Authors: Silkoff K, Hallak A, Yegena L, Rozen P, Mayberry JF, Rhodes J, Newcombe RG

Comment: In 27 patients with Crohn's disease living in Israel the current intake of refined carbohydrate (total sugars) and added sugar is significantly greater than in healthy controls. The dietary survey was retrospective and showed that patients with Crohn's disease ate 269 g of monosaccharides and disaccharides each day compared with 192 g by matched controls.

Similar differences were also found at the onset of the symptoms, 314 g compared with 207 g. These findings were independent of the country of origin or cultural grouping. Several factors are discussed which suggest a secondary rather than causal relationship between sugar consumption and Crohn's disease.

Study link: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7267494&dopt=Abstract

Authors: Thornton JR, Emmett PM, Heaton KW.

Comment: Thirty newly diagnosed patients with Crohn's disease were interviewed about their habitual, pre-illness diet and compared with 30 healthy controls, matched for age, sex, social class, and marital status.

The patients ate substantially more refined sugar, slightly less dietary fibre, and considerably less raw fruit and vegetables than the controls.

A diet high in refined sugar and low in raw fruit and vegetables precedes and may favour the development of Crohn's disease.

Study link: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=519184&dopt=Abstract

Authors: Matsui T, Iida M, Fujishima M, Imai K, Yao T.

Institution: Second Dep. of Intern. Med., Facul. of Med., Kyushu University, Fukuoka, Japan.

Study link: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2347479&dopt=Abstract

Authors: Martini GA, Brandes JW

Comment :The nutritional habits of 63 patients with Crohn's disease (CD) were explored by means of questionnaires and compared with a control group of 63 persons matched as to age, sex and social status. Before the disease was recognized patients with CD consumed 742 grams/week (g/w) sweets and 1380 g/w pastries, during the disease 482 g/w sweets and 905 g/w pastries. The controls only consumed 285 g/w sweets and 563 g/w pastries.

The differences between both groups are highly significant. There existed no significant difference in the intake of other foodstuffs such as proteins, fats, vegetables or alcohol.

The high intake of refined carbohydrates in patients with CD may be partly responsible for its increasing incidence in the developed countries. This might be due to the sugar content as such and/or the food additives.

Study link: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1271690&dopt=Abstract

Authors: Tragnone A, Valpiani D, Miglio F, Elmi G, Bazzocchi G, Pipitone E, Lanfranchi GA.

Institution: Division of Internal Medicine, Bellaria Hospital, University of Bologna, Italy.

Objective: To examine the influence of dietary factors in Italian patients with ulcerative colitis and Crohn's disease.

Design: We studied dietary habits immediately prior to the onset of disease in 104 patients enrolled in a prospective, epidemiological study of the incidence of inflammatory bowel disease in Italy.

Conclusions: Our results confirm that carbohydrate consumption is significantly higher in IBD patients than in healthy controls. Ulcerative colitis patients also consumed more total protein than controls. The pathogenetic significance of these findings, however, remains unclear.

Study link: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7866810&dopt=Abstract

Authors: Penny WJ, Mayberry JF, Aggett PJ, Gilbert JO, Newcombe RG, Rhodes J.

Comment: Seventy patients with Crohn's disease, 50 with ulcerative colitis, and 58 control subjects were questioned about their sugar consumption, measurements were made of their taste acuity, and blood levels of various trace elements including zinc and selenium were estimated.

Sugar consumption was significantly increased in Crohn's disease (p less than 0.01). There was only a minor reduction in taste acuity for acid taste in Crohn's disease. Plasma zinc and whole blood selenium were reduced in Crohn's disease. No relationship was found between sugar consumption, plasma zinc, and taste acuity in Crohn's disease.

Study link: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6832625&dopt=Abstract

Authors: Reif S, Klein I, Lubin F, Farbstein M, Hallak A, Gilat T.

Institution: Department of Gastroenterology, Tel Aviv Sourasky Medical Center, Israel.

Background: The effect of environmental factors has been demonstrated in the pathogenesis of inflammatory bowel disease (IBD). Nutrition may be one of them.

AIM: To investigate the pre-illness diet in patients with recent IBD in comparison with matched population and clinic controls.

Results: A high sucrose consumption was associated with an increased risk for IBD (OR 2.85 (p = 0.03) against population controls and 5.3 (p = 0.00) against clinic controls). Lactose consumption showed no effect while fructose intake was negatively associated with risk for IBD (NS). Similar trends were noted in UC and CD…

Conclusions: An association was found between pre-illness diet and subsequent development of UC and CD. The effect of dietary components may be primary or modulatory.

Study link: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9245929&query_hl=9

Authors: Persson PG, Ahlbom A, Hellers G.

Institution: Department of Epidemiology, Karolinska Institutet, Stockholm, Sweden.

Comment: We conducted a population-based case-control study of inflammatory bowel disease and dietary habits in Stockholm during 1984-1987. We obtained retrospective information about food intake 5 years previously by a postal questionnaire for 152 cases with Crohn's disease, 145 cases with ulcerative colitis, and 305 controls.

The relative risk of Crohn's disease was increased for subjects who had a high (55 gm or more per day) intake of sucrose (relative risk = 2.6, 95% confidence interval = 1.4-5.0) and was decreased for subjects who had a high (15 gm or more per day) intake of fiber (relative risk = 0.5, 95% confidence interval = 0.3-0.9).

The most striking finding was an increased relative risk of both Crohn's disease and ulcerative colitis associated with consumption of fast foods: the relative risk associated with consumption of fast foods at least two times a week was estimated at 3.4 (95% confidence interval = 1.3-9.3) for Crohn's disease and 3.9 (95% confidence interval = 1.4-10.6) for ulcerative colitis…

Study link: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1313310&dopt=Abstract

Authors: Jarnerot G, Jarnmark I, Nilsson K.

Comment: The daily dietary consumption of refined sugar was studied in four equal-sized groups of 30 patients with Crohn's disease, ulcerative colitis (UC), irritable bowel syndrome (IBS), or minor orthopedic conditions. The latter group was matched for sex and age with the Crohn's disease group.

The Crohn's disease patients consumed significantly more refined sugar (88.9 +/- 50.7 (SD) g/day) than the controls (64.3 +/- 45.6 g/day), the UC patients (64.3 +/- 38.7), or the IBS patients (59.9 +/- 33.3). Fifteen patients with Crohn's disease interviewed within 6 months of diagnosis consumed similar amounts of sugar (69.9 +/- 43.9) to those of the subjects in the other three groups.

Fifteen other patients with Crohn's disease studied 7-36 months after diagnosis consumed significantly more refined sugar (107.9 +/- 41.2).

These results indicate that the high sugar consumption in Crohn's disease is a secondary phenomenon without etiologic importance.

Study link: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6673083&dopt=Abstract