Dietary total antioxidant capacity alleviates inflammatory bowel disease-related surgery, gastrointestinal cancer, and mortality risks among middle-aged and older individuals - 18/04/26

Doi : 10.1016/j.jnha.2026.100848

Tian Fu ^a,^b,^c,^{^{†
Tian Fu, Lintao Dan, and Sidan Wang contributed equally to this work as joint first authors.}}, Lintao Dan ^b,^d,^{^{†
Tian Fu, Lintao Dan, and Sidan Wang contributed equally to this work as joint first authors.}}, Sidan Wang ^b,^{^{†
Tian Fu, Lintao Dan, and Sidan Wang contributed equally to this work as joint first authors.}}, Xing Wu ^b, Jiangwei Sun ^e, Shuai Yuan ^f,^g,^h, Alicja Wolk ^g, Jonas F Ludvigsson ^e,^g,ⁱ, Xiaoyan Wang ^b, Susanna C Larsson ^g,^j,⁎ , Jie Chen ^b,^c,^k,⁎ , Xue Li ^l,⁎

^a Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou, China

^b Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, China

^c Postdoctoral Station of Clinical Medicine, the Third Xiangya Hospital, Central South University, Changsha, China

^d Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

^e Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

^f Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States

^g Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

^h Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, United States

ⁱ Department of Paediatrics, Örebro University Hospital, Örebro, Sweden

^j Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden

^k Xiangya School of Public Health, Central South University, Changsha, China

^l Department of Big Data in Health Science School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China

^⁎ Corresponding authors.

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Graphical abstract

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Abstract

Objectives

This study aimed to investigate the association between dietary total antioxidant capacity (TAC) and the risks of clinical outcomes, including surgery, gastrointestinal cancer, and mortality, among middle-aged and older individuals with IBD.

Design

Nationwide prospective cohort study.

Setting and participants

We included middle-aged and older participants with IBD when recruited in the UK Biobank.

Measurements

Dietary TAC was calculated by the oxygen radical absorbance capacity from the food by repeated dietary recalls. The outcomes representing IBD prognosis include IBD-related surgery, gastrointestinal cancer, and death events. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models. Polymorphism of antioxidant-related enzymes genes was ascertained via genotype data.

Results

With a median follow-up period of 10.9 years, we documented 174 cases of IBD-related surgery, 52 gastrointestinal cancer, and 189 death events among 2487 IBD participants. Compared to the lowest quartile of dietary TAC, participants in the highest quartile presented lower risks of IBD-related surgery (HR 0.53; 95% CI 0.34−0.84; P-trend = 0.005) and all-cause mortality (HR 0.61; 95% CI 0.39−0.96; P-trend = 0.014). Compared to the lowest decile, participants in the higher deciles of dietary TAC had a lower risk of gastrointestinal cancer (HR 0.39; 95% CI 0.19−0.83; P = 0.014). We also found genetic variants in catalase gene CAT and antioxidant transporter gene SLC2A14 modified the association between dietary TAC and IBD prognosis.

Conclusions

Higher dietary TAC was associated with better prognosis of middle-aged and older individuals with IBD, including lower risk of related surgery, gastrointestinal cancer, and all-cause mortality, suggesting the importance of adherence to high-TAC diet in IBD management.

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Abbreviations : BMI, CD, CI, CRP, CCI, HR, IBD, RCS, SD, SOD, TAC, TDI, TE

Keywords : Inflammatory bowel disease, Dietary total antioxidant capacity, Surgery, Gastrointestinal cancer, Mortality

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Vol 30 - N° 6

Article 100848- juin 2026 Retour au numéro

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Dietary total antioxidant capacity alleviates inflammatory bowel disease-related surgery, gastrointestinal cancer, and mortality risks among middle-aged and older individuals - 18/04/26

Graphical abstract

Abstract

Objectives

Design

Setting and participants

Measurements

Results

Conclusions

Plan

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