Dietary fibre intake and the risk of diverticular disease: a systematic review and meta-analysis of prospective studies

Abstract

Background A high intake of dietary fibre has been associated with a reduced risk of diverticular disease in several studies; however, the dose-response relationship between fibre intake and diverticular disease risk has varied, and the available studies have not been summarised in a meta-analysis. We conducted a systematic review and meta-analysis of prospective cohort studies to clarify the association between dietary fibre intake, fibre subtypes, and the risk of diverticular disease. Methods PubMed and Embase databases were searched up to August 9th 2018. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated using a random-effects model and nonlinear associations were modelled using fractional polynomial models. Results Five prospective cohort studies with 19,282 cases and 865,829 participants were included in the analysis of dietary fibre and diverticular disease risk. The summary RR was 0.74 (95% CI 0.71-0.78, I 2 = 0%) per 10 g/day. There was no evidence of a nonlinear association between dietary fibre intake and diverticular disease risk, p nonlinearity = 0.35, and there was a 23%, 41% and 58% reduction in risk for an intake of 20, 30, and 40 g/day, respectively, compared to 7.5 g/day. There was no evidence of publication bias with Egger's test, p = 0.58 and the association persisted in subgroup and sensitivity analyses. The summary RR per 10 g/day was 0.74 (95% CI 0.67-0.81, I 2 = 60%, n = 4) for cereal fibre, 0.56 (95% CI 0.37-0.84, I 2 = 73%, n = 2) for fruit fibre, and 0.80 (95% CI 0.45-1.44, I 2 = 87%, n = 2) for vegetable fibre. Conclusions These results suggest that a high fibre intake may reduce the risk of diverticular disease and individuals consuming 30 g of fibre per day have a 41% reduction in risk compared to persons with a low fibre intake. Further studies are needed on fibre types and risk of diverticular disease and diverticulitis.

Role of Dietary Habits in the Prevention of Diverticular Disease Complications: A Systematic Review

“…This systematic review focused on dietary habits as potential risk factors for diverticular complications as acute diverticulitis or diverticular bleeding. Differently from previous systematic reviews [ 13 , 14 ], we tried to identify the role of different dietary components (dietary fiber, meat, alcohol, and coffee consumption) or dietetic pattern and the risk of complicated diverticular disease.…”

“…Fiber intake, achieved by consuming fruits, vegetables, and cereal grains, increases fecal mass and regularizes bowel movements, as well as acts as a colonic prebiotic, favoring health-promoting species of the gut microbiota [ 10 ]. Previous systematic review assessed whether a high-fiber diet can improve symptoms in patients with symptomatic uncomplicated diverticular disease [ 11 , 12 ] or might prevent diverticular disease [ 13 , 14 ] however, without a clear distinction between symptomatic uncomplicated diverticular disease and diverticular complications as acute diverticulitis or diverticular bleeding. On the other hand, data regarding alcohol consumption and diverticular disease showed discordant findings, with some studies showing a positive association [ 15 , 16 ] and others not [ 17 ], with uncertain effects regarding coffee consumption.…”

Effect of breakfast cereal type on portion size and nutritional implications

“…Considering fibre as an example, current UK intakes are woefully inadequate with the majority of every age group not meeting the revised target of 30 g/d (9) . Indeed, recent analyses have shown the importance of higher cereal fibre intake on markers of cardiovascular health such as lower waist-hip ratio (48) , in addition to being inversely associated with the prevalence of diverticular disease (49) and inflammation (50) . Thus, there is scope to utilise the overserving effect seen in our study to improve the population's intake of nutrients such as fibre; however, this requires input from manufacturers to reformulate products accordingly, reducing energy density of BC and simultaneously lowering salt and sugar.…”

Expanding the phenotypic spectrum of lipomatosis of the sciatic nerve: Early‐onset colonic diverticular disease

“…This disease becomes more prevalent with age. It has been estimated that around 10% of adults below the age of 40 might have diverticular disease 14 ; however, the prevalence is over 65%‐70% in adults above the age of 80 14-16 . The pathogenesis of diverticular disease remains controversial.…”