The considerable disease burden of irritable bowel syndrome (IBS) has coincided with the increase of ultraprocessed food (UPF) consumption over the past few decades. However, epidemiologic evidence for an association is lacking. We aimed to examine the long-term risk of IBS associated with UPF consumption in a large-scale prospective cohort. Participants who completed 24-hour dietary recalls during 2009 to 2012 from the UK Biobank, and free of IBS, celiac disease, inflammatory bowel disease, and any cancer at baseline, were included (N = 178,711; 53.1% female). UPF consumption was defined according to the NOVA food classification system, expressed as a percentage of UPF content in the total diet intake (as grams per day). The primary outcome was incident IBS. A Cox proportional hazard model was performed to estimate associated risk. The mean UPF consumption was 21.0% (SD, 11.0%) of the total diet. During a median of 11.3 years of follow-up, 2690 incident IBS cases were identified. An 8% higher risk of IBS (hazard ratio, 1.08; 95% CI, 1.04–1.12) was associated with every 10% increment of UPF consumption. Compared with the lowest quartile of UPF consumption, the highest quartile was associated with a significantly increased risk of incident IBS (hazard ratio, 1.19; 95% CI, 1.07–1.33; < .001). Subgroup analyses by age, sex, body mass index, smoking, and alcohol drinking status also showed similar results, except for the never/previous drinking subgroup. Further sensitivity analyses confirmed the positive association with a higher UPF consumption. Our findings provide evidence that a higher UPF consumption is associated with an increased risk of incident IBS, with a significant dose-response relationship.

中文翻译：

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超加工食品消费与肠易激综合症的长期风险：一项大规模前瞻性队列研究

过去几十年里，肠易激综合症（IBS）带来的巨大疾病负担与超加工食品（UPF）消费量的增加同时发生。然而，缺乏相关性的流行病学证据。我们的目的是在大规模前瞻性队列中研究与 UPF 摄入相关的 IBS 长期风险。参与者在 2009 年至 2012 年期间从英国生物银行完成了 24 小时饮食回忆，并且基线时没有肠易激综合征、乳糜泻、炎症性肠病和任何癌症（N = 178,711；53.1% 为女性）。 UPF 消耗量根据 NOVA 食品分类系统定义，以 UPF 含量占总饮食摄入量（以克/天计）的百分比表示。主要结局是肠易激综合征（IBS）事件。采用 Cox 比例风险模型来估计相关风险。平均 UPF 消耗量占总饮食的 21.0%（SD，11.0%）。在平均 11.3 年的随访期间，发现了 2690 例 IBS 病例。 UPF 摄入量每增加 10%，IBS 风险就会增加 8%（风险比，1.08；95% CI，1.04-1.12）。与 UPF 消耗量的最低四分位相比，最高四分位与发生 IBS 的风险显着增加相关（风险比，1.19；95% CI，1.07–1.33；< .001）。按年龄、性别、体重指数、吸烟和饮酒状况进行的亚组分析也显示出相似的结果，但从不/既往饮酒的亚组除外。进一步的敏感性分析证实了与较高的 UPF 消耗量呈正相关。我们的研究结果证明，较高的 UPF 消耗量与发生 IBS 的风险增加相关，并具有显着的剂量反应关系。