Association between energy-adjusted dietary inflammatory index and increased risk of all-cause Crohn's disease: a prospective cohort study.

Background: Crohn's disease (CD) is a chronic inflammatory bowel condition with increasing global incidence. Diet is a key modulator of chronic inflammation, often assessed by the Dietary Inflammatory Index (DII). However, prospective evidence linking the DII to CD risk remains limited in large populations. This study used the UK Biobank (UKB) to address this gap. Methods: Cox regression models were used to examine the association between the energy adjusted dietary inflammation index (E-DII) quartiles and CD with sequential adjustment for confounding variables. Restricted cubic spline regression (RCS) was additionally adopted to determine the association of the continuous E-DII and CD risk. Furthermore, sensitivity and subgroup analyses were conducted to explore the consistency of the results. Results: Among 207,582 participants included in the analysis, 455 incident CD cases were documented over a mean follow-up period of 12.65 years. A positive association was observed between higher E-DII scores, indicating a more pro-inflammatory diet, and an increased risk of CD. In a fully adjusted multivariable model, participants in the highest quartile of E-DII had a significantly elevated risk of CD [HR:1.45, 95% CI (1.11-1.90); Conclusion: In this large prospective cohort, a pro-inflammatory dietary pattern, as reflected by higher E-DII scores, was associated with a significantly increased risk of developing CD. From a public health perspective, this finding highlights the potential importance of dietary inflammation in CD prevention, warranting further investigation into targeted interventions.