Bone Loss in Crohnʼs Disease: Exercise As a Potential Countermeasure

Lee, Naomi; Radford‐Smith, Graham; Taaffe, Dennis R.

doi:10.1097/01.mib.0000192325.28168.08

Cited by 38 publications

(25 citation statements)

References 95 publications

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“…Exercise may improve skeletal health and has been shown to improve bone mineral density in patients with IBD. 12 Many patients with CD have some degree of bone loss 44 and are at increased risk to develop fracture. 45 Physical activity has been shown to decrease the risk of colon cancer 13 and this association might have implications in the IBD population already at increased risk for colon cancer.…”

Section: Discussionmentioning

confidence: 99%

Exercise Decreases Risk of Future Active Disease in Patients with Inflammatory Bowel Disease in Remission

Jones

Kappelman

Martin

et al. 2015

Inflammatory Bowel Diseases

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Background Although exercise impacts quality of life in patients with inflammatory bowel disease (IBD), little is known about its role in disease activity. Among IBD patients in remission, we aimed to evaluate the association between exercise and subsequent active disease. Methods We performed a prospective study using the Crohn's and Colitis Foundation of America (CCFA) Partners Internet-based cohort of individuals with self-reported IBD. We identified participants in remission, defined as short Crohn's disease activity index (sCDAI) <150 or simple clinical colitis activity index (SCCAI) ≤2. The primary exposure was exercise status, measured using the validated Godin leisure time activity index. The primary study outcome, assessed after six months, was active disease defined using the above disease activity index thresholds. We used bivariate and multivariate analyses to describe the independent association between exercise and risk of active disease. Results We identified 1308 patients with Crohn's Disease (CD) and 549 with ulcerative or indeterminate colitis (UC/IC) in remission, of whom 227(17.4%) with CD and 135 (24.6%) with UC/IC developed active disease after 6 months. Higher exercise level was associated with decreased risk of active disease for CD (adjusted RR 0.72, 95% CI 0.55-0.94) and UC/IC (adjusted RR 0.78, 95% CI 0.54-1.13). Conclusions In patients with CD in remission, those with higher exercise levels were significantly less likely to develop active disease at six months. In patients with UC/IC in remission, patients with higher exercise levels were less likely to develop active disease at six months, however this was not statistically significant.

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Section: Discussionmentioning

confidence: 99%

Exercise Decreases Risk of Future Active Disease in Patients with Inflammatory Bowel Disease in Remission

Jones

Kappelman

Martin

et al. 2015

Inflammatory Bowel Diseases

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“…Ankylosing spondylitis has been specifically associated with IBD, but the exercise therapy improved the flexibility strength and reduced pain of the joints [120]. IBD is associated with decreased bone mineral density and increased risk of osteoporosis [121] and preventive role of exercise has been proposed [122–124]. It was demonstrated that physical exercise can increase bone mineral density (BMD) in CD and may reduce the risk of osteoporotic fracture [122].…”

Section: Discussionmentioning

confidence: 99%

The Role of Physical Exercise in Inflammatory Bowel Disease

Bilski

Brzozowski

Mazur-Biały

et al. 2014

BioMed Research International

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We reviewed and analyzed the relationship between physical exercise and inflammatory bowel disease (IBD) which covers a group of chronic, relapsing, and remitting intestinal disorders including Crohn's disease (CD) and ulcerative colitis. The etiology of IBD likely involves a combination of genetic predisposition and environmental risk factors. Physical training has been suggested to be protective against the onset of IBD, but there are inconsistencies in the findings of the published literature. Hypertrophy of the mesenteric white adipose tissue (mWAT) is recognized as a characteristic feature of CD, but its importance for the perpetuation of onset of this intestinal disease is unknown. Adipocytes synthesize proinflammatory and anti-inflammatory cytokines. Hypertrophy of mWAT could play a role as a barrier to the inflammatory process, but recent data suggest that deregulation of adipokine secretion is involved in the pathogenesis of CD. Adipocytokines and macrophage mediators perpetuate the intestinal inflammatory process, leading to mucosal ulcerations along the mesenteric border, a typical feature of CD. Contracting skeletal muscles release biologically active myokines, known to exert the direct anti-inflammatory effects, and inhibit the release of proinflammatory mediators from visceral fat. Further research is required to confirm these observations and establish exercise regimes for IBD patients.

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“…This could be explained by the anti-inflammatory effect both APN [30] and moderate intensity exercise by reducing the oxidative tissue damage [27] and increasing the activity of free radical scavengers [31]. However, few contradictory conclusions had been drawn regarding the effects of exercise on ulcerative colitis [32] and hence the effects of exercise remain unclear [33]. The clinical and the histological observations were further supported by the secreted cytokine studies.…”

Section: Discussionmentioning

confidence: 99%

Effect of exercise on chemically-induced colitis in adiponectin deficient mice

et al. 2012

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BackgroundInflammatory bowel diseases are associated with increased adiponectin (APN) levels, which may exert pro-inflammatory effects in these individuals. Since habitual exercise may increase APN, the aim of this study was to determine how exercise training affects mice with acute colitis.MethodsMale adiponectin knock out (APNKO) and wild type (WT) mice (C57BL/6) were randomly assigned to 4 different groups: 1) Sedentary (SED); 2) Exercise trained (ET); 3) Sedentary with dextran sodium sulfate (DSS) treatment (SED + DSS); and 4) Exercise trained with DSS (ET + DSS). Exercise-trained mice ran at 18 m/min for 60 min, 5d/wk for 4 weeks. Subsequently, the ET + DSS and the SED + DSS mice received 2% DSS in their drinking water for 5 days (d), followed by 5d of regular water.ResultsThe clinical symptoms of acute colitis (diarrhea, stool haemoccult, and weight loss) were unaffected by exercise and there was no difference between the APNKO and WT mice (p > 0.05) except on day 39. However, the clinical symptoms of the DSS-treated APNKO mice were worse than WT mice treated with DSS and had increased susceptibility to intestinal inflammation due to increased local STAT3 activation, higher IL-6, TNF-α, IL-1β and IL-10 levels, and as a result had increased intestinal epithelial cell proliferation (p < 0.05). Exercise training significantly decreased pro-inflammatory cytokines including IL-6, TNF-α and IL-1β (p < 0.05) in the DSS + EX APNKO mice but had no effect on epithelial cell proliferation. Exercise was also found to significantly decrease the phosphorylation expression of STAT3 in both WT and APNKO mice in DSS + EX group when compared to DSS + SED.ConclusionsExercise training may contribute in alleviating the symptoms of acute colitis and APN deficiency may exacerbate the intestinal inflammation in DSS-induced colitis.

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Bone Loss in Crohnʼs Disease: Exercise As a Potential Countermeasure

Cited by 38 publications

References 95 publications

Exercise Decreases Risk of Future Active Disease in Patients with Inflammatory Bowel Disease in Remission

Exercise Decreases Risk of Future Active Disease in Patients with Inflammatory Bowel Disease in Remission

The Role of Physical Exercise in Inflammatory Bowel Disease

Effect of exercise on chemically-induced colitis in adiponectin deficient mice

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