Welcome to PracticeUpdate! We hope you are enjoying access to a selection of our top-read and most recent articles. Please register today for a free account and gain full access to all of our expert-selected content.
Already Have An Account? Log in Now
Ultra-Processed Food Consumption and Long-Term IBS Risk
abstract
This abstract is available on the publisher's site.
Access this abstract now Full Text Available for ClinicalKey SubscribersBACKGROUND & AIMS
The considerable disease burden of irritable bowel syndrome (IBS) has coincided with the increase of ultraprocessed food (UPF) consumption over the past few decades. However, epidemiologic evidence is lacking. We aimed to examine the long-term risk of IBS associated with UPF consumption in a large-scale prospective cohort.
METHODS
Participants who completed 24-hour dietary recalls during 2009 to 2012 from the UK Biobank, and free of IBS, celiac disease, inflammatory bowel disease, and any cancer at baseline, were included (N = 178,711; 53.1% female). UPF consumption was defined according to the NOVA food classification system, expressed as a percentage of UPF content in the total diet intake (as grams per day). The primary outcome was incident IBS. A Cox proportional hazard model was performed to estimate associated risk.
RESULTS
The mean UPF consumption was 21.0% (SD, 11.0%) of the total diet. During a median of 11.3 years of follow-up evaluation, 2690 incident IBS cases were identified. An 8% higher risk of IBS (hazard ratio, 1.08; 95% CI, 1.04-1.12) was associated with each 10% increment of UPF consumption. Compared with the lowest quartile of UPF consumption, the highest quartile was associated with a significantly increased risk of incident IBS (hazard ratio, 1.19; 95% CI, 1.07-1.33; Ptrend < .001). Subgroup analyses by age, sex, body mass index, smoking, and alcohol drinking status also showed similar results, except for the never/previous drinking subgroup. Further sensitivity analyses confirmed the positive association with a higher UPF consumption.
CONCLUSIONS
Our findings provide evidence that a higher UPF consumption is associated with an increased risk of incident IBS, with a significant dose-response relationship.
Additional Info
Disclosure statements are available on the authors' profiles:
Ultra-Processed Food Consumption and Long-Term Risk of Irritable Bowel Syndrome: A Large-Scale Prospective Cohort Study
Clin. Gastroenterol. Hepatol. 2024 Mar 21;[EPub Ahead of Print], S Wu, Z Yang, S Liu, Q Zhang, S Zhang, S ZhuFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Recently, associations between ultra-processed foods (UPFs) and an increasing number of negative health outcomes are being identified. This prospective cohort study by Wu et al investigated whether IBS should be added to the list of associations. Participants from the UK Biobank were enrolled between 2006 and 2010. After exclusions, 178,711 participants (female, 53.1%) had data available from 24-h dietary recall questionnaires. UPF intake was defined by the NOVA food classification and expressed as percentage of UPF content in their total diet intake (grams per day). An 8% higher risk of an IBS diagnosis was associated with each 10% increment of UPF intake (HR, 1.08; 95% CI, 1.04–1.12), suggesting a dose–response relationship between UPF intake and presence of IBS. This association remained after adjusting for various socioeconomic and dietary factors. These findings are consistent with a previous cross-sectional analysis of a cohort study, which also found that a higher UPF intake was significantly associated with a higher risk of IBS.1 However, the authors acknowledge that a weakness of 24-h dietary recall questionnaires is the difficulty categorizing foods without brand-specific ingredient information, and, thus, some foods may have been misclassified. Additionally, it is important to see whether these associations exist in a more diverse cohort, as this study investigated mainly White European individuals. Lastly, it is not yet known whether the actual processing of these foods, their nutrient profile (eg, fiber content or the presence of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols etc), or additives within these foods are responsible for these findings, and we currently lack robust human mechanistic studies to unravel this. Adequately powered human clinical trials are urgently required to confirm the exact mechanisms underpinning an association between UPFs and IBS, as currently there are none. If such clinical trials were to demonstrate causality, this could potentially direct dietary therapy for reducing UPFs, or perhaps only specific components of UPFs in diets of symptomatic individuals with IBS.
Reference
1. Schnabel L, Buscail C, Sabate JM, et al. Association Between Ultra-Processed Food Consumption and Functional Gastrointestinal Disorders: Results From the French NutriNet-Santé Cohort. Am J Gastroenterol. 2018;113(8):1217-1228. https://journals.lww.com/ajg/abstract/2018/08000/association_between_ultra_processed_food.20.aspx