Liu Po-Hong, Cao Yin, Keeley Brieze R, Tam Idy, Wu Kana, Strate Lisa L, Giovannucci Edward L, Chan Andrew T
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Clinical and Translational Epidemiology Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Am J Gastroenterol. 2017 Dec;112(12):1868-1876. doi: 10.1038/ajg.2017.398. Epub 2017 Nov 7.
Diverticulitis is a common disease with high clinical burden. We evaluated the joint contribution of multiple lifestyle factors to risks of incident diverticulitis. We also estimated the proportion of diverticulitis preventable by lifestyle modifications.
We prospectively examined the association between lifestyle factors (red meat, dietary fiber intake, vigorous physical activity (activity with metabolic equivalent ≥6), body mass index (BMI), and smoking) and risk of diverticulitis among participants in the Health Professionals Follow-Up Study.
We documented 907 incident cases of diverticulitis during 757,791 person-years. High intake of red meat, low intake of dietary fiber, low vigorous physical activity, high BMI, and smoking were independently associated with increased risks of diverticulitis (all P<0.05). Low-risk lifestyle was defined as average red meat intake <51 g per day, dietary fiber intake in the top 40% of the cohort (about 23 g per day), vigorous physical activity in the highest 50% among participants with non-zero vigorous physical activity (roughly 2 h of exercise weekly), normal BMI between 18.5-24.9 kg m, and never-smoker. There was an inverse linear relationship between number of low-risk lifestyle factors and diverticulitis incidence (P for trend<0.001). Compared with men with no low-risk lifestyle factors, the multivariable relative risks of diverticulitis were 0.71 (95% confidence interval (CI): 0.59-0.87) for men with 1 low-risk lifestyle factor; 0.66 (95% CI: 0.55-0.81) for 2 low-risk factors; 0.50 (95% CI: 0.40-0.62) for 3 low-risk factors; 0.47 (95% CI: 0.35-0.62) for 4 low-risk factors, and 0.27 (95% CI: 0.15-0.48) for 5 low-risk factors. Adherence to a low-risk lifestyle could prevent 50% (95% CI: 20-71%) of incident diverticulitis.
Adherence to a low-risk lifestyle is associated with reduced incidence of diverticulitis.
憩室炎是一种临床负担较高的常见疾病。我们评估了多种生活方式因素对憩室炎发病风险的共同影响。我们还估计了通过生活方式改变可预防的憩室炎比例。
我们前瞻性地研究了健康专业人员随访研究参与者的生活方式因素（红肉、膳食纤维摄入量、剧烈体力活动（代谢当量≥6的活动）、体重指数（BMI）和吸烟）与憩室炎风险之间的关联。
在757,791人年期间，我们记录了907例憩室炎发病病例。红肉摄入量高、膳食纤维摄入量低、剧烈体力活动少、BMI高和吸烟均与憩室炎风险增加独立相关（所有P<0.05）。低风险生活方式定义为平均红肉摄入量<51克/天、膳食纤维摄入量在队列前40%（约23克/天）、在有非零剧烈体力活动的参与者中剧烈体力活动处于最高50%（每周约2小时运动）、BMI在18.5 - 24.9千克/米之间且从不吸烟。低风险生活方式因素的数量与憩室炎发病率之间存在负线性关系（趋势P<0.001）。与没有低风险生活方式因素的男性相比，有1个低风险生活方式因素的男性患憩室炎的多变量相对风险为0.71（95%置信区间（CI）：0.59 - 0.87）；有2个低风险因素的为0.66（95%CI：0.55 - 0.81）；有3个低风险因素的为0.50（95%CI：0.40 - 0.62）；有4个低风险因素的为0.47（95%CI：0.35 - 0.62）；有5个低风险因素的为0.27（95%CI：0.15 - 0.48）。坚持低风险生活方式可预防50%（95%CI：20 - 71%）的憩室炎发病。
坚持低风险生活方式与憩室炎发病率降低相关。
