Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China; State Key Laboratory for Digestive Health, Beijing, China; National Clinical Research Center for Digestive Diseases, Beijing, China.
Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China; Primary Care Unit, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.
Clin Gastroenterol Hepatol. 2024 Jul;22(7):1497-1507.e5. doi: 10.1016/j.cgh.2024.01.040. Epub 2024 Mar 21.
BACKGROUND & 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 for an association is lacking. We aimed to examine the long-term risk of IBS associated with UPF consumption in a large-scale prospective cohort.
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.
The mean UPF consumption was 21.0% (SD, 11.0%) of the total diet. During a median of 11.3 years of follow-up, 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 every 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; P < .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.
Our findings provide evidence that a higher UPF consumption is associated with an increased risk of incident IBS, with a significant dose-response relationship.
过去几十年，肠易激综合征（IBS）的疾病负担相当大，与此同时，超加工食品（UPF）的消费也在增加。然而，目前缺乏相关的流行病学证据。我们旨在通过一项大型前瞻性队列研究，检查 UPF 消费与 IBS 之间的长期关联。
参与者来自英国生物库，他们在 2009 年至 2012 年间完成了 24 小时膳食回忆，且在基线时没有 IBS、乳糜泻、炎症性肠病和任何癌症。纳入了 178711 名参与者（53.1%为女性）。根据 NOVA 食品分类系统定义 UPF 消费，以 UPF 含量占总饮食摄入量（以克/天计）的百分比表示。主要结局是新发 IBS。采用 Cox 比例风险模型估计相关风险。
UPF 消费的平均水平为总饮食的 21.0%（标准差，11.0%）。在中位数为 11.3 年的随访期间，确定了 2690 例新发 IBS 病例。与 UPF 消费每增加 10%相关，IBS 的风险增加 8%（风险比，1.08；95%CI，1.04-1.12）。与 UPF 消费最低四分位数相比，最高四分位数与新发 IBS 的风险显著增加相关（风险比，1.19；95%CI，1.07-1.33；P<0.001）。按年龄、性别、体重指数、吸烟和饮酒状态进行的亚组分析也显示出类似的结果，但从不/以前饮酒亚组除外。进一步的敏感性分析证实了与更高 UPF 消费相关的阳性关联。
我们的研究结果提供了证据表明，更高的 UPF 消费与新发 IBS 的风险增加相关，且存在显著的剂量反应关系。
