Table 1_Association between pro-inflammatory diet and ulcerative colitis: a systematic review and meta-analysis.docx

BackgroundEmerging evidence suggests that dietary patterns can mediate intestinal inflammatory responses through immune-microbiome interactions. Diet and inflammation are important pathogenic factors for ulcerative colitis (UC). However, the existing evidence regarding the association between a pro-inflammatory diet and the risk of UC is controversial, and further clarification of this association is needed.
ObjectiveThis study aimed to explore the association between pro-inflammatory diet and UC risk.
MethodsWe systematically searched PubMed, Web of Science, Scopus, EMBASE, and Cochrane Library databases from their inception to January 15th, 2025. Two researchers independently used the Newcastle - Ottawa Scale to assess the quality of the included studies. Data analysis was performed using STATA 17 software.
ResultsThis systematic review and meta-analysis included eight studies involving approximately 758,068 participants. The meta-analysis indicated that an inflammatory or pro-inflammatory diet did not increase the risk of UC (OR = 0.97, 95% CI = 0.84–1.12). However, subgroup analyses revealed differing results: within the case–control study subgroup, a pro-inflammatory diet was associated with an increased risk of UC (OR = 2.09, 95% CI: 1.23–3.56), whereas in the cohort study subgroup, no significant association was found between a pro-inflammatory diet and UC (OR = 0.91, 95% CI: 0.78–1.06). Sensitivity analysis indicated that the study results were robust. Additionally, Begg’s test (p = 0.174) and Egger’s test (p = 0.085) showed no significant publication bias in this study.
ConclusionThe results of this study do not support a significant association between pro-inflammatory diets and UC risk. However, due to the limited level of evidence from observational studies and their heterogeneity, the association between pro-inflammatory diets and UC may be underestimated or overestimated. Therefore, larger multi-centre studies are needed to standardize the assessment of diets and adjust for microbial-related confounding factors in order to elucidate the association and mechanisms between pro-inflammatory diets and UC.