Combined impact of multiple healthy lifestyles on digestive diseases: a large population-based prospective cohort study

Healthy lifestyle modification is widely recommended for preventing digestive system diseases, but the effects of individual and combined behaviours, particularly potential interactions, are not fully understood.
A study published in BMC Medicine investigates the association between six healthy lifestyle behaviours (moderate alcohol consumption, never smoking, adequate sleep, regular physical activity, a healthy diet, and limited sedentary behaviour) and the risk of 20 digestive system diseases, participants were grouped into high, moderate, and low adherence. The associations between these behaviours and disease risk were evaluated.
Among 267,408 participants, 53,690 (20.08%) were classified as high adherence group, 158,023 (59.09%) as moderate adherence group, and 55,695 (20.83%) as low adherence group. Compared with the low adherence group, the high adherence group had a hazard ratio of 0.72 (95% CI: 0.70 to 0.74) and the moderate adherence group 0.82 (95% CI: 0.80 to 0.84). Each behaviour independently reduced risk, indicating there were only additive effects but no synergistic or antagonistic interactions.
Greater adherence to healthy lifestyle behaviours is associated with a reduced risk of digestive system diseases. The absence of interactions among behaviours simplifies implementation, allowing individuals to focus on adopting as many behaviours as possible to maximize benefits.
Source: Yuan L, Lan Z, Zhu J. et al. Combined impact of multiple healthy lifestyles on digestive diseases: a large population-based prospective cohort study. BMC Med 23, 648 (2025).