Physical Activity Protective Against Inflammatory Bowel Disease, Meta-Analysis Shows

TOPLINE:

Higher levels of physical activity are associated with a decreased risk of developing inflammatory bowel disease (IBD), particularly Crohn’s disease (CD).

METHODOLOGY:

• Because previous observational studies on the association between physical activity and IBD risk have yielded a wide range of results and conclusions, researchers conducted a systematic review and meta-analysis to estimate the aggregate effect of physical activity on IBD risk across various demographics.
• The analysis included three large population-based cohort studies and seven small and large case-control studies from several global regions that were published before April 2023.
• The cohort studies included 1182 patients with CD, 2361 with ulcerative colitis (UC), and 860,992 individuals without IBD. The case-control studies involved 781 patients with CD and 2636 individuals without CD, and 1127 patients with UC and 3752 individuals without UC.
• The Grading of Recommendations Assessment, Development and Evaluation approach was used to determine the quality of evidence in the included studies.

TAKEAWAY:

• Individuals with high physical activity levels had a 22% and 38% reduced risk of developing CD in the cohort studies and case-control studies, respectively, compared with individuals with low physical activity levels.
• The risk for incident UC was 13% lower in the high vs low physical activity level groups in the cohort studies, but the reduction in the case-control studies did not reach statistical significance.
• The quality-of-evidence assessment found no serious limitations in the cohort studies but serious limitations in the case-control studies due to a high risk for bias and significant heterogeneity.

IN PRACTICE:

“There could be a role of physical activity as a prevention strategy against developing IBD. In addition to implementing public health interventions to increase physical activity level, there may be a place for physicians to advise increased physical activity level, especially to individuals at high risk of developing IBD, such as those with a strong family history of IBD,” the authors wrote.

SOURCE:

The study, led by Ho Tuan Tiong, MD, Department of Gastroenterology, Christchurch Hospital, Christchurch, New Zealand, was published online in the Journal of Crohn’s and Colitis.

LIMITATIONS:

There may be a risk for residual confounding owing to the observational nature of the studies. There may also be a risk for reverse causality, as the individuals who had IBD symptoms before diagnosis may have been less physically active due to the disease. Except in two studies that measured physical activity directly, questionnaires were used to assess physical activity, possibly leading to misclassification of activity levels.

DISCLOSURES:

The study did not receive any funding. Two authors reported receiving grants and consulting fees from several pharmaceutical companies.

A version of this article appeared on Medscape.com.