Table 3.
Association between total ultra-processed food intake and risk of inflammatory bowel disease. Values are hazard ratios (95% confidence intervals) unless stated otherwise
| Ultra-processed food intake | ||||
|---|---|---|---|---|
| <1 serving/day | 1-4 servings/day | ≥5 servings/day | P trend | |
| Inflammatory bowel disease | ||||
| No of participants | 76 415 | 25 453 | 11 742 | |
| No (%) of events | 199 (0.26) | 134 (0.53) | 95 (0.81) | |
| Unadjusted model | 1 (ref) | 2.20 (1.77 to 2.74) | 3.18 (2.49 to 4.07) | <0.001 |
| Minimally adjusted model* | 1 (ref) | 1.41 (1.11 to 1.79) | 1.42 (1.07 to 1.90) | 0.01 |
| Fully adjusted model† | 1 (ref) | 1.67 (1.18 to 2.37) | 1.82 (1.22 to 2.72) | 0.006 |
| Fully adjusted plus AHEI score model | 1 (ref) | 1.75 (1.23 to 2.50) | 1.92 (1.28 to 2.90) | 0.004 |
| Sensitivity analysis using multiple imputation‡ | 1 (ref) | 1.54 (1.21 to 1.84) | 1.71 (1.22 to 2.37) | <0.001 |
| Crohn’s disease | ||||
| No of participants | 76 415 | 25 453 | 11 742 | |
| No (%) of events | 34 (0.04) | 23 (0.09) | 30 (0.26) | |
| Unadjusted model | 1 (ref) | 2.19 (1.29 to 3.72) | 5.84 (3.57 to 9.54) | <0.001 |
| Minimally adjusted model* | 1 (ref) | 1.15 (0.64 to 2.06) | 1.92 (1.05 to 3.49) | 0.07 |
| Fully adjusted model† | 1 (ref) | 2.72 (1.06 to 6.97) | 4.50 (1.67 to 12.13) | 0.01 |
| Fully adjusted plus AHEI score model | 1 (ref) | 2.93 (1.13 to 7.60) | 4.90 (1.78 to 13.45) | 0.008 |
| Sensitivity analysis using multiple imputation‡ | 1 (ref) | 1.30 (0.71 to 2.37) | 2.83 (1.45 to 4.65) | 0.40 |
| Ulcerative colitis | ||||
| No of participants | 76 415 | 25 453 | 11 742 | |
| No (%) of events | 165 (0.22) | 111 (0.44) | 65 (0.55) | |
| Unadjusted model | 1 (ref) | 2.20 (1.73 to 2.80) | 2.63 (1.97 to 3.51) | <0.001 |
| Minimally adjusted model* | 1 (ref) | 1.48 (1.13 to 1.93) | 1.27 (0.91 to 1.77) | 0.02 |
| Fully adjusted model† | 1 (ref) | 1.55 (1.06 to 2.28) | 1.46 (0.93 to 2.28) | 0.08 |
| Fully adjusted plus AHEI score model | 1 (ref) | 1.61 (1.09 to 2.38) | 1.52 (0.96 to 2.41) | 0.06 |
| Sensitivity analysis using multiple imputation‡ | 1 (ref) | 1.59 (1.23 to 1.98) | 1.45 (0.96 to 2.12) | <0.001 |
AHEI=Alternate Healthy Eating Index.
Heterogeneity of results from Crohn’s disease and ulcerative colitis: χ2 P=0.595; I2=0%.
*
Adjusted for age, sex, and geographical region.
†
Adjusted for age, sex, geographical region, education, alcohol intake, smoking status, body mass index, total energy intake, and location.
‡
To account for participants with missing data on food frequency questionnaire.