Association between dietary iron and zinc intake and development of ulcerative colitis: A case-control study in Japan

J Gastroenterol Hepatol. 2019 Oct;34(10):1703-1710. doi: 10.1111/jgh.14642. Epub 2019 Mar 21.

Abstract

Background and aim: The prevalence of ulcerative colitis (UC) has been increasing in Japan. Trace elements, such as iron, zinc, magnesium, and copper, can cause digestive symptoms where there is a deficiency or excess. We focused on the dietary intake of trace elements and their associations with UC development.

Methods: A multicenter, hospital-based case-control study was conducted in Japan. Cases were 127 newly diagnosed UC patients, and 171 age-matched and sex-matched hospital controls were recruited. We considered that UC patients had potentially changed their dietary habits due to disease symptoms. The dietary habits were investigated using a self-administered diet history questionnaire to analyze the dietary intakes and frequencies at two points, the previous 1 month and 1 year before.

Results: In the assessment of dietary habits 1 year before, the highest intake of iron showed an increased odds ratio (OR) for UC on multivariate analysis (OR = 4.05, 95% confidence interval, 1.46-11.2, P < 0.01). The highest intake of zinc 1 year before showed a decreased OR for UC (OR = 0.39, 95% confidence interval, 0.18-0.85, P = 0.01). Intakes of magnesium and copper had no significant association with UC. Because most UC cases had experienced the first symptom of UC within the previous 11 months, these intakes at 1 year before represented an association with pre-illness dietary habits.

Conclusion: A high intake of iron has some effect on the development of UC. In contrast, a high intake of zinc has a protective effect on the development of UC.

Keywords: case-control study; dietary iron intake; dietary zinc intake; ulcerative colitis.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Case-Control Studies
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / epidemiology*
  • Colitis, Ulcerative / prevention & control
  • Feeding Behavior
  • Female
  • Humans
  • Iron, Dietary / administration & dosage*
  • Iron, Dietary / adverse effects
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Protective Factors
  • Recommended Dietary Allowances*
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Young Adult
  • Zinc / administration & dosage*
  • Zinc / adverse effects

Substances

  • Iron, Dietary
  • Zinc