Eating Fruits and Vegetables Cuts Risk for Crohn’s Disease (but not UC)

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Eating Fruits and Vegetables Cuts Risk for Crohn’s Disease (but not UC)

A prospective European study of nearly 400,000 patients who were monitored for more than 10 years has shown that eating unprocessed or minimally processed foods, particularly fruits and vegetables, cuts the risk of developing Crohn’s disease by half. Yet this protective effect is not found among patients with ulcerative colitis.

These were the findings presented at this year’s French-language hepato-gastroenterology and digestive oncology conference (JFHOD 2023) and published in Clinical Gastroenterology and Hepatology.

“These data suggest that we should be advising our patients to consume minimally processed or unprocessed foods to cut the risk of Crohn’s disease, especially our high-risk patients, like those with a close relative suffering from the condition,” said the authors of the study, which was headed by Antoine Meyer, MD, of BicĂȘtre Hospital in Paris.

Ultraprocessed Foods

The study investigated the link between processed foods and the risk of developing inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis.

The consumption of ultraprocessed foods was found to be associated with an increase in the rate of Crohn’s disease, but this trend was not significant, owing to a lack of statistical power. However, a recent meta-analysis that included this study showed a statistically significant increase of 71% in the risk for Crohn’s disease associated with this type of food, Meyer said during his presentation.

In the European study, as in the meta-analysis, which collated the follow-up data of more than a million people, the consumption of processed food seemed to have an effect on the incidence of Crohn’s disease but not on that of ulcerative colitis.

The emergence of IBD coincided with industrialization, with “ulcerative colitis at first, then Crohn’s disease several decades later,” said Meyer. In addition to genetic factors, changes in diet are largely suspected of being responsible, mainly by changing the gut microbiome.

The increasing consumption of ultraprocessed, additive-rich foods that are generally low in fiber and essential micronutrients is thought to disrupt the gut’s microbiota, leading to gastrointestinal inflammation.

Four Food Categories

The food products that were consumed were categorized on the basis of the extent to which the foods underwent processing (NOVA classification):

  • Unprocessed or minimally processed foods: food that is fresh or that has been modified by processes such as drying, pasteurization, crushing, etc (eg, fruits, vegetables, milk, natural yogurt, eggs, rice, and pasta).

  • Processed culinary ingredients: substances derived from group 1 foods by processes that include pressing or grinding (eg, sugar, condiments, starch, butter, and vegetable oil).

  • Processed foods: simple products obtained from foods and ingredients from the previous groups with the purpose of increasing their durability or enhancing their sensory qualities (eg, cheese, bread, smoked foods).

  • Ultraprocessed foods: products obtained industrially by mixing several ingredients. These foods may involve food additives, lyophilized proteins, modified starch, etc. They are usually rich in added sugar, salt, and saturated fat.

The results suggest that these inflammatory diseases “probably have different mechanisms of onset,” Meyer added. He reiterated that risk factors associated with these two conditions may differ. For example, low-fiber diets favor the development of Crohn’s disease, while diets high in sugar, fatty acids, and meat are more likely to lead to the development of colitis.

Several hypotheses have been put forward to explain the excess risk for Crohn’s disease associated with consumption of ultraprocessed foods. Possibilities include an imbalance of the gut microbiota or modification of inflammatory proteins. “There is currently no argument allowing us to favor one theory over any other,” said Meyer.

This article was translated from the Medscape French Edition.

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