加拿大麦克马斯特大学Neeraj Narula团队研究了超加工食品摄入与炎症性肠病风险的相关性。这一研究成果发表在2021年7月15日出版的《英国医学杂志》上。
为了探讨超加工食品的摄入与炎症性肠病（IBD）风险的关系，研究组在横跨7个地理区域（欧洲、北美、南美、非洲、中东、南亚、东南亚和中国）的21个低、中、高收入国家进行了一项前瞻性群组研究。
2003-2016年，研究组共招募了116087名年龄在35-70岁之间的成年人，进行了至少一个周期的随访和完整的基线食物频率问卷（FFQ）数据（用于记录基线饮食摄入量）。参与者至少每三年进行一次前瞻性随访。主要结局是发生IBD，包括克罗恩病或溃疡性结肠炎。采用Cox比例风险多变量模型评估超加工食品摄入与IBD风险之间的关系。
中位随访9.7年后，共有467参与者发生IBD，其中克罗恩病90例，溃疡性结肠炎377例。在对潜在的干扰因素进行校正后，摄入超加工食品越多，发生IBD的风险就越高，与每天摄入不足1次相比，每天摄入≥5次的风险比为1.82，摄入1-4次的风险比为1.67，差异均显著。
超加工食品的不同亚组，包括软饮料、精制甜食品、咸零食和加工肉类，每一种都与IBD更高的风险比有关。克罗恩病和溃疡性结肠炎的结果一致，异质性低。摄入白肉、红肉、奶制品、淀粉、水果、蔬菜和豆类与IBD发病无关。
研究结果表明，超加工食品的高摄入量与IBD的风险呈正相关。
附：英文原文
Title: Association of ultra-processed food intake with risk of inflammatory bowel disease: prospective cohort study
Author: Neeraj Narula, Emily C L Wong, Mahshid Dehghan, Andrew Mente, Sumathy Rangarajan, Fernando Lanas, Patricio Lopez-Jaramillo, Priyanka Rohatgi, P V M Lakshmi, Ravi Prasad Varma, Andres Orlandini, Alvaro Avezum, Andreas Wielgosz, Paul Poirier, Majid A Almadi, Yuksel Altuntas, Kien Keat Ng, Jephat Chifamba, Karen Yeates, Thandi Puoane, Rasha Khatib, Rita Yusuf, Kristina Bengtsson Bostrm, Katarzyna Zatonska, Romaina Iqbal, Liu Weida, Zhu Yibing, Li Sidong, Antonio Dans, Afzalhussein Yusufali, Noushin Mohammadifard, John K Marshall, Paul Moayyedi, Walter Reinisch, Salim Yusuf
Issue&Volume: 2021/07/15
Abstract:
Objective To evaluate the relation between intake of ultra-processed food and risk of inflammatory bowel disease (IBD).
Design Prospective cohort study.
Setting 21 low, middle, and high income countries across seven geographical regions (Europe and North America, South America, Africa, Middle East, south Asia, South East Asia, and China).
Participants 116087 adults aged 35-70 years with at least one cycle of follow-up and complete baseline food frequency questionnaire (FFQ) data (country specific validated FFQs were used to document baseline dietary intake). Participants were followed prospectively at least every three years.
Main outcome measures The main outcome was development of IBD, including Crohn’s disease or ulcerative colitis. Associations between ultra-processed food intake and risk of IBD were assessed using Cox proportional hazard multivariable models. Results are presented as hazard ratios with 95% confidence intervals.
Results Participants were enrolled in the study between 2003 and 2016. During the median follow-up of 9.7 years (interquartile range 8.9-11.2 years), 467 participants developed incident IBD (90 with Crohn’s disease and 377 with ulcerative colitis). After adjustment for potential confounding factors, higher intake of ultra-processed food was associated with a higher risk of incident IBD (hazard ratio 1.82, 95% confidence interval 1.22 to 2.72 for ≥5 servings/day and 1.67, 1.18 to 2.37 for 1-4 servings/day compared with <1 serving/day, P=0.006 for trend). Different subgroups of ultra-processed food, including soft drinks, refined sweetened foods, salty snacks, and processed meat, each were associated with higher hazard ratios for IBD. Results were consistent for Crohn’s disease and ulcerative colitis with low heterogeneity. Intakes of white meat, red meat, dairy, starch, and fruit, vegetables, and legumes were not associated with incident IBD.
Conclusions Higher intake of ultra-processed food was positively associated with risk of IBD. Further studies are needed to identify the contributory factors within ultra-processed foods.
DOI: 10.1136/bmj.n1554
Source: https://www.bmj.com/content/374/bmj.n1554
BMJ-British Medical Journal:《英国医学杂志》，创刊于1840年。隶属于BMJ出版集团，最新IF：93.333
官方网址：http://www.bmj.com/
投稿链接：https://mc.manuscriptcentral.com/bmj
本期文章：《英国医学杂志》：Online/在线发表
