Especially not smoking, plenty of vigorous exercise, and getting enough sleep

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

Of the big 5 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 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 5 healthy behaviours—never smoking; at least 7 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 UK 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, 7604 (12%) said they didn’t do any of the 5 healthy lifestyle behaviours, while 20,662 (32%) reported one; 21,901 (34%) reported two; and 14,101 (22%) reported 3 to 5 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% lower risk, while 2 were associated with a 36% lower risk; and 3 to 5 were associated with a 42% 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% 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 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.”

Notes for editors
: Association of healthy lifestyle behaviours with incident irritable bowel syndrome: a large population-based prospective cohort study doi: 10.1136/gutjnl-2023-331254
Journal: Gut

Funding: National Key R&D Program of China; National Natural Science Foundation of China

Link to Academy of Medical Sciences labelling system 

Externally peer reviewed? Yes
Evidence type: Observational
Subjects: People