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Dietary Fiber and Risk of Inflammatory Bowel Disease: Fact or Hype?

Published:February 26, 2014DOI:https://doi.org/10.1053/j.gastro.2013.12.043
      In our modern society, it has become a dogma that a diet poor in fruits and vegetables and high in fat and carbohydrates is the culprit behind many diseases, including inflammatory bowel disease, despite the relatively weak evidence.
      • Hou J.K.
      • et al.
      Ananthakrishnan et al in their study also enshrine this dogma in a prospective study on the long-term intake of dietary fiber in a large group of highly educated white females followed over 26 years.
      • Ananthakrishnan A.N.
      • et al.
      The study raises a number of questions that have been partly addressed in the accompanying editorial.
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        • et al.
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        • et al.
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      Linked Article

      • A Prospective Study of Long-term Intake of Dietary Fiber and Risk of Crohn's Disease and Ulcerative Colitis
        GastroenterologyVol. 145Issue 5
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          Increased intake of dietary fiber has been proposed to reduce the risk of inflammatory bowel disease (Crohn's disease [CD] and ulcerative colitis [UC]). However, few prospective studies have examined associations between long-term intake of dietary fiber and risk of incident CD or UC.
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        GastroenterologyVol. 146Issue 4
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          We thank the authors for their insightful comments on our study.1 Stein et al suggest the possibility that reverse causation may have explained our findings by hypothesizing that women with subclinical Crohn’s disease may have reduced their fiber intake in response to symptoms before formal diagnosis. This is unlikely for several reasons. First, a key strength of our cohorts is that our dietary information was not obtained from a single time point, but rather based on cumulatively averaged intake from food frequency questionnaires administered serially over several decades.
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