{
  "abstract": "Background Both lifestyle factors and genetic predisposition contribute to the development of diverticulitis.Objective To examine whether lifestyle modification can reduce the genetic risk of diverticulitis.Design We derived an overall healthy lifestyle score for diverticulitis based on smoking, body mass index (BMI), physical activity, fibre and red meat among 179 564 participants in three prospective cohorts-the Nurses’ Health Study (NHS), NHSII and the Health Professionals Follow-Up Study. The association between the healthy lifestyle score and incident diverticulitis was confirmed among 30 750 participants in the Southern Community Cohort Study (SCCS). We assessed genetic risk using a polygenic risk score among 36 077 individuals with genotype data available. We further validated our findings in the Mass General Brigham Biobank (MGBB).Results A healthy lifestyle score was associated with a decreased risk of diverticulitis. Compared with a score of 0, the multivariable-adjusted HR for a score of 5 was 0.50 (95% CI, 0.44 to 0.57; p trend<0.0001). This association was consistent across the SCCS in both non-Hispanic black and white populations. Each unit increase in the healthy lifestyle score was associated with a reduced diverticulitis risk similarly across genetic risk categories, with HRs of 0.89 (95% CI, 0.83 to 0.95) for low, 0.86 (0.81 to 0.92) for mid and 0.87 (0.83 to 0.91) for high genetic risk. In the MGBB cohort, a higher BMI was associated with an increased diverticulitis risk across genetic risk categories.Conclusion Maintaining a healthy lifestyle was associated with a reduced risk of developing diverticulitis, regardless of population differences and genetic susceptibilities.",
  "authors": [
    {
      "affiliations": [
        "Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA",
        "Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA",
        "Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Wenjie Ma"
    },
    {
      "affiliations": [
        "Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA",
        "Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA",
        "Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Jane Ha"
    },
    {
      "affiliations": [
        "Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA"
      ],
      "name": "Christopher J Neylan"
    },
    {
      "affiliations": [
        "Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA"
      ],
      "name": "Heather Munro"
    },
    {
      "affiliations": [
        "Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA"
      ],
      "name": "Duncan Skerrett"
    },
    {
      "affiliations": [
        "Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA",
        "Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA",
        "Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Jonathan M Downie"
    },
    {
      "affiliations": [
        "Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA",
        "Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA",
        "Programs in Metabolism and Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA"
      ],
      "name": "Magdalena Sevilla-González"
    },
    {
      "affiliations": [
        "Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA"
      ],
      "name": "Mark Steinwandel"
    },
    {
      "affiliations": [
        "Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA"
      ],
      "name": "Michael Mumma"
    },
    {
      "affiliations": [
        "Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA",
        "Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA"
      ],
      "name": "Wei Zheng"
    },
    {
      "affiliations": [
        "Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA"
      ],
      "name": "Lillias H Maguire"
    },
    {
      "affiliations": [
        "Departments of Nutrition and Epidemiology, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA"
      ],
      "name": "Edward L Giovannucci"
    },
    {
      "affiliations": [
        "Division of Gastroenterology and Hepatology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA"
      ],
      "name": "Lisa L Strate"
    },
    {
      "affiliations": [
        "Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA",
        "Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA",
        "Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA",
        "Department of Immunology and Infectious Diseases, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA",
        "Cancer Center, Massachusetts General Hospital, Boston, MA, USA"
      ],
      "name": "Andrew T Chan"
    }
  ],
  "title": "Lifestyle factors, genetic susceptibility and risk of incident diverticulitis: an integrated analysis of four prospective cohort studies and electronic health records-linked biobank",
  "uid": "6d9d027f-2e3f-51be-a532-0c4b5e431d65"
}