Adherence to an overall healthy lifestyle appears to prevent a substantial proportion of
inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), as reported in one study.
The study used data from the Nurses’ Health Study (NHS; n = 72,290), the NHSII (n = 93,909) and the Health Professionals Follow-up Study (HPFS; n = 41,871). Researchers generated modifiable risk scores (MRS; 0 to 6) for CD and UC consistent with established lifestyle risk factors, as well as healthy lifestyle scores (HLS; 0 to 9). obtained from American healthy lifestyle recommendations.
Results were then externally validated in three European cohorts: the Swedish Mammography Cohort (n = 37,275), the Swedish Men’s Cohort (n = 40,810), and the European Prospective Cancer and Nutrition Survey ( n = 404,144).
A total of 346 CD cases and 456 UC cases occurred over a follow-up period of 5,117,021 person-years (NHS, HPFS: 1986-2016; NHSII: 1991-2017). The corresponding incidence rates for CD and UC were seven and nine cases per 100,000 person-years.
Estimates showed that adherence to low MRS could have prevented 42.9 percent (95 percent confidence interval (CI), 12.2 to 66.1) of CD cases and 44.4 percent (95 percent CI, 9.0 to 69.8) of UC cases, while following a healthy lifestyle could have prevented 61.1 percent (95 percent CI, 16.8 to 84.9) of CD cases and 42.2 percent (95 percent CI, 1.7 to 70.9) of UC cases.
The results were replicated in the validation cohorts, where adherence to a low MRS and a healthy lifestyle could have, respectively, prevented 43.9 to 51.2 percent and 48.8 to 60.4 percent of CD cases and 20.6 to 27.8 percent and 46.8 to 56.3 percent of UC cases.
Additional prospective interventional studies are needed to confirm whether lifestyle modification plays a role in the primary prevention of IBD, particularly in high-risk populations and in earlier-onset disease.
