by British Medical Journal

Micrograph showing inflammation of the large bowel in a case of inflammatory bowel disease. Colonic biopsy. Credit: Wikipedia/CC BY-SA 3.0

Adopting a healthy lifestyle is strongly linked to a lower risk of irritable bowel syndrome (IBS), finds new research published online in the journal Gut.

Of the big five healthy behaviors, not smoking, a high level of vigorous physical activity, and getting enough sleep were independently associated with keeping the condition at bay.

Characterized by abdominal pain, bloating, and abnormal bowel habit, IBS is thought to affect up to 1 in 10 people 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.

Previously published research has linked individual lifestyle factors with a heightened risk of IBS, and the researchers wanted to find out if a combination of these factors might ward off the condition.

They therefore looked at the big five healthy behaviors—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; and moderate alcohol intake—among middle-aged participants (average age 55) of the U.K. Biobank.

The final analysis included 64,286 people, just over half of whom (55%) 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%) cases of IBS were recorded.

Of the total sample, 7,604 (12%) said they didn't do any of the five healthy lifestyle behaviors, while 20,662 (32%) reported one; 21,901 (34%) reported two; and 14,101 (22%) reported three to five behaviors at the start of the monitoring period.

After accounting for potentially influential factors, the higher the number of healthy behaviors, the lower the risk of IBS.

One behavior was associated with a 21% lower risk, while two were associated with a 36% lower risk; and three to five were associated with a 42% lower risk.

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

This is an observational study, and as such, can't establish cause, added to which it relied on self-report, which may not always be accurate and older people, so may not be applicable to younger age groups. Nor was it possible to account for any lifestyle changes over time during the monitoring period.

Nevertheless, the researchers 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 etiology, 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 etiological factors on the incidence of IBS."

More information: Association of healthy lifestyle behaviours with incident irritable bowel syndrome: a large population-based prospective cohort study, Gut (2024). DOI: 10.1136/gutjnl-2023-331254

Journal information: Gut 

Provided by British Medical Journal