Healthy midlife habits tied to big drop in constipation risk, study finds
Large UK Biobank analysis links five lifestyle factors — including seven to nine hours’ sleep and not smoking — to up to a nearly 50% lower risk of functional constipation in people aged 40–70
Researchers have found that adopting several healthy lifestyle habits is associated with substantially lower rates of functional constipation in middle-aged and older adults, with those following multiple recommendations experiencing as much as a near-50 percent reduction in risk.
The study, published in the American Journal of Gastroenterology and led by investigators at The Chinese University of Hong Kong, analysed 107,475 participants from the UK Biobank aged 40 to 70 who had no history of functional constipation at baseline. During a median follow-up of almost 12 years, 3,591 new cases of functional constipation were recorded. Compared with participants who did not follow any of the five healthy behaviours studied, those who adopted at least one reduced their risk by nearly 20 percent, and those practising four of the five behaviours saw their risk fall by almost half.
The five healthy behaviours assessed were never smoking, engaging in regular vigorous physical activity, following a healthy diet, limiting alcohol consumption, and obtaining seven to nine hours of sleep per night. The researchers reported that several behaviours showed significant associations on their own: never smoking was linked with a roughly 17 percent lower risk of developing functional constipation, and getting seven to nine hours of sleep nightly corresponded to more than a 20 percent reduction in risk.
"Adopting a higher number of healthy lifestyle behaviours is significantly associated with a reduced risk of constipation in the middle-aged and elderly population, indicating their potential to be a primary prevention strategy," the authors wrote. They called for a "coordinated multilevel strategy" to promote uptake of the five lifestyle recommendations in the general population.
Functional constipation is generally defined by a notable reduction in bowel movement frequency or increased difficulty passing stool. The U.K. National Health Service considers having fewer than three bowel movements per week a sign of constipation, though normal frequency varies between individuals. Estimates cited by the researchers and media reports suggest chronic constipation affects about 15 percent of people worldwide and roughly one in seven adults in some populations.
Clinicians and public health experts have raised concern because chronic constipation has been linked to an elevated risk of bowel (colorectal) cancer in some studies. Regular bowel movements reduce the time potential irritants and toxins spend in contact with the bowel lining, which may be one pathway by which constipation could contribute to cancer risk. Colorectal surgeon Haney Yousef, speaking to the Daily Mail, said prolonged contact with harmful substances "can damage the delicate lining of our colon and rectum." The study authors and other experts emphasised that persistent or worsening bowel symptoms warrant clinical assessment.
Anyone experiencing new or persistent bloating, unexplained weight loss, blood in the stool, marked fatigue or ongoing abdominal pain should consult a general practitioner, clinicians recommend, because these signs can indicate more serious conditions that require investigation.
The research comes amid reports that bowel cancer is increasingly being diagnosed in younger adults, a trend that has prompted investigation into environmental and lifestyle factors beyond established risks such as obesity. Researchers and commentators have suggested multiple possible contributors, including changes in diet, exposures to modern chemicals, microplastics and pollution, and shifts in sleep and activity patterns, but no single cause has been established.
In the United Kingdom, about 44,000 new cases of bowel cancer are diagnosed each year and roughly 17,000 deaths are recorded annually, according to publicly reported figures cited in related coverage. Cancer Research UK estimates that a substantial proportion of bowel cancer cases — more than half in some estimates — could be prevented through changes in lifestyle and earlier detection. Overall survival has improved: slightly more than half of patients with bowel cancer are expected to be alive 10 years after diagnosis, though outcomes vary by stage at detection and other factors.
The authors of the constipation study stressed that lifestyle modification may serve as a practical primary prevention measure for functional constipation in midlife and older adults, and they urged public health actions to help people adopt and maintain the healthy behaviours examined in the analysis.