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Publications

Journal Article Ahead of print

PubMed: 42214560 DOI: 10.1053/j.gastro.2026.05.006

β-Glucan and Inulin Estimated Intake Are Associated With Reduced Risk of Crohn's Disease, Improved Gut Barrier and Systemic Inflammation Markers, and Multi-Omic Signatures in a High-Risk Cohort.

Gastroenterology

Authors: Mingyue Xue, Cathy McShane, Jeongseok Kim, Reihane Khorasaniha, Haim Leibovitzh, Jingcheng Shao, Rirong Chen, Sean Jeong, Karen L Madsen, Anne M Griffiths, Thomas D Walters, A Hillary Steinhart, Levinus A Dieleman, Hien Q Huynh, Remo Panaccione, Guy L Aumais, Alain Bitton, David Mack, Kevan Jacobson, Brian Bressler, John K Marshall, Paul Moayyedi, Luba Plotkin, Iris Dotan, Charles N Bernstein, Wael El-Matary, Jeffrey S Hyams, Anthony Otley, Sun-Ho Lee, Dan Turner, Heather Armstrong, Kenneth Croitoru, Williams Turpin

Affiliations

  • Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, Toronto, Ontario, Canada.
  • Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, Toronto, Ontario, Canada; Division of Gastroenterology & Hepatology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
  • Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
  • University of Alberta, Edmonton, Alberta, Canada.
  • IBD Center, The Hospital for Sick Children, Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
  • Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, Ontario, Canada.
  • Centre of Excellence for Gastrointestinal Inflammation and Immunity Research, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
  • Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
  • Inflammatory Bowel Disease Clinic, Division of Gastroenterology and Hepatology of Gastroenterology, University of Calgary, Calgary, Alberta, Canada.
  • Hôspital Maisonneuve-Rosemont, Department of Medicine, Montreal University, Montreal, Quebec, Canada.
  • Division of Gastroenterology and Hepatology, McGill University Health Centre, McGill University, Montreal, Quebec, Canada.
  • Division of Gastroenterology, Hepatology & Nutrition, Children's Hospital of Eastern Ontario and University of Ottawa, Ontario, Canada.
  • Canadian Gastro-Intestinal Epidemiology Consortium (CanGIEC); British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada.
  • Division of Gastroenterology, Department of Medicine, St Paul's Hospital, Vancouver, British Columbia.
  • Department of Medicine, McMaster University, Farncombe Family Digestive Health Research Institute, Hamilton, Ontario, Canada.
  • The Juliet Keidan Institute of Pediatric Gastroenterology and Nutrition, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel.
  • Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel.
  • Inflammatory Bowel Disease Clinical and Research Centre, and Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
  • Section of Pediatric Gastroenterology, Department of Pediatrics and Child Health, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
  • Division of Digestive Diseases, Hepatology, and Nutrition, Connecticut Children's Medical Center, Hartford, Connecticut, USA.
  • Department of Pediatrics, IWK Health Centre, Halifax, Nova Scotia, Canada.
  • Centre of Excellence for Gastrointestinal Inflammation and Immunity Research, University of Alberta, Edmonton, Alberta, Canada; Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada; Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
  • Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Nutritional Sciences Temerty Faculty of Medicine at the University of Toronto, Ontario, Canada.

Abstract

BACKGROUND & AIMS

The cause of Crohn's Disease (CD) remains unclear; however evidence suggests fiber intake may play a role. We aimed to investigate the association between intake of total fiber and select fermentable fiber subtypes and future risk of CD in an at-risk population.

METHODS

The Genetic, Environmental, Microbial Project prospectively followed asymptomatic first-degree relatives of individuals with CD. Habitual intake of total fiber and select fiber subtypes was estimated from baseline food frequency questionnaires and biologic samples were collected. Incident CD was confirmed during follow-up. Cox proportional hazards models estimated hazard ratios (HRs) for CD. Associations between fiber subtype intake and urinary fractional excretion of lactulose-mannitol ratio (LMR), C-reactive protein (CRP), gut microbiota (16S rRNA sequencing), and serum proteomics (Olink®) were evaluated using multivariable regression models.

RESULTS

During a median follow-up of 8.5 years of 3,314 FDRs, 94 developed CD. Higher β-glucan (HR 0.70, 95% CI 0.54-0.92) and inulin (HR 0.68, 95% CI 0.49-0.96) intake were associated with lower CD risk. Associations were strongest in those with higher baseline relative abundance of Erysipelotrichaceae UCG-003, but weaker with higher Colidextribacter. Higher β-glucan and inulin intake were associated with lower LMR, lower abundance of pathobionts (Ruminococcus torques and Lachnoclostridium), and lower concentrations of inflammation- and barrier-related proteins, including CRP, TREM-1, OSM, and MMP-9.

CONCLUSIONS

Higher estimated β-glucan and inulin intake was associated with preserved gut barrier function, lower systemic inflammatory markers and lower CD risk which was modified by the microbial context. These findings support microbiome-informed dietary strategies and intervention trials for CD prevention.

MeSH

Glucans, Gastroenterology, Crohn Disease, Multiple Chronic Conditions, Inulin, Dietary Fiber, Gastrointestinal Microbiome