Lifestyle modification may lower inflammatory bowel disease burden

Adherence to an overall healthy lifestyle appears to prevent a substantial proportion of inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), as reported in a study.

The study used data from the Nurses’ Health Study (NHS; n=72,290), NHSII (n=93,909), and Health Professionals Follow-up Study (HPFS; n=41,871). Researchers generated modifiable risk scores (MRS; 0–6) for CD and UC in line with established lifestyle risk factors, as well healthy lifestyle scores (HLS; 0–9) obtained from American healthy lifestyle recommendations.

Results were then externally validated in three European cohorts: the Swedish Mammography Cohort (n=37,275), Cohort of Swedish Men (n=40,810), and European Prospective Investigation into Cancer and Nutrition (n=404,144).

A total of 346 CD and 456 UC cases occurred over 5,117,021 person-years of follow-up (NHS, HPFS: 1986–2016; NHSII: 1991–2017). The corresponding incidence rates for CD and UC were seven and nine cases per 100,000 person-years.

Estimates showed that adherence to a low MRS could have prevented 42.9 percent (95 percent confidence interval [CI], 12.2–66.1) of CD and 44.4 percent (95 percent CI, 9.0–69.8) of UC cases, whereas adherence to a healthy lifestyle could have prevented 61.1 percent (95 percent CI, 16.8–84.9) of CD and 42.2 percent (95 percent CI, 1.7–70.9) of UC cases.

The results were replicated in the validation cohorts, where adherence to a low MRS and healthy lifestyle could have, respectively, prevented 43.9–51.2 percent and 48.8–60.4 percent of CD cases and 20.6–27.8 percent and 46.8–56.3 percent of UC cases.

Additional prospective interventional studies are needed to confirm whether lifestyle modification plays a role in the primary prevention of IBD, especially in high-risk populations and younger-onset disease.