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Lookup NU author(s): Professor Chris LambORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© Author(s) (or their employer(s)) 2026.Background IBD is characterised by recurrent flares, but evidence on whether modifiable dietary factors influence flare risk is limited. Objective The PREdiCCt study was designed to examine demographic, clinical and dietary factors associated with disease flare among patients with IBD in self-reported remission. Design Multicentre, prospective cohort study conducted across 47 UK centres. Patients with Crohn’s disease (CD), ulcerative colitis (UC) or IBD unclassified (IBDU) in self-reported remission were prospectively followed up. The baseline diet was assessed using a validated food frequency questionnaire. The primary outcome was time to patient-reported flare (captured by monthly IBD-Control) and objective flare (clinical flare plus C-reactive protein >5 mg/L and/or faecal calprotectin (FC) >250 µg/g with treatment escalation). Associations were evaluated using Cox frailty models adjusted for demographic, clinical and biochemical variables, including baseline FC. Results Between November 2016 and March 2020, 2629 participants (1370CD; 1259 UC/IBDU) were enrolled and followed up for a median of 4.1 years (IQR 3.0–5.0). Baseline FC was strongly associated with patient-reported flares (FC ≥250µg/g: adjusted HR (aHR) 2.22; FC 50–250µg/g: aHR 1.52 (reference <50µg/g)) and objective flares (FC ≥250µg/g: aHR 3.25; FC 50–250µg/g: aHR 1.98). In UC, higher total meat intake was associated with increased risk of objective flares (highest versus lowest quartile: aHR 1.95, 95%CI 1.07 to 3.56). No consistent associations were observed for ultraprocessed foods, fibre or polyunsaturated fatty acids and flare. Conclusion Higher habitual meat intake was associated with increased risk of objective flare in UC, suggesting diet may contribute to flare susceptibility in specific patient groups.
Author(s): Constantine-Cooke N, Gros B, Plevris N, Williams LJ, Jones G, Kyle J, Kennedy NA, Velasco-Pardo V, Rudge A, Alexander D, Anderson CA, Brusco De Freitas M, Derr LM, Derikx LAAP, Gilchrist S, Henderson P, Horgan GW, Irving P, Jostins-Dean L, Lamb CA, Lindsay JO, MacDonald J, Mowat C, Murray C, Parkes M, Siakavellas SI, Vallejos CA, Gaya DR, Rhodes J, Johnstone AM, Weir CJ, Lees CW
Publication type: Article
Publication status: Published
Journal: Gut
Year: 2026
Pages: epub ahead of print
Online publication date: 19/01/2026
Acceptance date: 31/12/2025
Date deposited: 03/02/2026
ISSN (print): 0017-5749
ISSN (electronic): 1468-3288
Publisher: BMJ Group
URL: https://doi.org/10.1136/gutjnl-2025-337846
DOI: 10.1136/gutjnl-2025-337846
Data Access Statement: Data are available upon reasonable request. Participant-level data are not currently available to external researchers. Data are expected to be available for external researchers under a responsible data sharing model following the publishing of planned manuscripts
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