Ultra-Processed Foods Associated with Crohn’s Disease Relapse

HIGHER ultra-processed food (UPF) intake was associated with increased odds of clinical relapse among patients with Crohn’s disease in remission, although the available evidence was rated as very low certainty. 

Study Examines UPFs 

A systematic review and meta-analysis assessed whether dietary intake of UPFs was associated with clinical relapse in adults with Crohn’s disease. The review included prospective cohort studies and randomised controlled trials involving patients with Crohn’s disease who were in clinical remission. 

Researchers searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials from database inception through 18 March 2025. Eligible studies compared higher versus lower UPF intake, or no UPF intake, and required at least 6 months of follow-up. Studies using retrospective designs and non-English publications were excluded. 

The search identified 1,945 studies. Following duplicate removal and abstract screening, 13 studies underwent full-text review. Three prospective cohort studies involving 276 patients with Crohn’s disease met the inclusion criteria and contributed data to the analysis. 

Higher Intake was Linked to Relapse 

The pooled data showed a significant association between UPF consumption and clinical relapse within one year. Patients with higher UPF intake had greater odds of relapse than those with lower intake (odds ratio: 2.27; 95% CI: 1.01–5.13; p=0.048). 

Statistical heterogeneity between the included studies was limited (I²=20.95%). The analysis used a DerSimonian-Laird random-effects model to pool odds ratios and 95% confidence intervals. 

The findings support the possibility that dietary patterns characterised by greater UPF consumption may be associated with disease activity in patients with Crohn’s disease. The study background noted that mechanisms such as alterations to the gut microbiome and increased intestinal permeability have been hypothesised to contribute to the relationship between UPFs and Crohn’s disease activity. 

Evidence Remains Very Low Certainty 

Despite the observed association, the certainty of evidence was graded as very low using the GRADE framework. This substantially limits confidence in the findings and means the results should not be interpreted as establishing that UPFs directly cause clinical relapse. 

The researchers therefore indicated that additional well-designed prospective studies and randomised trials are needed to clarify the relationship between UPF intake and relapse in Crohn’s disease. Until stronger evidence becomes available, the findings do not provide a sufficient basis for firm dietary recommendations. 

Reference 

Samnani S et al. Association between ultra-processed foods and clinical relapse in Crohn’s disease: a systematic review and meta-analysis. J Acad Nutr Diet. 2026;DOI:10.1016/j.jand.2026. 

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