Healthy Lifestyle Could Prevent IBD Cases


New research indicates that inflammatory bowel disease (IBD) risk could be moderated by a healthy lifestyle.

Maintaining a healthy lifestyle might prevent up to 60% of inflammatory bowel disease (IBD) cases, according to new research.

Researchers at Massachusetts General Hospital and other health organizations published the large international study on IBD, which includes Crohn’s disease and ulcerative colitis (UC), in the journal Gut.1

Previously published research has linked IBD risk with several lifestyle factors, but it’s not clear if adopting and maintaining a healthy lifestyle might lower the risk of developing the condition in the first place, the BMJ (British Medical Journal) said in a news release.2

The researchers reviewed data from the Nurses’ Health Study (NHS), NHSII, and the Health Professionals Follow-up Study (HPFS). The NHS enrolled 121,700 female nurses aged 30–55 years from 11 US states in 1976, while the NHSII study, established in 1989, monitored 116,429 female nurses aged 25–42 years from 15 US states. The HPFS included 51,529 male doctors aged 40–75 years from across the United States in 1986.

The researchers created modifiable risk scores (MRS) for each participant based on established modifiable risk factors for IBD to estimate the proportion of IBD cases that could have been avoided. Risk factors included weight (body mass index, BMI); smoking; use of non-steroidal anti-inflammatory drugs; physical activity; and daily intake of fruit, fiber, vegetables, polyunsaturated fatty acids, and red meat.

The researchers then estimated the proportion of avoidable cases if an overall healthy lifestyle were adopted and maintained. A healthy lifestyle comprised: BMI between 18.5 and 25, never smoking, at least 7.5 weekly MET hours (METS express the amount of energy (calories) expended per minute of physical activity); and at least 8 daily servings of fruit and vegetables, less than half a daily serving of red meat, at least 25 g of fiber per day, at least 2 weekly servings of fish at least half a daily serving of nuts/seeds, and a maximum of 1 alcoholic drink/day for women or 2 for men.

Based on the MRS scores, the researchers estimated that a low MRS could have prevented 43% and 44.5%, respectively, of Crohn’s disease and UC cases, the BMJ said.

Similarly, maintaining a healthy lifestyle could have prevented 61% of Crohn’s disease cases and 42% of UC cases.

“Lifestyle modification may be an attractive target for future prevention strategies in IBD,” the authors wrote. “This may be of particular relevance to high-risk groups, such as first-degree relatives of IBD patients, who have an estimated 2%–17% risk of developing the disease over their lifetime.”

A key assumption of the findings is that the relationship between lifestyle factors and IBD development is causal, the researchers added. “Though this has yet to be established, several lines of evidence support the critical role of environmental and lifestyle factors in the development of IBD.”


1. Lopes EW, Chan SSM, Song M, et al. Lifestyle factors for the prevention of inflammatory bowel disease. Gut. 2022. doi:10.1136/gutjnl-2022-328174

2. Maintaining healthy lifestyle might prevent up to 60% of inflammatory bowel disease cases. News release. BMJ. December 6, 2022. Accessed December 16, 2022.

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