Associations between demographic, clinical and dietary factors and flares in inflammatory bowel disease: the PRognostic effect of Environmental factors in Crohn’s and Colitis (PREdiCCt) prospective cohort study
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: IBD is characterised by recurrent flares, but evidence on whether modifiable dietary factors influence flare risk is limited. OBJECTIVE: The PREdiCCt study was designed to examine demographic, clinical and dietary factors associated with disease flare among patients with IBD in self-reported remission. DESIGN: Multicentre, prospective cohort study conducted across 47 UK centres. Patients with Crohn's disease (CD), ulcerative colitis (UC) or IBD unclassified (IBDU) in self-reported remission were prospectively followed up. The baseline diet was assessed using a validated food frequency questionnaire. The primary outcome was time to patient-reported flare (captured by monthly IBD-Control) and objective flare (clinical flare plus C-reactive protein >5 mg/L and/or faecal calprotectin (FC) >250 µg/g with treatment escalation). Associations were evaluated using Cox frailty models adjusted for demographic, clinical and biochemical variables, including baseline FC. RESULTS: Between November 2016 and March 2020, 2629 participants (1370 CD; 1259 UC/IBDU) were enrolled and followed up for a median of 4.1 years (IQR 3.0-5.0). Baseline FC was strongly associated with patient-reported flares (FC ≥250 µg/g: adjusted HR (aHR) 2.22; FC 50-250 µg/g: aHR 1.52 (reference <50 µg/g)) and objective flares (FC ≥250 µg/g: aHR 3.25; FC 50-250 µg/g: aHR 1.98). In UC, higher total meat intake was associated with increased risk of objective flares (highest versus lowest quartile: aHR 1.95, 95% CI 1.07 to 3.56). No consistent associations were observed for ultraprocessed foods, fibre or polyunsaturated fatty acids and flare. CONCLUSION: Higher habitual meat intake was associated with increased risk of objective flare in UC, suggesting diet may contribute to flare susceptibility in specific patient groups. TRIAL REGISTRATION NUMBER: NCT03282903.
Source: Gut
Authors: Nathan Constantine-Cooke, Beatriz Gros, Nikolas Plevris, Linda J Williams, Gareth-Rhys Jones, Janet Kyle, Nicholas A Kennedy, Victor Velasco-Pardo, Alexander Rudge, Debbie Alexander, Carl A Anderson, Maiara Brusco de Freitas, Lisa M Derr, Lauranne AAP Derikx, Sian Gilchrist, Paul Henderson, Graham W Horgan, Peter Irving, Christopher A Lamb, Luke Jostins-Dean, James O Lindsay, Jonathan MacDonald, Craig Mowat, Charles Murray, Miles Parkes, Spyros I Siakavellas, Catalina A Vallejos, Daniel R Gaya, Jonathan M Rhodes, Alexandra M Johnstone, Christopher J Weir, Charlie W Lees
Institutions: Western General Hospital, Institute of Genetics and Cancer, University of Edinburgh, Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Universitario Reina Sofía, University of Glasgow, University of Aberdeen, University of Exeter, Royal Devon & Exeter NHS Foundation Trust, Royal Devon University Healthcare NHS Foundation Trust, Wellcome Sanger Institute, Aalborg University, Erasmus MC, NHS Fife, Biomathematics and Statistics Scotland, St Thomas' Hospital, King's College London, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle University, University of Oxford, Kennedy Institute of Rheumatology, Queen Mary University of London, Barts Health NHS Trust, NHS Greater Glasgow and Clyde, University of Dundee, The Royal Free Hospital, Cambridge University Hospitals NHS Foundation Trust, Health Data Research UK, University of Liverpool
Language: English
Topic: Inflammatory Bowel Disease
Subfield: Genetics
Domain: Life Sciences
Open Access status: hybrid
Awards: G6724588998, G6934480339
OpenAlex ID: W7124954066