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Mediterranean Diet May Reduce the Risk of Crohn’s Disease Onset in Middle-Aged or Older Adults

Monika Fischer, MD, reviewing Khalili H, et al. Gut 2019 Jan 3.

A large prospective cohort study from Sweden (N=83,147; age range, 45-79 years; mean follow-up, 17 years) demonstrated a decreased incidence of late-onset Crohn’s disease in individuals who reported adherence to a modified Mediterranean diet (hazard ratio=0.42; 95% confidence interval, 0.22-0.80). The association between the Mediterranean diet and a decreased risk of developing Crohn’s disease remained significant after adjustments for age, sex, education level, body mass index, or smoking. Interestingly, there was no difference in the incidence of ulcerative colitis.

Currently, there is no specific guideline-recommended diet for the prevention of Crohn’s disease or flares in already diagnosed patients. A Mediterranean diet has numerous proven health benefits, but its impact on the development of Crohn’s disease later in life was previously unknown. The findings of this large cohort study are quite encouraging; we certainly can recommend a Mediterranean diet for individuals with a family history of inflammatory bowel disease (IBD) and advise parents of children with IBD about the benefits of a Mediterranean diet. Hopefully, the ongoing DINE-CD study will shed some light on the role of a Mediterranean diet versus that of a specific carbohydrate diet in patients with symptomatic Crohn’s disease.

Monika Fischer, MD, FASGE


Khalili H, Håkansson N, Chan SS, et al. Adherence to a Mediterranean diet is associated with a lower risk of later-onset Crohn’s disease: results from two large prospective cohort studies. Gut 2020 Jan 3. (Epub ahead of print) (

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