Amre Devendra K, D'Souza Savio, Morgan Kenneth, Seidman Gillian, Lambrette Philippe, Grimard Guy, Israel David, Mack David, Ghadirian Parviz, Deslandres Colette, Chotard Virginie, Budai Balint, Law Liliane, Levy Emile, Seidman Ernest G
Department of Pediatrics, University of Montreal, Montreal, Canada.
Am J Gastroenterol. 2007 Sep;102(9):2016-25. doi: 10.1111/j.1572-0241.2007.01411.x. Epub 2007 Jul 7.
The role of dietary factors in the etiology of Crohn's disease (CD) is inconsistent largely due to difficulties in acquiring valid information on consumption habits. We examined the impact of diet on new onset CD in children using a validated food-frequency questionnaire (FFQ).
A case-control study was carried out. Children < or =20 yr, newly diagnosed with CD, were recruited from 3 pediatric gastroenterology clinics across Canada. Population or hospital controls were selected matched to cases for time of diagnosis (+/-6 months) and area of residence. Dietary consumption 1 yr prior to disease diagnosis was evaluated using a validated FFQ, administered within 1 month of diagnosis. Conditional logistic regression analysis adjusting for potential confounding variables (energy intake, age, gender, body mass index) was carried out.
A total of 130 CD patients and 202 controls were studied. Mean age at diagnosis (+/-SD) was 14.2 (2.7). There were more male patients (59%). Comparing the highest to the lowest levels of consumption, higher amounts of vegetables (OR 0.69, 95% CI 0.33-1.44, P= 0.03), fruits (OR 0.49, 95% CI 0.25-0.96, P= 0.02), fish (OR 0.46, 95% CI 0.20-1.06, P= 0.02), and dietary fiber (OR 0.12, 95% CI 0.04-0.37, P < 0.001) protected from CD. Consumption of long-chain omega-3 fatty acids (LCN-omega-3) was negatively associated with CD (OR 0.44, 95% CI 0.19-1.00, P < 0.001). A higher ratio of LCN-omega-3/omega-6 fatty acids was significantly associated with lower risks for CD (OR 0.32, 95% CI 0.14-0.71, P= 0.02).
Our findings indicate that an imbalance in consumption of fatty acids, vegetables, and fruits is associated with increased risks for CD among Canadian children.
饮食因素在克罗恩病（CD）病因学中的作用尚不明确，这主要是由于获取饮食习惯的有效信息存在困难。我们使用经过验证的食物频率问卷（FFQ）研究了饮食对儿童新发CD的影响。
开展了一项病例对照研究。从加拿大3家儿科胃肠病诊所招募了年龄≤20岁、新诊断为CD的儿童。选择与病例在诊断时间（±6个月）和居住地区相匹配的人群或医院对照。在诊断后1个月内使用经过验证的FFQ评估疾病诊断前1年的饮食摄入情况。进行了条件逻辑回归分析，对潜在混杂变量（能量摄入、年龄、性别、体重指数）进行了调整。
共研究了130例CD患者和202例对照。诊断时的平均年龄（±标准差）为14.2（2.7）岁。男性患者更多（59%）。将最高摄入量与最低摄入量进行比较，较多的蔬菜（比值比[OR]0.69，95%置信区间[CI]0.33 - 1.44；P = 0.03）、水果（OR 0.49，95% CI 0.25 - 0.96；P = 0.02）、鱼类（OR 0.46，95% CI 0.20 - 1.06；P = 0.02）和膳食纤维（OR 0.12，95% CI 0.04 - 0.37；P < 0.001）可预防CD。长链ω-3脂肪酸（LCN-ω-3）的摄入与CD呈负相关（OR 0.44，95% CI 0.19 - 1.00；P < 0.001）。较高的LCN-ω-3/ω-6脂肪酸比例与较低的CD风险显著相关（OR 0.32，95% CI 0.14 - 0.71；P = 0.02）。
我们的研究结果表明，脂肪酸、蔬菜和水果摄入不均衡与加拿大儿童患CD的风险增加有关。
