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Environmental and dietary factors can amplify paediatric IBD risk

Presented by
Dr Nisha Thacker, University of Newcastle, Australia
DDW 2023
A systematic review, which included 461,490 participants, investigated the influence of diet and environmental factors on paediatric inflammatory bowel disease (IBD). The review found that early antibiotic exposure, high socioeconomic status, and urban living increased the risk of IBD, while a diet rich in vegetables decreased it.

Recognising modifiable and non-modifiable paediatric causative factors can aid in identifying children at an increased risk of IBD. The systematic review, presented by Dr Nisha Thacker (University of Newcastle, Australia), aimed to explore the relationship between dietary habits and environmental exposure and paediatric IBD diagnosis [1]. Out of the 4,763 studies examined, the researchers analysed 35 observational studies that included 461,490 participants.

The study found a higher likelihood of paediatric IBD diagnosis among individuals who were exposed to antibiotics in early childhood (OR 4.54; 95% CI 1.47–14.02; P=0.009), those who had 1-4 antibiotic courses (OR 2.55; 95% CI 1.79–3.65; P≤0.001), and those who had >4 antibiotic courses during childhood (OR 3.46; 95% CI 2.14–5.60; P≤0.001).

Additional factors, including high socioeconomic status (OR 2.55; 95% CI 1.40–4.63; P=0.002) and urban living (OR 1.70; 95% CI 0.96–3.00; P=0.067), significantly increased the chances of paediatric IBD.

Dietary patterns also played a significant role. Regular or high vegetable intake was associated with a lower risk of paediatric IBD (OR 0.47; 95% CI 0.2–1.06; P=0.067), whereas regular intake of sugary beverages and candies conferred a higher risk (OR 2.02; 95% CI 1.06–3.85; P=0.033).

In conclusion, the understanding of paediatric IBD risk factors is evolving. It is becoming increasingly evident that early-life environmental and dietary exposures significantly influence these risks. Prevention strategies should be comprehensive, considering antibiotic use, dietary habits, lifestyle factors, and microbiome health. Continuous research is needed to refine research and aid in the development of more effective strategies to prevent paediatric IBD.

  1. Thacker N, et al. Antibiotics, urban environment and western diet pattern increase risk of paediatric inflammatory bowel disease: a meta-analysis. Lecture 350, DDW 2023, 6–9 May, Chicago, IL, USA.


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