title: High Dietary Intake of Specific Fatty Acids Increases Risk of Flares in Patients With Ulcerative Colitis in Remission During Treatment With Aminosalicylates.
abstract: OBJECTIVE
  Dietary factors may have a significant role in relapse of disease among patients with ulcerative colitis (UC). However, the relationship between diet and UC is inadequately understood. We analyzed data from the diet's role in exacerbations of mesalamine maintenance study to determine whether dietary factors affect the risk of disease flares in patients with UC.
  
  
  METHODS
  We performed a prospective, multicenter, observational study of 412 patients, from 25 sites, with UC in remission during monotherapy with an aminosalicylate. Patients completed a validated food frequency questionnaire at enrollment and were followed for 12 months. We analyzed the relationship between diet and disease remission or flare for groups of macronutrients and micronutrients, and food groups previously associated with an increased risk of flare.
  
  
  RESULTS
  Forty-five patients (11%) had a UC relapse within 1 year of study enrollment. When analyzed in tertiles, increasing intake of multiple fatty acids was associated with increasing odds of relapse. In multivariable logistic regression analysis, only myristic acid (odds ratio, 3.01; 95% confidence interval, 1.17-7.74) maintained this dose-response relationship. Other foods previously implicated in flares of UC, such as processed meat, alcohol, and foods high in sulfur, were not associated with an increased risk of flare.
  
  
  CONCLUSIONS
  In a prospective study of more than 400 patients with UC undergoing treatment with aminosalicylates, we associated high dietary intake of specific fatty acids, including myristic acid (commonly found in palm oil, coconut oil, and dairy fats) with an increased risk of flare. These findings can help design interventional studies to evaluate dietary factors in UC.
authors.affiliation: Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts. Electronic address: elb799@mail.harvard.edu.
authors.forename: Edward L
authors.initials: EL
authors.lastname: Barnes
authors.affiliation: Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Molly
authors.initials: M
authors.lastname: Nestor
authors.affiliation: Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Louisa
authors.initials: L
authors.lastname: Onyewadume
authors.affiliation: Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Punyanganie S
authors.initials: PS
authors.lastname: de Silva
authors.affiliation: Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Korzenik
authors.affiliation: Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003093:Colitis, Ulcerative / Q000473:pathology*; D005227:Fatty Acids / Q000378:metabolism*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D000067251:Symptom Flare Up; D055815:Young Adult
chemical_list: D005227:Fatty Acids
keywords: DREAM Study; Disease Progression; IBD; Risk Factor