{
  "abstract": "Background Ultra-processed foods (UPFs), defined by the NOVA classification, have been implicated in chronic inflammatory disorders, but South Asian data on their relationship with inflammatory bowel disease (IBD) remain scarce. We aimed to (1) quantify UPF consumption among Indian adults with and without IBD, and (2) examine its association with IBD presence and symptom severity.Methods In this single-centre hospital-based case–control study, 299 adults (150 IBD cases; 149 non-IBD controls) were enrolled at a tertiary care hospital in Eastern India (( IDDF2026-ABS-0235 Figure 1. Study design and methodological framework for assessing UPF consumption in IBD)(Study flowchart illustrating enrollment, group allocation, NOVA-based dietary classification into Groups 1–4, UPF exposure tertiles [Low, Moderate, High], and clinical assessment using the IBD Symptom Inventory [IBDSI]–Short Form)). IBD was diagnosed using standard clinical, endoscopic, radiologic, and histopathologic criteria. Dietary intake was assessed via 24-hour recall and a 153-item semi-quantitative FFQ (Harvard 2007). The primary exposure was the percentage of total daily energy from NOVA Group 4 (UPFs). Group comparisons used t-tests, Chi-square tests, and one-way ANOVA.Results Of 150 IBD cases, 116 (77.3%) had ulcerative colitis and 34 (22.7%) had Crohn’s disease; mean age was 41.3 ± 8.6 years with male predominance (83.3%). Total energy intake was comparable between cases and controls (2062.7 ± 285.9 vs 2100.8 ± 292.3 kcal/day; p=0.255). UPF energy intake (570.0 ± 211.2 vs 601.6 ± 226.7 kcal/day) and percentage energy from UPFs (27.7 ± 9.7% vs 28.5 ± 9.7%) were similarly non-significant (both p>0.05), as illustrated in figure 2 (IDDF2026-ABS-0235 Figure 2. Comparative analysis of dietary UPF intake and correlation with IBD symptom severity). Detailed statistical comparisons across all parameters are presented in table 1(IDDF2026-ABS-0235 Table 1). Among cases, IBDSI scores showed a numerical increase across UPF tertiles (Low: 7.05 ± 3.58; Moderate: 8.61 ± 4.03; High: 8.46 ± 4.01; p=0.119), suggesting a trend toward greater symptom burden with higher UPF exposure.Conclusions UPF consumption accounted for nearly one-third of daily energy in both groups, reflecting a substantial dietary transition in Eastern India. While UPF intake did not differ significantly between cases and controls, a graded increase in IBD symptom severity with higher UPF consumption was observed. These findings highlight UPFs as a potentially modifiable exposure in IBD management and underscore the need for larger multicentre longitudinal studies integrating dietary, microbiome, and inflammatory biomarkers.Abstract IDDF2026-ABS-0235 Table 1Summary of comparative analyses and statistical findings (n=299)ParameterComparison/ValuesFindingp-valueTotal energy intake (cases vs controls)Cases: 2062.7 ± 285.9 kcal/day; Controls:2100.8 ± 292.3 kcal/dayNo significant difference0.255UPF energy intake(cases vs controls)Cases: 570.0 ± 211.2 kcal/day; Controls:601.6 ± 226.7 kcal/dayNo significantdifference0.214% Energy from UPF(cases vs controls)Cases: 27.7 ± 9.7%; Controls: 28.5 ± 9.7%No significantdifference0.485UPF category distribution (cases vs controls)Low: 31.3% vs 29.5%; Moderate: 48.0% vs 51.7%; High: 20.7% vs 18.8%No significantdifference0.786Comorbidities (cases vs controls)Any comorbidity present: 36.0% vs 25.5%Trend toward significance0.056IBDSI score across UPF categories (cases only)Low: 7.05 ± 3.58; Moderate: 8.61 ± 4.03; High: 8.46 ± 4.01Trend toward higher severity with higher UPF0.119IBD type across UPF categories (cases only)Distribution of UC/CD/IBD-U similar across Low, Moderate, High UPF groupsNo significantdifference0.449(IBD: Inflammatory Bowel Disease; UPF: Ultra-Processed Food (NOVA Group 4); IBDSI: IBD Symptom Inventory – Short Form; UC/CD/IBD-U: Ulcerative Colitis / Crohn’s Disease / IBD-Unclassified)Abstract IDDF2026-ABS-0235 Figure 1Abstract IDDF2026-ABS-0235 Figure 2",
  "authors": [
    {
      "affiliations": [
        "Department of Medical Gastroenterology, IMS & SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, India"
      ],
      "name": "Jonnalagadda Vihari"
    },
    {
      "affiliations": [
        "Department of Medical Gastroenterology, IMS & SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, India"
      ],
      "name": "Girish Kumar Pati"
    },
    {
      "affiliations": [
        "Department of Medical Gastroenterology, IMS & SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, India"
      ],
      "name": "Anuraag Jena"
    },
    {
      "affiliations": [
        "Department of Medical Gastroenterology, IMS & SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, India"
      ],
      "name": "Jimmy Narayan"
    },
    {
      "affiliations": [
        "Department of Medical Gastroenterology, IMS & SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, India"
      ],
      "name": "Manjit Kanungo"
    },
    {
      "affiliations": [
        "Department of Medical Gastroenterology, IMS & SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, India"
      ],
      "name": "Swarup Patnaik"
    },
    {
      "affiliations": [
        "Department of Medical Gastroenterology, IMS & SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, India"
      ],
      "name": "Srakesh Kumar"
    }
  ],
  "title": "IDDF2026-ABS-0235 Association of ultra-processed food consumption with inflammatory bowel disease and symptom severity: a case-control study from Eastern India",
  "uid": "0348f141-d563-5d24-b427-a63cf73b4ac5"
}