Obesity, but Not Physical Activity, Is Associated With Higher Prevalence of Asymptomatic Diverticulosis

Mashayekhi, Rouzbeh; Bellavance, Danielle; Chin, Sang; Maxner, Benjamin; Staller, Kyle; Xavier, Ramnik J.; Chung, Daniel C.; Khalili, Hamed

doi:10.1016/j.cgh.2017.09.005

Cited by 13 publications

(11 citation statements)

References 8 publications

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“…In contrast to our findings, two studies conducted in South Korea and Taiwan found no significant associations between the consumption of fruit and vegetables and risk of diverticulosis [10,11]. However, the prevalence of diverticulosis in East Asian countries varies from 8 to 25%, an estimate that is significantly lower than those reported by us and others in Western populations [8][9][10][11][20][21][22]. In addition, diverticulosis predominately affects the right colon in Asia compared to the left in the West, likely due to distinct risk factors and mechanisms of development [10].…”

Section: Discussioncontrasting

confidence: 99%

Fruit and vegetable consumption is associated with lower prevalence of asymptomatic diverticulosis: a cross-sectional colonoscopy-based study

et al. 2020

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Background: Previous studies of the relationship between dietary factors and risk of diverticulosis have yielded inconsistent results. We therefore sought to investigate the association between consumption of fruit and vegetables and prevalent diverticulosis. Methods: Our study population included participants in the Gastrointestinal Disease and Endoscopy Registry (GIDE R), a colonoscopy-based longitudinal cohort at the Massachusetts General Hospital, who provided comprehensive information on dietary intake and lifestyle factors using validated questionnaires prior to colonoscopy. Information on presence and location of diverticula was obtained from the endoscopist at the end of each procedure. We used Poisson regression modeling to calculate the prevalence ratios (PRs) and 95% confidence intervals (CIs). Results: Among 549 participants with a mean age of 61 years enrolled in GIDER, we confirmed diverticulosis in 245 (44.6%). The prevalence of diverticulosis appeared to decrease with higher consumption of fruit and vegetables (P trend = 0.007 for fruit and 0.008 for vegetables, respectively). Compared to participants with less than five servings of vegetables per week, the multivariable-adjusted PRs of diverticulosis were 0.84 (95% CI, 0.60-1.17) with five to seven servings per week and 0.62 (95% CI, 0.44-0.89) with greater than one serving per day. Similarly, compared to participants with less than five servings per week of fruit, the multivariable-adjusted PR of diverticulosis was 0.60 (95% CI, 0.41-0.87) with greater than one serving per day. These associations were not modified by age, BMI, smoking, or red meat intake (All P interaction > 0.055). Conclusion: In a colonoscopy-based longitudinal cohort study, we show that higher consumption of fruit and vegetables is associated with lower risk of prevalent diverticulosis.

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Section: Discussioncontrasting

confidence: 99%

Fruit and vegetable consumption is associated with lower prevalence of asymptomatic diverticulosis: a cross-sectional colonoscopy-based study

et al. 2020

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“…The aim of our present study was to assess the role of genetic variations consistently identified in the three large recent GWAS 10,12,13 for the specific risks for diverticulosis and diverticulitis, respectively. Our results are in line with previous data concerning the association of diverticulosis with age and BMI as risk factors (diverticulosis) [22][23][24] , as well as alcohol consumption 25,26 and smoking status [27][28][29] as risk factors for diverticulitis.…”

Section: Discussionsupporting

confidence: 92%

Common variation in FAM155A is associated with diverticulitis but not diverticulosis

