Lifestyle factors can help prevent many cases of inflammatory bowel disease

Effects of inflammatory bowel disease

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Inflammatory bowel disease (IBD) is a chronic condition that causes inflammation and damage to the gastrointestinal tract. People with IBD may experience various symptoms, including abdominal pain, sometimes bloody diarrhea, nausea, and vomiting. A person’s symptoms depend on the severity of IBD and the type of IBD.

The author of the study, Dr. Ioannis Economou, gastroenterologist and associate professor of medicine at Columbia University Irving Medical Center, told Medical News Today:

“Inflammatory bowel disease affects more than 3 million people in the USA. It consists of two diseases, Crohn’s disease and ulcerative colitis, which have many similarities but also significant differences. These are chronic diseases for which there is no known cure and which have a significant impact on the quality of life of those affected. Patients are diagnosed during the most productive years of their lives, with many of them diagnosed during childhood. They may have no symptoms if their disease is under control, but may develop multiple intestinal and extraintestinal manifestations in episodes.”

The exact cause of IBD is unknown, but researchers are continuing to investigate how lifestyle factors may play a role in the development and prevention of IBD.

IBD prevention and lifestyle factors

This particular study was a prospective cohort study. The researchers wanted to find out whether IBD could be prevented by changing certain lifestyle factors. They created modifiable risk scores (MRS) for participants based on their compliance with these lifestyle factors.

For example, they examined factors such as smoking, body mass index (BMI), use of nonsteroidal anti-inflammatory drugs (NSAIDs), and levels of physical activity. They also looked at dietary factors such as red meat, fruit and vegetables, and fiber intake. The specific factors included depended on the type of IBD.

They also gave participants healthy lifestyle scores based on adherence to a healthy lifestyle. The researchers defined a healthy lifestyle based on recommendations from 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) healthy living guidelines.

Their analysis found that with low modifiable risk values, almost 43% of Crohn’s disease cases and over 44% of ulcerative colitis cases could be prevented. They further estimated that a healthy lifestyle could prevent around 61% of Crohn’s disease and around 42% of cases of ulcerative colitis.

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Study author Dr. Emily W. Lopes, M.P.H., explained to MNT:

“In six large cohorts of adults in the US and Europe, compliance with a range of dietary and lifestyle factors known to be linked to the risk of Crohn’s disease (CD) and ulcerative colitis (UC) could have prevented a significant number of cases. Adhering to a healthy diet and lifestyle could also have prevented a significant number of CD and UC cases. It is important to note that an important assumption underlying our analysis is that there is a direct causal relationship between lifestyle and dietary factors and the risk of CD and UC.”

Study limitations and continued research

The study had some limitations. First, the average age of their cohort at which IBD was diagnosed was older than when IBD typically occurs. Therefore, lifestyle changes may not be as effective in preventing earlier cases of IBD, where genetics may be more involved.

Dr. Economou noted:

“A prospective study starting in early childhood, involving a diverse population from several countries, in particular high-risk people with a positive family history, and possible interventions, can help to further delineate the effects of lifestyle and modifiable risk factors.”

The researchers also did not look at other factors that could have played a role in the development of IBD, such as environmental pollution and socio-economic status, as these factors could not simply be changed. They also had no data on other potentially influential factors, such as stress. There is a risk of confusion due to the factors they were unable to consider.

Based on the sample, further research could include more participants from non-Western countries and more participants. More information is also needed to establish an actual causal relationship between these lifestyle factors and IBD.

Dr. Lopes told MNT:

“If our findings are correct, this suggests that choosing “low-risk” or healthy diet and lifestyle habits may be an effective strategy for preventing CD and UC. It is important that future studies, such as causal analyses and randomized trials, be conducted to confirm our findings and to examine the effectiveness of this strategy to prevent celiac disease and UC in high-risk populations.”