Accelerometer-measured moderate-to-vigorous physical activity is associated with reduced risk of bowel resection and mortality in inflammatory bowel disease: a prospective cohort study

Background: There is limited consensus on physical activity recommendations for inflammatory bowel disease (IBD) patients due to insufficient high-quality evidence. Methods: We collected data from 1,303 UK Biobank participants with IBD diagnosis and device-measured physical activity. Moderate-to-vigorous physical activity (MVPA) was classified based on data measured by wrist-worn accelerometers over a 7-day period. MVPA patterns were defined as inactive, active weekend warrior, and regularly active. Results: During a median follow-up of 7.8 years, 56 incident bowel resection cases and 86 deaths were documented. Compared to those in the lowest tertile, participants in the highest tertile of MVPA duration had lower risks of bowel resection (HR, 0.44; 95% CI, 0.22-0.86) and mortality (HR, 0.49; 95% CI, 0.27-0.89). MVPA duration showed a linear association with bowel resection, while its dose-response relationship with mortality plateaued at approximately 58 min/day. The active weekend warrior pattern was inversely associated with bowel resection (HR, 0.28; 95% CI, 0.12-0.65), the regularly active pattern was inversely associated with both bowel resection (HR, 0.37; 95% CI, 0.19-0.69) and mortality (HR, 0.53; 95% CI, 0.31-0.91) compared to the inactive group. The findings remained consistent after individually adjusting for C-reactive protein, Charlson Comorbidity Index, disease severity, baseline disease activity status, use of IBD-related medications, and baseline bowel resection history. Conclusion: Longer durations of accelerometer-measured MVPA were associated with reduced bowel resection risk and mortality. For affected individuals, the regularly active pattern may be the optimal choice, although the active weekend warrior pattern still provides health benefits compared to being inactive.