Dietary Intake of Total Carbohydrates, Sugar and Sugar-Sweetened Beverages, and Risk of Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

Overview

Journal Front Nutr

Specialty Nutritional Sciences

Date 2021 Oct 18

PMID 34660658

Citations 14

Authors

Zeinab Khademi

Alireza Milajerdi

Bagher Larijani

Ahmad Esmaillzadeh

Affiliations

Soon will be listed here.

Abstract

No earlier study has summarized findings from prospective cohort studies on the association of dietary carbohydrates, sugar, and sugar-sweetened beverages (SSBs) consumption and risk of inflammatory bowel disease (IBD). The current study was done to quantitatively summarize earlier information from prospective cohort studies on the link between dietary carbohydrates, sugar, and SSBs intake with risk of IBD. Relevant studies published up to June 2021 were searched through PubMed, Medline, SCOPUS, EMBASE, and Google Scholar with the use of relevant keywords. All prospective cohort studies investigating the association of dietary carbohydrates, sugar, and SSBs consumption with risk of IBD were included. Combining 5 effect sizes from 4 cohort studies, no significant association was found between dietary intake of carbohydrates and risk of ulcerative colitis (UC) (RR: 1.22; 95% CI: 0.70-2.14). The same findings were obtained for risk of Crohn's disease (CD) (RR: 1.06; 95% CI: 0.64-1.75) based on 4 studies with 5 effect sizes. A significant positive association was observed between sugar intake and risk of UC (RR: 1.59; 95% CI: 1.15-2.20), as well as CD (RR: 1.90; 95% CI: 1.06-3.41) when 5 effect sizes from 4 cohort studies were combined. The overall effect size, based on 4 estimates, revealed no significant association between SSBs consumption and risk of UC (RR: 1.02; 95% CI: 0.92-1.12) and CD (RR: 1.22; 95% CI: 0.91-1.64). Summarizing earlier studies, sugar intake was found to be associated with increased risk of IBD and its subtypes. Any significant association between dietary intake of carbohydrates and SSBs and risk of IBD and its subtypes was not found.

Citing Articles

Health Benefits of Montmorency Tart Cherry Juice Supplementation in Adults with Mild to Moderate Ulcerative Colitis; A Placebo Randomized Controlled Trial.

Sinclair J, McLaughlin G, Allan R, Brooks-Warburton J, Lawson C, Goh S Life (Basel). 2025; 15(2).

PMID: 40003718 PMC: 11857002. DOI: 10.3390/life15020306.

Specific Composition Diets and Improvement of Symptoms of Immune-Mediated Inflammatory Diseases in Adulthood-Could the Comparison Between Diets Be Improved?.

Guerrero Aznar M, Villanueva Guerrero M, Beltran Garcia M, Hernandez Cruz B Nutrients. 2025; 17(3).

PMID: 39940351 PMC: 11819864. DOI: 10.3390/nu17030493.

From Evidence to Practice: A Narrative Framework for Integrating the Mediterranean Diet into Inflammatory Bowel Disease Management.

Naik R, Purcell S, Gold S, Christiansen V, DAloisio L, Raman M Nutrients. 2025; 17(3).

PMID: 39940329 PMC: 11821149. DOI: 10.3390/nu17030470.

Risk factors for inflammatory bowel disease: an umbrella review.

Wu T, Cheng H, Zhuang J, Liu X, Ouyang Z, Qian R Front Cell Infect Microbiol. 2025; 14:1410506.

PMID: 39926114 PMC: 11802543. DOI: 10.3389/fcimb.2024.1410506.

Dietary content and eating behavior in ulcerative colitis: a narrative review and future perspective.

Qin L, Lv W Nutr J. 2025; 24(1):12.

PMID: 39849464 PMC: 11755847. DOI: 10.1186/s12937-025-01075-y.

References

Russel M, Engels L, Muris J, Limonard C, Volovics A, Brummer R . Modern life' in the epidemiology of inflammatory bowel disease: a case-control study with special emphasis on nutritional factors. Eur J Gastroenterol Hepatol. 1998; 10(3):243-9. DOI: 10.1097/00042737-199803000-00010. View

Khalili H, Hakansson N, Chan S, Ludvigsson J, Olen O, Chan A . No Association Between Consumption of Sweetened Beverages and Risk of Later-Onset Crohn's Disease or Ulcerative Colitis. Clin Gastroenterol Hepatol. 2018; 17(1):123-129. DOI: 10.1016/j.cgh.2018.04.059. View

Malik V, Schulze M, Hu F . Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr. 2006; 84(2):274-88. PMC: 3210834. DOI: 10.1093/ajcn/84.1.274. View

Laffin M, Fedorak R, Zalasky A, Park H, Gill A, Agrawal A . A high-sugar diet rapidly enhances susceptibility to colitis via depletion of luminal short-chain fatty acids in mice. Sci Rep. 2019; 9(1):12294. PMC: 6707253. DOI: 10.1038/s41598-019-48749-2. View

