Environmental and Lifestyle Factors in Inflammatory Bowel Diseases

Inflammatory bowel disease (IBD) is a chronic, multifactorial disease resulting from complex interactions between the immune system, gut microbiota, genetic susceptibility, and environmental factors. Although advances in pharmacologic therapies have improved disease control, increasing evidence indicates that lifestyle and environmental factors influence disease course and patient well-being. In this review, we assess the impact of lifestyle factors (diet, physical activity, sleep, mental health, and smoking) and environmental factors (pesticides, microplastics, and heavy metals) on IBD. Our manuscript highlights the importance of minimizing highly processed foods, such as those in the Western diet, while promoting a whole-food and Mediterranean diets, regular physical activity, and monitoring for micronutrient deficiencies. We also provide information on sleep disturbances, mental health, and disease activity, as well as interventions such as cognitive-behavioral therapy and mindfulness, which may improve the quality of life of these patients. Emerging evidence suggests that environmental pollutants, including microplastics and pesticides, may affect IBD risk and progression, highlighting the need for further research. Integrating structured lifestyle recommendations into clinical care may have a significant role in improving outcomes in patients with IBD.