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Association between physical activity and inflammatory bowel disease: a prospective cohort study
Yitian Wei1, Binbin He1, Ge Zhang1
1School of Physical Education, Shandong University, Jinan, China.
Objective:
Evidence regarding the association between physical activity (PA) and the long-term incidence of inflammatory bowel disease (IBD) remains limited and inconsistent. This study aimed to evaluate the longitudinal relationship between varying intensities of PA and the risk of developing IBD, specifically Crohn's disease (CD) and ulcerative colitis (UC).
Methods:
This prospective cohort study analyzed data from 293,578 participants enrolled in the UK Biobank. Self-reported PA was categorized by intensity into light, moderate, and vigorous levels. Incident IBD cases were identified through linked hospital admission and death registry records. The association between PA levels and IBD incidence was assessed using multivariable Cox proportional hazards regression models. Furthermore, restricted cubic spline curves were utilized to examine potential non-linear associations, and cumulative event curves were generated to visualize disease progression over time.
Results:
During the follow-up period, higher levels of total PA were significantly associated with a reduced risk of CD, suggesting a protective effect of consistent physical exertion. While the relationship between PA and UC was insignificant in the general cohort, a significant reduction in UC risk was observed among individuals whose activity levels exceeded standard health recommendations. Notably, the data revealed a complex intensity-dependent relationship: whereas moderate-to-vigorous activity generally trended toward benefit, excessive light PA was paradoxically associated with an increased risk of UC within specific subpopulations.
Conclusion:
In this large-scale prospective study, PA was inversely associated with the risk of CD. However, the association between PA and UC appears more nuanced, with the protective benefits potentially contingent upon higher activity thresholds and specific intensity profiles. These findings suggest that tailored exercise recommendations may be necessary for IBD prevention strategies.
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