Download This Paper
Preprints with The Lancet is a collaboration between The Lancet Group of journals and SSRN to facilitate the open sharing of preprints for early engagement, community comment, and collaboration. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early-stage research papers that have not been peer-reviewed. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. The findings should not be used for clinical or public health decision-making or presented without highlighting these facts. For more information, please see the FAQs.
Dietary Total Antioxidant Capacity Alleviates the Hazards of Intestinal Surgery, Gastrointestinal Cancer, and All-Cause Mortality of Inflammatory Bowel Disease
24 Pages Posted: 18 Jun 2024
More...Abstract
Background: Diets rich in antioxidants are associated with reduced risk of adverse outcomes in multiple diseases, such as disease relapse, complications, and death events, but the association between dietary antioxidant capacity and the prognosis of inflammatory bowel disease (IBD) remains uncertain.
Methods: We conducted a prospective cohort study of 2,487 participants with IBD in the UK Biobank. Dietary total antioxidant capacity (TAC) was estimated by the oxygen radical absorbance capacity of the food items from repeated 24-hour diet recalls. The prognostic outcomes include IBD-related surgery, gastrointestinal cancer, and all-cause mortality, ascertained via inpatient data, primary care data, cancer registry, and death registry. Cox proportional hazards models were applied to estimate hazard ratios (HRs) with 95% confidence intervals (CIs).
Findings: During a median follow-up of 10·9 years, we documented 174 cases of IBD-related surgery, 52 cases of gastrointestinal cancer, and 189 death events among IBD patients. When comparing the fourth with the first quartile of dietary TAC, participants with IBD presented a significantly reduced risk of IBD-related surgery (HR 0·53; 95% CI 0·34-0·84; P=0·007; P-trend=0·005) and all-cause mortality (HR 0·61; 95% CI 0·39-0·96; P=0·034; P-trend=0·014). Compared to the low intake group (first decile of dietary TAC), individuals with higher dietary TAC were associated with a lower risk of gastrointestinal cancer (HR 0·39; 95% CI 0·19-0·83; P=0·014). Similar findings were observed in subgroup and sensitivity analysis
Interpretation: A high dietary TAC was associated with better prognosis of IBD, including IBD-related surgery, gastrointestinal cancer, and all-cause mortality.
Funding: The Swedish Research Council (Grant Number 2019-00977), the Swedish Heart-Lung Foundation (Grant number 20190247), and the Swedish Cancer Society (Cancerfonden); the Natural Science Fund for Distinguished Young Scholars of Zhejiang Province (LR22H260001) and the National Natural Science Foundation of China (82204019); the National Undergraduate Training Program for Innovation and Entrepreneurship (Grant Number: 202310335170).
Declaration of Interest: JFL has coordinated an unrelated study on behalf of the Swedish IBD quality register (SWIBREG). That study received funding from Janssen corporation. JFL has also received financial support from MSD developing a paper reviewing national healthcare registers in China. JFL has an ongoing research collaboration on celiac disease with Takeda. No financial disclosures were reported by the other authors of this paper.
Ethical Approval: Ethical approval was granted for the UK Biobank by the North West-Haydock Research Ethics Committee (REC reference: 21/NW/0157). All participants provided informed consent through electronic signature at baseline assessment. This study was conducted with the UK Biobank Resource under application number 73595.
Keywords: dietary total antioxidant capacity, inflammatory bowel disease, surgery, gastrointestinal cancer, mortality, prospective cohort study
Suggested Citation: Suggested Citation