P0760 - Dietary Nut and Legume Intake and Risk of Inflammatory Bowel Disease in US Adults

Sunday, October 22, 2023

3:30 PM – 7:00 PM PT

Location: Exhibit Hall

Has Audio

Presenting Author(s)

EL

Emily Lopes, MD, MPH

Massachusetts General Hospital
Boston, MA

Emily Lopes, MD, MPH, Zeling Yu, BS, Kristin Burke, MD, MPH, James Richter, MD, Ashwin Ananthakrishnan, MD, MPH, Andrew Chan, MD, MPH, Hamed Khalili, MD, MPH
Massachusetts General Hospital, Boston, MA

Introduction: Several dietary risk factors have been identified for Crohn’s disease (CD) and ulcerative colitis (UC). Nuts and legumes may possess anti-inflammatory effects either directly or by impacting the intestinal microbiota. To date, no prospective studies have investigated the relationship between nut and legume intake and risk of CD or UC.

Methods: We conducted a prospective cohort study of 129,784 US adults from the Nurses’ Health Study and Health Professionals Follow-Up Study between 1986-2016. We excluded those with CD or UC at baseline. Semiquantitative food frequency questionnaires completed every 4 years were used to calculate cumulative average of daily servings of dietary nut and legume intake. CD and UC were self-reported on follow-up questionnaires and confirmed via blinded record review by two gastroenterologists. Cox proportional hazards models were used to calculate multivariable-adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for CD and UC according to quintiles of nut or legume intake.

Results: We ascertained 211 CD cases and 240 UC cases over 3,213,883 person-years. Nut intake was associated with decreased risk of CD, though this did not reach statistical significance (P_trend=0.06; Table 1). Compared to those in the lowest quintile of nut intake (mean=0 servings/day), those in the highest quintile (mean=0.60 servings/day) had an aHR of 0.71 (95% CI 0.43-1.15) for CD. No association was seen between nut intake and risk of UC (aHR for highest compared with lowest quintile=1.29 (95% CI 0.81-2.04), P_trend=0.28). Legume intake was associated with a decreased risk of UC, though this did not reach statistical significance (P_trend=0.09). Compared to those in the lowest quintile of legume intake (mean=0.04 servings/day), those in the highest quintile (mean=0.57 servings/day) had an aHR of 0.72 (95% CI 0.45-1.15) for UC. No association was seen between legume intake and risk of CD (aHR for highest compared with lowest quintile=0.98 (95% CI 0.60-1.58), P_trend=0.72). In stratified analysis, baseline age, smoking status, and body mass index did not modify the relationship between nut or legume intake and risk of CD or UC (all P_interaction≥0.16).

Discussion: In two large, prospective cohorts in the US, dietary nut intake was associated with a trend toward decreased risk of CD and dietary legume intake was associated with a trend toward decreased risk of UC. Additional prospective or interventional studies are needed to expand upon these findings.

A. Nut Intake^a	Quintile 1 (n=35,622)	Quintile 2 (n=19,218)	Quintile 3 (n=24,532)	Quintile 4 (n=24,869)	Quintile 5 (n=25,543)	P_trend
Mean servings/day	0 (0)	0.05 (0.02)	0.09 (0.03)	0.15 (0.06)	0.60 (0.58)
Person-Years	599,567	583,115	662,545	683,912	684,745
Crohn's Disease Cases (n=211)	43	56	29	49	34
HR (95% CI)	1.00 (ref)	1.34 (0.90-2.01)	0.60 (0.37-0.96)	1.00 (0.66-1.50)	0.70 (0.45-1.10)	0.04
aHR (95% CI) ^b	1.00 (ref)	1.35 (0.90-2.03)	0.62 (0.39-1.01)	1.00 (0.65-1.54)	0.71 (0.43-1.15)	0.06
Ulcerative Colitis Cases (n=240)	37	45	52	54	52
HR (95% CI)	1.00 (ref)	1.18 (0.76-1.82)	1.25 (0.82-1.91)	1.26 (0.82-1.91)	1.20 (0.79-1.84)	0.40
aHR (95% CI)^b	1.00 (ref)	1.20 (0.77-1.86)	1.31 (0.85-2.02)	1.29 (0.84-2.00)	1.29 (0.81-2.04)	0.28
B. Legume Intake ^c	Quintile 1 (n=28,893)	Quintile 2 (n=14,552)	Quintile 3 (n=34,251)	Quintile 4 (n=27,145)	Quintile 5 (n=24,943)	P_trend
Mean servings/day	0.04 (0.03)	0.12 (0.01)	0.16 (0.03)	0.26 (0.06)	0.57 (0.28)
Person-Years	617,551	598,426	694,840	673,152	629,915
Crohn's Disease Cases (n=211)	39	41	56	38	37
HR (95% CI)	1.00 (ref)	1.02 (0.66-1.59)	1.30 (0.86-1.96)	0.87 (0.55-1.36)	0.90 (0.57-1.41)	0.45
aHR (95% CI)^b	1.00 (ref)	1.04 (0.67-1.62)	1.34 (0.88-2.04)	0.92 (0.58-1.45)	0.98 (0.60-1.58)	0.72
Ulcerative Colitis Cases (n=240)	51	55	48	51	35
HR (95% CI)	1.00 (ref)	1.11 (0.75-1.62)	0.86 (0.58-1.28)	0.93 (0.63-1.38)	0.69 (0.45-1.07)	0.07
aHR (95% CI)^b	1.00 (ref)	1.15 (0.78-1.69)	0.88 (0.59-1.32)	0.95 (0.63-1.42)	0.72 (0.45-1.15)	0.09
Models stratified by time period (year), age (months), and cohort (NHS vs HPFS). ^aNut intake includes walnuts, peanuts, and other nuts. ^b Adjusted for body mass index, non-steroidal anti-inflammatory drugs, history of appendectomy, smoking status (never, past, current), physical activity (quintiles), alternate healthy eating index (quintiles), family history of inflammatory bowel disease (yes/no), and total daily calories (quintiles). ^cLegume intake includes beans, peas, and tofu. aHR Multivariable-Adjusted Hazard Ratio. CI Confidence Interval. HR Hazard Ratio.

Table: Table 1. (A) Nut intake and risk of Crohn’s disease and ulcerative colitis, and (B) Legume intake and risk of Crohn’s disease and ulcerative colitis

Disclosures:

Emily Lopes indicated no relevant financial relationships.

Zeling Yu indicated no relevant financial relationships.

Kristin Burke: Bristol Myers Squibb – Advisory Committee/Board Member. OM1 – Consultant.

James Richter indicated no relevant financial relationships.

Ashwin Ananthakrishnan indicated no relevant financial relationships.

Andrew Chan: Boehringer Ingelheim – Consultant. Freenome – Grant/Research Support. Pfizer Inc. – Consultant, Grant/Research Support. Zoe Ltd. – Advisory Committee/Board Member.

Hamed Khalili indicated no relevant financial relationships.

Emily Lopes, MD, MPH, Zeling Yu, BS, Kristin Burke, MD, MPH, James Richter, MD, Ashwin Ananthakrishnan, MD, MPH, Andrew Chan, MD, MPH, Hamed Khalili, MD, MPH. P0760 - Dietary Nut and Legume Intake and Risk of Inflammatory Bowel Disease in US Adults, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.