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

BACKGROUND: Healthy lifestyle modification is widely recommended for preventing digestive system diseases, but the effects of individual and combined behaviors, particularly potential interactions, are not fully understood. METHODS: This study investigates the association between six healthy lifestyle behaviors (moderate alcohol consumption, never smoking, adequate sleep, regular physical activity, a healthy diet, and limited sedentary behavior) and the risk of 20 digestive system diseases, participants were grouped into high, moderate, and low adherence. Cox proportional hazards models evaluated the associations between these behaviors and disease risk. RESULTS: 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 behavior independently reduced risk, indicating there were only additive effects but no synergistic or antagonistic interactions. CONCLUSIONS: Greater adherence to healthy lifestyle behaviors is associated with a reduced risk of digestive system diseases. The absence of interactions among behaviors simplifies implementation, allowing individuals to focus on adopting as many behaviors as possible to maximize benefits.