Chan, S.S.M.

Hart, A.R.

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S. S. M. Chan

A. R. Hart

Crossref

Alimentary Pharmacology & Therapeutics

Commentary: the association between high dietary intake of docosahexaenoic acid and reduced risk of Crohn's disease - authors' reply

Chan, S. S. M.

Hart, A. R.

University of East Anglia digital repository

increased incidence of Crohn disease in Japan. Am J Clin Nutr1996; 63: 741–5.3. Sakamoto N, Kono S, Wakai K, et al. Dietary risk factors forinﬂammatory bowel disease: a multicenter case-control study inJapan. Inﬂamm Bowel Dis 2005; 11: 154–63.4. Ananthakrishnan AN, Khalili H, Konijeti GG, et al. Long-termintake of dietary fat and risk of ulcerative colitis and Crohn’sdisease. Gut 2014; 63: 776–84.5. Chan SS, Luben R, Olsen A, et al. Association between highdietary intake of the n-3 polyunsaturated fatty aciddocosahexaenoic acid and reduced risk of Crohn’s disease.Aliment Pharmacol Ther 2014; 39: 834–42.6. Albenberg LG, Wu GD. Diet and the intestinal microbiome:associations, functions, and implications for health and disease.Gastroenterology 2014; doi: 10.1053/j.gastro.2014.01.058 [Epubahead of print].7. Zoetendal EG, de Vos WM. Effect of diet on the intestinalmicrobiota and its activity. Curr Opin Gastroenterol 2014; 30:189–95.Commentary: the association betweenhigh dietary intake of docosahexaenoicacid and reduced risk of Crohn’s disease –authors’ replyS. S. M. Chan*,† & A. R. Hart*,†*Department of Medicine, Norwich Medical School, University of EastAnglia, Norwich, UK.†Norfolk & Norwich University Hospitals NHS Trust, Norwich, UK.E-mail: simon.chan@uea.ac.ukdoi:10.1111/apt.12755SIRS, Thank you for the commentary on our articlewhich showed, for the ﬁrst time, a large inverse associa-tion between higher dietary intakes of the dietary n-3polyunsaturated fatty acid docosahexaenoic acid (DHA)and incident Crohn’s disease (CD) using data from aprospective cohort study.1, 2Our study design is important in nutritional epidemi-ological work as it removes both recall and selectionbiases inherent in retrospective case–control studies.Only one other similar prospective investigation exists inthis area, the US Nurses’ Health Study, which identiﬁed269 incident cases and did not report any associationswith total long-chain n-3 PUFA intake and CD.3 Thisinvestigation was very well conducted with large num-bers of participants and several assessments of habitualdiet, but did not speciﬁcally report DHA intake. As indi-vidual n-3 PUFAs may have differing effects on theinﬂammatory process, this may explain the discrepanciesbetween the results from the two cohorts.Our ﬁndings are unlikely to be due to recall bias, asall participants were well at recruitment and their dietwould not be affected by symptoms. Although in ourwork, more than one measure of diet would have beenpreferable, any changes over time would result in spuri-ous under-estimates of effect sizes, rather than falseover-estimates. Ideally, other cohort studies are requiredto investigate DHA, in the aetiology of CD, although weare unaware of any.An approach to help clarify the effect of DHA is toconduct clinical trials of purely DHA supplementation,as opposed to ﬁsh oils in previous studies, in the treat-ment of CD. Whether the potential effects of DHA aresimilar in aetiology and on clinical parameters isunknown. However, our epidemiological work wouldsupport the further investigation of DHA as a chemopre-ventive and possibly a treatment option for CD.ACKNOWLEDGEMENTThe authors’ declarations of personal and ﬁnancial inter-ests are unchanged from those in the original article.2REFERENCES1. Ooi S-YJ, Andrews JM. Commentary: the association betweenhigh dietary intake of docosahexaenoic acid and reduced risk ofCrohn’s disease. Aliment Pharmacol Ther 2014; 39: 1331–2.2. Chan SS, Luben R, Olsen A, et al. Association between highdietary intake of the n-3 polyunsaturated fatty aciddocosahexaenoic acid and reduced risk of Crohn’s disease.Aliment Pharmacol Ther 2014; 39: 834–42.3. Ananthakrishnan AN, Khalili H, Konijeti GG, et al. Long-termintake of dietary fat and risk of ulcerative colitis and Crohn’sdisease. Gut 2014; 63: 776–84.1332 Aliment Pharmacol Ther 2014; 39: 1331-1336ª 2014 John Wiley & Sons LtdInvited Commentaries

Commentary: The association between high dietary intake of docosahexaenoic acid and reduced risk of Crohn's disease - Authors' reply

Commentary:The association between high dietary intake of docosahexaenoic acid and reduced risk of Crohn's disease - Authors' reply

Commentary:The association between high dietary intake of docosahexaenoic acid and reduced risk of Crohn's disease - Authors' reply

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