A Healthy Lifestyle May Reduce Risk of IBD

Inflammatory bowel disease (IBD) affects an estimated 3.1 million Americans, typically starting in adolescence and enduring a lifetime. IBD, a chronic condition characterized by inflammation of the intestinal tract, comprises two major disorders: Crohn's disease and ulcerative colitis.

The exact cause of IBD is unclear. According to Aditi Chhada, M.D., a gastroenterologist at Gastroenterology Associates of New Jersey, genetics can influence the development of the disease, but a growing body of research suggests lifestyle and environment likely play a role.

Contributing to the mounting evidence is a new study published in Gut, a monthly, peer-reviewed medical journal on gastroenterology and hepatology. Researchers found certain modifiable factors—such as following a healthy diet and getting regular exercise—can decrease your risk of developing IBD.

Assessing risk factors

For the study, the researchers pulled participant data from six large studies of adults in the United States and Europe. The research team assigned participants modifiable risk scores ranging from 0 to 6, with lower risk factors earning a lower score. Risk factors included smoking, use of nonsteroidal anti-inflammatory drugs, body mass index (BMI) and physical activity levels, as well as dietary factors such as fruit, vegetable, fiber and meat intake.

In addition, the researchers assigned participants a healthy lifestyle score ranging from 0 to 9, with healthier lifestyles scoring higher.

The study authors defined a healthy lifestyle based on recommendations outlined by the U.S. Department of Health and Human Services (HHS), the U.S. Department of Agriculture (USDA) Dietary Guidelines for Americans, and the American Heart Association (AHA) Guidelines for Healthy Living. Based on the recommendations, a healthy lifestyle comprises a BMI between 18.5 and 25, no smoking, regular physical activity, a nutritious diet and a maximum of one alcoholic drink per day for women or two for men.

Prevention is possible

Researchers found low modifiable risk factors could have prevented 43 percent of cases of Crohn's disease and 44.5 percent of ulcerative colitis cases. They also estimated that adhering to a healthy lifestyle could prevent about 61 percent of Crohn's disease cases and about 42 percent of ulcerative colitis cases.

"In six large cohorts of U.S. and European adults, adherence to a number of dietary and lifestyle factors known to be associated with risk of Crohn's disease and ulcerative colitis could have prevented a substantial number of cases," study author Emily Lopes, M.D., M.P.H., from Massachusetts General Hospital in Boston, told Medical News Today. "Adherence to a healthy diet and lifestyle also could have prevented a substantial number of [cases]."

"It is important to remember this is an observational study and, therefore, does not establish a causal relationship," said Chhada, who was not involved in the study.

Further research is needed to confirm a causal relationship between a healthy lifestyle and IBD. Nevertheless, lifestyle modification may be a useful prevention strategy in the future, especially for high-risk groups such as first-degree relatives of patients with IBD, according to Chhada.

"Focusing on fresh fruits and vegetables is good for everybody, including those with inflammatory bowel disease. Foods rich in fiber can promote a healthy gut microbiome," Chhada said.

"Regular moderate-intensity exercise has been shown to boost the immune system," she added. "So exercise is a good way to potentially reduce systemic inflammation."