Dietary factors and patterns in relation to risk of later‐onset ulcerative colitis in Chinese: A prospective study of 0.5 million people

Summary Background There is limited evidence on the associations of dietary factors and patterns with risk of later‐onset ulcerative colitis (UC) in Chinese adults. Aims To investigate the associations of dietary factors and patterns with risk of later‐onset UC in Chinese. Methods The prospective China Kadoorie Biobank cohort study recruited 512,726 participants aged 30–79. Dietary habits were assessed using food frequency questionnaires. Dietary patterns were derived by factor analysis with a principal component method. Cox regression analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results During a median follow‐up of 12.1 years, 312 cases of newly diagnosed UC were documented (median age of diagnosis 60.1 years). Egg consumption was associated with higher risk of UC (HR for daily vs. never or rarely: 2.29 [95% CI: 1.26–4.16]), while spicy food consumption was inversely associated with risk of UC (HR: 0.63 [0.45–0.88]). The traditional northern dietary pattern, characterised by high intake of wheat and low intake of rice, was associated with higher risk of UC (HR for highest vs. lowest quartile of score: 2.79 [1.93–4.05]). The modern dietary pattern, characterised by high intake of animal‐origin foods and fruits, was associated with higher risk of UC (HR: 2.48 [1.63–3.78]). Population attributable fraction was 13.04% (7.71%–19.11%) for daily/almost daily consumption of eggs and 9.87% (1.94%–18.22%) for never/rarely consumption of spicy food. Conclusions The findings highlight the importance of evaluating dietary factors and patterns in the primary prevention of later‐onset UC in Chinese adults.