Associations between participation in, intensity of, and time spent on leisure time physical activity and risk of inflammatory bowel disease among older adults (PA-IBD): a prospective cohort study

Abstract

Background Inflammatory bowel diseases (IBDs) are diseases of the immune system that share some genetic and lifestyle-related predisposing factors. Increasing incidences have been reported in all age groups. Based on experimental studies suggesting a role of physical activity on intestinal inflammation, this study aimed to investigate the association between leisure time physical activity and the risk of IBD in older adults. Methods The study is a prospective cohort study using Danish registry data and questionnaire data from the Danish “Diet, Cancer and Health” cohort. The outcome IBD was defined as having at least two main diagnoses of Crohn’s disease or ulcerative colitis registered in the National Patient Registry from the period between December 1993 and May 1997 with an average follow-up of 25 years. Cox proportional hazard models were used to estimate hazard-ratios for IBD onset associated with being physically active and with levels of the metabolic equivalent of task (MET) hours/week of physical activity and hours/week spent on six types of physical activity. All analyses were adjusted for potential confounders. Furthermore, the analyses were stratified according to age-group, occupational physical activity, smoking, BMI and work status to test for effect modification. Results In total, 54,645 men and women aged between 50 and 64 years were included, and of which there were 529 cases. When comparing physically active with inactive participants measured by MET hours/week there was no statistically significant difference in risk of IBD (0.89 [0.13; 6.27]), regardless of how participation was measured. Results did not indicate any dose-response effect when comparing quartile groups of MET hours/week (HR = 0.97 [0.76; 1.22], HR = 0.82 [0.64; 1.05] and HR = 0.83 [0.65; 1.07] or whether five of the six types of activities were compared with the lowest quartile as reference. For do-it-yourself-work, the third quartile of hours/week was associated with a higher risk of IBD compared to the second quartile of hours/week (HR = 1.44 [1.10; 1.90]. No effect modification was found. Conclusions There was no association between physical activity and risk of IBD when comparing physically active with inactive participants. Neither did the results indicate any dose-response effect when comparing quartile groups of MET hours/week with the lowest quartile as reference. Do-it-yourself work, however, appeared to be associated with a higher risk of IBD when comparing the third quartile with the second quartile of hours/week. The study has clinical relevance by its contribution to the explanatory field of the causes of IBD. However, the study has some limitations, and further research is needed to clarify associations between physical activity and risk of IBD.

Lifestyle factors associated with inflammatory bowel disease: data from the Swiss IBD cohort study

“…These findings are in line with the result of a review of metaanalyses recently published, that demonstrated a protective effect of physical activity regarding the development of CD [32]. On the other hand, a Danish prospective cohort study reported no association between physical activity and risk of IBD [33]. A possible explanation for this discrepancy to our result is, that the Danish study did not investigate the association between timing in life of physical activity and risk of IBD.…”

Empowering Preventive Strategies: The Role of Dietitians in Modifying Lifestyle Factors Associated with Inflammatory Bowel Disease Development

“…These findings align with previous meta-analyses indicating a protective effect of physical activity against CD development [3]. However, it is important to note the nuanced nature of these associations as demonstrated by conflicting evidence from other studies such as a Danish prospective cohort study that reported no significant association between physical activity and IBD risk [4]. The protective effect of regular physical activity against IBD onset can be attri­buted to its impact on various aspects of the immune system and inflammatory processes.…”

Physical activity in childhood and later risk of inflammatory bowel disease: A Scandinavian birth cohort study

“…Within the same adult population cohort, a recent prospective study proposed that a healthy lifestyle, including adequate PA, might have prevented 61% of CD and 42% of UC cases 26 . Contrary, a Danish prospective cohort study showed no relationship between IBD risk and the degree of PA amongst elderly individuals 27 …”

“… 26 Contrary, a Danish prospective cohort study showed no relationship between IBD risk and the degree of PA amongst elderly individuals. 27 …”

“…26 Contrary, a Danish prospective cohort study showed no relationship between IBD risk and the degree of PA amongst elderly individuals. 27 We did not identify any previous work that specifically addressed ST and the risk of IBD.…”