Can a healthy lifestyle prevent IBD?

Adopting and maintaining a healthy lifestyle may prevent inflammatory bowel disease (IBD), according to an analysis of three prospective US cohort studies validated in three external European cohorts .

In the primary analysis, a low modifiable risk score was based on risk factors such as BMI, smoking status, non-steroidal anti-inflammatory drug use, physical activity, daily intake of fruits, vegetables, fiber and polyunsaturated fatty acids. and red meat – Hamed Khalili, MD, MPH and colleagues at Massachusetts General Hospital in Boston could have prevented 42.9% of Crohn’s disease cases and 44.4% of ulcerative colitis cases I reported.

Additionally, they note, 61.1% of Crohn’s disease cases and 42.2% of ulcerative colitis cases could have been prevented by following a healthy lifestyle. intestine.

“We were surprised at the percentage of cases that could have been prevented through lifestyle changes,” Kariri said. MedPage Today“One of the reasons for this finding is that the population is older and most cases of IBD occurred in older people.”

“We know that lifestyle and environmental factors play a greater role in the development of IBD in this population compared to those diagnosed with the disease earlier in life.

These findings from nurse health survey (NHS), NHS II, and Medical Professional Follow-up (HPFS) was primarily validated in three external European cohorts – the Swedish Mammography Cohort, the Swedish Men’s Cohort, and the European Prospective Study on Cancer and Nutrition.

Looking at Crohn’s disease cases in the European validation cohort, adherence to low-risk factors could have prevented 44% to 51% of cases, and adherence to a healthy lifestyle could have prevented 49% to 51% of cases. 60% of cases could have been prevented. In ulcerative colitis, adherence to low-risk factors could have prevented 21% to 28% of cases, and adherence to a healthy lifestyle could have prevented 47% to 56% of cases. could have been prevented.

Each point increase in the modifiable risk score increases the risk of Crohn’s disease (P. <0.0001 if trending) and ulcerative colitis (P. trend = 0.008) was observed and was similar for men and women.

IBD affects about 3.1 million people in the United States and 1.3 million people in Europe, with incidence rates rising globally, especially in newly industrialized countries, Khalili’s group said. IBD is associated with medical costs of $23,000 per year per patient in the United States, and there are no current strategies to prevent the development of IBD.One of his approaches to preventing many chronic diseases is lifestyle changes and dietary factorthe success of adhering to such changes remains unknown.

For this study, Khalili and colleagues examined data from 72,290 participants from the NHS, 93,909 from NHS II, and 41,871 from HPFS. The NHS registered women nurses in 11 states from her 30 to her 55 in 1976. State in 1986.

To externally validate the findings, the researchers pooled data from 40,810 participants in a cohort of Swedish men, 404,144 in a European Prospective Cancer and Nutrition Study, and 37,275 in a Swedish mammography cohort. I rated it.

Using participants’ baseline and biennial questionnaires to assess lifestyle factors, anthropomorphic data, and medical history, Khalili and colleagues assessed modifiable risk for Crohn’s disease and ulcerative colitis ranging from 0 to 6. created a score. Higher scores indicate more risk factors. A healthy lifestyle score ranging from 0 to 9 was also developed based on recommendations from the American Heart Association and other organizations. A higher score indicates a healthier lifestyle.

A healthy lifestyle includes no smoking, a BMI between 18.5 and 25, less than half of the red meat intake per day and at least 8 servings, plus a metabolic rate of at least 7.5 per week. It includes engaging in physical activity during working hours. 1 serving of fruit/vegetables daily; 2 or more servings of nuts or seeds daily; 2 or more servings of fish per week; 25 g or more of fiber daily;

With 5,117,021 person-years of follow-up, 346 cases of Crohn’s disease and 456 cases of ulcerative colitis were reported.

In the falsification analysis, adherence to low-risk factors for Crohn’s disease could have also prevented 32.3% of rheumatoid arthritis cases, 13.3% of colorectal cancer cases, and 14% of cardiovascular disease cases, This was not the case with ulcerative disease. colitis.

“This is largely due to differences in the strength of association and prevalence of risk factors, and the presence of other modifiable risk factors such as alcohol and drugs and supplements that are strongly associated with these other conditions. ‘, Kariri and a colleague suggested.

They acknowledged that early-onset IBD was underestimated in their study because the mean age of the cohort (approximately 45 years) was older than the usual age of onset for IBD. Data on modifiable risk factors have not been investigated and high-risk individuals have not been evaluated.