Abstract Background The impact of dietary habits on the course of Inflammatory Bowel Disease (IBD) is increasingly recognized. Data from North African populations remain limited. Methods We conducted a prospective single-center study including 160 adult patients with Crohn’s Disease (n = 92, 57.5%) or Ulcerative Colitis (n = 68, 42.5%) at our Hospital between January 2021 and October 2025. Dietary intake was assessed using a validated food frequency questionnaire (FFQ), allowing calculation of an anti-/pro-inflammatory diet score. Disease activity was evaluated using the Harvey-Bradshaw Index (HBI) or Mayo Score, C-reactive protein (CRP), and fecal calprotectin. Patients were followed longitudinally for 12 months to capture flares and treatment escalations. Multivariate analyses were adjusted for age, sex, smoking, BMI, vitamin D status, and ongoing therapy (including vedolizumab, infliximab, ustekinumab, or biosimilars). Results High consumption of ultra-processed foods was associated with increased clinical activity (OR = 2.18; 95% CI 1.22–3.89, p = 0.009) and higher fecal calprotectin (p = 0.007). Conversely, a diet rich in fiber, fruits/vegetables, and omega-3 was linked to reduced risk of flares at 12 months (OR = 0.54; 95% CI 0.31–0.93, p = 0.03). In patients with colonic Crohn’s Disease (n = 45), high intake of refined sugars doubled the risk of HBI5 (70% vs 33%, p = 0.01). Associations remained significant after adjusting for ongoing therapy. A dose-response trend was observed: higher anti-inflammatory diet scores correlated with lower HBI and calprotectin levels. Conclusion In this cohort, dietary patterns significantly influenced IBD activity, with pronounced effects in specific subgroups. Adoption of an anti-inflammatory diet may represent a complementary strategy alongside standard therapy, warranting randomized interventional studies Conflict of interest: Mrs. Lasfar, Intissar: No conflict of interest Gharbi, Khalid: No conflict of interest Akka, Rachid: No conflict of interest
Lasfar et al. (Thu,) studied this question.