Can a Healthy Lifestyle Prevent IBD?

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

In the primary analysis, maintaining low modifiable risk scores — based on risk factors including body mass index, smoking status, use of non-steroidal anti-inflammatory drugs, physical activity, and daily consumption of fruit, vegetables, fiber, polyunsaturated fatty acids, and red meat — could have prevented 42.9% of Crohn’s disease cases and 44.4% of ulcerative colitis cases, reported Hamed Khalili, MD, MPH, of Massachusetts General Hospital in Boston, and colleagues.

Moreover, adherence to a healthy lifestyle could have prevented 61.1% of Crohn’s disease cases and 42.2% of ulcerative colitis cases, they noted in Gut.

“We were surprised by the proportion of cases that could have been prevented through lifestyle modifications,” Khalili told MedPage Today. “One reason for this finding may be that our population was older and therefore most of our cases of IBD happened in older adults.”

“We know that lifestyle and environmental factors play a bigger role in the development of IBD in this population as compared to those who are diagnosed with disease earlier in life,” he added.

These findings from the Nurses’ Health Study (NHS), the NHS II, and the Health Professionals Follow-Up Study (HPFS) were largely validated in three external European cohorts — the Swedish Mammography Cohort, Cohort of Swedish Men, and the European Prospective Investigation into Cancer and Nutrition.

Looking at cases of Crohn’s disease among the European validation cohorts, adhering to low-risk factors could have prevented 44% to 51% of cases, while adhering to a healthy lifestyle could have prevented 49% to 60% cases. For ulcerative colitis, adherence to low-risk factors could have prevented 21% to 28% of cases, while healthy lifestyle adherence could have prevented 47% to 56% of cases.

For every 1-point increase in modifiable risk score, a higher risk of Crohn’s disease (P for trend<0.0001) and ulcerative colitis (P for trend=0.008) was observed, and was similar for men and women.

IBD affects about 3.1 million people in the U.S. and 1.3 million in Europe, with incidence rising globally, especially among newly industrialized countries, Khalili’s group said. IBD is associated with an annual healthcare cost of $23,000 per patient in the U.S., and there are no current strategies to prevent the development of IBD. While one approach

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