World Gastroenterology Organisation

Global Guardian of Digestive Health. Serving the World.


Diet in Infancy and Risk of IBD

Review by Prof. Eamonn Quigley (USA)

Study Summary 

In this study the authors prospectively (and this is very important!) recorded one-year and three-year questionnaires in children from cohorts in southeast Sweden and Norway. These questionnaires included information on diet quality and food frequency. Over 80,000 participants were followed from birth through childhood and adolescence – 307 developed inflammatory bowel disease (IBD). Risk for IBD was associated with low diet quality, low intake of fish and vegetables and high intake of sugar-sweetened beverages. Interestingly, the impact of fish intake was evident for ulcerative colitis (UC) but not IBD, in general. These associations, with the exception of the protective effect of fish intake, were significant at one year of age but not at three years of age.


Many strands of evidence suggest that dietary patterns in early childhood can determine health outcomes later in life and, indeed, well into adulthood. Most of this data comes from retrospective studies with their attendant problems. This, however, was a prospective study with many years of almost complete follow up and involved two cohorts which yielded similar results (it must be conceded that these cohorts were geographically adjacent and most likely quite similar genetically and ethnically). The message is clear: an infant’s diet in early life can impact on health much later in life, as evidenced by studies in obesity and irritable bowel syndrome. This study provides some of the best evidence to date to support the role of diet in early life on the subsequent development of IBD. How are these long-term impacts exerted? The obvious culprit is the microbiome. Over the first few years of life, the infant’s microbiome develops from a relatively sterile status at birth to the fully formed adult microbiome at around three years of age. During that period of expansion and diversification the developing microbiome is especially vulnerable to disruption, as evidenced by the impact of antibiotics in infancy on health later in life. Diet plays a major role in fashioning the infant microbiome as exemplified by the striking differences in microbiome composition between breast-fed and non-breast-fed infants. In this study we see the influence of vegetable intake and eating fish on the prevention of IBD; the former well known to promote “good” bacteria while the latter feature prominently in anti-inflammatory diets such as the Mediterranean diet.

You may not be what you eat now but what a very younger version of yourself ate in the past!


Guo A, Ludvigsson J, Brantsaeter AL, Klingberg S, Ostensson M, Stordal K, Marild K. Early-life diet and risk of inflammatory bowel disease: a pooled study in two Scandinavian birth cohorts. Gut 2024;73:590-600.

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