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P704 Dairy products, dietary calcium and the risk of inflammatory bowel disease: results from a European prospective cohort investigation

J. Opstelten*1, M. Leenders1, V. Dik1, S. Chan2, 3, F. van Schaik1, P. Siersema1, B. Bueno-de-Mesquita1, 4, 5, 6, A. Hart2, 3, B. Oldenburg1

1University Medical Centre Utrecht, Department of Gastroenterology and Hepatology, Utrecht, Netherlands, 2Norfolk and Norwich University Hospital NHS Trust, Department of Gastroenterology, Norwich, United Kingdom, 3University of East Anglia, Norwich Medical School, Department of Medicine, Norwich, United Kingdom, 4National Institute for Public Health and the Environment (RIVM), Department for Determinants of Chronic Diseases, Bilthoven, Netherlands, 5Imperial College London, School of Public Health, Department of Epidemiology and Biostatistics, London, United Kingdom, 6University of Malaya, Faculty of Medicine, Department of Social and Preventive Medicine, Kuala Lumpur, Malaysia

Background

Dairy products may be involved in the aetiology of inflammatory bowel disease by modulating gut microbiota and immune responses, but epidemiological studies examining this relationship are limited. We investigated the association between prediagnostic intake of these foods and dietary calcium and the subsequent development of Crohn’s disease (CD) and ulcerative colitis (UC).

Methods

In total, 401 326 participants were enrolled in the European Prospective Investigation into Cancer and Nutrition cohort. At recruitment, consumption of total and specific dairy products (milk, yogurt, and cheese) and dietary calcium was measured using validated food-frequency questionnaires. Cases developing incident CD (n = 110) or UC (n = 244) during follow-up were matched with 4 controls. Conditional logistic regression analyses were used to calculate odds ratios (ORs) with 95% confidence intervals (CIs), adjusted for total energy intake and smoking.

Results

Compared with the lowest quartile, the ORs for the highest quartile of total dairy products and dietary calcium intake were 0.61 (95% CI 0.32–1.19, p trend = 0.19) and 0.63 (95% CI 0.28–1.42, p trend = 0.23) for CD, and 0.80 (95% CI 0.50–1.30, p trend = 0.40) and 0.81 (95% CI 0.49–1.34, p trend = 0.60) for UC. Compared with nonconsumers, individuals consuming milk had significantly reduced odds of CD (OR 0.30, 95% CI 0.13–0.65) and nonsignificantly reduced odds of UC (OR 0.85, 95% CI 0.49–1.47).

Conclusion

Milk consumption seems to be associated with a decreased risk of developing CD, although a clear dose-response relationship was not established. Further studies are warranted to confirm this possible protective effect.