Associations Between Physical Activity and Irritable Bowel Syndrome in the All of Us Research Program

INTRODUCTION: Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction that affects over 6% of Americans. Increased physical activity improves IBS symptoms and may be associated with lower odds of IBS; however, previous studies are small or limited by self-reported measurements. This study aimed to investigate associations between Fitbit-recorded physical activity data and the prevalence of IBS. METHODS: A retrospective, cross-sectional analysis was conducted using the All of Us Research Program . Adults aged older than 18, who shared Fitbit and electronic healthcare record data, were included. Participants were placed into quartiles based on their mean daily activity metrics: steps, active minutes, sedentary minutes, and maximum heart rate. Covariates included demographics, lifestyle factors (alcohol and smoking), body mass index, education, income, and comorbidities. Multivariable logistic regression was used to analyze associations between activity metrics and IBS. RESULTS: Of 43,967 participants, 1,551 (3.5%) had an IBS diagnosis. The IBS group was 83% women, 79% White, with a median age of 53 years. Compared with the lowest quartile, participants in the highest quartile of average daily steps (odds ratio [OR]: 0.82; P = 0.028), very active minutes (OR: 0.72; P < 0.001), and maximum heart rate (OR: 0.73; P < 0.001) had significantly lower odds of IBS. Conversely, those in the highest quartile of sedentary minutes had higher odds of IBS (OR: 1.24; P = 0.007). DISCUSSION: This large, real-world study, using objective physical activity data, demonstrates that higher levels of physical activity is associated with lower odds of IBS. Prospective studies are warranted to determine whether physical activity has a causal protective effect against IBS.