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Inflammatory bowel diseases: are we ready to recommend a preventive diet for infants?
  1. Ashwin N Ananthakrishnan
  1. Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
  1. Correspondence to Dr Ashwin N Ananthakrishnan, Division of Gastroenterology, Massachusetts General Hospital, Boston, MA 02421, USA; aananthakrishnan{at}

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Environmental factors throughout life play a critical role in the development of IBD (Crohn’s disease (CD), UC). The past decade has witnessed an acceleration of environmental research in IBD with several landmark prospective cohorts identifying dietary and other lifestyle determinants of disease. In parallel, we have also made substantial progress in identifying how the environment contributes to IBD through microbiome-dependent and microbiome-independent effects. Adding to this literature is a study in Gut examining the impact of early life diet on risk of IBD.1 Guo et al use the All Babies in Southeast Sweden study and the Norwegian Mother, Father and Child Cohort Study to examine the association between early life diet and risk of IBD. These large prospective cohorts administered comprehensive questionnaires assessing early life diet (at 12–18 months and 30–36 months) covering intake of meat, fish, fruits and vegetables, breast milk, baby foods and sweets and snacks. The main predictors of interest were overall diet quality using the modified Healthy Eating Index and intake of individual food groups. Cases of CD or UC were identified by linkage to the patient registries. The final analysis included 81 282 children with complete dietary data at 1 year of age among whom 307 developed incident IBD (131 CD, 97 UC, 79 IBD-unclassified). Adjusting for parental IBD history, sex, origin, education and maternal comorbidities, a medium-quality (HR 0.74, 95% CI 0.57 to 0.97) or high-quality (HR 0.73, 95% CI 0.55 to 0.97) diet …

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  • Contributors The author was responsible for the full content.

  • Funding ANA is supported by grants from the National Institutes of Health (R01-DK127171), the Leona M. and Harry B. Helmsley Charitable Trust and the Chleck Family Foundation.

  • Competing interests ANA has served on the scientific advisory board for Geneoscopy.

  • Provenance and peer review Commissioned; internally peer reviewed.

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