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Vigorous physical activity may reduce risk of diverticulitis and diverticular bleeding among men

Research Activities, December 2009, No. 352

It has been known for some time that physical activity may reduce the risk of colon cancer and a number of other gastrointestinal disorders by decreasing colon transit time, inflammation, and pressure. Now a new study shows that vigorous physical activity can reduce the risk of diverticular bleeding and diverticulitis by more than a third.

Diverticulosis is the condition of having small pouches (diverticula) in the lining of the large intestine that bulge outward through weak spots, which can cause cramps or discomfort in the lower abdomen, bloating, and constipation. Diverticulitis refers to inflammation of the diverticula, which can cause symptoms ranging from cramping, nausea, and vomiting to fever, diarrhea, or constipation.

A team led by Lisa L. Strate, M.D., M.P.H., of the University of Washington, examined the physical activity of 48,000 men over an 18-year period. Those engaging in vigorous physical activity had a 34 percent reduction in the risk of diverticulitis and a 39 percent reduction in the risk of diverticular bleeding when compared with men who did not exercise vigorously. This reduction in risk occurred in a group who engaged in at least 28 MET-h/week of vigorous physical activity (equivalent to 3 hours of running). One MET is defined as the energy expended by a 70 kg adult while at rest. Activities assigned a MET score of 6 or greater were classified as vigorous. The MET score was multiplied by the duration of activity in hours and expressed in MET-h/week. Running was the only specific activity associated with a significantly decreased risk of diverticulitis. This finding contrasts to many other medical disorders, for which walking and other moderate activities help reduce risks.

Study patients were participants in the Health Professionals Follow up Study, who were free of diverticulosis or its complications at baseline (1986). In the period 1986-2004, the researchers identified 800 incident cases of diverticulitis and 383 cases of diverticular bleeding. The patients' physical activity levels were assessed on a biennial basis. Average weekly time spent in various recreational activities was measured according to 13 different categories. The activities included walking, jogging, running, bicycling, lap swimming, tennis, squash or racquet ball, calisthenics, rowing, and using a stair climber or ski machine. Each activity was assigned a MET score based on energy expenditure. Other risk factors such as sedentary behavior, diet, medication use, and body mass index were also measured.

The study was supported by the Agency for Healthcare Research and Quality (HS14062). See "Physical activity decreases diverticular complications," by Dr. Strate, Yan L. Liu, M.S., Walid H. Aldoori, M.D., and Edward L. Giovannucci, M.D., Sc.D. in the American Journal of Gastroenterology 104, pp. 1221-1230, 2009.

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Page last reviewed December 2009
Internet Citation: Vigorous physical activity may reduce risk of diverticulitis and diverticular bleeding among men: Research Activities, December 2009, No. 352. December 2009. Agency for Healthcare Research and Quality, Rockville, MD.