Cited by 1,009Inflammatory Bowel DiseaseNutritional Studies and DietGut microbiota and health

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Dietary Intake and Risk of Developing Inflammatory Bowel Disease: A Systematic Review of the Literature

Hou, Jason K, Abraham, Bincy, El-Serag, Hashem·2011·American Journal of Gastroenterology

DOI 10.1038/ajg.2011.44

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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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“Several studies have investigated the association between diet and the potential risk of UC: the consumption of red meat, fats, and sweets is positively associated with the development of UC (Hansen et al., 2011; Hou et al., 2011; Ananthakrishnan et al., 2014), and breastfeeding is negatively associated with the risk…”
Background
Treatment of Active Crohn’s Disease in Children Using Partial Enteral Nutrition Combined with a Modified Crohn’s Disease Exclusion Diet: A Pilot Prospective Cohort Trial on Clinical and Endoscopic Outcomes
Urlep, D., Orel, R., Kunstek, P., & Benedik, E. (2023) · Nutrients · doi:10.3390/nu15214676 · Cited by 22
Diet, the Gut Microbiome and the Metabolome in IBD
Wu, G. D. (2014) · Nestlé Nutrition Institute Workshop series · doi:10.1159/000360686 · Cited by 20
Dual effects of a high-protein diet on DSS-treated mice during colitis resolution phase
Lan, A., Blais, A., Coelho, D., Capron, J., Maarouf, M., Benamouzig, R., Lancha, A. H., Walker, F., Tomé, D., & Blachier, F. (2016) · American Journal of Physiology-Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.00433.2015 · Cited by 20
“The aim of present work was to evaluate the potential impact of an HP diet on the colitis induction and resolution phases in the widely used dextran sulfate sodium (DSS)treated mouse model of IBD (36, 37).”
BackgroundInfluential
Serological investigation of IgG and IgE antibodies against food antigens in patients with inflammatory bowel disease
Wang, H., Li, Y., Li, J., Jiao, C.-H., Zhao, X., Li, X., Lu, M., Mao, X., & Zhang, H. (2019) · World Journal of Clinical Cases · doi:10.12998/wjcc.v7.i16.2189 · Cited by 20
Immune-mediated inflammatory diseases and nutrition: results from an online survey on patients’ practices and perceptions
Pham, T., Sokol, H., Halioua, B., Pourcel, G., Brun, M., Pain, É., & Testa, D. (2021) · BMC Nutrition · doi:10.1186/s40795-021-00446-y · Cited by 20
Mangosteen Extract Prevents Dextran Sulfate Sodium-Induced Colitis in Mice by Suppressing NF- κ B Activation and Inflammation
Chae, H., You, B. H., Song, J., Ko, H. W., Choi, Y. H., & Chin, Y. (2017) · Journal of Medicinal Food · doi:10.1089/jmf.2017.3944 · Cited by 20
Dietary total antioxidant capacity and risk of ulcerative colitis: A case‐control study
Rahmani, J., Kord‐Varkaneh, H., Ryan, P. M., Rashvand, S., Clark, C. C. T., Day, A. S., & Hekmatdoost, A. (2019) · Journal of Digestive Diseases · doi:10.1111/1751-2980.12823 · Cited by 20
“In conclusion, this case-control study found that high dietary TAC was associated with a significantly reduced risk of UC.”
BackgroundInfluential
Dietary Porphyra tenera ameliorated dextran sodium sulfate-induced colitis in mice via modulating gut microbiota dysbiosis
Yi, L., Han, Y., Shen, P., Du, H., Guo, X., Zhou, Z., & Xiao, H. (2024) · Food Chemistry · doi:10.1016/j.foodchem.2024.140832 · Cited by 20
Casein-fed mice showed faster recovery from DSS-induced colitis than chicken-protein-fed mice
Yu, L., Zhao, D., Nian, Y., & Li, C. (2021) · Food & Function · doi:10.1039/d1fo00659b · Cited by 19
Diet, Gut Enterotypes and Health: Is There a Link?
