alexa Risk of inflammatory bowel disease attributable to smoking, oral contraception and breastfeeding in Italy: a nationwide case-control study. Cooperative Investigators of the Italian Group for the Study of the Colon and the Rectum (GISC).
Nutrition

Nutrition

Journal of Nutrition & Food Sciences

Author(s): Corrao G, Tragnone A, Caprilli R, Trallori G, Papi C,

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Abstract BACKGROUND: Using data from a case-control study carried out in Italy 1989-1992, we estimated the odds ratios (OR) and the population attributable risks (AR) for inflammatory bowel diseases (IBD) in relation to smoking, oral contraception and breastfeeding in infancy. METHODS: The study focused on 819 cases of IBD (594 ulcerative colitis: UC; 225 Crohn's disease: CD) originating from populations resident in 10 Italian areas, and age-sex matched paired controls. RESULTS: Compared with non-smokers, former smokers were at increased risk of UC (OR = 3.0; 95\% confidence interval [CI]: 2.1-4.3), whereas current smokers were at increased risk of CD (OR = 1.7; 95\% CI: 1.1-2.6). Females who reported use of oral contraceptives for at least one month before onset of symptoms had a higher risk of CD (OR = 3.4; 95\% CI: 1.0-11.9), whereas no significant risk was observed for UC. Lack of breastfeeding was associated with an increased risk of UC (OR = 1.5; 95\% CI: 1.1-2.1) and CD (OR = 1.9; 95\% CI: 1.1-3.3). Being a 'former smoker' was the factor with the highest attributable risk of UC both in males (AR = 28\%; 95\% CI: 20-35 \%) and in females (AR = 12\%; 95\% CI: 5-18\%). Smoking was the factor with the highest attributable risk for CD in males (AR = 31\%; 95\% CI: 11-50\%). Lack of breastfeeding accounted for the highest proportion of CD in females (AR = 11\%; 95\% CI: 1-22\%). Oral contraceptive use accounted for 7\% of cases of UC and for 11\% of cases of CD. CONCLUSIONS: Taken together, the considered factors were responsible for a proportion of IBD ranging from 26\% (CD females) to 36\% (CD males). It is concluded that other environmental and genetic factors may be involved in the aetiology of IBD.
This article was published in Int J Epidemiol and referenced in Journal of Nutrition & Food Sciences

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