Reichert

Kupčinskas

Schulz

et al. 2020

Sci Rep

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colonic diverticulosis is a very common condition. Many patients develop diverticulitis or other complications of diverticular disease. Recent genome-wide association studies (GWAS) consistently identified three major genetic susceptibility factors for both conditions, but did not discriminate diverticulititis and diverticulosis in particular due the limitations of registry-based approaches. Here, we aimed to confirm the role of the identified variants for diverticulosis and diverticulitis, respectively, within a well-phenotyped cohort of patients who underwent colonoscopy. Risk variants rs4662344 in Rho GTPase-activating protein 15 (ARHGAP15), rs7609897 in collagen-like tail subunit of asymmetric acetylcholinesterase (COLQ) and rs67153654 in family with sequence similarity 155 A (FAM155A) were genotyped in 1,332 patients. Diverticulosis was assessed by colonoscopy, and diverticulitis by imaging, clinical symptoms and inflammatory markers. Risk of diverticulosis and diverticulitis was analyzed in regression models adjusted for cofactors. Overall, the variant in FAM155A was associated with diverticulitis, but not diverticulosis, when controlling for age, BMI, alcohol consumption, and smoking status (oR adjusted 0.49 [95% CI 0.27-0.89], p = 0.002). Our results contribute to the assessment specific genetic variants identified in GWAS in the predisposition to the development of diverticulitis in patients with diverticulosis. Colonic diverticulosis is a widespread gastrointestinal condition described as formation of diverticula, which are sac-like protrusions of mucosa and submucosa through muscularis externa 1,2. Although diverticulosis is predominantly asymptomatic, many patients develop symptoms 3,4. These manifestations are classified as uncomplicated and complicated diverticular disease (DD), an inflammation of the tissue (diverticulitis) or diverticular bleeding. The prevalence of the disease and its complications is constantly increasing due to the aging populations 5,6. Therefore, the identification of underlying pathobiological mechanisms of the disease is relevant for improving everyday clinical practice. It is hypothesized that environmental factors together with structural alteration of the colonic wall and remodeling of the enteric nervous system are all predisposing components in the development of colonic diverticula 5. In recent years, epidemiological twin data have suggested that genetic factors are another major cofactor in the pathogenesis of DD 7,8. Up to date, there has been relatively little research effort to determine these genes and their sequence variants that are associated with the development of DD 9. Recently an Icelandic study group published a genome-wide association study (GWAS) searching for sequence variants that affect the

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“…In contrast to our ndings, two studies conducted in South Korea and Taiwan found no signi cant associations between the consumption of fruit and vegetables and risk of diverticulosis 10,11 . However, the prevalence of diverticulosis in East Asian countries varies from 8 to 25%, an estimate that is signi cantly lower than those reported by us and others in Western populations [8][9][10][11][20][21][22] . In addition, diverticulosis predominately affects the right colon in Asia compared to the left in the West, likely due to distinct risk factors and mechanisms of development 10 .…”

Section: Discussioncontrasting

confidence: 63%

Fruit and vegetable consumption is associated with lower prevalence of asymptomatic diverticulosis: a cross-sectional colonoscopy-based study

Maxner

McGoldrick

Bellavance

et al. 2020

Preprint

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Background: Previous studies of the relationship between dietary factors and risk of diverticulosis have yielded inconsistent results. We therefore sought to investigate the association between consumption of fruit and vegetables and prevalent diverticulosis. Methods: Our study population included participants in the Gastrointestinal Disease and Endoscopy Registry (GIDER), a colonoscopy-based longitudinal cohort at the Massachusetts General Hospital, who provided comprehensive information on dietary intake and lifestyle factors using validated questionnaires prior to colonoscopy. Information on presence and location of diverticula was obtained from the endoscopist at the end of each procedure. We used Poisson regression modeling to calculate the prevalence ratios (PRs) and 95% confidence intervals (CIs).Results: Among 549 participants with a mean age of 61 years enrolled in GIDER, we confirmed diverticulosis in 245 (44.6%). The prevalence of diverticulosis appeared to decrease with higher consumption of fruit and vegetables (P trend =0.007 for fruit and 0.008 for vegetables, respectively). Compared to participants with less than five servings of vegetables per week, the multivariable-adjusted PRs of diverticulosis were 0.84 (95% CI, 0.60-1.17) with five to seven servings per week and 0.62 (95% CI, 0.44-0.89) with greater than one serving per day. Similarly, compared to participants with less than five servings per week of fruit, the multivariable-adjusted PR of diverticulosis was 0.60 (95% CI, 0.41-0.87) with greater than one serving per day. These associations were not modified by age, BMI, smoking, or red meat intake (All P interaction >0.055). Conclusion: In a colonoscopy-based longitudinal cohort study, we show that higher consumption of fruit and vegetables is associated with lower risk of prevalent diverticulosis. Key Words : Diverticulosis, Diet, Fruit and Vegetables, and Epidemiology

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Obesity, but Not Physical Activity, Is Associated With Higher Prevalence of Asymptomatic Diverticulosis

Cited by 13 publications

References 8 publications

Fruit and vegetable consumption is associated with lower prevalence of asymptomatic diverticulosis: a cross-sectional colonoscopy-based study

Fruit and vegetable consumption is associated with lower prevalence of asymptomatic diverticulosis: a cross-sectional colonoscopy-based study

Common variation in FAM155A is associated with diverticulitis but not diverticulosis

Fruit and vegetable consumption is associated with lower prevalence of asymptomatic diverticulosis: a cross-sectional colonoscopy-based study

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