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It is still unclear what leads to the ultimate expression of inflammatory bowel disease (IBD). To determine factors that are associated with development of IBD as well as those that are protective against the disease, European investigators reviewed 53 meta-analyses that examined environmental factors and risks for IBD.
Nine factors were moderately or highly associated with development of IBD, including urban living, antibiotic or oral contraceptive use, vitamin D deficiency, and infection with non–Helicobacter pylori (odds ratios, 1.31–1.64). Seven factors were protective against development of IBD, including breast-feeding and H. pylori infection (ORs, 0.74 and 0.43, respectively). As expected, cigarette smoking was significantly associate…