Bushman, F. D., Lewis, J. D., & Wu, G. D. (2013) · Nestlé Nutrition Institute Workshop series · doi:10.1159/000351385 · Cited by 19
Stool Phospholipid Signature is Altered by Diet and Tumors
Davies, J. M., Hua, H.-U., Dheer, R., Martinez, M., Bhattacharya, S. K., & Abreu, M. T. (2014) · PLoS ONE · doi:10.1371/journal.pone.0114352 · Cited by 21
Oral Diets and Nutrition Support for Inflammatory Bowel Disease
Shah, N. D., Parian, A. M., Mullin, G. E., & Limketkai, B. N. (2015) · Nutrition in Clinical Practice · doi:10.1177/0884533615591059 · Cited by 19
Treatment response and long term follow up in nineteen dogs diagnosed with chronic enteropathy in Australia
Dandrieux, J. R. S., Martínez-López, L. M., Prakash, N., & Mansfield, C. (2019) · Australian Veterinary Journal · doi:10.1111/avj.12846 · Cited by 19
The Gut Microbiome, Its Metabolome, and Their Relationship to Health and Disease
Wu, G. D. (2016) · Nestlé Nutrition Institute Workshop series · doi:10.1159/000436993 · Cited by 22
Reasoning Beyond the Potential Use of Exclusive Enteral Nutrition and Other Specified Diets in Children With Ulcerative Colitis
Shaoul, R. R., Brown, S., & Day, A. S. (2017) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000001785 · Cited by 19
“This may help to partially explain the protective effect of a high vegetable intake in the prevention of UC (45).”
Background
Switching to a Healthy Diet Prevents the Detrimental Effects of Western Diet in a Colitis-Associated Colorectal Cancer Model
Gröschel, C., Prinz-Wohlgenannt, M., Mesteri, I., George, S. K., Trawnicek, L., Heiden, D., Aggarwal, A., Tennakoon, S., Baumgartner, M., Gasché, C., et al. (2019) · Nutrients · doi:10.3390/nu12010045 · Cited by 18
“We evaluated the number and size of mucosal regions forming ACF, the earliest premalignant lesions that precede dysplasia in sporadic CRC as well as in CAC.”
BackgroundInfluential
Where Do We Stand in the Behavioral Pathogenesis of Inflammatory Bowel Disease? The Western Dietary Pattern and Microbiota—A Narrative Review
Krela‐Kaźmierczak, I., Zakerska‐Banaszak, O., Skrzypczak-Zielińska, M., Łykowska‐Szuber, L., Szymczak‐Tomczak, A., Zawada, A. E., Rychter, A. M., Ratajczak, A. E., Skoracka, K., Skrzypczak, D., et al. (2022) · Nutrients · doi:10.3390/nu14122520 · Cited by 18
“Additionally, the intake of vegetables decreased the risk of UC [188].”
Background
Uptake and Advanced Therapy of Butyrate in Inflammatory Bowel Disease
Ota, S., & Sakuraba, H. (2022) · Immuno · doi:10.3390/immuno2040042 · Cited by 21
“Westernized diets contain high sugar, high fat, and low fiber levels and high calories; they elevate the risk of IBD onset [22,23].”
Background
The Mediterranean Diet in Paediatric Gastrointestinal Disorders
Cenni, S., Sesenna, V., Boiardi, G., Casertano, M., Nardo, G. D., Esposito, S., & Strisciuglio, C. (2022) · Nutrients · doi:10.3390/nu15010079 · Cited by 18
“It is known that diet can play a role in the generation of inflammation, by modulating the microbiome, the function of the intestinal barrier and the mucosal layer [22].”
Background
Role of Rho GTPases in inflammatory bowel disease
Li, X., Zhang, M., Zhou, G., Xie, Z., Wang, Y., Han, J., Li, L., Wu, Q., & Zhang, S. (2023) · Cell Death Discovery · doi:10.1038/s41420-023-01329-w · Cited by 19
What Should I Eat? Dietary Recommendations for Patients with Inflammatory Bowel Disease
Saha, S., & Patel, N. (2023) · Nutrients · doi:10.3390/nu15040896 · Cited by 19
“In contrast to high dietary fat and meat consumption, high dietary fiber and fruit intake decreases the risk of developing CD, but not UC [6,8].”
