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Medical News Today
01-08-2025
- Health
- Medical News Today
Inflammatory diets, ultra-processed foods may increase Crohn's disease risk
Inflammatory bowel disease (IBD) is a group of chronic conditions that damage the intestines and can cause uncomfortable symptoms. Preventing IBD remains a challenge, and research is underway to minimize this risk. A recent systematic review and meta-analyses identified dietary choices that may affect risk for Crohn's disease, a major type of IBD. The study saw benefits from a Mediterranean-style diet and increased risk from diets containing inflammatory and ultraprocessed bowel disease (IBD) is a group of conditions that impact intestinal health. Ulcerative colitis and Crohn's disease are the major IBD subtypes.A systematic review and meta-analyses published in eClinicalMedicine examined how food can affect the development of IBD, ulcerative colitis, and Crohn's disease. The researchers did not find consistent associations between food choices or food patterns and the risk for developing ulcerative colitis. However, they observed that ultraprocessed foods and eating an inflammatory diet increased the risk for Crohn's contrast, the findings suggest that following a healthy or Mediterranean diet, consuming high levels of fiber, and eating minimally processed or unprocessed foods might decrease the risk for Crohn's disease. How does diet impact Crohn's or ulcerative colitis?There is a need for more data and analysis on diet and people's risk for IBD, which is what this study focused on. Researchers identified relevant studies from three electronic databases and conducted a systematic literature review. All studies were either case-control studies nested in prospective cohorts or prospective cohort studies. The studies assessed people's diets before they were diagnosed with Crohn's disease or ulcerative colitis and reported on the diagnosis of these conditions or just IBD. The studies also looked at the relationship between risk for IBD, Crohn's disease, or ulcerative colitis and food exposure. The final systematic review included 72 studies. Most studies involved adults, but some involved children. Researchers examined data from over 2 million participants with an average follow-up of almost 13 years. Among the participants, 4,617 experienced ulcerative colitis, and 1,902 experienced Crohn's disease. The researchers also conducted meta-analyses, looking at Crohn's disease and ulcerative colitis separately. The researchers did not find an association between Crohn's disease or ulcerative colitis and some foods and food patterns. For example, they did not find that eating foods like red meat or eggs increased or decreased the risk for ulcerative colitis or Crohn's disease. Overall, the researchers noted that they did not find a consistent association between food patterns or foods and ulcerative colitis the systematic review, one study found that following a Western dietary pattern increased risk for Crohn's disease. Two studies also suggested that diets with less intake of vegetables and whole grains and higher intake of low-calorie drinks, red meat, and processed meat increased the chances of developing Crohn's disease. Three overlapping studies from the European Prospective Investigation into Cancer found that the omega-3 fatty acid docosahexaenoic acid decreased risk for Crohn's disease and ulcerative colitis. Two overlapping UK Biobank studies found that fish oil decreased risk for both conditions, and two studies found that two plant flavonoids decreased ulcerative colitis risk. How processed food affects disease riskResearchers identified more associations between foods and risk for Crohn's disease. They found that fiber appeared to decrease the risk of Crohn's disease, and that following the Mediterranean diet decreased the risk. They also found that having a healthy diet that aligns 'with recommendations for prevention of non-communicable diseases,' may decrease the risk for Crohn's disease. Finally, eating foods with no or low levels of processing decreased risk for Crohn's disease. In contrast, following an inflammatory diet increased the risk for Crohn's disease, as well as eating more ultra-processed foods. In the sensitivity analysis, researchers found that the associations were dose-dependent for these major associations with food and food patterns and Crohn's disease. How pregnancy and childhood affect IBD riskWhen looking at diet in childhood, one study found that eating high amounts of fish at one and three years may decrease ulcerative colitis risk, eating a high-quality diet at one year may decrease IBD risk, and drinking low amounts of sugar-sweetened beverages may decrease IBD risk. One study suggested that diet diversity during pregnancy may help decrease the risk of the offspring developing ulcerative colitis. Two abstracts further suggest that eating high amounts of lean fish and n-3 polyunsaturated fatty acids during pregnancy decreases IBD risk in offspring and that diet diversity during pregnancy decreases offspring's risk for Crohn's disease. Study author Professor Jean-Frederic Colombel, Director of the Susan and Leonard Feinstein IBD Clinical Center at Icahn School of Medicine at Mount Sinai, New York, summed up the main findings of the research to Medical News Today: 'In this systematic literature review and in meta-analyses based on 72 prospective studies, we examine the association between pre-disease diet and the risk of inflammatory bowel disease. The main findings were that inflammatory and ultra-processed diets were associated with a