Abstract Background Sustained remission is a central therapeutic goal in the management of inflammatory bowel disease (IBD). Emerging evidence highlights the potential of dietary patterns to improve disease activity and progression. The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet has been associated with the risk of IBD onset, but its relevance for subsequent clinical outcomes remains unclear. This study evaluated the association between MIND diet adherence and the risk of IBD-related surgery in a prospective cohort. Methods This study included 2,288 UK Biobank participants with a pre-baseline diagnosis of Crohn’s disease (CD, n = 777) or ulcerative colitis (UC, n = 1,511) who had completed at least one valid WebQ 24-hour dietary recall between 2006 and 2010. Dietary intake was assessed using the validated Oxford WebQ instrument, and adherence to the MIND diet was derived using a validated 15-component score comprising 10 beneficial and 5 detrimental food groups. Incident IBD-related surgery was identified through the UK National Health Service records. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Kaplan-Meier curves and restricted cubic splines were used to characterise survival differences and dose–response relationships. Effect modification was examined in pre-specified subgroups, and multiple sensitivity analyses were conducted to assess robustness. Results Over a median follow-up of 10.9 years, 166 incident IBD-related surgery cases occurred. Adherence to the MIND diet was comparable between patients with CD and UC (Figure 1A). Compared with the lowest tertile of MIND diet adherence, the highest tertile showed a 41% lower surgical risk in IBD (HR 0.59, 95% CI 0.41-0.85, P = 0.005) and 56% in CD (HR 0.44, 95% CI 0.24-0.80, P = 0.008), while the middle tertile showed a protective trend in UC (HR 0.61, 95% CI 0.36-1.04, P = 0.070, Figures 1B and 1C). A linear inverse association between the MIND diet and surgical risk was observed in CD (Pnon-linearity = 0.713), whereas the protective effect plateaued beyond a MIND score of 5.2 in UC (Pnon-linearity = 0.006, Figure 2A). Component-level analyses identified higher consumption of vegetables and lower intake of butter and fried foods as being independently associated with reduced surgical risk (Figure 2B). The inverse association was more evident in younger participants (P-interaction = 0.049, Figure 2C). Sensitivity analyses supported the robustness of the results. Conclusion Greater adherence to the MIND diet is associated with a reduced risk of IBD-related surgery. These findings support that dietary modification based on the MIND diet could be a feasible dietary strategy to improve IBD prognosis. Conflict of interest: Sun, Yuhao: No conflict of interest Dan, Lintao: I have no COI related to submitted program Jiang, Zhuoyuan: No conflict of interest Qian, Yuxin: No conflict of interest Wellens, Judith: No conflict of interest Li, Xue: No conflict of interest Yao, Jialu: No conflict of interest Wang, Xiaoyan: No conflict of interest Magro, Fernando: No conflict of interest Dr. Chen, Jie: No conflict of interest
Sun et al. (Thu,) studied this question.