Food processing and risk of Crohn's disease and ulcerative colitis: A European Prospective Cohort Study.
Meyer A., Dong C., Casagrande C., Chan S., Huybrechts I., Nicolas G., Rauber F., Levy RB., Millett C., Oldenburg B., Weiderpass E., Heath AK., Tong TY., Tjønneland A., Kyrø C., Kaaks R., Katzke VA., Bergman MM., Palli D., Masala G., Tumino R., Sacerdote C., Colorado-Yohar SM., Sánchez M-J., Grip O., Lindgren S., Luben R., Gunter MJ., Mahamat-Saleh Y., Boutron-Ruault M-C., Carbonnel F.
BACKGROUND & AIMS: Industrial foods have been associated with increased risks of several chronic conditions. We investigated the relation between degree of food processing, and risks of Crohn's disease (CD) and ulcerative colitis (UC) in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. METHODS: Analyses included 413,590 participants (68.6% women; mean baseline age 51.7 years) from eight European countries. Dietary data were collected at baseline from validated country-specific dietary questionnaires. Associations between proportions of unprocessed/minimally processed foods and of ultra-processed foods intake, and CD and UC risks were estimated using Cox models to obtain Hazards Ratios (HRs) and 95% confidence intervals (95%CIs). Models were stratified by centre, age, and sex, and adjusted for smoking status, BMI, physical activity, energy intake, educational level, and alcohol consumption. RESULTS: During a mean follow-up of 13.2 years, 179 incident cases of CD and 431 incident cases of UC were identified. The risk of CD was lower in people consuming high proportions of unprocessed/minimally processed foods (adjusted HR for the highest vs. lowest quartile: 0.57 (95%CI: 0.35-0.93; P-trend<0.01); particularly fruits and vegetables (adjusted HRs 0.54; 95%CI: 0.34-0.87 and 0.55; 95%CI: 0.34-0.91, respectively)). There was no association between unprocessed/minimally processed food intake and the risk of UC. No association was detected between ultra-processed foods consumption and CD or UC risks. CONCLUSIONS: In the EPIC cohort, consumption of unprocessed/minimally processed foods was associated with a lower risk of CD. No association between UC risk and food processing was found.