higher risk of Crohn's disease, while Mediterranean, healthy diets, unprocessed/ minimally processed foods, and high fiber intakes were associated with a lower risk of Crohn's disease.'What the study may be missingIt's possible that some relevant data was missed due to the methods and criteria researchers chose to use. Researchers acknowledge that classification bias is possible for participants' exposure to ultra-processed foods. They also note the possibility of residual confounding bias. They also had limited information regarding certain foods and food patterns. For example, they only had one study that looked at the difference between sugar-sweetened and artificially sweetened beverages. Most studies relied on questionnaires to collect data about participants' food intake, so there is a risk for memory bias, and some only had baseline questionnaires from participants. There were some differences between studies regarding how the Mediterranean diet was defined and scored. Additionally, some studies used differing methods to measure inflammatory diets. Most of the studies were conducted in Europe and the United States. A lot of research focused on white participants, so work in additional groups may be warranted. Since most participants were older or middle-aged, it's possible that the results may not apply to younger individuals. While the risk is small, reverse causality is possible when it comes to the link between ulcerative colitis and Crohn's disease risk and foods. Another small risk is that the link between Crohn's disease and dietary patterns could be obesity-mediated. Finally, there were additional limitations in the studies. For example, in at least one study, IBD status was self-reported by participants, which could have been inaccurate. More research is required to further understand the relationship between food and ulcerative colitis. More examination of certain foods and food patterns may also be helpful. What this study means for people with IBDThe authors of this research explain that this data can help with prevention trial designs and IBD prevention. The data suggest the differences between how diet affects ulcerative colitis and Crohn's disease. Emma Halmos, Associate Professor of Gastroenterology Research & Dietitian at the School of Translational Medicine, Monash University, who was not involved in the study, explained that 'the findings coming from this study are [that] there is likely a difference between the role of diet in Crohn's disease and ulcerative colitis development. Features of a healthy diet, such as having an adequate intake of dietary fiber and limiting ultra-processed food, that is also in line with a Mediterranean diet that encourages plant-based foods and limits protein from meat, reduces the risk of developing Crohn's disease, but not ulcerative colitis.' Finally, it also indicates the need for more dietary discussions. Neeraj Narula, associate professor and gastroenterologist who focuses on IBD research, who was not involved in the study, explained: 'These findings strongly support the idea that dietary counseling for patients with increased risk of Crohn's disease, or for those with early IBD symptoms, should emphasize minimizing ultra-processed food consumption. There is mounting justification for integrating dietitians and nutritional education into standard IBD care, not just as a supportive measure, but as a core strategy for prevention and management.'
Medscape
27-06-2025
- Health
- Medscape
Pollution, Weather Linked to Atopic Dermatitis
TOPLINE: In a meta-analysis of 42 studies, exposure to air pollutants and high temperatures was associated with higher risk for clinic visits and worsened symptoms in adults with atopic dermatitis. METHODOLOGY: Researchers conducted a meta-analysis and systematic review of 42 studies from 14 countries between 1985 and 2024. They included cohort, case-control, and cross-sectional studies that examined associations between environmental exposures and atopic dermatitis outcomes in adults. Researchers assessed exposure to ambient air pollutants: Nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ), particulate matter with a diameter of 10 µm or less (PM 10 ), PM with a diameter of 2.5 µm or less (PM 2.5 ), carbon dioxide (CO 2 ), ozone (O 3 ), temperature, precipitation, sunlight or solar radiation, humidity, secondhand smoke, seasonal variations, and pollution from traffic or industrial sources. TAKEAWAY: Outpatient clinic visits for atopic dermatitis increased with every 10-µg/m 3 increase in PM 10 (risk ratio [RR], 1.008; 95% CI, 1.003-1.012; high certainty evidence) and SO 2 (RR, 1.029; 95% CI, 1.020-1.039; high certainty evidence). increase in PM (risk ratio [RR], 1.008; 95% CI, 1.003-1.012; high certainty evidence) and SO (RR, 1.029; 95% CI, 1.020-1.039; high certainty evidence). High temperatures were also associated with moderate (OR, 2.39; 95%CI, 1.40-4.09) and severe atopic dermatitis (OR, 3.91; 95% CI, 2.20-6.96). Higher precipitation and humidity levels demonstrated probable associations with increased atopic dermatitis severity. Secondhand smoking exposure and traffic-related pollution showed probable associations with increased atopic dermatitis prevalence. IN PRACTICE: 'Increased air pollution and other environmental factors were associated with increased prevalence and activity of atopic dermatitis,' the authors wrote. These findings, they added, 'have direct public health implications, adding to the impetus to decrease pollution and mitigate climate change worldwide.' SOURCE: The study was led by Megan Park, University of Toronto, Toronto, Ontario, Canada, and was published online on June 25 in JAMA Dermatology. LIMITATIONS: Limitations included heterogeneity in air pollutant measurement and reporting across regions. Only moderate-to-severe disease was likely captured. Socioeconomic data was not available and inconsistent lag reporting restricted analysis of short-term and long-term effects. DISCLOSURES: The authors did not disclose any funding source. One author reported receiving consulting fees and research grants from the British Journal of Dermatology, American Academy of Dermatology, Canadian Dermatology Today, National Eczema Association, Eczema Society of Canada, Canadian Dermatology Foundation, Canadian Institutes for Health Research, National Institutes of Health, and Physicians Services Incorporated Foundation. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