. Dietary and other risk factors of ulcerative colitis. A case-control study in Japan. Epidemiology Group of the Research Committee of Inflammatory Bowel Disease in Japan. J Clin Gastroenterol. 1994; 19(2):166-71. View

Lee D, Albenberg L, Compher C, Baldassano R, Piccoli D, Lewis J . Diet in the pathogenesis and treatment of inflammatory bowel diseases. Gastroenterology. 2015; 148(6):1087-106. PMC: 4409494. DOI: 10.1053/j.gastro.2015.01.007. View

Wang F, Feng J, Gao Q, Ma M, Lin X, Liu J . Carbohydrate and protein intake and risk of ulcerative colitis: Systematic review and dose-response meta-analysis of epidemiological studies. Clin Nutr. 2016; 36(5):1259-1265. DOI: 10.1016/j.clnu.2016.10.009. View

Rogler G, Biedermann L, Scharl M . New insights into the pathophysiology of inflammatory bowel disease: microbiota, epigenetics and common signalling pathways. Swiss Med Wkly. 2018; 148:w14599. DOI: 10.4414/smw.2018.14599. View

Jin Z, Lu H, Wu Q, Ge H, Zhou T, Zhang X . A meta-analysis of dietary carbohydrate intake and inflammatory bowel disease risk: evidence from 15 epidemiology studies. Rev Esp Enferm Dig. 2018; 111(1):5-9. DOI: 10.17235/reed.2018.5490/2018. View

10.

Jantchou P, Morois S, Clavel-Chapelon F, Boutron-Ruault M, Carbonnel F . Animal protein intake and risk of inflammatory bowel disease: The E3N prospective study. Am J Gastroenterol. 2010; 105(10):2195-201. DOI: 10.1038/ajg.2010.192. View

11.

Liberati A, Altman D, Tetzlaff J, Mulrow C, Gotzsche P, Ioannidis J . The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009; 339:b2700. PMC: 2714672. DOI: 10.1136/bmj.b2700. View

12.

Geerling B, Dagnelie P, Russel M, Stockbrugger R, Brummer R . Diet as a risk factor for the development of ulcerative colitis. Am J Gastroenterol. 2000; 95(4):1008-13. DOI: 10.1111/j.1572-0241.2000.01942.x. View

13.

Rizzello F, Spisni E, Giovanardi E, Imbesi V, Salice M, Alvisi P . Implications of the Westernized Diet in the Onset and Progression of IBD. Nutrients. 2019; 11(5). PMC: 6566788. DOI: 10.3390/nu11051033. View

14.

Witkowski M, Witkowski M, Gagliani N, Huber S . Recipe for IBD: can we use food to control inflammatory bowel disease?. Semin Immunopathol. 2017; 40(2):145-156. PMC: 5809523. DOI: 10.1007/s00281-017-0658-5. View

15.

Racine A, Carbonnel F, Chan S, Hart A, Bueno-de-Mesquita H, Oldenburg B . Dietary Patterns and Risk of Inflammatory Bowel Disease in Europe: Results from the EPIC Study. Inflamm Bowel Dis. 2015; 22(2):345-54. DOI: 10.1097/MIB.0000000000000638. View

16.

Thornton J, Emmett P, Heaton K . Diet and Crohn's disease: characteristics of the pre-illness diet. Br Med J. 1979; 2(6193):762-4. PMC: 1596421. DOI: 10.1136/bmj.2.6193.762. View

17.

Cui G, Yuan A . A Systematic Review of Epidemiology and Risk Factors Associated With Chinese Inflammatory Bowel Disease. Front Med (Lausanne). 2018; 5:183. PMC: 6018203. DOI: 10.3389/fmed.2018.00183. View

18.

Cox C, Stanhope K, Schwarz J, Graham J, Hatcher B, Griffen S . Circulating concentrations of monocyte chemoattractant protein-1, plasminogen activator inhibitor-1, and soluble leukocyte adhesion molecule-1 in overweight/obese men and women consuming fructose- or glucose-sweetened beverages for 10 weeks. J Clin Endocrinol Metab. 2011; 96(12):E2034-8. PMC: 3232623. DOI: 10.1210/jc.2011-1050. View

19.

Nishida A, Inoue R, Inatomi O, Bamba S, Naito Y, Andoh A . Gut microbiota in the pathogenesis of inflammatory bowel disease. Clin J Gastroenterol. 2017; 11(1):1-10. DOI: 10.1007/s12328-017-0813-5. View

20.

Ananthakrishnan A, Khalili H, Song M, Higuchi L, Richter J, Nimptsch K . High School Diet and Risk of Crohn's Disease and Ulcerative Colitis. Inflamm Bowel Dis. 2015; 21(10):2311-9. PMC: 4567521. DOI: 10.1097/MIB.0000000000000501. View