Background/Aims: The causes of ulcerative colitis are unknown, although it is plausible that dietary factors are involved. Case-control studies of diet and ulcerative colitis are subject to recall biases. The aim of this study was to examine the prospective relationship between the intake of nutrients and the development of ulcerative colitis in a cohort study. Methods: The study population was 260,686 men and women aged 20–80 years, participating in a large European prospective cohort study (EPIC). Participants were residents in the UK, Sweden, Denmark, Germany or Italy. Information on diet was supplied and the subjects were followed up for the development of ulcerative colitis. Each incident case was matched with four controls and dietary variables were divided into quartiles. Results: A total of 139 subjects with incident ulcerative colitis were identified. No dietary associations were detected, apart from a marginally significant positive association with an increasing percentage intake of energy from total polyunsaturated fatty acids (trend across quartiles OR = 1.19 (95% CI = 0.99–1.43) p = 0.07). Conclusions: No associations between ulcerative colitis and diet were detected, apart from a possible increased risk with a higher total polyunsaturated fatty acid intake. A biological mechanism exists in that polyunsaturated fatty acids are metabolised to pro-inflammatory mediators.

1.
Eaden JA, Abrams KR, Mayberry JF: The risk of colorectal cancer in ulcerative colitis: a meta-analysis. Gut 2001;48:526–535.
[PubMed]
2.
Baron S, Turck D, Leplat C, Merle V, Gower-Rousseau C, Marti R, Yzet T, Lerebours E, Dupas JL, Debeugny S, Salomez JL, Cortot A, Colombel JF: Environmental risk factors in paediatric inflammatory bowel diseases: a population based case-control study. Gut 2005;54:357–363.
[PubMed]
3.
Brauer PM, Gee MI, Grace M, Thomson ABR: Diet of women with Crohn’s disease and other gastrointestinal diseases. J Am Diet Assoc 1983;82:659–664.
[PubMed]
4.
Jarnerot G, Jarnmark I, Nilsson K: Consumption of refined sugar by patients with Crohn’s disease, ulcerative colitis and irritable bowel syndrome. Scand J Gastroenterol 1983;18:999–1002.
[PubMed]
5.
Thornton JR, Emmett PM, Heaton KW: Diet and ulcerative colitis. BMJ 1980;i:293–294.
6.
Thornton JR, Emmett PM, Heaton KW: Smoking, sugar, and inflammatory bowel disease. BMJ 1985;290:1786–1787.
[PubMed]
7.
Tragnone A, Valpiani D, Miglio F, Elmi G, Bazzocchi G, Pipitone E, Lanfranchi GA: Dietary habits as risk factors for inflammatory bowel disease. Eur J Gastroenterol Hepatol 1995;7:47–51.
[PubMed]
8.
Gee MI, Grace M GA, Wensel RH, Sherbaniuk RW, Thomson ABR: Nutritional status of gastroenterology out-patients: comparison of inflammatory bowel disease with functional disorders. J Am Diet Assos 1985;85:1591–1599.
[PubMed]
9.
Geerling BJ, Dagnelie PC, Badart-Smook A, Russel MG, Stockbrugger RW, Brummer RJM: Diet as a risk factor for the development of ulcerative colitis. Am J Gastroenterol 2000;95:1008–1013.
[PubMed]
10.
Panza E, Porro GB: Smoking, sugar and inflammatory bowel disease. BMJ Clin Res Ed 1985;291:971–972.
[PubMed]
11.
Persson PG, Ahlbom A, Hellers G: Diet and inflammatory bowel disease: a case-control study. Epidemiology 1992;3:47–52.
[PubMed]
12.
Reif S, Klein I, Lubin F, Farbstein M, Hallak A, Gilat T: Pre-illness dietary factors in inflammatory bowel disease. Gut 1997;40:754–760.
[PubMed]
13.
Rosman-Urbach M, Niv Y, Birk Y, Morgenstern S, Schwartz B: Relationship between nutritional habits adopted by ulcerative colitis relevant to cancer development patients at clinical remission stages and molecular-genetic parameters. Br J Nutr 2006;95:188–195.
[PubMed]
14.
Russel MG, Engels LG, Muris JW, Limonard CB, Volovics A, Brummer RJ, Stockbrugger RW: Modern life in the epidemiology of inflammatory bowel disease: a case-control study with special emphasis on nutritional factors. Eur J Gastroenterol Hepatol 1998;10:243–249.
[PubMed]
15.
Sakamoto N, Kono S, Wakai K, Fukuda Y, Satomi M, Shimoyama T, Inaba Y, Miyake Y, Sasaki S, Okamoto K, Kobashi G, Washio M, Yokoyama T, Date C, Tanaka H: Dietary risk factors for inflammatory bowel disease: a multi-centre case-control study in Japan. Inflamm Bowel Dis 2004;11:154–163.
16.
Brandes JW, Stenner A, Martini GA: Dietary habits of patients with ulcerative colitis. Z Gastroenterol 1979;12:834–842.
17.
Tragnone A, Hanau C, Bazzocchi G, Lanfranchi GA: Epidemiological characteristics of inflammatory bowel disease in Bologna, Italy: incidence and risk factors. Digestion 1993;54:183–188.
