Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological AssociationMar 7, 2020

Healthy Lifestyles Linked to Lower Death Rates in People With Inflammatory Bowel Diseases

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Updated Mar 31, 2026

Abstract

Patients with inflammatory bowel diseases (IBD) who adhered to 3-5 healthy lifestyle factors experienced a 71% reduction in all-cause mortality.

A total of 83 deaths were documented in 363 patients with Crohn's disease (CD) and 80 deaths in 465 patients with ulcerative colitis (UC).
Patients with IBD who did not adopt healthy lifestyle factors had a higher mortality risk compared to those who did.
Specific lifestyle factors associated with reduced mortality included non-smoking, maintaining a healthy body weight, engaging in vigorous physical activity, following a Mediterranean diet, and light alcohol consumption.
The reduction in mortality was statistically significant for both CD and UC patients, with hazard ratios indicating a strong protective effect.
Individual lifestyle factors showed varying impacts on mortality risk, with high physical activity and low alcohol consumption being particularly beneficial.

Simplified

BACKGROUND & AIMS: It is not clear whether a healthy lifestyle affects mortality of patients with inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC).

METHODS: We collected data form the Nurses' Health Study (1986-2014), Nurses' Health Study II (1991-2015), and Health Professionals Follow-up Study (1986-2014), which assess lifestyles with serial questionnaires. We estimated joint and individual associations between 5 healthy lifestyle factors after IBD diagnosis (never smoking, body mass index 18.5-24.9 kg/m, vigorous physical activity in the highest 50% with non-zero value, alternate Mediterranean diet score ≥4, and light drinking [0.1-5.0 g/d]) and mortality using Cox proportional hazards models. 2

RESULTS: We documented 83 deaths in 363 patients with CD during 4741 person-years and 80 deaths in 465 patients with UC during 6061 person-years. The median age of IBD diagnosis was 55 y. Compared to patients with IBD with no healthy lifestyle factors, patients with IBD with 3-5 healthy lifestyle factors had a significant reduction in all-cause mortality (hazard ratio [HR], 0.29; 95% CI, 0.16-0.52; P< .0001). This reduction was significant in patients with CD (P = .003) as well as in patients with UC (P = .0003). Individual associations were more than 25 pack-years (HR, 1.92; 95% CI, 1.24-2.97; P< .0001), physical activity (HR according to quintiles, 0.55-0.31; P = .001), Mediterranean diet (HR, 0.69; 95% CI, 0.49-0.98), and alcohol consumption (HR0.61; 95% CI, 0.39-0.95 vs HR1.84; 95% CI, 1.02-3.32). The findings did not change when we adjusted for family history of IBD, immunomodulator use, and IBD-related surgery. trend trend trend trend trend0.1-5 g/d >15 g/d

CONCLUSIONS: In an analysis of data from 3 large cohort studies, we associated adherence to a healthy lifestyle with reduced mortality in patients with CD or UC.

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Disclosures: J.M.R is a consultant to Policy Analysis Inc and Takeda Pharmaceuticals. A.T.C. serves as a consultant for Janssen, Pfizer, and Bayer Pharma AG for work unrelated to the topic of this manuscript. A.N.A. has served as a Scientific Advisory Board member for Abbvie, Gilead, Kyn therapeutics and received research grants from Pfizer and Merck. No other conflict of interest exists.

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Healthy Lifestyles Linked to Lower Death Rates in People With Inflammatory Bowel Diseases

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