{
  "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.",
  "authors": [
    {
      "affiliations": [
        "Institute of Genetics and Cancer, University of Edinburgh Western General Hospital, Edinburgh, UK"
      ],
      "name": "Nathan Constantine-Cooke"
    },
    {
      "affiliations": [
        "Gastroenterology Department, Reina Sofía University Hospital, IMIBIC, CIBERehd, Córdoba, Spain",
        "Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK"
      ],
      "name": "Beatriz Gros"
    },
    {
      "affiliations": [
        "Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK"
      ],
      "name": "Nikolas Plevris"
    },
    {
      "affiliations": [
        "Usher Institute, The University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK"
      ],
      "name": "Linda J Williams"
    },
    {
      "affiliations": [
        "School for Infection and Immunity, University of Glasgow, Glasgow, UK"
      ],
      "name": "Gareth-Rhys Jones"
    },
    {
      "affiliations": [
        "Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK"
      ],
      "name": "Janet Kyle"
    },
    {
      "affiliations": [
        "Gastroenterology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK",
        "University of Exeter, Exeter, UK"
      ],
      "name": "Nicholas A Kennedy"
    },
    {
      "affiliations": [
        "Institute of Genetics and Cancer, University of Edinburgh Western General Hospital, Edinburgh, UK"
      ],
      "name": "Victor Velasco-Pardo"
    },
    {
      "affiliations": [
        "Institute of Genetics and Cancer, University of Edinburgh Western General Hospital, Edinburgh, UK"
      ],
      "name": "Alexander Rudge"
    },
    {
      "affiliations": [
        "Institute of Genetics and Cancer, University of Edinburgh Western General Hospital, Edinburgh, UK"
      ],
      "name": "Debbie Alexander"
    },
    {
      "affiliations": [
        "Wellcome Trust Genome Campus, Wellcome Trust Sanger Institute, Cambridge, UK"
      ],
      "name": "Carl A Anderson"
    },
    {
      "affiliations": [
        "Clinical Medicine, Aalborg Universitet, Copenhagen, Denmark"
      ],
      "name": "Maiara Brusco de Freitas"
    },
    {
      "affiliations": [
        "Usher Institute, The University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK",
        "The University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK"
      ],
      "name": "Lisa M Derr"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Erasmus MC, Rotterdam, The Netherlands"
      ],
      "name": "Lauranne AAP Derikx"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, NHS Fife, Kirkcaldy, UK"
      ],
      "name": "Sian Gilchrist"
    },
    {
      "affiliations": [
        "Paediatric Gastroenterology and Nutrition, Royal Hospital for Children and Young People, Edinburgh, UK",
        "Child Life and Health, The University of Edinburgh Department of Child Life and Health, Edinburgh, UK"
      ],
      "name": "Paul Henderson"
    },
    {
      "affiliations": [
        "Biomathematics and Statistics Scotland, Edinburgh, UK"
      ],
      "name": "Graham W Horgan"
    },
    {
      "affiliations": [
        "St Thomas’ Hospital, London, UK",
        "King’s College London, London, UK"
      ],
      "name": "Peter Irving"
    },
    {
      "affiliations": [
        "Translational & Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK",
        "Gastroenterology, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK"
      ],
      "name": "Christopher A Lamb"
    },
    {
      "affiliations": [
        "Kennedy Institute of Rheumatology, Oxford University, Oxford, UK"
      ],
      "name": "Luke Jostins-Dean"
    },
    {
      "affiliations": [
        "Barts and The London School of Medicine, Queen Mary University of London, London, UK",
        "Barts Health NHS Trust, London, UK"
      ],
      "name": "James O Lindsay"
    },
    {
      "affiliations": [
        "NHS Glasgow and Greater Clyde, Glasgow, UK"
      ],
      "name": "Jonathan MacDonald"
    },
    {
      "affiliations": [
        "University of Dundee, Dundee, UK"
      ],
      "name": "Craig Mowat"
    },
    {
      "affiliations": [
        "Gastroenterology, Royal Free Hospital, London, UK"
      ],
      "name": "Charles Murray"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"
      ],
      "name": "Miles Parkes"
    },
    {
      "affiliations": [
        "Gastroenterology Department, University of Edinburgh Western General Hospital, Edinburgh, UK"
      ],
      "name": "Spyros I Siakavellas"
    },
    {
      "affiliations": [
        "Institute of Genetics and Cancer, University of Edinburgh Western General Hospital, Edinburgh, UK",
        "HDR UK, London, UK"
      ],
      "name": "Catalina A Vallejos"
    },
    {
      "affiliations": [
        "NHS Glasgow and Greater Clyde, Glasgow, UK"
      ],
      "name": "Daniel R Gaya"
    },
    {
      "affiliations": [
        "University of Liverpool Department of Molecular and Clinical Cancer Medicine, Liverpool, UK"
      ],
      "name": "Jonathan M Rhodes"
    },
    {
      "affiliations": [
        "University of Aberdeen, The Rowett Institute, Aberdeen, UK"
      ],
      "name": "Alexandra M Johnstone"
    },
    {
      "affiliations": [
        "The University of Edinburgh Usher Institute, Edinburgh, UK"
      ],
      "name": "Christopher J Weir"
    },
    {
      "affiliations": [
        "Institute of Genetics and Cancer, University of Edinburgh Western General Hospital, Edinburgh, UK",
        "Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK"
      ],
      "name": "Charlie W Lees"
    },
    {
      "affiliations": [],
      "name": "on behalf of the PREdiCCt study group"
    }
  ],
  "title": "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",
  "uid": "41d77a15-53fb-56e5-9c85-c4ed336c3612"
}