Higher Processed Food Consumption Linked to Increased Risk of Crohn’s Disease

by | Nov 8, 2022 | 2022, Digestive Health

Written by Taylor Woosley, Staff Writer. When combining all regions, Crohn’s patients had more frequent intake of processed food, soft drinks, and all additives (polysorbate-80, carrageenan, carboxymethylcellulose, aluminosilicates, titanium dioxide, sucralose, total emulsifiers, and total additives) compared to healthy unrelated controls. 

stomach painCrohn’s disease (CD) is an increasingly prevalent chronic inflammatory condition that affects the gastrointestinal tract1. CD inflammation interests the entire intestine and patients with CD experience periods of flares and periods of remissions during their disease course2. Uncontrolled inflammation leads to long-term complications, including fibrotic strictures, enteric fistulae, and intestinal neoplasia3. Symptoms involve abdominal pain, diarrhea, rectal blood loss, and fatigue, with disease progression often leading to weight loss and malnutrition4.

Accumulating evidence of CD pathogenesis points to a gut dysbiosis combined with an aberrant immune response; a process potentially triggered by changes in environmental factors, including diet5. Dietary changes, including increased intake of refined sugars and dietary fats such as n-6 polyunsaturated fatty acids and decreased intake of fiber, have been suggested as potential risk factors for the development of CD6. A high consumption of sugar and soft drinks combined with a low vegetable intake has already been linked to CD7. Besides those pro-inflammatory foods, processed foods are harmful because they contain emulsifiers, preservatives, and/or thickeners, that cluster together as part of industry-added ingredients8.

Trakman et al. conducted a case-control, cross-sectional, observational study to determine if food and food additive intake differed in Crohn’s disease patients compared to control groups (related, cohabiting, and healthy). The study design was divided and assessed by four participant groups: patients with Crohn’s disease, their first-degree relatives, their household members, and non-cohabiting healthy unrelated controls, across three regions: Australia, Hong Kong, and China. Inclusion criteria consisted of being aged 18 years or older with confirmed Crohn’s disease using clinical, endoscopic, and histologic criteria.

Retrospective data on early life and diet intake of the last 12 months was collected from all subjects using the Early Life Processed Food Intake (ELPFI), comprising 42 items about food habits and specific food consumption. A prospective 3-day food diary, the Current Food Additive and Nutrient Intake, was obtained from all participants in Australia and Hong Kong. Study population comprised of 274 Crohn’s disease patients and 257 control subjects (first-degree relatives (n=82), household members (n=83), healthy unrelated controls (n=92)). The median age of participants was 43 years and 53% were male. Weekly consumption of ultra-processed and processed foods obtained from the ELPFI were reported as proportions. The Shapiro-Wilk test was utilized to assess normality of continuous variables (additive intake, dietary inflammatory index (DII)). Comparisons between Crohn’s disease and controls were conducted with all regions combined as well as within individual regions. Chi-squared analysis for categorical variables was used for comparisons across regions and Krushkal-Wallis was utilized for continuous variables. The Spearman’s rank correlation coefficient was used to assess the relationships between energy-adjusted DII and additive intake. Significant findings of the case-control, cross-sectional, observational study are as follows:

  • Across all regions, Crohn’s disease patients had more frequent intake of processed meat, processed grains, fast foods, soft drinks, and ultra-processed snacks, in all age groups except 4-12 months, than healthy unrelated controls.
  • When combining all regions, CD patients had a significantly higher DII, indicative of a more pro-inflammatory diet, than all controls combined (1.4453 vs. 0.7582, p=0.011).
  • When combining all regions, CD patients consumed significantly more of all additives than healthy unrelated controls.
  • There was a weak, positive correlation between energy-adjusted DII and total additive intake (mg/kg body weight/day) across the whole cohort (r = 0.144, p = 0.015), in all Australian participants (r = 0.019, p = 0.032), in all Hong Kong participants (r = 0.198, p = 0.012), in Australian Crohn’s disease participants (r = 0.261, p = 0.013), and in all Crohn’s participants combined (r = 0.198, p = 0.12).

Results of the study show that CD patients in early life had a higher intake of ultra-processed and processed foods compared to various control groups. Significant findings support the idea that dietary factors, particularly highly processed pro-inflammatory food containing additives, in early life may be a risk factor for Crohn’s disease development later in life. Further research should continue to explore the role of diet and inflammation in the pathogenesis of CD. Study limitations include the use of retrospective recall of early life intake which could lead to recall bias.

Source: Trakman, Gina L., Winnie YY Lin, Amy L. Hamilton, Amy L. Wilson-O’Brien, Annalise Stanley, Jessica Y. Ching, Jun Yu et al. “Processed Food as a Risk Factor for the Development and Perpetuation of Crohn’s Disease—The ENIGMA Study.” Nutrients 14, no. 17 (2022): 3627.

© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/)

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Posted November 8, 2022.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

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