García-Mateo Sandra, Martínez-Domínguez Samuel Jesús, Gargallo-Puyuelo Carla Jerusalén, Gallego Beatriz, Alfambra Erika, Escuin María, García-Mateo Sergio, López Julia, Gomollón Fernando
Department of Gastroenterology, Lozano Blesa University Clinical Hospital, 50009 Zaragoza, Spain.
Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain.
Inflamm Bowel Dis. 2025 Jan 6;31(1):95-104. doi: 10.1093/ibd/izae062.
A healthy lifestyle, including good adherence to a Mediterranean diet (MD) and regular physical exercise, may be an important factor during the course of inflammatory bowel disease (IBD). Our aim is to determine whether adherence to MD, physical activity, and the combination of both can impact on IBD course.
This prospective cohort study includes 693 IBD outpatients who were in remission with a median follow-up time of 27 months (interquartile range 22-29 months). Each patient completed a survey to assess their adherence to the MD and physical activity. Healthy lifestyle was considered to be a proper adherence to both MD and an active lifestyle. Relapse during follow-up, severity of relapses, need for systemic steroids, and therapy changes were recorded.
During the follow-up period, 188 patients (27.1%) experienced relapse, of which 56.1% were moderate or severe. Among patients with relapse, 85 (45%) required treatment with corticosteroids, and 15 (7.9%) were hospitalized. Patients with ulcerative colitis (CU) were more adherent to healthy lifestyle than patients with Crohn's disease (P = .011). Healthy lifestyle was associated with lower risk of moderate and severe relapses (adjusted Hazard ratio [aHR], 0.250; 95% confidence interval [CI], 0.093-0.670) and steroids use (aHR 0.292; 95% CI, 0.103-0.828) in IBD patients and with lower risk of moderate and severe relapses (aHR 0.270; 95% CI, 0.093-0.789) in UC patients.
Healthy lifestyle has a favorable influence on promoting a milder disease course, and thus should be a crucial part of clinical management of patients with IBD.
健康的生活方式，包括良好地坚持地中海饮食（MD）和定期体育锻炼，可能是炎症性肠病（IBD）病程中的一个重要因素。我们的目的是确定坚持MD、体育活动以及两者的结合是否会对IBD病程产生影响。
这项前瞻性队列研究纳入了693例处于缓解期的IBD门诊患者，中位随访时间为27个月（四分位间距22 - 29个月）。每位患者完成一项调查以评估他们对MD和体育活动的坚持情况。健康的生活方式被认为是同时适当地坚持MD和积极的生活方式。记录随访期间的复发情况、复发的严重程度、全身用类固醇的需求以及治疗的变化。
在随访期间，188例患者（27.1%）经历了复发，其中56.1%为中度或重度复发。在复发的患者中，85例（45%）需要使用皮质类固醇进行治疗，15例（7.9%）住院治疗。溃疡性结肠炎（CU）患者比克罗恩病患者更坚持健康的生活方式（P = 0.011）。健康的生活方式与IBD患者中度和重度复发风险较低（调整后风险比[aHR]，0.250；95%置信区间[CI]，0.093 - 0.670）以及使用类固醇的风险较低（aHR 0.292；95% CI，0.103 - 0.828）相关，并且与UC患者中度和重度复发风险较低（aHR 0.270；95% CI，0.093 - 0.789）相关。
健康的生活方式对促进病情较轻的病程有有利影响，因此应该是IBD患者临床管理的关键部分。
