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IBD risk lower in children from rural areas
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People who live in rural areas, especially children who grow up there, have a lower risk for developing inflammatory bowel disease, according to the results of a Canadian population-based cohort study.
Researchers suggested that early changes in the gut microbiome tied to living in an urban vs. rural area may drive these differences in IBD risk.
“Our findings show that children, particularly those under the age of 10, experience a protective effect against IBD if they live in a rural household,” Eric I. Benchimol, MD, pediatric gastroenterologist at the Children’s Hospital of Eastern Ontario Inflammatory Bowel Disease Center in Ottawa, said in a press release. “This effect is particularly strong in children who are raised in a rural household in the first 5 years of life.”
He noted that these findings are significant given his group’s previous research showing a marked increase in very young-onset IBD in Canada over the past 20 years.
“The findings also strengthen our understanding that environmental risk factors that predispose people to IBD may have a stronger effect in children than adults,” he added.
Benchimol and colleagues evaluated data on residents from four Canadian provinces (Alberta, Manitoba, Nova Scotia and Ontario), and identified 45,567 patients diagnosed with IBD. Among them, 38,905 lived in urban areas and 6,662 lived in rural areas between 1999 and 2010, which corresponded to overall incidences of 33.16 vs. 30.72 per 100,000 people (incidence RR = 0.9; 95% CI 0.81–0.99).
Living in a rural area showed the greatest protective effects for children aged younger than 10 years (IRR = 0.58; 95% CI, 0.43–0.73) and those aged between 10 and 17.9 years (IRR = 0.72; 95% CI, 0.64–0.81).
Finally, a separate “birth cohort study” involving 331 rural and 2,302 urban children showed a link between exposure to a rural area in the first 1to 5 years of life and a significantly lower risk for IBD (IRR 0.75–0.78), which was similar for both Crohn’s disease and ulcerative colitis.
“We’ve known that in addition to genetic risk factors, environmental factors have been associated with the risk of developing IBD,” Benchimol said in the press release. “But this new study demonstrates the importance of early life exposure in altering the risk of IBD, and that needs further study.” – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.
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