Colon to Rectum
Gut. 2024;73(6):922–31
Association of healthy lifestyle behaviours with incident irritable bowel syndrome: A large population-based prospective cohort study
Objectives: To evaluate the association between healthy lifestyle behaviours and the incidence of irritable bowel syndrome (IBS). Design: Population-based prospective cohort study. Setting: The UK Biobank. Participants: 64,268 adults aged 37–73 years who had no IBS diagnosis at baseline were enrolled between 2006 and 2010 and followed up to 2022. Main exposure: The 5 healthy lifestyle behaviours studied were never smoking, optimal sleep, high level of vigorous physical activity, high dietary quality and moderate alcohol intake. Main outcome measure: The incidence of IBS. Results: During a mean follow-up of 12.6 years, 961 incident IBS cases (1.5%) were recorded. Among the 64,268 participants (mean age, 55.9 years, 35,342 female [55.0%]), 7604 (11.8%) reported none of the 5 healthy lifestyle behaviours, 20,662 (32.1%) reported 1 behaviour, 21,901 (34.1%) reported 2 behaviours and 14,101 (21.9%) reported 3–5 behaviours at baseline. The multivariable adjusted hazard ratios associated with having 1, 2 and 3–5 behaviours for IBS incidence were 0.79 (95% confidence interval [CI]: 0.65–0.96), 0.64 (95% CI: 0.53–0.78) and 0.58 (95% CI: 0.46–0.72), respectively (ptrend < 0.001). Never smoking (0.86, 95% CI: 0.76–0.98, p = 0.02), high level of vigorous physical activity (0.83, 95% CI: 0.73–0.95, p = 0.006) and optimal sleep (0.73, 95% CI: 0.60–0.88, p = 0.001) demonstrated significant independent inverse associations with IBS incidence. No significant interactions were observed between these associations and age, sex, employment status, geographic location, gastrointestinal infection, endometriosis, family history of IBS or lifestyle behaviours.
Conclusions: Adhering to a higher number of healthy lifestyle behaviours is significantly associated with a lower incidence of irritable bowel syndrome (IBS) in the general population. These findings suggest the potential of lifestyle modifications as a primary prevention strategy for IBS.