Ultraprocessed Grains and Risk of Inflammatory Bowel Disease: Results From the Prospective Urban Rural Epidemiology Study
Narula N, Wong ECL, Wong ECL, Mente A, Rangarajan S, Lang X, Li Q, Chen M, Mohan I, Mat-Nasir N, Diaz ML, Lopez-Jaramillo P, Bahonar A, Avezum A, Karsidag K, Rosengren A, Abat MEM, Lanas F, Swart EC, Yusuf R, Alhabib KF, Iqbal R, Basiak-Rasała A, Khatib R, Yusufali A, Yeates K, Chifamba J, Marshall JK, Moayyedi P, Reinisch W, Yusuf S
The American journal of gastroenterology · 2 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Cohort study (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
- Intake measured by
- Food frequency questionnaire
Who paid for it
- Funding
- Funding not disclosed
Publication
- Published
- 2025-08-04 · Am J Gastroenterol · vol. 121 · issue 6 · pp. 1445–1454
- Publisher
- Lippincott Williams & Wilkins
- Cited
- 3 citations · more than 81% of similar papers · 1.5× the field average
- References
- 35 works
- Access
- Paywalled
- Research areas
- Food composition and properties · Consumer Attitudes and Food Labeling · Celiac Disease Research and Management
- Keywords
- Medicine, Hazard ratio, Epidemiology, Confounding, Confidence interval, Prospective cohort study, Environmental health, Refined grains, Ulcerative colitis, Proportional hazards model, Multivariate analysis, Internal medicine, Disease, Food science, Whole grains
- MeSH
- humans, colitis, ulcerative, inflammatory bowel diseases, crohn disease, diet, proportional hazards models, risk factors, prospective studies, adult, middle aged, rural population, female, male, edible grain, food, processed
30 authors
From CA, FR, CN, IN, MY, AR, CO, BR, TR, SE, PH, CL, ZA, BD, SA, PK, PL, US, PS, TZ, ZW, AT
- Neeraj NarulaPopulation Health Research Institute; Institut de Recherche en Santé Digestive
- Emily C L WongInstitut de Recherche en Santé Digestive
- Andrew MentePopulation Health Research Institute
- Sumathy RangarajanPopulation Health Research Institute
- Xinyue LangBeijing Anzhen Hospital
- Qi LiChinese Academy of Medical Sciences & Peking Union Medical College; Fu Wai Hospital
Abstract
Introduction
Ultraprocessed 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 ultraprocessed grain consumption and the risk of developing inflammatory bowel disease (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 ultraprocessed grain intake was categorized into 3 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 ultraprocessed grain intake was associated with increased IBD risk. Participants consuming ≥19 g/d of ultraprocessed grains had a higher risk of developing IBD compared with those consuming <9 g/d (hazard ratio [HR] 1.86, 95% confidence interval 1.26-2.61, Ptrend = 0.0003) after multivariate adjustment. Fresh bread and rice consumption were associated with lower IBD risk. Participants with greater ultraprocessed food intake (≥5 servings per day) were linked to a higher risk of developing IBD compared with those consuming <1 serving per day (HR 3.95, 95% confidence interval 2.74-5.71, Ptrend < 0.0001).
Discussion
Higher intake of ultraprocessed grains is associated with significantly increased risk of developing IBD. A healthy eating pattern should minimize consumption of ultraprocessed grains. Further studies should be performed to understand which components of ultraprocessed grains may be detrimental for health.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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