Evidence map›Paper›PMID 34261638›Full record

ArticleBMJ (Clinical research ed.)2021

Association of ultra-processed food intake with risk of inflammatory bowel disease: prospective cohort study.

Neeraj Narula, Emily C L Wong, Mahshid Dehghan, Andrew Mente, Sumathy Rangarajan, Fernando Lanas, Patricio Lopez-Jaramillo, Priyanka Rohatgi, P V M Lakshmi, Ravi Prasad Varma and 25 more

2 registry-linked trialsOpen access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ (Clinical research ed.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 190 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
190citing papers in PubMed, 9 pooled it
45.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03225586 recruitingnot on this map

Prospective Urban Rural Epidemiology Study

TypeobservationalSponsorPopulation Health Research InstituteRan2002 to 2030Enrolled200,000ConditionsCardiovascular Diseases, Risk Factor, Cardiovascular, Health Behavior, Environmental Exposure
NCT07169123 recruitingnot on this mapstarted 2025, after this paper: background citation

Protease Regulation and Impact of Sodium as Mechanisms of Inflammation in IBD

TypeobservationalSponsorMcMaster UniversityRan2025 to 2029Enrolled300ConditionsCrohns Disease
3 · Its place in the literature

Who cites it

190 citing papers in PubMed, 9 syntheses or guidelines pooled it, 347 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Trial
  11. Trial
  12. Trial
  13. Article
  14. Article
  15. Review
  16. Article
  17. Article
  18. Review
  19. Review
  20. Article

130 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

35 authors at 20 institutions in 23 countries.

Neeraj NarulaDepartment of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada neeraj.narula@medportal.ca.ORCID 0000-0002-1536-8436
Emily C L WongDepartment of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada.
Mahshid DehghanPopulation Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
Andrew MentePopulation Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
Sumathy RangarajanPopulation Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
Fernando LanasDepartment of Internal Medicine, Universidad de La Frontera, Temuco, Chile.
Patricio Lopez-JaramilloMasira Research Institute, Universidad de Santander (UDES) Fundación Oftalmológica de Santander-FOSCAL-Bucaramanga, Colombia.
Priyanka RohatgiDepartment of Nutrition and Dietetics, Apollo Hospitals, Bangalore, India.
P V M LakshmiSchool of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Ravi Prasad VarmaAchutha Menon Centre for Health Science Studies, SCTIMST and Health Action by People, Thiruvananthapuram, India.
Andres OrlandiniDepartment of Cardiology, Estudios Clinicos Latinoamerica ECLA Rosario, Santa Fe, Argentina.
Alvaro AvezumInternational Research Centre, Hospital Alemao Oswaldo Cruz, Sao Paulo, Brazil, Universidade Santo Amaro (UNISA), Sao Paulo, Brazil.
Andreas WielgoszDepartment of Medicine, University of Ottawa, Ottawa, ON, Canada.
Paul PoirierFaculté de pharmacie, Université Laval Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada.
Majid A AlmadiDepartment of Medicine, Division of Gastroenterology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Yuksel AltuntasUniversity of Health Sciences, Faculty of Medicine, Istanbul Sisli Hamidiye Etfal Health Training and Research Hospital, Clinic of Endocrinology and Metabolism Sisli/Istanbul, Turkey.
Kien Keat NgFaculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia.
Jephat ChifambaDepartment of Physiology, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe.
Karen YeatesDepartment of Medicine, Queen's University, Kingston, ON, Canada.
Thandi PuoaneSchool of Public Health, University of the Western Cape, Bellville. South Africa.
Rasha KhatibInstitute for Community and Public Health, Birzeit University, Birzeit, Palestine.
Rita YusufAdvocate Research Institute, Advocate Health Care, IL, USA.
Kristina Bengtsson BoströmSchool of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
Katarzyna ZatonskaDepartment of Social Medicine, Wroclaw Medical University, Wroclaw, Poland.
Romaina IqbalDepartment of Community Health Sciences, The Aga Khan University, Karachi, Pakistan.
Liu WeidaMedical Research and Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences Mentougou District, Beijing, China.
Zhu YibingMedical Research and Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences Mentougou District, Beijing, China.
Li SidongMedical Research and Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences Mentougou District, Beijing, China.
Antonio DansSection of Adult Medicine and Medical Research Unit, University of Philippines, Manila, Philippines.
Afzalhussein YusufaliHatta Hospital, Dubai Medical University, Dubai Health Authority, Dubai, United Arab Emirates.
Noushin MohammadifardIsfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
John K MarshallDepartment of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada.
Paul MoayyediDepartment of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada.
Walter ReinischDepartment of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria.
Salim YusufPopulation Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
Population Health Research Institute · CAChinese Academy of Medical Sciences & Peking Union Medical College · CNAga Khan University · PKApollo Hospitals · INBirzeit University · PSDubai Health Authority · AEEstudios Clínicos Latinoamérica · ARHealth Action by People · INHospital Alemão Oswaldo Cruz · BRIndependent University · BDInstitut universitaire de cardiologie et de pneumologie de Québec · CAIsfahan University of Medical Sciences · IRKing Saud University · SAMedical University of Vienna · ATNational Defence University of Malaysia · MYPost Graduate Institute of Medical Education and Research · INQueen's University · CASağlık Bilimleri Üniversitesi · TRUniversidad de La Frontera · CLUniversidad De Santander · CO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the relation between intake of ultra-processed food and risk of inflammatory bowel disease (IBD).

designProspective cohort study.

setting21 low, middle, and high income countries across seven geographical regions (Europe and North America, South America, Africa, Middle East, south Asia, South East Asia, and China).

participants116 087 adults aged 35-70 years with at least one cycle of follow-up and complete baseline food frequency questionnaire (FFQ) data (country specific validated FFQs were used to document baseline dietary intake). Participants were followed prospectively at least every three years.

main outcome measuresThe main outcome was development of IBD, including Crohn's disease or ulcerative colitis. Associations between ultra-processed food intake and risk of IBD were assessed using Cox proportional hazard multivariable models. Results are presented as hazard ratios with 95% confidence intervals.

resultsParticipants were enrolled in the study between 2003 and 2016. During the median follow-up of 9.7 years (interquartile range 8.9-11.2 years), 467 participants developed incident IBD (90 with Crohn's disease and 377 with ulcerative colitis). After adjustment for potential confounding factors, higher intake of ultra-processed food was associated with a higher risk of incident IBD (hazard ratio 1.82, 95% confidence interval 1.22 to 2.72 for ≥5 servings/day and 1.67, 1.18 to 2.37 for 1-4 servings/day compared with <1 serving/day, P=0.006 for trend). Different subgroups of ultra-processed food, including soft drinks, refined sweetened foods, salty snacks, and processed meat, each were associated with higher hazard ratios for IBD. Results were consistent for Crohn's disease and ulcerative colitis with low heterogeneity. Intakes of white meat, red meat, dairy, starch, and fruit, vegetables, and legumes were not associated with incident IBD.

conclusionsHigher intake of ultra-processed food was positively associated with risk of IBD. Further studies are needed to identify the contributory factors within ultra-processed foods. STUDY REGISTRATION: ClinicalTrials.gov NCT03225586.

Indexed as

AdultAgedCausalityColitis, UlcerativeCrohn DiseaseDiet, WesternEnergy IntakeFemaleHumansMaleMiddle AgedProportional Hazards ModelsProspective Studies

Identifiers

PMID34261638
PMCPMC8279036
OpenAlexW3177911292

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.