Western and carnivorous dietary patterns are associated with greater likelihood of IBD-development in a large prospective population-based cohort

OBJECTIVE: Nutrition plays a role in the development of Crohn's disease (CD) and ulcerative colitis (UC). However, prospective data on nutrition and disease-onset is limited. Here, we analysed dietary patterns and scores to IBD-development in a prospective population-based cohort. DESIGN: We analysed 125,445 participants of whom 224 individuals developed de novo UC and 97 CD over a maximum 14-year follow-up period. Participants answered health-related (also prospectively) and dietary questionnaires (FFQ) at baseline. Principal Component Analysis (PCA) was conducted deriving a-posteriori dietary patterns. Hypotheses-based a-priori dietary scores were also calculated, including the protein score, Healthy Eating Index, LifeLines Diet Score (LLDS) and alternate Mediterranean Diet Score. Logistic regression models were performed between dietary patterns, scores, and IBD-development. RESULTS: PCA identified five dietary patterns. A pattern characterized by high intake of snacks, prepared meals, non-alcoholic beverages, sauces along with low vegetables and fruit consumption was associated with higher likelihood of CD-development (OR: 1.16, 95% CI: 1.03-1.30, p=0.013). A pattern comprising red meat, poultry, and processed meat, was associated with increased likelihood of UC-development (OR: 1.11, 95% CI: 1.01-1.20, p=0.023). A high diet quality score (LLDS) was associated with decreased risk of CD (OR: 0.95, 95% CI: 0.92-0.99, p=0.009). CONCLUSIONS: A Western dietary pattern was associated with a greater likelihood of CD-development and a carnivorous pattern with UC-development, while a relatively high diet quality (LLDS) was protective for CD-development. Our study strengthens the importance of evaluating dietary patterns to aid prevention of IBD in the general population