Breakfast skipping and steroid withdrawal in ulcerative colitis: A population-based study in Japan

Area of Science:

• Gastroenterology
• Inflammatory Bowel Disease Research
• Chronobiology and Health

Background:

• Ulcerative colitis (UC) is a chronic inflammatory bowel disease with rising prevalence.
• Current UC treatments focus on pharmacology, but lifestyle factors like dietary timing are under-explored.
• The impact of breakfast skipping on UC disease course and treatment outcomes remains unclear.

Purpose of the Study:

• To investigate the association between breakfast skipping and steroid withdrawal in ulcerative colitis (UC) patients.
• To explore the potential role of meal timing in achieving sustained remission for UC.
• To analyze dietary timing habits in a large cohort of UC patients in Japan.

Main Methods:

• Retrospective cohort study utilizing the JMDC database (2015-2023) with data from ~8.17 million individuals.
• Identified 1645 UC patients initiating corticosteroid therapy, followed for at least 3 years.
• Defined breakfast skipping as skipping >3 times/week; primary outcome was steroid withdrawal (discontinuation of corticosteroids).

Main Results:

• 18.4% of UC patients reported skipping breakfast.
• Steroid withdrawal occurred in 33.0% of patients overall.
• Breakfast skipping was associated with significantly higher odds of steroid withdrawal (OR 1.52, 95% CI 1.08-2.14) after adjusting for other medications.

Conclusions:

• Meal timing, specifically breakfast skipping, may negatively influence sustained remission in ulcerative colitis (UC).
• These findings highlight the potential importance of dietary timing as a modifiable factor in UC management.
• Further research into chrononutrition and IBD is warranted to confirm these associations.