Brief Article
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World J Gastroenterol. Sep 14, 2010; 16(34): 4297-4304
Published online Sep 14, 2010. doi: 10.3748/wjg.v16.i34.4297
Pre-illness changes in dietary habits and diet as a risk factor for inflammatory bowel disease: A case-control study
Giovanni Maconi, Sandro Ardizzone, Claudia Cucino, Cristina Bezzio, Antonio Giampiero Russo, Gabriele Bianchi Porro
Giovanni Maconi, Sandro Ardizzone, Cristina Bezzio, Gabriele Bianchi Porro, Department of Clinical Sciences, L. Sacco University Hospital, 20157 Milan, Italy
Claudia Cucino, Endoscopy Unit, Istituto Clinico Santa Rita, 20131 Milan, Italy
Antonio Giampiero Russo, Epidemiology and Biostatistics Unit, San Carlo Borromeo Hospital, 20153 Milan, Italy
Author contributions: Maconi G contributed to the hypothesis, study design, data analysis, statistical analysis, manuscript preparation, and editing; Ardizzone S contributed to interpretation of data, manuscript preparation and editing; Cucino C contributed to the hypothesis, study design, collection of data and manuscript preparation; Bezzio C contributed to the collection of data and editing; Russo AG contributed to the statistical analysis and editing; Bianchi Porro G contributed to the editing and final approving of the study.
Correspondence to: Dr. Giovanni Maconi, Chair of Gastroenterology, Department of Clinical Sciences, L. Sacco University Hospital, Via G.B. Grassi, 74, 20157 Milan, Italy.
Telephone: +39-2-39042486 Fax: +39-2-39042232
Received: July 7, 2009
Revised: September 14, 2009
Accepted: September 21, 2009
Published online: September 14, 2010

AIM: To evaluate whether symptoms of inflammatory bowel disease (IBD), before diagnosis modify dietary habits, and to investigate the pre-illness diet in patients with recent IBD in comparison with an age-matched healthy control group.

METHODS: Overall, 83 new cases of IBD (41 ulcerative colitis, 42 Crohn’s disease) and 160 healthy controls were studied. Portions per week of 34 foods and beverages before onset of symptoms were recorded using a validated questionnaire. Duration of symptoms before IBD diagnosis, presence of specific symptoms and their impact on subjective changes in usual dietary habits were also recorded. The association between diet and IBD was investigated by multiple logistic regression and dietary patterns were assessed by factor analysis.

RESULTS: Changes in dietary habits, due to the presence of symptoms, were reported by 38.6% of patients and were not significantly related to specific symptoms, rather to long duration of symptoms, only in Crohn’s disease patients. In IBD patients who did not change dietary habits, moderate and high consumption of margarine (OR = 11.8 and OR = 21.37) was associated with ulcerative colitis, whilst high consumption of red meat (OR = 7.8) and high intake of cheese were associated with Crohn’s disease.

CONCLUSION: More than one third of IBD patients change dietary habits before diagnosis. Margarine, red meat and cheese increase the risk of ulcerative colitis and Crohn’s disease.

Keywords: Inflammatory bowel diseases, Diet, Symptoms, Factor analysis