Fiber Intake and Crohn’s Disease

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There are several lines of evidence that diet can contribute to the development and treatment of Crohn’s disease.

From a treatment standpoint, the most dramatic data has been with the effectiveness of enteral nutrition as a treatment option.  In addition other environmental factors like being raised on a farm and use of antibiotics have been shown to alter the risk for Crohn’s disease; the former has been associated with a reduction in risk and the latter with an increased risk.

A new prospective study from 170,776 women followed over 26 years in the Nurses’ Health Study has identified up to a 40% reduction in the risk of Crohn’s disease among the highest fiber intake quintile (24 g/day) in comparison to the lowest intake quintile (12 g/day) (Gastroenterol 2013; 145: 970-77, editorial 925).  Link to abstract: http://dx.doi.org/10.1053/j.gastro.2013.07.050 …

Specific findings:

  • Fruit intake was associated with greatest risk reduction.  The median daily intake of fiber from fruit in the highest quintile was 6 g/day which is equivalent to 2 fruits (eg. banana or orange).
  • Vegetable intake was not associated with protection from Crohn’s disease.
  • The editorial notes that “reverse causation was addressed by evaluating cumulative exposure and including a 2-4 year lag period.”
  • However, the women in this study may not be representative and fiber intake could be an epiphenomenon.  The women in the highest quintile were also less likely to smoke, use aspirin and have a body mass index <30 kg/m-squared.
  • Fiber intake did not significantly reduce the risk of ulcerative colitis

Bottomline: the “Institute of Medicine recommends that daily fiber consumption should be 14 g of fiber for every 1000 calories.”  Thus, if one were to follow the guidelines by the IOM, all individuals would be consuming enough fiber to potentially reduce their risk of Crohn’s disease by 40%.  Other fiber benefits include improve bowel habits, lowered cholesterol levels, weight loss, and lowered diabetes risk.

Related blog links:

Also, in the past week, I posted a blog regarging Hepatitis C (Wiping out Hepatitis C | gutsandgrowth).  Another helpful review of the emergence of new therapies comes from yesterday’s NPR.  This story also reported that the expected (not yet set) cost of sofusbuvir will be $90,000!  Here’s the link:

http://www.npr.org/blogs/health/2013/12/05/248934833/fda-set-to-approve-hepatitis-drug