BackgroundInfluential
Global evolving patterns and cross-country inequalities of inflammatory bowel disease burden from 1990 to 2019: a worldwide report
Cao, L., Dayimu, A., Guan, X., Duan, M., Zeng, S., Wang, H., Zong, J., Sun, C., Yang, X., & Yang, X. (2024) · Inflammation Research · doi:10.1007/s00011-023-01836-7 · Cited by 21
“A systematic review reported that high fiber and fruit intakes were associated with a decreased risk of ulcerative colitis and Crohn’s disease [36].”
Prevention of ulcerative colitis by Huangqin decoction: reducing the intestinal epithelial cell apoptosis rate through the IFN-γ/JAK/ETS signalling pathway
Mo, X., Tang, K., Deng, L., Zhou, X., Li, X., Zhang, Y., & Wang, J. (2022) · Pharmaceutical Biology · doi:10.1080/13880209.2022.2070220 · Cited by 18
“The increased intake of total fat, animal fat and polyunsaturated fatty acids in the diet increases the host’s UC risk (Hou et al. 2011; Singh et al. 2017).”
Background
Dietary triggers of gut inflammation following exclusive enteral nutrition in children with Crohn’s disease: a pilot study
Gkikas, K., Logan, M., Nichols, B., Ijaz, U. Z., Clark, C., Svolos, V., Gervais, L., Duncan, H., Garrick, V., Curtis, L., et al. (2021) · BMC Gastroenterology · doi:10.1186/s12876-021-02029-4 · Cited by 17
“This observation is in contrast to the previously ascribed protective role of fibre in the development of CD [3, 24, 25].”
Result
Diet, Sun, Physical Activity and Vitamin D Status in Children with Inflammatory Bowel Disease
Śledzińska, K., Landowski, P., Zmijewski, M. A., Kamińska, B., Kowalski, K., & Liberek, A. (2022) · Nutrients · doi:10.3390/nu14051029 · Cited by 17
“analyzes the diets of patients with IBD prior to onset and showed an increased refined sugar intake in patients with CD [53].”
Background
The Impact of Low‐Viscosity Soluble Dietary Fibers on Intestinal Microenvironment and Experimental Colitis: A Possible Preventive Application of Alpha‐Cyclodextrin in Intestinal Inflammation
Yamanouchi, Y., Chudan, S., Ishibashi, R., Ohue‐Kitano, R., Nishikawa, M., Tabuchi, Y., Kimura, I., Nagai, Y., Ikushiro, S., & Furusawa, Y. (2022) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.202200063 · Cited by 18
Mechanistic insight: Linking cardiovascular complications of inflammatory bowel disease
Kumarapperuma, H., Wang, R., Little, P. J., & Kamato, D. (2023) · Trends in Cardiovascular Medicine · doi:10.1016/j.tcm.2023.01.002 · Cited by 17
The Role of Fecal Microbiota Transplantation in the Induction of Remission in Ulcerative Colitis
Saleh, A. G., Parsa, S., Garza, M. A., Quigley, E. M. M., & Abraham, B. P. (2023) · Digestive Diseases · doi:10.1159/000529591 · Cited by 17
Self-citation
Inflammatory Potential of the Diet and Risk of Crohn's Disease and Ulcerative Colitis
Meyer, A., Chan, S. S. M., Touvier, M., Julia, C., Tjønneland, A. M., Kyrø, C., Dahm, C. C., Katzke, V. A., Schulze, M. B., Tumino, R., et al. (2025) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.18497 · Cited by 17
“The impact of polyunsaturated fatty acids (PUFAs) has been re-ported on the risk of developing CD [4, 38].”
