Diet and IBD Flares: Gut | July 2026

Introduction:

Patients with inflammatory bowel disease (IBD) frequently ask whether diet influences disease relapse, yet high-quality prospective evidence has been scarce. The multicenter PREdiCCt study evaluated the impact of demographic, clinical, and habitual dietary factors on future disease flares in patients with Crohn's disease and ulcerative colitis who were in remission.

Why was this study needed?

• Evidence linking habitual diet to IBD relapse has been limited and inconsistent.
• Most previous studies were cross-sectional or focused on exclusive enteral nutrition rather than routine dietary habits.
• Dietary counselling remains one of the most common unmet needs in IBD care.
• Reliable predictors of disease relapse beyond symptoms are needed.
• Identifying modifiable lifestyle factors may help maintain long-term remission.

Results:

• Baseline fecal calprotectin was the strongest predictor of future relapse, with progressively increasing flare risk as fecal calprotectin levels increased.
• Higher habitual total meat intake nearly doubled the risk of objectively confirmed flare in ulcerative colitis, independent of demographic, clinical, and biochemical factors.
• No consistent association was observed between flare risk and ultraprocessed foods, dietary fibre, or polyunsaturated fatty acid intake, suggesting these dietary components were not major determinants of relapse in this cohort.

Clinical Impact:

This landmark prospective study provides the strongest evidence to date that habitual meat consumption is a potentially modifiable risk factor for relapse in ulcerative colitis, while reaffirming fecal calprotectin as the most powerful biomarker for predicting future disease activity. These findings support incorporating objective biomarker monitoring and individualized dietary counselling into routine IBD management.

Bottom Line:

Among patients with ulcerative colitis in remission, higher habitual meat intake was associated with an increased risk of future disease flare, whereas ultraprocessed foods, fibre, and polyunsaturated fatty acids showed no consistent relationship with relapse. Fecal calprotectin remains the single best predictor of future IBD flares.