Fibre intake and the development of inflammatory bowel disease: A European prospective multi-centre cohort study (EPIC-IBD)

Research output: Contribution to journalArticle


Background and Aims: Population-based prospective cohort studies investigating fibre intake and development of inflammatory bowel disease are lacking. Our aim was to investigate the association between fibre intake and the development of Crohn's disease [CD] and ulcerative colitis [UC] in a large European population. Methods: In total, 401 326 participants, aged 20-80 years, were recruited in eight countries in Europe between 1991 and 1998. At baseline, fibre intake [total fibres, fibres from fruit, vegetables and cereals] was recorded using food frequency questionnaires. The cohort was monitored for the development of inflammatory bowel disease. Each case was matched with four controls and odds ratios [ORs] for the exposures were calculated using conditional logistic regression. Sensitivity analyses according to smoking status were computed. Results: In total, 104 and 221 participants developed incident CD and UC, respectively. For both CD and UC, there were no statistically significant associations with either quartiles, or trends across quartiles, for total fibre or any of the individual sources. The associations were not affected by adjusting for smoking and energy intake. Stratification according to smoking status showed null findings apart from an inverse association with cereal fibre and CD in non-smokers [Quartile 4 vs 1 OR = 0.12, 95% confidence interval = 0.02-0.75, p = 0.023, OR trend across quartiles = 0.50, 95% confidence interval = 0.29-0.86, p = 0.017]. Conclusion: The results do not support the hypothesis that dietary fibre is involved in the aetiology of UC, although future work should investigate whether there may be a protective effect of specific types of fibre according to smoking status in CD.


  • Vibeke Andersen
  • Simon Chan
  • Robert Luben
  • Kay Tee Khaw
  • Anja Olsen
  • Anne Tjonneland
  • R. Kaaks
  • M. M. Bergmann
  • H. Boeing
  • Johan Hultdin
  • Pontus Karling
  • Kim Overvad
  • Bas Oldenburg
  • Jorrit Opstelten
  • Marie Christine Boutron-Ruault
  • Franck Carbonnel
  • Antoine Racine
  • Timothy Key
  • Giovanna Masala
  • Domenico Palli
  • R. Tumino
  • A. Trichopoulou
  • Elio Riboli
  • Andrew Hart
External organisations
  • University of Southern Denmark
  • University of East Anglia
  • Norfolk and Norwich University Hospital NHS Trust
  • University of Cambridge
  • Danish Cancer Society Research Center
  • German Cancer Research Centre
  • Skåne University Hospital
  • German Institute of Human Nutrition
  • Umeå University
  • Aarhus University
  • University Medical Center Utrecht
  • Institut Gustave Roussy
  • University of Paris-Sud
  • Bicêtre Hospital
  • University of Oxford
  • Cancer Research and Prevention Institute (ISPO)
  • Imperial College London
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Nutrition and Dietetics
  • Gastroenterology and Hepatology
  • Public Health, Global Health, Social Medicine and Epidemiology


  • Diet, Dietary fibre, Epidemiology, Fibre food, Inflammatory bowel disease, Prospective study
Original languageEnglish
Article numberjjx136
Pages (from-to)129-136
Number of pages8
JournalJournal of Crohn's and Colitis
Issue number2
Publication statusPublished - 2018
Publication categoryResearch
Externally publishedYes