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ExerciseFeb 19, 2024

Researchers identify strong link between having a healthy lifestyle and lower risk of developing IBS

Adopting a healthy lifestyle is strongly linked to a lower risk of irritable bowel syndrome (IBS), according to a research study published online today (21 February) in the journal Gut. Of the 'big five' healthy behaviours not smoking, a high level of vigorous physical activity, and getting enough sleep were independently associated with keeping the condition at bay.

Characterised by abdominal pain, bloating, and abnormal bowel habit, IBS is thought to affect up to one person in 10 worldwide. Exactly what causes IBS isn’t fully understood, but disordered functioning of the gut-brain axis has a key role in the symptoms, explain the researchers.

The article’s first author is Fai Fai Ho, who is based at the School of Chinese Medicine, The Chinese University of Hong Kong in Hong Kong. Previously published research has linked individual lifestyle factors with a heightened risk of IBS, and the Hong Kong and China-based team wanted to find out if a combination of these factors might ward off the condition.

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Having plenty of vigorous exercise on a weekly basis was a key factor, the study showed

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'Big five’ healthy behaviours

The researchers therefore looked at the ‘big five’ healthy behaviours, among middle aged participants (with an average age of 55) of the UK Biobank (see note below).  These were

  • never smoking
  • at least seven hours of sleep every night
  • a high level of vigorous physical activity every week
  • a high-quality balanced diet every day
  • moderate alcohol intake

The final analysis included 64,286 people, just over half of whom (55 per cent) were women, and who had completed at least two 24-hour dietary recall questionnaires. During an average monitoring period of just over 12.5 years, 961 (1.5 per cent) cases of IBS were recorded. 

Of the total sample, 7604 (12 per cent) said they didn’t do any of the 5 healthy lifestyle behaviours, while 20,662 (32 per cent) reported one; 21,901 (34 per cent) reported two; and 14,101 (22 per cent) reported from three to five behaviours at the start of the monitoring period.

After accounting for potentially influential factors, the higher the number of healthy behaviours, the lower was the risk of IBS. One behaviour was associated with a 21 per cent lower risk, while two were associated with a 36 per cent lower risk; and from three to five were associated with a 42 per cent lower risk.

Although of a smaller size than when combined, 3 healthy behaviours were independently associated with a lower risk of IBS: never smoking (14 per cent lower); high level of physical activity (17 per cent lower); and a good night’s sleep (27 per cent lower).

Further in-depth analysis showed that these associations were independent of age, sex, employment status, residential area, gut infection, family history of IBS or other lifestyle choices.

Our findings underscore the value of lifestyle modification in the primary prevention of IBS and suggest that healthy lifestyle choices could significantly attenuate the effects of aetiological factors on the incidence of IBS [Fai Fai Ho et al]

Conclusions and caveats

As this study was observational in nature it cannot establish cause. The researchers also relied on self-report mechanisms – which may not always be accurate and on older people, meaning it may not be applicable to younger age groups. It was also not possible to account for any lifestyle changes over time during the monitoring period.

Nevertheless, Fai Fai Ho and colleagues point out: ‘Although lifestyle modification is recommended as a means of managing IBS symptoms, its potential role in preventing the onset of the condition has not been given due attention.’ 

And they conclude: ‘IBS has a complex aetiology, involving biological, genetic, psychosocial and environmental factors. Our findings underscore the value of lifestyle modification in the primary prevention of IBS and suggest that healthy lifestyle choices could significantly attenuate the effects of aetiological factors on the incidence of IBS.'

What is the UK Biobank study?

It is a large-scale prospective cohort study that recruited 502,492 participants aged from 37-73 years by sending invitation letters to their homes from 2006-2010. 

To access the full version of the article– titled Association of healthy lifestyle behaviours with incident irritable bowel syndrome: a large population-based prospective cohort study doi: 10.1136/gutjnl-2023-331254  – click 

Author: I A McMillan
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