In a study published July 2021 in the BMJ, researchers found that a higher intake of ultra-processed foods was associated with a higher risk of IBD. Ultra-processed foods include packaged baked goods, fizzy drinks, and sugary cereals, which often contain high levels of added sugar, fat, and salt, but lack vitamins and fiber. The analysis included about 116,000 adults ages 35 to 70 years old living in 21 low-, middle-, and high-income countries who were taking part in the Prospective Urban Rural Epidemiology (PURE) study. Between 2003 and 2016, 467 adults developed IBD: 90 with Crohn’s disease and 377 with ulcerative colitis. Compared with people who ate less than one serving of ultra-processed food per day, researchers found an 82 percent increased risk of IBD among those who consumed five or more servings per day, and a 67 percent increased risk for those who ate one to four servings per day. Andrés Hurtado-Lorenzo, PhD, who is the vice president of translational research programs at the Crohn’s & Colitis Foundation and was not involved in the study, says that the research is consistent with the current epidemiology of IBD in countries that have adopted Western diets. “In countries like India and China, this disease was not in existence or had very low incidence 10 or 20 years ago, and now it’s rampant,” he says. IBD is a result of a malfunctioning immune system. Although the exact cause is unknown, some risk factors include:
SmokingDietFamily historyNonsteroidal anti-inflammatory drugs (NSAIDs)
You can reduce your risk of developing an IBD by:
Eating nutrient-dense foodsExercising regularlyQuitting cigarette smoking
The Missing Link and Areas for Future Research
According to researchers, this study does not establish causality. The results did not account for dietary changes over time but relied on self-reported diagnoses. “Further studies are needed to identify specific potential contributory factors among processed foods that might be responsible for the observed associations in our study,” the researchers concluded. Dr. Hurtado-Lorenzo says there is room for future research based on what he has seen in the analysis. “Are there any biological factors that are interacting with those components in the ultra-processed food that in combination trigger IBD?” asks Hurtado-Lorenzo. He also noted that it remains unclear how chemicals in processed foods trigger the disease in younger populations. According to Neeraj Narula, MD, MPH, an author of the study, an assistant professor of medicine at McMaster University in Hamilton, Ontario, and the director of the IBD clinic and staff gastroenterologist at Hamilton Health Sciences, there are promising dietary interventions that could benefit people with IBD. For example, he notes the Crohn’s disease exclusion diet, which is based on excluding parts of the Western diet that are associated with intestinal inflammation–processed meat, dairy, packaged snacks–and replacing them with whole foods and complex and simple carbs. Other diets include:
Mediterranean diet, which involves a high intake of fruits, vegetables, nuts, fish, seafood, whole grains, and olive oil, and a low intake of red and processed meats as well as sweets.Specific carbohydrates diet, which involves a high intake of unprocessed meats, poultry, fish, and most fruits and vegetables, with restrictions on grains, dairy, and sweeteners, apart from cheeses, yogurt, and honey.
Dr. Narula suggests that people with IBD should try to eat as healthy as possible and stick to home-cooked meals.