TOPLINE:

Among patients in self‑reported remission of ulcerative colitis (UC), habitual meat intake was associated with the risk for objective flares reported by those with treatment escalation and an increase in biomarker levels. Higher faecal calprotectin levels were associated with an increased risk for both patient-reported and objectively confirmed flares in those with inflammatory bowel disease (IBD).

METHODOLOGY:

• Researchers conducted a prospective study to assess associations between baseline dietary factors, such as total animal protein intake, dietary fibre, polyunsaturated fatty acids (PUFAs), and ultraprocessed foods, and disease flares in the UK population.
• A total of 2629 patients with IBD in self-reported clinical remission (median age, 44 years; 45.9% men), including 1370 patients with Crohn's disease and 1259 patients with UC/IBD unclassified (IBDU), were recruited from 47 centres across the UK (November 2016 to March 2020) and were followed up for a median duration of 4.1 years.
• Habitual dietary intakes were assessed using the Scottish Collaborative Group Food Frequency Questionnaire (FFQ), which were converted into nutrient intakes and divided into quartiles. Baseline faecal calprotectin levels were measured, and patient‑reported flares were tracked for 24 months.
• The primary outcome was the time to the first patient‑reported flare, defined as any response in which patients indicated their disease was not well controlled in the past month or since their last portal login.
• The secondary outcome was the time to the first objective flare, defined as a patient‑reported flare plus treatment escalation and a rise in biomarker levels (C-reactive protein levels ≥ 5 mg/L and/or faecal calprotectin levels ≥ 250 µg/g).

TAKEAWAY:

• A higher proportion of patients with UC/IBDU had a patient-reported flare than those with Crohn's disease (log-rank P = .018). Objective flare rates did not differ between the two groups.
• Overall meat intake was associated with an increased risk for objective flares in patients with UC (adjusted hazard ratio, 1.95; 95% CI, 1.07-3.56), but not in those with Crohn's disease.
• No associations were observed between fibres or PUFAs and the risk for disease flares in either patients with Crohn's disease or UC/IBDU.
• In patients with IBD, faecal calprotectin levels of 50-250 and > 250 vs < 50 µg/g were associated with an increased risk for both patient-reported and objective flares (P < .001 for all).

IN PRACTICE:

"[The study] findings support the integration of dietary assessments and biomarker-based monitoring into routine IBD care and highlight the need for further research into personalised, preventive strategies," the authors of the study wrote.

SOURCE:

This study was led by Nathan Constantine-Cooke, University of Edinburgh Western General Hospital, Edinburgh, Scotland; Beatriz Gros, Reina Sofía University Hospital, IMIBIC, CIBERehd, Córdoba, Spain; and Nikolas Plevris, Western General Hospital, Edinburgh, Scotland. It was published online on January 19, 2026, in Gut.

LIMITATIONS:

This study lacked any protocolised mucosal assessment at baseline or during follow‑up. The FFQ was not completed by all participants at baseline. The study was partially conducted during the COVID‑19 pandemic, which halted recruitment and may have changed treatment behaviours and diet.

DISCLOSURES:

The PREdiCCt study was funded by Cure Crohn's Colitis, Crohn's & Colitis in Childhood, the Chief Scientist Office, and UK Research and Innovation via a Future Leaders Fellowship "Predicting outcomes in IBD." Two authors reported receiving fellowships and support. Several authors reported receiving speaker fees, advisory board fees, speaker honoraria, and travel support; holding committee roles; and serving as consultants, speakers, or advisory board members for various institutions and pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.