Ulcerative Colitis Resource Center

Ulcerative Colitis Resource Center

Disclosures: Khalili reports receiving consulting fees from AbbVie and Takeda and receiving granting funding from Pfizer and Takeda.

March 31, 2021
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Gluten intake not linked with IBD risk

Disclosures: Khalili reports receiving consulting fees from AbbVie and Takeda and receiving granting funding from Pfizer and Takeda.

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Dietary gluten intake was not associated with risk for Crohn’s disease or ulcerative colitis, according to study results.

Hamed Khalili, MD, MPH, from Massachusetts General Hospital, and colleagues wrote that patients with inflammatory bowel often report improvements in symptoms after restricting their gluten intake.

Photo of gluten
Dietary gluten intake was not associated with risk for Crohn’s disease or ulcerative colitis. Source: Adobe Stock

“This may be due to undiagnosed celiac disease, which constitutes a substantial portion of celiac cases, or an effect of gluten on IBD activity,” they wrote. “Evidence for the role of gluten in gut inflammation, independent of celiac disease, is scant.”

Researchers conducted a prospective cohort study of 208,280 individuals from the Nurses’ Health Study (NHS), NHSII and Health Professionals Follow-up study to determine the relationship between gluten intake and risk for IBD. All patients did not have IBD or celiac disease at baseline and completed semi-quantitative food frequency questionnaires.

Investigators used that data to estimate the risk for IBD based on quintiles of average-adjusted dietary gluten intake over the course of follow-up.

Khalili and colleagues identified 337 cases of Crohn’s disease and 447 cases of UC over 5,115,265 person-years of follow-up.

Compared with individuals in the lowest quintile of gluten intake, individuals in the highest quintile were not at increased risk for CD (adjusted HR = 1.16; 95% CI, 0.82-1.64) or UC (aHR = 1.04; 95% CI, 0.75-1.44). Khalili and colleagues wrote that their findings did not change after adjusting for primary sources of gluten intake.

“Long-term intake of gluten did not confer an increased risk of developing IBD in adults [in the U.S.], even among high-risk participants with a family history of IBD,” they wrote. “Our findings do not support the theory that gluten contributes to IBD development. This is important because of the established health benefits of a diet rich in whole grains.

“Gluten should not be empirically avoided in persons without celiac disease for the purpose of preventing IBD.”