Associations of daily sedentary behavior, physical activity, and sleep with irritable bowel syndrome: A prospective analysis of 362,193 participants

Background: Irritable bowel syndrome (IBS) substantially affects quality of life and requires early prevention. This study aimed to elucidate the relationships between IBS and daily behaviors, including sedentary behavior (SB), physical activity (PA), and sleep. In particular, it seeks to identify healthy behaviors to reduce IBS risk, which previous studies have rarely addressed. Methods: Daily behaviors were retrieved from self-reported data of 362,193 eligible UK Biobank participants. Incident cases were determined by self-report or health care data according to Rome IV criteria. Results: A total of 345,388 participants were IBS-free at baseline, during a median follow-up of 8.45 years, 19,885 incident IBS cases were recorded. When examined individually, SB and shorter (<= 7 h/day) or longer (>7 h/day) sleep duration were each positively associated with increased IBS risk, and PA was associated with lower IBS risk. The isotemporal substitution model suggested that replacing SB with other activities could provide further protective effects against IBS risk. Among people sleeping <= 7 h/day, replacing 1 h of SB with equivalent light PA, vigorous PA, or sleep was associated with 8.1% (95% confidence interval (95%CI): 0.901-0.937), 5.8% (95%CI: 0.896-0.991), and 9.2% (95%CI: 0.885-0.932) reduced IBS risk, respectively. For people sleeping >7 h/day, light and vigorous PA were associated with a 4.8% (95%CI: 0.926-0.978) and a 12.0% (95%CI: 0.815-0.949) lower IBS risk, respectively. These benefits were mostly independent of genetic risk for IBS. Conclusion: SB and unhealthy sleep duration are risk factors for IBS. A promising way to mitigate IBS risk for individuals sleeping <= 7 h/day and for those sleeping >7 h/day appears to be by replacing SB with adequate sleep or vigorous PA, respectively, regardless of the genetic predisposition of IBS.