Plasma Metabolite Profiles Linked to EAT-Lancet Diet and Risk of Inflammatory Bowel Disease: A Prospective Cohort Study From UK Biobank

The EAT-Lancet Commission recommends a sustainable, health-focused diet, but its impact on inflammatory bowel disease (IBD) and metabolic mechanisms remains unclear. This study explores the association between the EAT-Lancet diet and IBD risk. We included 187 558 participants from the UK Biobank, free from IBD at baseline. Dietary intake was assessed using a validated 24-h dietary recall, and an EAT-Lancet diet score was calculated. Incident IBD cases were identified through primary care, hospital data, and death registries. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Over a mean follow-up of 13.15 years, 571 cases of Crohn's disease (CD) and 1066 of ulcerative colitis (UC) were recorded. HRs per 1-point increase in the EAT-Lancet score were 0.95 (95% CI: 0.91–0.98) for IBD, 0.95 (95% CI: 0.91–1.00) for UC, and 0.93 (95% CI: 0.87–0.98) for CD. Seven metabolites were identified as mediators, accounting for 10.7% of the association. Greater adherence to the EAT-Lancet diet was associated with a trend toward reduced IBD risk, with identified metabolites mediating this association. These findings emphasize the nutritional relevance of the EAT-Lancet diet in reducing IBD risk.