P3371 - Association of Ultra-Processed Food and Unprocessed or Minimally Processed Food Consumption With Bowel Function Among US Adults

Chun-Han Lo, MD, MPH¹, Longgang Zhao, PhD², Euridice Martinez, PhD³, Chun-Wei Pan, MD⁴, Jeffrey Lee, MD, MPH⁵, Xuehong Zhang, PhD², Harminder Singh, MD⁶, Niloy Samadder, MD^7
1Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV; ²Channing Division of Network Medicine and Harvard Medical School, Boston, MA; ³University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil; ⁴John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; ⁵Kaiser Permanente San Francisco Medical Center, San Francisco, CA; ⁶University of Manitoba, Winnipeg, MB, Canada; ⁷Mayo Clinic, Phoenix, AZ

Introduction: Ultra-processed food (UPF) consumption has increased over the past few decades, raising concerns about potential negative impact on the gut microbiome. The pro-inflammatory microenvironment induced by UPFs may lead to disordered bowel function but may be mitigated by increasing consumption of unprocessed or minimally processed foods (UMPs). In this study, we aimed to assess the association between UPF and UMP consumption and bowel function among US adults and the outcomes for substituting UPFs with UMPs.

Methods: We performed a cross-sectional study using data from the National Health and Nutrition Examination Survey (2005-2010). Dietary intake was evaluated by two 24-hour dietary recalls. UPF and UMP intake (% of total gram/d) was derived based on the NOVA Classification. Constipation and diarrhea were defined according to Bristol Stool Form Scale. We used logistic regression to estimate the odds ratio (OR) and 95% confidence interval (CI) for constipation and diarrhea according to quartiles of UPF and UMP intake. Appropriate sample weights, stratification, and clustering were applied to account for the complex survey design. We performed substitution analysis to estimate the risk of constipation and diarrhea when replacing UPFs with an equivalent proportion of UMPs.

Results: Among 12,758 participants, there were 986 cases of constipation and 988 cases of diarrhea. The median UPF intake was 27% among total food intake in gram/d, while the median UMP intake was 66%. Participants who had greater UPF intake had higher risks of constipation (OR_{Q4 vs Q1}, 1.87; 95% CI, 1.47-2.38) (P_trend < 0.001) but not diarrhea (OR_{Q4 vs Q1}, 0.95; 95% CI, 0.71-1.26) (P_trend =0.99). Greater UMP intake was associated with a lower risk of constipation (OR_{Q4 vs Q1}, 0.54; 95% CI, 0.43-0.69) (P_trend < 0.001) but not diarrhea (OR_{Q4 vs Q1}, 1.12; 95% CI, 0.85-1.48) (P_trend =0.72). In addition, replacing 50% of UPF weight in diet with an equivalent proportion of UMPs was associated with a lower risk of constipation (OR, 0.68; 95% CI, 0.57-0.81).

Discussion: Dietary UPF intake was associated with a higher risk of constipation but not diarrhea, while UMP consumption had an inverse association with constipation. Substituting UPFs with UMPs may reduce the risk of constipation. These findings could be explained by differences in dietary constituents such as low fiber content in UPFs. Altered gut microbiota may also play a role through modulating the metabolic activities in colon.


Disclosures:


Chun-Han Lo, MD, MPH¹, Longgang Zhao, PhD², Euridice Martinez, PhD³, Chun-Wei Pan, MD⁴, Jeffrey Lee, MD, MPH⁵, Xuehong Zhang, PhD², Harminder Singh, MD⁶, Niloy Samadder, MD⁷. P3371 - Association of Ultra-Processed Food and Unprocessed or Minimally Processed Food Consumption With Bowel Function Among US Adults, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.