Inflammatory Bowel Disease

Subject Category: Inflammatory Bowel Disease

Am J Gastroenterol 2013; 108:575–582; doi:10.1038/ajg.2012.453; published online 15 January 2013

Body Mass Index and the Risk for Crohn's Disease and Ulcerative Colitis: Data From a European Prospective Cohort Study (The IBD in EPIC Study)

Simon S M Chan MB BChir, PhD1,2, Robert Luben BSc3, Anja Olsen PhD, MSc4, Anne Tjonneland PhD, DMSc4, Rudolf Kaaks PhD5, Birgit Teucher PhD5, Stefan Lindgren MD, PhD6, Olof Grip MD, PhD6, Timothy Key DPhil7, Francesca L Crowe PhD7, Manuela M Bergmann PhD8, Heiner Boeing PhD8, Göran Hallmans MD, PhD9, Pontus Karling PhD10, Kim Overvad PhD11, Domenico Palli MD, MPH12, Giovanna Masala MD, MPH12, Hugh Kennedy MD, FRCP2, Fiona vanSchaik MD, PhD13, Bas Bueno-de-Mesquita MD, PhD13,14, Bas Oldenburg MD, PhD13, Kay-Tee Khaw MB BChir, FRCP3, Elio Riboli MD, MPH15 and Andrew R Hart MB ChB, MD1,2

  1. 1Department of Medicine, Norwich Medical School, University of East Anglia, Norwich, UK
  2. 2Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
  3. 3Strangeways Research Laboratory, Institute of Public Health, University of Cambridge, Cambridge, UK
  4. 4Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
  5. 5Division of Clinical Epidemiology, DKFZ-German Cancer Research Centre, Heidelberg, Germany
  6. 6Department of Clinical Sciences, University Hospital, Malmö, Sweden
  7. 7Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
  8. 8Department of Epidemiology, German Institute of Human Nutrition, Potsdam, Germany
  9. 9Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden
  10. 10Department of Public Health and Clinical Medicine, GI Unit, Umeå University, Umeå, Sweden
  11. 11Department of Clinical Epidemiology, University of Aarhus, Denmark
  12. 12Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Centre, Florence, Italy
  13. 13Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands
  14. 14National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands
  15. 15Division of Epidemiology, Imperial College London, London, UK

Correspondence: Simon S.M. Chan, MB BChir, PhD, Norwich Medical School, University of East Anglia, Norwich NR4 7T, UK. E-mail:

Received 19 September 2012; Accepted 6 December 2012
Advance online publication 15 January 2013





Obesity is associated with a proinflammatory state that may be involved in the etiology of inflammatory bowel disease (IBD), for which there are plausible biological mechanisms. Our aim was to perform the first prospective cohort study investigating if there is an association between obesity and the development of incident IBD.



A total of 300,724 participants were recruited into the European Prospective Investigation into Cancer and Nutrition study. At recruitment, anthropometric measurements of height and weight plus physical activity and total energy intake from validated questionnaires were recorded. The cohort was monitored identifying participants who developed either Crohn's disease (CD) or ulcerative colitis (UC). Each case was matched with four controls and conditional logistic regression used to calculate odds ratios (ORs) for body mass index (BMI) adjusted for smoking, energy intake, and physical activity.



In the cohort, 177 participants developed incident UC and 75 participants developed incident CD. There were no associations with the four higher categories of BMI compared with a normal BMI for UC (Ptrend=0.36) or CD (Ptrend=0.83). The lack of associations was consistent when BMI was analyzed as a continuous or binary variable (BMI 18.5<25.0 vs. ≥25kg/m2). Physical activity and total energy intake, factors that influence BMI, did not show any association with UC (physical activity, Ptrend=0.79; total energy intake, Ptrend=0.18) or CD (physical activity, Ptrend=0.42; total energy, Ptrend=0.11).



Obesity as measured by BMI is not associated with the development of incident UC or CD. Alternative measures of obesity are required to further investigate the role of obesity in the development of incident IBD.