At one year of age, eating a lot of fish and vegetables and drinking less sugary drinks appears to protect against inflammatory bowel disease. These are the conclusions of a study conducted by the University of Gothenburg on over 80,000 youngsters.
The global increase of inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, has no obvious cause. Dietary patterns that impact gut bacteria, or the gut microbiota, which is especially sensitive during the earliest years of life, are thought to be a contributing role.
Previous study has focused on dietary patterns and IBD in adults, but less is known about children’s diets and their relationship with IBD. The present study, published in the journal Gut, aimed to expand knowledge in this area. The study’s final analysis contains dietary data for 81,280 one-year-olds in Sweden and Norway. The data on the children included are from two population studies: All Children in Southeastern Sweden (ABIS) and the Norwegian Mother, Father, and Child Cohort Study (MoBa).
Although we cannot rule out other explanations, the new findings are consistent with the hypothesis that diet early in life, possibly mediated by changes in the gut microbiome, can affect the risk of developing IBD.
Annie Guo
Less ulcerative colitis in fish eaters
Parents were asked specific questions about their children’s diet at 12-18 and 30-36 months of age. Diet quality was assessed using a child-friendly version of the Healthy Eating Index tool, which looks at the quality of the whole diet. Diet quality was systematically scored and classified as either low, medium, or high.
Higher quality equaled a higher intake of vegetables, fruit, dairy products, and fish, and a lower intake of meat, sweets, snacks, and sweet drinks. Intakes of individual food groups were also studied. Data on breastfeeding and the child’s intake of formula and antibiotics exposure were also included. Children’s health was monitored from the age of 1 and for an average of 21 years for ABIS and 15 years for MoBa, until the end of 2020/2021.
During this period, 307 of the participants were diagnosed with IBD, with 131 having Crohn’s disease, 97 having ulcerative colitis and 79 having an unclassified IBD. The incidence of IBD was higher in the Swedish ABIS study than in the Norwegian MoBa cohort, probably due to the longer follow-up time in ABIS.
High fish intake at age 1 year, compared to a low intake, was associated with a 54% lower risk of ulcerative colitis. High vegetable intake at 1 year of age was associated with an overall reduced IBD risk. High intake of sugar beverages, compared to a low intake, was accompanied by a 42% increased risk of IBD.
Findings support the hypothesis
There were no clear connections between IBD and any of the other food groups, including meat, dairy, fruit, cereals, potatoes, and foods high in sugar, fat, or both. At three years of age, only a high fish intake was related to a lower risk of IBD, namely ulcerative colitis.
The relationships persisted after controlling for the child’s use of formula and antibiotics at age one, as well as breastfeeding and the parents’ overall household income. According to the researchers, because the study was conducted in high-income countries, it is uncertain whether the findings can be applied to low- or middle-income countries with different eating habits. Causality cannot be established because this is an observational study.
“Although we cannot rule out other explanations, the new findings are consistent with the hypothesis that diet early in life, possibly mediated by changes in the gut microbiome, can affect the risk of developing IBD,” says Annie Guo, a dietician and postgraduate student in pediatrics at Sahlgrenska Academy at the University of Gothenburg, and the study’s first author.
