Healthy lifestyle behaviors associated with up to 42% lower risk for IBS
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Key takeaways:
- Researchers evaluated the association of five healthy lifestyle behaviors with incidence of irritable bowel syndrome.
- Adults who adhered to at least three behaviors had 42% lower risk for IBS.
Adhering to a higher number of healthy lifestyle behaviors, such as not smoking, staying physically active and getting optimal sleep, was significantly associated with lower incidence of irritable bowel syndrome, according to data in Gut.
“Finding a primary prevention strategy for IBS is essential for reducing its disease burden,” Fai Fai Ho, of the School of Chinese Medicine at The Chinese University of Hong Kong, and colleagues wrote. “In previous studies, some modifiable lifestyle factors, including smoking, sleeping, physical activity, diet and alcohol consumption, were found to be independently associated with IBS. It can be hypothesized that the combination of these healthy lifestyle behaviors might also protect against the occurrence of IBS.”
In a population-based cohort study, researchers evaluated the association between five healthy lifestyle behaviors — never smoking, optimal sleep, high levels of vigorous physical activity, high dietary quality and moderate alcohol intake — and the incidence of IBS.
They included 64,268 adults aged 37 to 73 years (mean age, 55.9 years; 55% women) with no IBS diagnosis at baseline who were enrolled in the UK Biobank between 2006 and 2010. At baseline, 11.8% of participants reported none of the studied healthy lifestyle behaviors, 32.1% reported one, 34.1% reported two and 21.9% reported three to five behaviors.
During a mean follow-up of 12.6 years, researchers recorded 961 (1.5%) incident cases of IBS. Results from multivariable analysis showed the adjusted hazard ratios associated with one, two or three to five healthy lifestyle behaviors were 0.79 (95% CI, 0.65-0.96), 0.64 (95% CI, 0.53-0.78) and 0.58 (95% CI, 0.46-0.72), respectively, which corresponded to 21%, 36% and 42% lower risk for IBS.
Further, never smoking (aHR = 0.86; 95% CI, 0.76-0.98), high level of vigorous physical activity (aHR = 0.83; 0.73-0.95) and optimal sleep (aHR = 0.73; 95% CI, 0.6-0.88) demonstrated “significant independent inverse associations” with incidence of IBS.
“This study provides evidence that adherence to a higher number of healthy lifestyle behaviors — never smoking, optimal sleep, high level of physical activity, high dietary quality and moderate alcohol intake — is significantly associated with a lower risk of subsequent IBS incidence,” Ho and colleagues concluded. “These findings suggest that lifestyle modifications should be considered as key primary prevention strategies for IBS.” They added, “Future research with repeated measurements of lifestyle factors is required to further verify our observations.”
Reference:
- Adopting healthy lifestyle strongly linked to lower irritable bowel syndrome risk. https://www.bmj.com/company/newsroom/adopting-healthy-lifestyle-strongly-linked-to-lower-irritable-bowel-syndrome-risk/. Accessed Feb. 21, 2024.
Perspective
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Anthony Lembo, MD
This study adds to a burgeoning body of literature that underscores the role of modifiable lifestyle factors — including smoking, sleep, exercise, diet and alcohol consumption — as contributors to IBS symptoms. Cross-sectional studies have consistently revealed correlations between lifestyle factors and IBS, and some have additionally demonstrated that adjusting these factors, such as enhancing sleep behavior, can lead to amelioration of IBS symptoms.
This study is novel in assessing each of the five lifestyle factors — never smoking, optimal sleep, high level of vigorous physical activity, high dietary quality and moderate alcohol intake — individually and in combination in developing IBS over a mean follow-up of 12.6 years.
It is worth mentioning a few of the study’s limitations: Out of the 64,268 individuals included in this study as part of the UK Biobank, a relatively small number (1.5%) developed IBS during the 12.6-year follow-up period. This is likely due to the fact the mean age that an individual entered into this study was in the mid-50s, which is much older than the typical individual who develops IBS, and development of IBS was determined by ICD code — in other words, diagnosed by a clinician — and not through questionnaires to assess symptoms.
Notably, the assessment of lifestyle factors was captured only at the time the individual entered the study, which was between 2006 and 2010. It is possible that their lifestyle behavior may have changed over time, which may be particularly relative due to the age that they entered the study. The researchers did an excellent job adjusting for multiple potential confounders such as age, sex and family history of IBS; however, it is still possible that other unknown confounders could exist.
It is important to note that the IBS guidelines from the ACG and AGA recommend modifying lifestyle behaviors as the first-line treatment in patients with IBS. This current study adds further evidence to support the benefits of a healthy lifestyle in the general population.
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