Influence of dietary factors on the clinical course of ulcerative colitis: a prospective cohort study
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Background and aims: The causes of relapses of ulcerative colitis (UC) are unknown. Dietary factors have been implicated in the pathogenesis of UC. The aim of this study was to determine which dietary factors are associated with an increased risk of relapse of UC. Methods: A prospective cohort study was performed with UC patients in remission, recruited from two district general hospitals, who were followed for one year to determine the effect of habitual diet on relapse. Relapse was defined using a validated disease activity index. Nutrient intake was assessed using a food frequency questionnaire and categorised into tertiles. Adjusted odds ratios for relapse were determined using multivariate logistic regression, controlling for non-dietary factors. Results: A total of 191 patients were recruited and 96% completed the study. Fifty two per cent of patients relapsed. Consumption of meat (odds ratio (OR) 3.2 (95% confidence intervals (CI) 1.3–7.8)), particularly red and processed meat (OR 5.19 (95% CI 2.1–12.9)), protein (OR 3.00 (95% CI 1.25–7.19)), and alcohol (OR 2.71 (95% CI 1.1–6.67)) in the top tertile of intake increased the likelihood of relapse compared with the bottom tertile of intake. High sulphur (OR 2.76 (95% CI 1.19–6.4)) or sulphate (OR 2.6 (95% CI 1.08–6.3)) intakes were also associated with relapse and may offer an explanation for the observed increased likelihood of relapse. Conclusions: Potentially modifiable dietary factors, such as a high meat or alcoholic beverage intake, have been identified that are associated with an increased likelihood of relapse for UC patients. Further studies are needed to determine if it is the sulphur compounds within these foods that mediates the likelihood of relapse and if reducing their intake would reduce relapse frequency.
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The association with UC relapse was stronger for red and processed meats than for other meats.
“The association was much stronger for red and processed meats than for other meats.”
From Diet and the Intestinal Microbiome: Associations, Functions, and Implications for Health and Disease (2014) · cites this paper as [66]
In a prospective study, patients reporting higher consumption of meat, eggs, protein, and alcohol were more likely to relapse with UC.
“In a prospective study, Jowett et al. found that patients who reported consuming higher amounts of meat, eggs, protein, and alcohol were more likely to experience a relapse of UC66.”
From Diet and the Intestinal Microbiome: Associations, Functions, and Implications for Health and Disease (2014) · cites this paper as [66]
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- Authors
- Jowett, S. L., Seal, C. J., Pearce, M. S., Phillips, E., Gregory, W., Barton, J. R., & Welfare, M. R.
- Affiliations
- North Tyneside General Hospital (GB)
- Newcastle University (GB)
- Corresponding author
- Welfare, M R
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2004-09-10
- Volume
- 53
- Issue
- 10
- Pages
- 1479-1484
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC1774231
- OpenAlex
- W2090742607
- Cited by
- 462
- References
- 76
- Citations by year
- 2026: 18 · 2025: 23 · 2024: 31 · 2023: 38 · 2022: 29 · 2021: 25 · 2020: 37 · 2019: 35 · 2018: 18 · 2017: 33 · 2016: 21 · 2015: 18 · 2014: 23 · 2013: 18 · 2012: 14
- FWCI
- 5.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Keywords
- ulcerative colitis, recurrence, dietary factors, meat consumption, red and processed meat, alcohol consumption, dietary protein, sulfur compounds, remission, risk factors
- MeSH terms
- Adult, Alcohol Drinking, Colitis, Ulcerative, Diet, Female, Humans, Male, Meat, Middle Aged, Prospective Studies, Recurrence, Risk Factors, Nutrition Assessment, Logistic Models, Odds Ratio
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