Frailty, adherence to healthy diet and risk of inflammatory bowel disease: a large-scale prospective cohort study

Abstract Background Emerging research indicates a potential correlation between frailty, healthy diet and IBD because of overlapping mechanisms. To evaluate the individual and joint effects of frailty and healthy diet on the risk of IBD. Methods Data on frailty and diet were collected from a prospective cohort of 338,716 UK Biobank participants. Cox proportional-hazard regression was used to analyze the association of frailty status and dietary pattern with incident IBD. A joint effect analysis was conducted to demonstrate the potential modification effect of healthy diet on the relationship between frailty and IBD. Results During a median follow-up of 12.47 years, 2032 RA were identified. Compared with non-frail participants, those with pre-frailty and frailty showed a significantly increased risk of IBD, which was 13% higher in pre-frailty (95% CI: 1.03, 1.23) and 33% higher in frailty (95% CI: 1.08, 1.62), respectively. Participants with moderate and ideal dietary patterns had a significantly lower incidence of IBD compared with those with poor dietary patterns. The adjusted hazard ratios (HRs) were 0.84 (95% CI: 0.74, 0.96) and 0.76 (95% CI: 0.67, 0.88) for moderate dietary pattern and ideal dietary pattern, respectively. Moreover, individuals with non-frailty and ideal dietary pattern had a 43% (95% CI: 0.32, 0.89) reduced risk of IBD in contrast with those with frailty and poor dietary patterns. Conclusion The study provides evidence linking frailty and unhealthy diet to the risk of IBD. Our findings suggested that adherence to a healthy diet might attenuate the deleterious effect of frailty on IBD risk.