title: Pre-illness changes in dietary habits and diet as a risk factor for inflammatory bowel disease: a case-control study.
abstract: OBJECTIVE
  To evaluate whether symptoms of inflammatory bowel disease (IBD), before diagnosis modify dietary habits, and to investigate the pre-illness diet in patients with recent IBD in comparison with an age-matched healthy control group.
  
  
  METHODS
  Overall, 83 new cases of IBD (41 ulcerative colitis, 42 Crohn's disease) and 160 healthy controls were studied. Portions per week of 34 foods and beverages before onset of symptoms were recorded using a validated questionnaire. Duration of symptoms before IBD diagnosis, presence of specific symptoms and their impact on subjective changes in usual dietary habits were also recorded. The association between diet and IBD was investigated by multiple logistic regression and dietary patterns were assessed by factor analysis.
  
  
  RESULTS
  Changes in dietary habits, due to the presence of symptoms, were reported by 38.6% of patients and were not significantly related to specific symptoms, rather to long duration of symptoms, only in Crohn's disease patients. In IBD patients who did not change dietary habits, moderate and high consumption of margarine (OR = 11.8 and OR = 21.37) was associated with ulcerative colitis, whilst high consumption of red meat (OR = 7.8) and high intake of cheese were associated with Crohn's disease.
  
  
  CONCLUSIONS
  More than one third of IBD patients change dietary habits before diagnosis. Margarine, red meat and cheese increase the risk of ulcerative colitis and Crohn's disease.
authors.affiliation: Department of Clinical Sciences, L. Sacco University Hospital, Via G.B. Grassi 74, 20157 Milan, Italy. giovanni.maconi@unimi.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Maconi
authors.forename: Sandro
authors.initials: S
authors.lastname: Ardizzone
authors.forename: Claudia
authors.initials: C
authors.lastname: Cucino
authors.forename: Cristina
authors.initials: C
authors.lastname: Bezzio
authors.forename: Antonio-Giampiero
authors.initials: AG
authors.lastname: Russo
authors.forename: Gabriele
authors.initials: G
authors.lastname: Bianchi Porro
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
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