High Red Meat Consumption is Associated With Greater Risk of Ulcerative Colitis Flare

Background: Dietary factors and possible dietary interventions that may affect inflammatory bowel disease (IBD) disease course are of great interest. Several epidemiologic studies show a correlation between dietary patterns and the risk of developing IBD, but data regarding specific dietary components, and their effect on disease course in established IBD are still lacking. Some studies have shown a correlation between dietary fat intake and the risk of developing ulcerative colitis (UC), but not Crohn’s disease (CD). We aimed to study the association between the consumption of dietary items high in saturated fat and the risk of IBD flare. Methods: The data for this study were derived from the IBD Partners Study. Briefly, this is a longitudinal internet-based cohort of patients with IBD older than 18 years of age. Baseline surveys included demographic characteristics, details regarding their IBD history and a nutritional survey in a subset of individuals. The dietary survey used was the 26-item Dietary Screener Questionnaire developed by the National Cancer Institute. The survey asks about the frequency of consumption of selected food items in the past month. Follow-up surveys were completed every six months to document changes in disease activity. In this analysis we included patients that completed the nutritional survey, were in a clinical remission at baseline, and had a follow-up documentation of clinical disease activity score 6-12 months after the baseline visit. Dietary intake of food items high in saturated fat was categorized into quartiles and compared using chi square test. Clinical remission was defined as Simple Clinical Colitis Activity Index (SCCAI) < 3 for UC, and Short Crohn’s Disease Activity Index (sCDAI) < 150 for Crohn’s disease (CD). Disease flare was defined as disease activity index score above the cutoffs for remission and/or hospitalization for IBD. All statistical analyses were performed using SPSS version 29. Results: Our study population included 317 UC patients and 734 CD patient. 66% of UC patients were female, with a median age of 44 (IQR 31-56) years and median disease duration of 9 (IQR 4.25-17) years. Among patients with CD, 71% were female, median age was 45 (IQR 33-58) years and median disease duration was of 13 years (IQR 6-25). The median time from baseline to the follow-up visit was 6.9 months (IQR 6.4-7.5) in both groups. 85/317 (26.8%) of UC patients and 147/734 (20%) of CD patients had a flare. Patients with UC in the highest quartile of red meat consumption had a higher rate of disease flare compared to patients in the bottom quartile with an OR 2.60 (95% CI 1.26-5.70). This association was not demonstrated in patients with CD, OR 1.22 (95% CI 0.75-1.98). We observed no associations between high consumption of other individual high saturated fat dietary items including processed meat, milk, cheese, and ice cream and disease flare in UC or CD. Discussion: High consumption of red meat was associated with higher risk of UC flare, but not with CD flare. This association was not found with other dietary items high in saturated fat.