Recent Progress in Engineering Human-Associated Microbiomes
Yaung, S. J., Church, G. M., & Wang, H. H. (2014) · Methods in molecular biology · doi:10.1007/978-1-4939-0554-6_1 · Cited by 16
A pea (Pisum sativum L.) seed albumin extract prevents colonic DSS induced dysbiosis in mice
Aranda‐Olmedo, I., Ruiz, R., Peinado, M. J., & Rubio, L. A. (2017) · Journal of Functional Foods · doi:10.1016/j.jff.2017.05.038 · Cited by 17
The role of dietary factors in inflammatory bowel diseases: New perspectives
Zhou, Y., Xu, R., & Wan, Y. P. (2018) · Journal of Digestive Diseases · doi:10.1111/1751-2980.12686 · Cited by 18
“A negative relationship between oleic acid intake and risk of UC (odds ratio [OR] 0.03, 95% CI 0.002–0.56) was reported based on the EPIC study.54 More notably, PUFAs can be categorized into anti- inflammatory n-3 PUFAs (α-linolenic acid [ALA], docosahexaenoic acid [DHA] and eicosapentaenoic acid [EPA]) and pro-inflam…”
BackgroundResultInfluential
Dietary Management of Pediatric Inflammatory Bowel Disease
Kaenkumchorn, T. K., & Kesavan, A. (2019) · Journal of Medicinal Food · doi:10.1089/jmf.2019.0063 · Cited by 17
Sodium butyrate inhibits colitis-associated colorectal cancer through preventing the gut microbiota dysbiosis and reducing the expression of NLRP3 and IL-1β
Liu, H., Bian, Z., Zhang, Q., Xiao, Z., Cao, Y., Sun, X., Qin, Y., Mao, L., Chu, X., Liao, W., et al. (2021) · Journal of Functional Foods · doi:10.1016/j.jff.2021.104862 · Cited by 18
Crohn’s Disease Remission with a Plant-Based Diet: A Case Report
Sandefur, K., Kahleová, H., Desmond, A. N., Elfrink, E., & Barnard, N. D. (2019) · Nutrients · doi:10.3390/nu11061385 · Cited by 17
Dietary Support in Elderly Patients with Inflammatory Bowel Disease
Eder, P., Niezgódka-Klósak, A., Krela‐Kaźmierczak, I., Stawczyk‐Eder, K., Banasik, E., & Dobrowolska, A. (2019) · Nutrients · doi:10.3390/nu11061421 · Cited by 19
“noted that a high intake of omega-6 PUFA, saturated fats, and meat is correlated with an increased risk of developing UC and CD [129].”
Background
Examination of food consumption in United States adults and the prevalence of inflammatory bowel disease using National Health Interview Survey 2015
Han, M. K., Anderson, R. K., Viennois, É., & Merlin, D. (2020) · PLoS ONE · doi:10.1371/journal.pone.0232157 · Cited by 17
“A systemic review of the literature has found high consumption of total fat, polyunsaturated fatty acids, omega-6 fatty acids, saturated fats, and meats to be associated with increased risk for IBD [19].”
Background
A nutritional approach for managing irritable bowel syndrome
Bhesania, N., & Cresci, G. (2017) · Current Opinion in Pediatrics · doi:10.1097/mop.0000000000000536 · Cited by 16
Inflammatory bowel disease - A peek into the bacterial community shift and algae-based ‘biotic’ approach to combat the disease
Kiron, V., Hayes, M., & Avni, D. (2022) · Trends in Food Science & Technology · doi:10.1016/j.tifs.2022.09.012 · Cited by 16

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
ORCID: Hou, Jason K
Abraham, Bincy
Venue: American Journal of Gastroenterology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2011-04
Volume: 106
Issue: 4
Pages: 563-573
ISSN: 0002-9270 (ISSN-L)
DOI: 10.1038/ajg.2011.44
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
Licence: www.springer.com/tdm (unspecified)
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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Dietary Intake and Risk of Developing Inflammatory Bowel Disease: A Systematic Review of the Literature

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