Meyer Antoine, Agrawal Manasi, Savin-Shalom Einat, Wong Emily C L, Levinson Carrie, Gold Stephanie, Narula Neeraj, Colombel Jean-Frédéric, Carbonnel Franck
Service de Gastroentérologie, University Hospital of Bicêtre, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France.
Faculté de Médecine, Université Paris Saclay, Le Kremlin Bicêtre, France.
EClinicalMedicine. 2025 Jul 14;86:103353. doi: 10.1016/j.eclinm.2025.103353. eCollection 2025 Aug.
Data on dietary risk factors for inflammatory bowel disease (IBD), while extensive, are inconsistent. Our aim was to systematically review and meta-analyze available data unraveling the relationship between diet and IBD subtypes, Crohn's disease (CD) and ulcerative colitis (UC).
We conducted a systematic literature review following PRISMA guidelines, from inception to May 8 2025, using OVID Medline, Embase, and Scopus databases, to identify prospective cohorts of healthy participants, on the association between diet and the risk of CD or UC. Meta-analyses were performed using random-effects model, pooling hazard ratios (HRs) for each exposure category, relative to the lowest.
Of 7916 studies identified by the search, 72 studies (65 in adults, 7 in children) met the inclusion criteria. The 65 adult cohort studies included 2.043.601 participants; 62.3% were women, the mean age at recruitment was 53.1 years and mean follow up was 12.8 years. Overall, 1902 participants developed CD and 4617 developed UC. Inflammatory diet (pooled aHR 1.63, 95% CI: 1.26, 2.11) and ultra-processed foods (pooled aHR 1.71, 95% CI: 1.36-2.14) were associated with an increased risk of CD. High fiber intake (pooled aHR 0.53, 95% CI: 0.41-0.70), Mediterranean diet (pooled aHR 0.59, 95% CI: 0.43-0.81), healthy diet (pooled aHR 0.70, 95% CI: 0.54-0.91), and unprocessed or minimally processed foods (pooled aHR 0.71, 95% CI: 0.53-0.94) were associated with a lower risk of CD. No consistent associations were found between individual foods or food patterns and the risk of UC.
This study summarizes evidence on the link between specific dietary items or patterns and the risk of IBD. These data will help inform the design of prevention trials that include a dietary component as well as prevention strategies overall.
This study received no funding.
关于炎症性肠病（IBD）饮食风险因素的数据虽然广泛，但并不一致。我们的目的是系统回顾和荟萃分析现有数据，以阐明饮食与IBD亚型、克罗恩病（CD）和溃疡性结肠炎（UC）之间的关系。
我们按照PRISMA指南进行了系统的文献回顾，从开始到2025年5月8日，使用OVID Medline、Embase和Scopus数据库，以确定健康参与者的前瞻性队列，研究饮食与CD或UC风险之间的关联。使用随机效应模型进行荟萃分析，汇总每个暴露类别的风险比（HRs），并与最低水平进行比较。
在搜索到的7916项研究中，72项研究（65项成人研究，7项儿童研究）符合纳入标准。65项成人队列研究包括2043601名参与者；62.3%为女性，招募时的平均年龄为53.1岁，平均随访时间为12.8年。总体而言，1902名参与者患CD，4617名参与者患UC。炎症性饮食（汇总调整后HR为1.63，95%CI：1.26，2.11）和超加工食品（汇总调整后HR为1.71，95%CI：1.36 - 2.14）与CD风险增加相关。高纤维摄入量（汇总调整后HR为0.53，95%CI：0.41 - 0.70）、地中海饮食（汇总调整后HR为0.59，95%CI：0.43 - 0.81）、健康饮食（汇总调整后HR为0.70，95%CI：0.54 - 0.91）以及未加工或最少加工的食品（汇总调整后HR为0.71，95%CI：0.53 - 0.94）与CD风险较低相关。未发现单一食物或食物模式与UC风险之间存在一致的关联。
本研究总结了特定饮食项目或模式与IBD风险之间联系的证据。这些数据将有助于为包含饮食成分的预防试验设计以及整体预防策略提供信息。
本研究未获得资金。
