How can we reduce the risk of developing IBD?
I often get asked how we may be able to reduce the risk of developing IBD, so I wanted to share the guidance from a recently published study which summarised the findings from 79 meta-analyses on the environmental factors we can modify which are associated with the development of IBD.
Background
The causes of Inflammatory Bowel Disease (IBD) are a complex interplay between genetic, environmental, and microbial factors. We are not able to change our genes but many of the environmental factors are modifiable, which offers opportunities to prevent disease or delay its onset.
A recent study summarised the findings from 79 meta-analyses on the environmental factors we can modify which are associated with the development of IBD.
Here is an overview of the risk factors and protective factors published in the paper:
Breastfeeding
Breastfeeding offers numerous health benefits to infants and is encouraged when possible. Breastfeeding for at least 3 months may be more beneficial than for shorter durations.
Diet
Certain dietary habits may be associated with a lower risk of IBD:
—> Lower intake of red meat and higher consumption of fish.
—> Increase consumption of plant-based foods, including fruits and vegetables
—> Maintain the recommended daily fibre intake (>25 g/d)
—> Ensure adequate vitamin D intake through diet or supplementation.
—> Reduce consumption of ultra-processed foods.
—> Prioritise tea consumption while minimising the intake of soft drinks.
—> Adopt the Mediterranean-like diet over the traditional Western diet.
Lifestyle Factors
Optimising the following lifestyle factors may help prevent IBD:
- Physical activity: Follow the World Health Organization’s recommendations of at least 150 minutes of moderate-intensity aerobic physical activity or 75 minutes of vigorous-intensity aerobic physical activity per week for adults aged 18–64.
- Maintaining a healthy weight: Avoid obesity (defined as a BMI over 30) through regular exercise and healthy eating.
- Mental health: Individuals experiencing depression should seek appropriate treatment.
- Smoking: Avoid smoking. In addition to its negative impacts on cardiovascular health and its role as a risk factor for lung disease and numerous other concerns, smoking is also an independent risk factor for developing IBD. Smoking increases the risk of CD, while former smokers are at a higher risk of UC.
Medications
- PPIs: Avoid excessive use when possible.
- Antibiotics: Use antibiotics as recommended by healthcare providers. However, unnecessary use, particularly in early life, should be avoided.
- Oral contraceptive pills: Consult with a primary care doctor on the risks and benefits of oral contraceptive pills compared to alternate forms of contraception.
Limitations
The points in this paper focus on reducing the risk of developing IBD based on meta-analyses of observational research studies, while we await higher quality interventional and randomised controlled studies of disease prevention.
Reference
Tarun Chhibba, Beatriz Gros, James A King, Joseph W Windsor, Julia Gorospe, Haim Leibovitzh, Mingyue Xue, Williams Turpin, Kenneth Croitoru, Ashwin N Ananthakrishnan, Richard B Gearry, Gilaad G Kaplan, Environmental risk factors of inflammatory bowel disease: toward a strategy of preventative health, Journal of Crohn's and Colitis, Volume 19, Issue 4, April 2025, jjaf042, https://doi.org/10.1093/ecco-jcc/jjaf042
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We are all wonderfully unique and what works for one person may not work for another so please seek help and advice before changing your diet to work out the right way forward for you.