Physical activity, sedentary behavior and risk of inflammatory bowel disease: a prospective cohort study in the UK Biobank

Dec 30, 2025BMC public health

Physical activity, sitting time, and risk of inflammatory bowel disease in UK adults

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Abstract

During 13.6 years of follow-up, 2,242 incident cases were recorded among 355,021 participants.

Moderate and high levels of (PA) are associated with a reduced risk of inflammatory bowel disease (IBD), with hazard ratios of 0.80 and 0.87, respectively, compared to low PA.
A nonlinear relationship indicates that approximately 2000 MET min/week of PA correlates with the lowest IBD risk.
Each additional hour of (SB) per day is linked to a 3% increase in IBD risk.
The protective effect of moderate and high PA can mitigate the risks associated with prolonged SB (≥ 6 hours/day), reducing IBD risk by 18% and 27%, respectively.
Individuals with low PA and long SB exhibit the highest risk for developing IBD.

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BACKGROUND: Evidence suggests that (PA) may mitigate chronic inflammation, while (SB) could exacerbate gut dysbiosis-key mechanisms in (IBD). However, epidemiological data on their independent and joint associations with IBD risk remains inconsistent and inconclusive.

OBJECTIVE: This cohort study aimed to examine the separate and joint association of PA and SB with IBD risk.

METHODS: The research contained 355,021 people with no IBD at baseline in the UK Biobank. PA was measured using the International PA Questionnaire(IPAQ), calculating metabolic equivalent tasks (METs) min/wk based on the frequency and duration of walking, moderate, and vigorous activities. SB was assessed by self-reported total time spent driving, using computers, and watching television in a day. Using Cox proportional hazard models to evaluate the hazard ratios (HRs) and 95% confidence intervals (CIs) for IBD, Crohn's disease (CD) and ulcerative colitis (UC) risks, while restricted cubic splines (RCS) assessing nonlinear relationships.

RESULTS: During 13.6 years of follow-up, 2,242 incident IBD cases (664 CD and 1,481 UC) were recorded. Compared to the low level of PA, IBD risk was found to be lower for moderate and high PA, with HRs of 0.80 (95% CI: 0.72-0.89, p < 0.001) and 0.87 (95% CI: 0.78-0.98, p = 0.02), respectively. We also found a nonlinear correlation of PA with IBD risk (p < 0.05 for nonlinearity), with a moderate level of PA (~ 2000 MET min/wk) offering the lowest risk. Besides, each additional hour of SB per day increased IBD risk (HR: 1.03; 95% CI: 1.01-1.05; p < 0.001). The risk reduction from moderate and high levels of PA attenuated the adverse effects of long SB (≥ 6 h/day), decreasing the risk by 18% and 27%, respectively. The results of PA and SB together on IBD risk showed that participants with low PA and long SB have the highest IBD risk.

CONCLUSIONS: The results revealed that promoting PA and reducing SB synergistically lower IBD risk. Individuals combining high PA with lowest SB time are at the lowest probability of developing IBD.

Key numbers

0.80

Decrease in Risk with Moderate

Hazard ratio for moderate vs. low

1.03

Increase in Risk per Hour of

Hazard ratio for each hour of per day

1.26

Highest Risk Group

Hazard ratio for low and long

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Physical activity, sedentary behavior and risk of inflammatory bowel disease: a prospective cohort study in the UK Biobank

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