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Original research
Association of healthy lifestyle behaviours with incident irritable bowel syndrome: a large population-based prospective cohort study
  1. Fai Fai Ho1,
  2. Hui Sun2,
  3. Hong Zheng3,
  4. David C N Wong3,
  5. Yin-Yan Gao2,
  6. Chen Mao4,
  7. Yin Ting Cheung5,
  8. Chun Sing Lam5,
  9. Maggie H Wang3,
  10. Irene Xin-Yin Wu2,
  11. Justin C Y Wu6,
  12. Vincent C H Chung3
  1. 1School of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
  2. 2Xiangya School of Public Health, Central South University, Changsha, Hunan, China
  3. 3The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
  4. 4Department of Epidemiology, Southern Medical University School of Public Health, Guangzhou, Guangdong, China
  5. 5School of Pharmacy, The Chinese University of Hong Kong, Hong Kong, Hong Kong
  6. 6Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong
  1. Correspondence to Professor Irene Xin-Yin Wu, Xiangya School of Public Health, Central South University, Changsha, Hunan, China; irenexywu{at}csu.edu.cn

Abstract

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 to 73 years who had no IBS diagnosis at baseline were enrolled between 2006 and 2010 and followed up to 2022.

Main exposure The five 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 (1.5%) incident IBS cases were recorded. Among the 64 268 participants (mean age 55.9 years, 35 342 (55.0%) female, 7604 (11.8%) reported none of the five healthy lifestyle behaviours, 20 662 (32.1%) reported 1 behaviour, 21 901 (34.1%) reported 2 behaviours and 14 101 (21.9%) reported 3 to 5 behaviours at baseline. The multivariable adjusted hazard ratios associated with having 1, 2 and 3 to 5 behaviours for IBS incidence were 0.79 (95% confidence intervals 0.65 to 0.96), 0.64 (0.53 to 0.78) and 0.58 (0.46 to 0.72), respectively (P for trend <0.001). Never smoking (0.86, 0.76 to 0.98, P=0.02), high level of vigorous physical activity (0.83, 0.73 to 0.95, P=0.006) and optimal sleep (0.73, 0.60 to 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 IBS in the general population. Our findings suggest the potential of lifestyle modifications as a primary prevention strategy for IBS.

  • IRRITABLE BOWEL SYNDROME

Data availability statement

Data may be obtained from a third party and are not publicly available. The UK Biobank data are available on application at https://www.ukbiobank.ac.uk.

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Data availability statement

Data may be obtained from a third party and are not publicly available. The UK Biobank data are available on application at https://www.ukbiobank.ac.uk.

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Footnotes

  • Contributors VCHC designed the study. FFH, HS, HZ and DCNW conducted the data analysis. Y-YG, MHW, IX-YW and JW contributed to project administration. FFH and VCHC drafted the manuscript. All authors critically revised the manuscript for important intellectual content and approved the final version of the manuscript. IX-YW is the funding receiver and study guarantor. The corresponding author (IX-YW) attests that all the listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

  • Funding This work was supported by the National Key R&D Program of China (No. 2020YFC2008601) and National Natural Science Foundation of China (No. 81973709). The funders had no role in the study design or implementation; data collection, management, analysis, or interpretation; manuscript preparation, review, or approval; or the decision to submit the manuscript for publication.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.