12-06-2025
- Health
- Medscape
Pediatric HS Linked to Obesity, Acne, Other Comorbidities
A meta-analysis of 19 studies found that pediatric patients with hidradenitis suppurativa (HS) show an increased rate of medical and psychiatric comorbidities, including obesity. METHODOLOGY: Researchers conducted a systematic review and meta-analysis of 19 observational studies (14 US studies), which included 17,267 pediatric patients with HS (76.7% girls; mean age, 12-17 years) and 8,259,944 pediatric patients without HS. The primary outcome was the prevalence of comorbidities in pediatric patients with HS. The main categories included metabolic, endocrinologic, inflammatory, psychiatric, dermatologic, and genetic comorbidities. TAKEAWAY: In the meta-analysis, the most prevalent condition in patients with HS was acne vulgaris (43%), followed by obesity (37%), anxiety (18%), and hirsutism (14%). Obesity showed moderate certainty association with HS in children, with prevalence ratios ranging up to 2.48, odds ratios ranging from 1.27 to 2.68, and hazard ratios up to 1.52 ( P < .001). < .001). Researchers also found a probable association between depression and HS (moderate certainty), with all studies reporting a higher incidence among patients with HS. An association with diabetes was reported in three studies (low certainty). IN PRACTICE: 'Given the significant risk of chronic comorbidities and negative sequelae in pediatric HS, our findings highlight a need for comprehensive comorbidity screening clinical guidelines in this population and emphasize the involvement of multidisciplinary teams to achieve this,' the study authors wrote. SOURCE: The study was led by Samiha T. Mohsen, MSc, University of Toronto, Toronto, and was published online on June 11 in JAMA Dermatology . LIMITATIONS: Several of the included studies were graded as low quality, and most studies did not compare the risks of comorbidities between the two groups. Most of the studies were from the US, which could limit generalizability. Significant heterogeneity was reported across the studies. DISCLOSURES: The funding source was not disclosed. Three authors reported receiving grants, personal fees, and honoraria from multiple pharmaceutical companies, including AbbVie, Novartis, UCB, Incyte, Novartis, Celltrion, Leo Pharma, Pfizer, Sanofi, and the Pediatric Dermatology Research Alliance. Other authors reported no conflicts of interest.
Medscape
29-05-2025
- Health
- Medscape
Bariatric Surgery Linked With Psoriasis Improvement
Most patients with psoriasis experienced clinical improvement or remission after metabolic and bariatric surgery (MBS) in a systematic review. METHODOLOGY: Researchers conducted a systematic review of 14 studies that included 169 patients (mean age, 46.8 years; 74% women) with psoriasis who underwent MBS. Participants underwent various surgical procedures; gastric bypass was the most common (75.1%), followed by sleeve gastrectomy (17.8%), gastric banding (5.3%), and jejunoileal bypass (0.6%). Psoriasis treatments prior to surgery included topical treatments (46.2%), non-biologic systemic treatments (35.5%), and biologics (16.6%). At baseline, psoriasis severity was predominantly moderate (76.3%); 8.2% were severe and 15.6% were mild cases, based on psoriasis area and severity index and percent body surface area scores. TAKEAWAY: Average body mass index (BMI) decreased from 43.7 at baseline to 32.9after surgery, with BMI reduction ranging from 8 to 25 during follow-up periods of 4 months to 9 years. Psoriasis was either mild or had completely resolved in 97.2% of patients after bariatric surgery, whereas 2.4% experienced worsening of psoriasis. A total of 78.1% of patients continued psoriasis treatment post-surgery, but medications were downgraded to a lower category (such as systemic to topical treatments, or no treatment) in many patients. IN PRACTICE: 'MBS may improve psoriasis outcomes following surgery,' the study authors wrote. 'While initial findings are promising, further controlled trials are necessary to validate the long-term effects of MBS on psoriasis and explore its potential role as an adjunctive therapy.' SOURCE: The study was led by Miranda K. Branyiczky, BSc, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada, and was published online on May 24 in the Journal of the American Academy of Dermatology . LIMITATIONS: Limitations were reporting bias, variability in outcome measures, and the inclusion of case reports or series. DISCLOSURES: This study did not receive any funding. One author reported receiving grants, research support, speaker fees, and honoraria from multiple pharmaceutical companies including AbbVie, Alumis, Amgen, Arcutis Biotherapeutics, Bristol Myers Squibb, Eli Lilly and Company, Janssen Pharmaceuticals, Novartis, and Pfizer.
