You may not have heard of diverticulitis – unless you’ve suffered through a bout of it – but by the age of 50, you have a 50/50 chance of your gut being primed for this painful condition to strike. But the good news is you can drastically reduce your odds of this rather nasty but common gastrointestinal trauma – even if it’s genetic – with even just one daily tweak.
In an observational study spanning decades, medical researchers at Massachusetts General Hospital assessed the health records of 179,564 people from the Nurses’ Health Study (NHS), the NHS II and the Health Professionals Follow-Up Study (HPFS), and created a “Healthy Lifestyle Score” (HLS) linked to diverticulitis risk over around 20 years. Then, two validation groups were analyzed, to validate the results across a broader population: The 30,750-strong Southern Community Cohort Study (SCCS), which included around 65% non-Hispanic Black Americans, and the Mass General Brigham Biobank (MGBB), featuring more than 65,000 people and their genomic data.
Participants received one point for each of five different factors: healthy-range BMI, never having smoked, high physical activity, high fiber intake and low red meat intake. Using the massive amount of health data, the team found that every one-point increase in HLS resulted in 12% lower risk of diverticulitis. And those with a full house – a score of five – were 50% less likely to be diagnosed with the condition than those with zero points.
Diverticulitis is a painful condition affecting the colon (large intestine), and it starts with something surprisingly common: little “pouches” in the gut wall called diverticula (diverticulosis). These pouches can then become inflamed or infected (diverticulitis) and cause sharp pain, fever, nausea, constipation or diarrhea; it’s been described as feeling like appendicitis, but on the other side of the abdomen.
And it’s incredibly common with advancing age. Nearly half of Americans aged 50 or over will develop diverticulosis, and this rises to up to 80% for those aged 80 and above. While diverticulosis – those pouches – can remain dormant and pose no issue for life – up to 10% of older people will have bouts of diverticulosis, with prevalence again increasing with age but also certain lifestyle factors.
Diverticulitis is one of the top gastrointestinal reasons for US hospitalizations, with more than 200,000 people a year seeking help nationwide. Severe cases can lead to abscesses, tears in the colon and even emergency surgery.
The reason it disproportionally hits older adults is due to age-related deterioration in the walls of the colon, where tiny bulges can form these pouches, almost like tiny balloons. Diverticulosis is extremely common especially after age 40 and for many, it won’t ever cause an issue – but for some, whose risk significantly increases with factors like obesity and smoking, diverticulitis will develop seemingly without warning.
Flare-ups can be treated with rest, antibiotics and better diet choices (less red meat, more fiber), but it’s thoroughly unpleasant and, as noted, can pose serious health risks.
These findings confirm that a healthy lifestyle in older age – especially regarding diet, exercise and not smoking – can cut your chances of developing diverticulitis in half, even if you’re genetically predisposed to these intestinal wall pouches.
The researchers found that people who were overweight were 32% more likely to develop diverticulitis, compared to participants with a BMI below 25, and smokers were 17% at higher risk of suffering from the condition (13% for former smokers). Meanwhile, a high amount of physical activity cut this risk by 16% when compared to people who did very little exercise.
As for diet, eating plenty of fiber cut the risk by 14%, while high red meat intake increased it by 9%.
Essentially, you don’t have to change all five contributing factors to reduce your risk of diverticulitis, but the benefits compound with each intervention. The researchers found that those with a HLS of between three and five points had, overall, a 31% reduced risk compared to those who scored zero. And for people with a higher genetic predisposition to the condition, the researchers found that scoring four to five points on the HLS cut the risk by 37% compared to people who scored zero.
While this is an observational study, albeit an extensive one with validation cohorts, it doesn’t prove causation – and there were some differences in how participants answered health surveys throughout the 10-20 years they were monitored in their respective studies. But it does shed light on how diet and lifestyle greatly impact the risk factor of developing diverticulitis.
“Our data provide consistent evidence from multiple data sets indicating that adherence to a healthy lifestyle is linked to a reduced risk of developing diverticulitis, irrespective of one’s genetic predisposition,” the researchers said.
The study was published in the journal Gut.
Source: Massachusetts General Hospital via Scimex