[PubMed]
18.
Riboli E: Nutrition and cancer: background and rationale of the European Prospective Investigation into Cancer and Nutrition. Ann Oncol 1992;3:783–791.
[PubMed]
19.
Bingham S, Riboli E: Diet and cancer: the European Prospective Investigation into Cancer and Nutrition. Nat Rev Cancer 2004;4:206–215.
[PubMed]
20.
Kaaks R, Slimani N, Riboli E: Pilot phase studies on the accuracy of dietary intake measurements in the EPIC project: overall evaluation of results. European Prospective Investigation into Cancer and Nutrition. Int J Epidemiol 1997;26:S26–S36.
[PubMed]
21.
Margetts BM, Pietinen P: European Prospective Investigation into Cancer and Nutrition: validity studies on dietary assessment methods. Int J Epidemiol 1997;26:S1–S5.
[PubMed]
22.
Bingham SA, Gill C, Welch A, Cassidy A, Runswick S, Oakes S, Luben R, Thurnham DI, Key T, Roe L, Khaw KT, Day NE: Validation of dietary assessment methods in the UK arm of EPIC using weighed records and 24 hour urinary nitrogen and potassium and serum vitamin C and carotenoids as biomarkers. Int J Epidemiol 1997;26(suppl 1):S137–S151.
[PubMed]
23.
Logan RFA, Kay CR: Oral contraception, smoking and inflammatory bowel disease – findings in the Royal College of General Practitioners Oral Contraception Study. Int J Epidemiol 1989;18:105–107.
[PubMed]
24.
Calkins BM: A meta-analysis of the role of smoking in inflammatory bowel disease. Dig Dis Sci 1989;34:1841–1854.
[PubMed]
25.
Lee TH, Mencia-Huerta JM, Shih C, Corey EJ, Lewis RA, Austen KF: Characterization and biological properties of 5,12-dihydroxy derivatives of eicosapentaenoic acid, including leukotriene B5 and the double lipoxygenase product. J Biol Chem 1984;259:2383–2389.
[PubMed]
26.
Heller A, Koch T, Schmeck J, Van Ackern K: Lipid mediators in inflammatory disorders. Drugs 1998;55:487–496.
[PubMed]
27.
Goldman DW, Pickett WC, Goetzl EJ: Human neutrophil chemotactic and degranulating activities of leukotriene B5 (LTB5) derived from eicosapentaenoic acid. Biochem Biophys Res Comm 1983;117:282–288.
[PubMed]
28.
Sharon P, Stenson WF: Enhanced synthesis of leukotriene B4 by colonic mucosa in inflammatory bowel disease. Gastroenterology 1984;86:453–460.
[PubMed]
29.
Sharon P, Ligumsky M, Rachilewitz D, Zor U: Role of prostaglandins in ulcerative colitis: enhanced production during active disease and inhibition by sulfasalazine. Gastroenterology 1978;75:638–640.
[PubMed]
30.
Nishida T, Miwa H, Shigematsu A, Yamamoto M, Iida M, Fujishima M: Increased arachidonic acid composition of phospholipids in colonic mucosa from patients with active ulcerative colitis. Gut 1987;28:1002–1007.
[PubMed]
31.
Hallert C, Kaldma M, Petersson BG: Ispaghula husk may relieve gastrointestinal symptoms in ulcerative colitis in remission. Scand J Gastroeneterol 1991;26:747–750.
[PubMed]
32.
Hallert C, Bjorck I, Nyman M, Pousette A, Granno C, Svensson H: Increasing fecal butyrate in ulcerative colitis patients by diet: controlled pilot study. Inflamm Bowel Dis 2003;9:116–121.
[PubMed]
33.
Davies P, Rhodes J: Maintenance of remission in ulcerative colitis with sulphasalazine or a high-fibre diet: a clinical trial. BMJ 1978;1524–1525.
34.
Gilat T, Hacohen D, Lilos P, Langman M: Childhood factors in ulcerative colitis and Crohn’s disease: an international cooperative study. Scand J Gastroenterol 1987;22:1009–1024.
[PubMed]
35.
Koutroubakis I, Vlachonikolis I: Appendectomy and the development of ulcerative colitis: results of a metaanalysis of published case-control studies. Am J Gastroenterol 2000;95:171–176.
[PubMed]
36.
Rutgeerts P, D’Haens G, Hiele M, Geboes K, Vantrappen G: Appendicectomy protects against ulcerative colitis. Gastroenterology 1994;106:1251–1253.
[PubMed]
37.
Shivananda S, Lennard-Jones JE, Logan R, Fear N, Price A, Carpenter L, Van Blankenstein M, EC-IBD Study Group: Incidence of inflammatory bowel disease across Europe: is there a difference between north and south? Results of the European collaborative study on inflammatory bowel disease (EC-IBD). Gut 1996;39:690–697.
[PubMed]
38.
Lennard-Jones JE, Shivananda S: Clinical uniformity of inflammatory bowel disease at presentation and during the first year of disease in the north and south of Europe. EC-IBD Study group. Eur J Gastroenterol Hepatol 1997;9:353–359.
[PubMed]
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