Medscape
28-05-2025
- General
- Medscape
Fast Five Quiz: Acute Management for Migraine
Migraine is a complex disorder characterized by recurrent episodes of headache often associated with visual or sensory symptoms, collectively known as an aura, that usually arise before the head pain but that might occur during or afterward. Further, migraine has a strong genetic component. Additionally, a variety of environmental and behavioral factors might precipitate migraine attacks in individuals with a predisposition to migraine. Acute management of migraine headache should provide rapid relief from headache pain and related symptoms, restore patient functioning, and prevent recurrence. What do you know about acute management for migraine? Check your knowledge with this quick quiz. Acute medications for migraine include triptans, ergotamine derivatives, gepants, and certain serotonin 5-HT1F receptor agonists, although nonspecific drugs such as NSAIDs can be used as well. A recent systematic review and network meta-analysis found that triptans have the best safety profiles and efficacy for treating migraine when compared with other drugs such as certain serotonin 5-HT1F receptor agonists, gepants, and NSAIDs. Featured head-to-head comparisons found that the triptans were the most efficacious for pain freedom at 2 hours. However, the same meta-analysis noted that cost effectiveness and cardiovascular risk should also be considered before use, as 'cerebrovascular events may present primarily as migraine-like headaches, and misdiagnosis of transient ischemic attack and minor stroke as migraine is not rare.' Learn more about triptans for migraine. For acute treatment of migraine, the American Headache Society (AHS) recommends administering medical therapy as soon as symptoms appear; more specifically, researchers note that within 30 minutes is preferable, according to a recent review. Other sources suggest utilizing therapy within 15 minutes for those who experience migraine with aura. This time frame is generally more effective for management rather than specifically waiting for aura phase to complete or when pain reaches moderate intensity. However, even if a patient is unable to take medication within that time frame, taking medication during the episode can reduce symptom severity and migraine duration. A recent meta-analysis also explored the difference in efficacy between different acute medications for migraine, which can be found here. Learn more about acute treatments for migraine. The AHS encourages the use of validated measures of migraine treatment response to guide management decisions. Specifically, they suggest mTOQ for assessing acute treatment, as well as the Migraine Assessment of Current Therapy (Migraine-ACT), Patient Perception of Migraine Questionnaire (PPMQ-R), Functional Impairment Scale (FIS). In the same guidelines, the AHS suggests PGIC, MFIQ, or MSQ v2.1 as valid instruments for measuring response to preventative migraine treatment. Learn more about migraine severity measures. REN is approved for use by the FDA for both prophylactic and acute treatment of migraine in adults and pediatric patients ages 8 years and older. For migraine prevention and treatment, eTNS and TENS are approved only for adults, and eCOT-NS is approved only for acute treatment in adults with migraine. Of the approved devices, eTNS, REN, and noninvasive vagus nerve stimulation (nVNS) are specifically mentioned by the AHS for use alone or in conjunction with pharmacotherapy, and single-pulse transcranial magnetic stimulation (sTMS) can also be used as monotherapy for preventive treatment. Further, nVNS and sTMS can be used in both patients 12-17 years and adults. Learn more about the acute management for migraine. Before a patient can initiate acute treatment for migraine with gepants, ditans, or neuromodulatory devices, the AHS recommends trialing at least two oral triptans. Treatment failure can be assessed by validated patient-reported outcome questionnaires (mTOQ, Migraine-ACT, PPMQ-R, FIS, PGIC) or clinician attestation. Risk factors for an inadequate response to triptan include severe baseline headache severity, nausea, depression, photophobia, and phonophobia. Further, triptans are contraindicated for patients with vascular diseases. CGRP inhibitors are usually not recommended as an initial acute treatment for migraine. Though caffeine can be used as an adjuvant to initial analgesics for migraine, it usually does not determine the initiation of gepants, ditans, or neuromodulatory devices. Inadequate response to combination therapy including NSAIDs, a recommended non-pharmacologic regimen, and CGRP inhibitors are not part of the criteria for initiating acute treatment with gepants, ditans, or neuromodulatory devices from the AHS. Learn more about acute treatments for migraine.
