Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China.
Center for Global Health, Zhejiang University School of Medicine, Hangzhou, China.
Aliment Pharmacol Ther. 2023 Sep;58(5):516-525. doi: 10.1111/apt.17649. Epub 2023 Jul 18.
Limited prospective studies that have examined the association of dietary fibre with IBD have provided inconsistent evidence.
To examine any associations between dietary fibre intake and subsequent incidence of IBD, Crohn's disease (CD) and ulcerative colitis (UC) METHODS: We conducted a prospective cohort study of 470,669 participants from the UK Biobank and estimated dietary fibre intake from a valid food frequency questionnaire at baseline. Incident IBD was ascertained from primary care data and inpatient data. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between dietary fibre intake and the risk of IBD, CD and UC.
During an average follow-up of 12.1 years, we ascertained 1473 incident IBD cases, including 543 cases of CD and 939 cases of UC. Comparing the lowest quintiles, an inverse association was observed between dietary fibre intake and risk of IBD (HR 0.74, 95% CI 0.58-0.93, p = 0.011) and CD (HR 0.48, 95% CI 0.32-0.72, p < 0.001), but not UC (HR 0.92, 95% CI 0.69-1.24, p = 0.595). For specified sources, dietary fibre intake from fruit and bread decreased the risk of CD, while dietary fibre intake from cereal decreased the risk of UC.
Higher consumption of dietary fibre was associated with a lower risk of IBD and CD, but not UC. Our findings support current recommendations to increase the intake of dietary fibre.
有限的前瞻性研究表明膳食纤维与 IBD 之间存在关联，但提供的证据并不一致。
研究膳食纤维摄入量与随后发生 IBD、克罗恩病（CD）和溃疡性结肠炎（UC）的风险之间的任何关联。
我们对来自英国生物银行的 470669 名参与者进行了一项前瞻性队列研究，并在基线时使用有效的食物频率问卷来估计膳食纤维的摄入量。通过初级保健数据和住院数据来确定 IBD 的发病情况。使用 Cox 比例风险模型来估计膳食纤维摄入量与 IBD、CD 和 UC 风险之间的风险比（HR）和 95%置信区间（CI）。
在平均 12.1 年的随访期间，我们确定了 1473 例 IBD 发病病例，其中包括 543 例 CD 和 939 例 UC。与最低五分位数相比，膳食纤维摄入量与 IBD（HR 0.74，95%CI 0.58-0.93，p=0.011）和 CD（HR 0.48，95%CI 0.32-0.72，p<0.001）的发病风险呈负相关，但与 UC（HR 0.92，95%CI 0.69-1.24，p=0.595）无关。对于特定来源，水果和面包中的膳食纤维摄入降低了 CD 的发病风险，而谷物中的膳食纤维摄入降低了 UC 的发病风险。
较高的膳食纤维摄入量与较低的 IBD 和 CD 风险相关，但与 UC 风险无关。我们的发现支持目前增加膳食纤维摄入量的建议。
