Healthy Habits Slash Diverticulitis Risk in Half: Clinical Insights

A recent 20‑year prospective analysis of over 36,000 health professionals demonstrates that a healthful lifestyle significantly lowers the risk of diverticulitis, even in individuals with high genetic predisposition. The study, published in BMJ, used cohorts including Nurses’ Health Study I & II and Health Professionals Follow‑Up Study.

Can One Prevent Diverticulitis With Lifestyle? (Risk Reduction)

Researchers followed over 36,000 participants from multiple U.S. health professional cohorts and found that five modifiable behaviors, maintaining a healthy BMI, not smoking, regular physical activity, high dietary fiber intake, and limiting red/processed meat, had significant protective effects.

Participants who followed all five healthy lifestyle practices were up to 50% less likely to develop diverticulitis compared to those who followed none. Each additional habit was associated with a 12% risk reduction.

Top Habits That Prevent Diverticulitis

The five lifestyle components correlated with significant risk modulation:

• Smoking: Former and current smokers had 17% and 13% increased risk, respectively, compared to never‑smokers.
• BMI: Overweight (BMI 25–30) increased risk by 32%; obesity (>30) by 44%.
• Exercise: Higher physical activity corresponded to a 16% lower risk.
• Fiber Intake: High fiber intake lowered risk by 14%.
• Red/Processed Meat: Increased meat intake raised risk by 9%

Is Diverticulitis Preventable if It Runs in Families?

Using polygenic risk scores (PRS), the study stratified participants into low, medium, and high genetic risk groups. Surprisingly, even individuals in the highest genetic risk tier experienced substantial benefit from lifestyle modifications.

• High PRS + Healthy Habits: 50% risk reduction
• Medium PRS + Healthy Habits: 48%
• Low PRS + Healthy Habits: 37%

The researchers estimate that 23–42% of diverticulitis cases could be preventable with sustained lifestyle changes.

Implications for Clinical Practice

Those with high genetic risk and poor lifestyle adherence had a 5-fold increased risk compared to low-risk, healthy individuals. These findings underscore the role of behavioral counseling and preventive education in primary care and gastroenterology settings.

Lifestyle intervention remains a powerful tool, regardless of genetic predisposition.

More information: Lifestyle factors, genetic susceptibility and risk of incident diverticulitis: an integrated analysis of four prospective cohort studies and electronic health records-linked biobank, Gut (2025). DOI: 10.1136/gutjnl-2025-335364

Journal information: Gut