Fruits, Vegetables, Legumes, and Potatoes and Risk of Crohn's Disease and Ulcerative Colitis

Objectives: Low intake of fiber, fruits and vegetables is associated with the risk of developing Crohn's disease (CD) and ulcerative colitis (UC). We therefore aimed to assess the risk of developing CD and UC according to individual fruits, vegetables, legumes, and potatoes and their diversity in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Methods: Validated food frequency questionnaires collected at baseline were used to assess fruits, vegetables, legumes, and potatoes intakes. The association between these foods and CD and UC risks were estimated using Cox models stratified by center, sex and age; and adjusted for smoking status, BMI, physical activity, energy intake, educational level and alcohol intake. Results: 341,519 individuals were followed prospectively. Among them, 149 developed CD and 379 developed UC after a median follow-up of 13.4 years. High intake of combined fruits, vegetables, legumes, and potatoes were associated with a lower risk of CD (fourth vs first quartile adjusted HR=0.44, 95%CI: 0.26-0.76; p-trend<0.01) but not UC (aHR=1.07, 95%CI: 0.76-1.50; p-trend=0.73). Pooled consumption of apple/pear, banana, mushrooms, and onion/garlic was associated with a lower risk of CD (fourth vs first quartile aHR 0.58; 95%CI: 0.33-1.02, p-trend 0.03). A higher risk of UC was observed with high intakes of potatoes (fourth vs first quartile aHR 1.51; 95%CI: 1.05-2.17). Fruits/Vegetables/Legumes/Potatoes diversity score was not associated with risk of CD nor of UC. Conclusions: High apple/pear, banana, mushrooms, and onion/garlic intake is associated with a lower risk of developing CD whereas high intake of potatoes is associated with UC.