The role of long-term alcohol consumption for the risk of developing ulcerative colitis (UC) and Crohn’s disease (CD) is unclear. For the first time, to prospectively assess the role of pre-disease alcohol consumption on the risk of developing UC or CD.
Nested within the European Prospective Investigation into Cancer and Nutrition (EPIC-IBD), incident UC and CD cases and matched controls where included. At recruitment, participants completed validated food frequency and lifestyle questionnaires. Alcohol consumption was classified as either: non-use, former, light (⩽0.5 and 1 drink per week), below the recommended limits (BRL) (⩽1 and 2 drinks per day), moderate (⩽2.5 and 5 drinks per day), or heavy use (>2.5 and >5 drinks per day) for women and men, respectively; and was expressed as consumption at enrolment and during lifetime. Conditional logistic regression was applied adjusting for smoking and education, taking light users as the reference.
Out of 262 451 participants in six countries, 198 UC incident cases/792 controls and 84 CD cases/336 controls were included. At enrolment, 8%/27%/32%/23%/11% UC cases and 7%/29%/40%/19%/5% CD cases were: non-users, light, BRL, moderate and heavy users, respectively. The corresponding figures for lifetime non-use, former, light, BRL, moderate and heavy use were: 3%/5%/23%/44%/19%/6% and 5%/2%/25%/44%/23%/1% for UC and CD cases, respectively. There were no associations between any categories of alcohol consumption and risk of UC or CD in the unadjusted and adjusted odds ratios.
There was no evidence of associations between alcohol use and the odds of developing either UC or CD.
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We thank the participants of the EPIC study for providing information, the data manager for processing the data and organising the databases and the technical staff for collecting the exposure and the outcome data in each of the 7 centres. This study was funded by The Sir Halley Stewart Trust, Crohn’s and Colitis UK and The NHS Executive Eastern Region. The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by the Danish Cancer Society (Denmark); Ligue contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l'Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, Federal Ministry of Education and Research (Germany); Hellenic Health Foundation (Greece); The Italian Association for Research on Cancer, Compagnia San Paolo (Italy); Dutch Ministry of Health, Welfare and Sports, Dutch Prevention Funds, LK Research Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Swedish Cancer Society, Swedish Scientific Council and Regional Government of Skane and Västerbotten (Sweden); Cancer Research UK, Medical Research Council (UK). VH received an intensification grant through the European Commission supported "BIOCAPS" project (FP-7-REGPOT 2012-2013-1, Grant agreement no. FP7-316265).
SSMC and ARH designed the study, recruited the centres, RL generated the master data set; WB calculated the alcohol variables, included them in the data set and analysed the data and MMB and VH wrote the paper. The remaining co-authors HB, KTK, FvS, BO, BBdM, KO, DP, GM, FC, MB, AO, AT, RK, VK, ER and ARH are principal investigators in their respective centres who contributed to the local design, development and enrolment of participants into their cohorts. These authors generated the local IBD databases, and contributed to the analysis and writing of the manuscript.
MMB is the Guarantor of the article. The remaining authors declare no conflict of interest.
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Bergmann, M., Hernandez, V., Bernigau, W. et al. No association of alcohol use and the risk of ulcerative colitis or Crohn’s disease: data from a European Prospective cohort study (EPIC). Eur J Clin Nutr 71, 512–518 (2017). https://doi.org/10.1038/ejcn.2016.271
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