Ultra-processed grains and risk of inflammatory bowel disease: Results from the Prospective Urban Rural Epidemiology (PURE) Study

Neeraj Narula, Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute; McMaster University, Hamilton ON, Canada.
Emily C. Wong, Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute; McMaster University, Hamilton ON, Canada.
Andrew Mente, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
Sumathy Rangarajan, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
Xinyue Lang, Department of Pharmacy and Clinical Trial Unit, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Qi Li, Medical Research & Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
Mengxi Chen, Medical Research & Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
Indu Mohan, Mahatma Gandhi University of Medical Sciences & Technology, Jaipur India.
Nafiza Mat-Nasir, Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia.
Maria Luz Diaz, ECLA (Estudios Clínicos Latinoamérica).
Patricio Lopez-Jaramillo, Masira Research Institute, Universidad de Santander (UDES), Bucaramanga, Colombia.
Ahmad Bahonar, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan.
Alvaro Avezum, International Research Center, Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil.
Kubilay Karsidag, Medical Faculty of Istanbul University, Department of Internal Medicine Division of Endocrinology.
Annika Rosengren, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, VGR region, Sweden.
Marc Evans Abat, Division of Adult Medicine, Department of Medicine, Philippine General Hospital Taft Avenue, Ermita, Manila, Philippines.
Fernando Lanas, Universidad de La Frontera. M Montt 112, Temuco Chile.
Elizabeth C. Swart, Department of Dietetics and Nutrition, University of the Western Cape, South Africa.
Rita Yusuf, BRAC James P. Grant School of Public Health BRAC University KHA 224 Progati Sarani, Merul Badda Dhaka 1212, Bangladesh.
Khalid F. Alhabib, Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Romaina Iqbal, Department of Community Health Sciences, The Aga Khan University, Stadium Road, Karachi, Pakistan.
Alicja Basiak-Rasała, Department of Population Health, Wroclaw Medical University, Poland.
Rasha Khatib, Advocate Health - MidwestFollow
et al

Abstract

Background: Ultra-processed grains, commonly consumed in Western diets, undergo refining processes that often remove beneficial components and include additives to enhance taste, texture, or durability, potentially influencing gastrointestinal health. This study examines the association between ultra-processed grain consumption and the risk of developing IBD using data from the Prospective Urban Rural Epidemiology (PURE) study.

Methods: This analysis included 124,590 participants from 21 countries who had dietary data available in the PURE study. Dietary intake was assessed through validated food frequency questionnaires, and ultra-processed grain intake was categorized into three levels. The primary outcome was the development of IBD, including Crohn's disease (CD) and ulcerative colitis (UC). Multivariate Cox proportional hazard models were used to calculate hazard ratios (HRs), adjusting for confounders including age, sex, smoking status, eating habits, and physical activity.

Results: Among 124,590 participants, higher ultra-processed grain intake was associated with increased IBD risk. Participants consuming ≥19g/day of ultra-processed grains had a higher risk of developing IBD compared to those consuming <9g/day [HR: 1.86 (95% confidence interval (CI): 1.26-2.61), ptrend=0.0003] after multivariate adjustment. Fresh bread and rice consumption were associated with lower IBD risk. Participants with greater ultra-processed food intake (≥ 5 servings/day) were linked to a higher risk of developing IBD compared to those consuming

Conclusion: Higher intake of ultra-processed grains is associated with significantly increased risk of developing IBD. A healthy eating pattern should minimize consumption of ultra-processed grains. Further studies should be performed to understand which components of ultra-processed grains may be detrimental for health.

Document Type

Article

PubMed ID

40758217

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