IBD negatively associated with cardiorespiratory endurance among children and adolescents

Recent research from Taiwan found that better cardiorespiratory endurance reduces the risk of Inflammatory bowel disease (IBD) in children and adolescents, and it is negatively associated with IBD. The study results were published in the journal JAMA Pediatrics. 

Inflammatory bowel disease (IBD) is a global health problem that is characterized by chronic relapsing intestinal inflammation. It results from an aberrant and continuing immune response to the microbes in the gut and is catalyzed by the genetic susceptibility of the individual. Its incidence is increasing steadily in industrialized nations. Recent research suggests that a lack of research might cause an increased risk of IBD among children and adolescents. Hence Taiwanese researchers conducted a study to understand the association between physical fitness and subsequent IBD risk among children and adolescents. 

A nationwide cohort study was conducted between January 1, 2010, and December 31, 2018. Data were collected from the Taiwan National Health Insurance Research Database, the National Student Fitness Tests Database, and the Air Quality Monitoring System Database. Students who were aged 10 years, completed physical fitness tests between grades 4 and 13, and had at least 1 year of follow-up were included in the study. Physical fitness tests included cardiorespiratory endurance (CE; the number of minutes to complete an 800-m run), musculoskeletal endurance (ME; the number of bent-leg curl-ups in 1 minute), musculoskeletal power (MP; standing broad jump distance), and flexibility fitness (FF; 2-leg sit-and-reach distance). Based on the physical fitness results the subsequent risk of IBD was compared. After adjusting for competing mortality, six-year cumulative incidences and hazard ratios (HRs) were calculated. Performance was reported in quantiles, ranging from 1 (best) to 4 (poorest).

Key findings: 

• 45,52,866 students completed physical fitness tests between grades 4 and 13.
• Among them, 13,93,641 were aged 10 years and included in the analysis.
• Six-year cumulative incidence of IBD risk was lowest among students in the best-performing quantile of CE (quantile 1, 0.74%), ME (0.77%), and MP (0.81%) compared with students in quantiles 2 through 4, respectively. But there was no association observed for quantiles of FF.
• After adjusting for competing HRs for mortality and other confounders, it was found that better CE was inversely associated with IBD risk. 
• No independent association was seen between other measures of physical fitness and associated IBD risk.

Thus, cardiorespiratory endurance was a better predictor for the risk of IBD development. 

Further reading: Physical Fitness and Inflammatory Bowel Disease Risk Among Children and Adolescents in Taiwan. JAMA Pediatr. Published online May 1, 2023. doi:10.1001/jamapediatrics.2023.0929