News Excerpt:

Recently, a Swedish study found that children who had a high intake of fish and vegetables at one year of age were at lower risk of developing Inflammatory Bowel Disease (IBD).

About Inflammatory Bowel Disease (IBD):

• Inflammatory Bowel Disease (IBD) describes disorders where the lining of the digestive tract is inflamed. 
• There are two types of IBD disorders: 
  • Ulcerative colitis, where the large intestine and the rectum are prone to inflammation and sores.
  • Crohn’s disease, which usually affects the small intestine.
• According to the research, diet, age, family history, cigarette smoking, and certain medications, among other factors, are responsible for causing or worsening IBD.
  • Changing diet patterns can help explain changing patterns of the prevalence of IBD. 

About the diet and its effects on IBD:

• According to the study done on 80,000 children through adolescence in Norway and Sweden, the diet of infants as young as a year old could affect their chances of developing IBD in future.
• Children who consumed plenty of vegetables and fish in the first year of life, were associated with a lower future risk of developing IBD.
• Consuming sugar-sweetened beverages at this time was associated with a higher risk of IBD.
• At three years of age, no dietary factor other than fish intake was associated with IBD risk.
• Infants may benefit from a “preventive” diet that includes adequate dietary fibre, particularly from fruit and vegetables.
• A minimal amount of sugar-sweetened beverages, and a preference of fresh over processed and ultra-processed foods and snacks.

Databases used in the study:

• The researchers tracked participants from two large-scale databases: All Babies in Southeast Sweden (ABIS) and Norwegian Mother, Father and Child Cohort (MoBa).
• Both databases used questionnaires to document a child’s upbringing and lifestyle, including diets. 
• ABIS records data from children born in southeast Sweden from October 1997 to October 1999. 
• MoBa recruited pregnant women throughout Norway from 1999 to 2008.
• Researchers found an IBD incidence rate of 32 per 100,000 person-years in the ABIS database and 22 per 100,000 person years in the MoBa database.

Methodology used in the study:

• According to the researchers, the study’s strength lies in being the first to “prospectively investigate the association between early-life diet quality and intake frequency of specific food groups and later IBD risk”.
• To test whether an early-life diet correlated with later incidence of IBD, the authors collated data of the children’s dietary habits at 1-1.5 years and 2.5-3 years of age from the two databases. 
• They assigned a score to the diet quality, and recorded the frequency of intake of nine food categories: dairy, fish, fruits, grains, meat, sugar-dense and fat-dense food, sugar-sweetened beverages, and vegetables.
• In their analyses, the researchers used a statistical test to check whether a child’s early-life dietary intake could also predict later IBD risk. 
• The analysis was adjusted to account for several factors implicated in the past as causes of IBD, including parental history of IBD, early-life antibiotic exposure, and intake of formula food in the first year.
• The study’s sample came from two high-income countries, the results may not be readily generalisable to low- and middle-income countries.

Loopholes in the study:

• The study didn’t account for additives and emulsifiers common in baby foods. These compounds have been implicated in accelerating IBD by changing the composition of the gut microbiome.
• According to experts, individual foods cannot be blanket-classified as ‘detrimental’ or ‘beneficial’ in the context of IBD. For eg: -  some people with IBD show improvement with whole milk while others deteriorate. 
• Several studies demonstrate the benefit of high-fibre diets for people with IBD, other studies show fibre intake prior to developing IBD to be linked with the risk of the disease.
• Gut study’s use of secondary data (data used in Swedish study)– i.e. data collected by a different researcher and not specifically for the purpose of studying the relationship between early-life diet and later development of IBD. 
• Such data may be less qualitatively suited for a specific analysis than that collected for the purpose.
• Since, IBD has been shown to be aggravated by multiple triggers and their interactions with each other and that's why interventions that provide one or the other foods or eliminate one or the other would not be advisable.

Conclusion:

The study suggests that an early-life diet rich in vegetables and fish may reduce the risk of developing Inflammatory Bowel Disease (IBD) in children. However, it's important to consider individual responses to food and the complexity of IBD triggers. Further research is needed to understand the full impact of diet on IBD development.