Peer-reviewed article
Timing of complementary food introduction is not associated with inflammatory bowel disease risk: A prospective birth cohort study.
Ida Sigvardsson, Johnny Ludvigsson, Tereza Lerchova, Henrik Imberg, Ketil Størdal et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study followed nearly 95,000 children from Sweden and Norway from birth into young adulthood to see if the timing of introducing solid foods affected their risk of developing inflammatory bowel disease. Researchers tracked when children started eating foods like cereals and dairy, then checked national health records to see who developed the disease. The study found no link between when complementary foods were introduced (before 4 months, 4-5 months, or at 6 months or later) and later IBD risk.
Key points
- 400 participants developed IBD over 1.56 million person-years of follow-up
- Introducing complementary foods before 4 months showed no increased IBD risk (aHR 1.04 [95% CI 0.67-1.60]) compared to introduction at 6 months or later
- Introduction at 4-5 months was not associated with IBD risk (aHR 0.83 [95% CI 0.63-1.10]) versus later introduction
- Results were consistent across both cohorts (ABIS and MoBa), both disease subtypes (Crohn's disease and ulcerative colitis), and sensitivity analyses
- Neither timing nor pattern of complementary food introduction was identified as a major risk factor for IBD development
Limitations
The study observes associations in a specific population (Sweden and Norway) and cannot establish causation or determine other unmeasured factors that might influence IBD risk. The findings may not generalize to populations with different genetic backgrounds, dietary practices, or healthcare systems.
Abstract
BACKGROUND: Complementary feeding (ie, food introduction besides formula or breast milk) imprints on the developing gut microbiome and immune system, which may have durable influences on disease risk. This study aimed to prospectively assess the association between the timing of complementary feeding and subsequent inflammatory bowel disease (IBD) risk. METHODS: We followed 94 238 participants from the All Babies in Southeast Sweden (ABIS) (n = 11 947) and the Norwegian Mother, Father and Child (MoBa) (n = 82 291) cohorts from birth (1997-2009) through 2023 (mean age 16.5 [MoBa] to 25.2 [ABIS] years). National patient registers identified IBD diagnoses. The timing of complementary food introduction (<4, 4-5, or ≥6 months) was assessed using early-life food diaries and questionnaires. Latent class analyses identified 4 patterns across introductions of major food groups (eg, cereals and dairy). Cox regression estimated hazard ratios (aHRs) for IBD adjusted for socio-demographics and parental IBD. Sensitivity analysis additionally adjusted for breastfeeding duration, formula feeding, and perinatal factors. RESULTS: Over 1 562 350 person-years of follow-up, 400 participants developed IBD (ABIS, n = 124; MoBa, n = 276). Overall timing of complementary food introduction was not associated with IBD (<4 months: aHR, 1.04 [95% CI, 0.67-1.60]; 4-5 months: aHR, 0.83 [95% CI, 0.63-1.10] vs ≥6 months). Also, aHRs for IBD by latent class analyses-defined introduction patterns approached 1. Results were consistent across cohorts, sensitivity analyses, and Crohn's disease and ulcerative colitis subtypes. CONCLUSIONS: The findings from this binational birth cohort study indicate that neither the timing nor the pattern of complementary food introduction is a major risk factor for later development of IBD.