Adolescents with IBD
Carroll, M. W., Kuenzig, M. E., Mack, D. R., Otley, A. R., Griffiths, A. M., Kaplan, G. G., Bernstein, C. N., Bitton, A., Murthy, S. K., Nguyen, G. C., et al. (2018) · Journal of the Canadian Association of Gastroenterology · doi:10.1093/jcag/gwy056 · Cited by 150
“Westernized diets are higher in animal fats and some carbohydrates but lower in fruits, vegetables and their attendant resistant starches and omega-3 fatty acids derived from fish (24, 25).”
BackgroundTriggering Akkermansia with dietary polyphenols: A new weapon to combat the metabolic syndrome?
Anhê, F. F., Pilon, G., Roy, D., Desjardins, Y., Levy, E. H., & Marette, A. (2016) · Gut Microbes · doi:10.1080/19490976.2016.1142036 · Cited by 155
Why interleukin-10 supplementation does not work in Crohn’s disease patients
Marlow, G. (2013) · World Journal of Gastroenterology · doi:10.3748/wjg.v19.i25.3931 · Cited by 148
Diet therapy for inflammatory bowel diseases: The established and the new
Durchschein, F., Petritsch, W., & Hammer, H. F. (2016) · World Journal of Gastroenterology · doi:10.3748/wjg.v22.i7.2179 · Cited by 147
Martin, D., & Bolling, B. W. (2015) · Food & Function · doi:10.1039/c5fo00202h · Cited by 144
Epidemiology of inflammatory bowel disease: Focus on Asia
Ng, S. C. (2014) · Best Practice & Research Clinical Gastroenterology · doi:10.1016/j.bpg.2014.04.003 · Cited by 143
“In a recent systematic review, a high dietary intake of fats, fatty acids, sugars and meat increased the risk for developing CD and UC, while increased intake of fibre, fruit and vegetables decreased the risk for development of CD and UC [75].”
Background
Metadata
- Authors
- Hou, J. K., Abraham, B., & El-Serag, H.
- Affiliations
- Michael E. DeBakey VA Medical Center (US)
- Baylor College of Medicine (US)
- Corresponding author
- Hou, Jason K
- Venue
- American Journal of Gastroenterology
- Published
- 2011-04
- Volume
- 106
- Issue
- 4
- Pages
- 563-573
- ISSN
- 0002-9270 (ISSN-L)
- OpenAlex
- W2030631780
- Semantic Scholar
- 846fa3e7e7f98a379c5e4b67d65a7f58ab57640c
- Cited by
- 1,009
- References
- 33
- Citations by year
- 2026: 35 · 2025: 72 · 2024: 84 · 2023: 105 · 2022: 96 · 2021: 83 · 2020: 65 · 2019: 88 · 2018: 43 · 2017: 65 · 2016: 67 · 2015: 52 · 2014: 53 · 2013: 54 · 2012: 39
- FWCI
- 5.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK-56338, P30DK056338)
- Topics
- Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- inflammatory bowel disease, Crohn's disease, ulcerative colitis, dietary intake, Western diet, saturated fat, polyunsaturated fatty acids, omega-6 fatty acids, omega-3 fatty acids, dietary fiber, fruit consumption, vegetable consumption, meat consumption, dietary risk factors
- MeSH terms
- Colitis, Ulcerative, Crohn Disease, Diet, Dietary Carbohydrates, Dietary Fats, Dietary Fiber, Dietary Proteins, Fatty Acids, Unsaturated, Fruit, Humans, Meat, Vegetables, Inflammatory Bowel Diseases, Risk Assessment, Fatty Acids, Omega-6
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