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Diverticulitis risk lower among men with healthy lifestyle
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Men who led a healthy lifestyle, including those who limited their red meat intake, ate higher levels of dietary fiber, exercised, maintained a healthy weight and avoided smoking, showed a reduced risk for developing diverticulitis in a recent study.
Adhering to an overall “low-risk” lifestyle accounting for these factors could prevent half of all incident diverticulitis cases in the U.S., investigators concluded.
“The incidence of diverticulitis has risen drastically to become one of the most common indications for gastrointestinal admission in the United States at a cost of more than two billion dollars annually,” Andrew T. Chan, MD, MPH, associate professor in the division of gastroenterology at Massachusetts General Hospital and Harvard Medical School, and colleagues wrote. “We found that red meat intake, low dietary fiber intake, lack of vigorous physical activity, obesity, and smoking were jointly and independently associated with increased risk of diverticulitis.”
To evaluate for associations between lifestyle factors and diverticulitis risk, Chan and colleagues analyzed data on 45,203 men who participated in the Health Professionals Follow-up Study since its inception in 1986. Overall, 907 incident cases of diverticulitis occurred throughout 757,791 person-years of follow-up.
They found that high red meat consumption, low dietary fiber consumption, low levels of vigorous physical activity, high BMI and smoking were all independently associated with higher odds of developing diverticulitis (P < .05 for all).
To estimate the impact of lifestyle modifications on prevention of diverticulitis, Chan and colleagues defined a “low-risk” lifestyle as consuming average levels of red meat (less than 51 g daily), consuming dietary fiber in the top 40% of the cohort (about 23 g daily), engaging in vigorous physical activity in the highest 50% of the cohort, excluding those who reported no vigorous physical activity (about 2 hours of exercise per week), having a normal BMI and no history of smoking.
They observed an inverse linear relationship between the number of these factors and the incidence of diverticulitis (P for trend < .001). Those with one low-risk lifestyle factor showed a relative risk (RR) of 0.71 (95% CI, 0.59-0.87), those with two showed a RR of 0.66 (95% CI; 0.55-0.81), those with three showed a RR of 0.5 (95% CI; 0.4-0.62), those with four showed a RR of 0.47 (95% CI; 0.35-0.62), and those with five showed a RR of 0.27 (95% CI; 0.15–0.48) vs. those with no low-risk factors.
Chan and colleagues concluded that adherence to this low-risk lifestyle could potentially prevent 50% (95% CI; 20% to 71%) of incident diverticulitis. They acknowledged that the study is limited by its observational design, and the reliance on self-reported questionnaire data.
“An overall low-risk lifestyle was associated with a 50% lower risk of diverticulitis,” Chan and colleagues concluded. “Adherence to a low-risk lifestyle may be an effective strategy for preventing diverticulitis. Given the high burden of diverticulitis on the US population and the lack of alternative preventive interventions, broader adoption of a healthy, low-risk lifestyle may have a substantial impact on the health care landscape.” – by Adam Leitenberger
Disclosures: Chan reports previously consulting for Bayer Healthcare, Aralaz Pharmaceuticals and Pfizer.
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