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A high-fiber diet does not protect against asymptomatic diverticulosis.
Gastroenterology 2012; 142(2):266-72.e1G

Abstract

BACKGROUND & AIMS

The complications of diverticulosis cause considerable morbidity in the United States; health care expenditures for this disorder are estimated to be $2.5 billion per year. Many physicians and patients believe that a high-fiber diet and frequent bowel movements prevent the development of diverticulosis. Evidence for these associations is poor. We sought to determine whether low-fiber or high-fat diets, diets that include large quantities of red meat, constipation, or physical inactivity increase risk for asymptomatic diverticulosis.

METHODS

We performed a cross-sectional study of 2104 participants, 30-80 years old, who underwent outpatient colonoscopy from 1998 to 2010. Diet and physical activity were assessed in interviews using validated instruments.

RESULTS

The prevalence of diverticulosis increased with age, as expected. High intake of fiber did not reduce the prevalence of diverticulosis. Instead, the quartile with the highest fiber intake had a greater prevalence of diverticulosis than the lowest (prevalence ratio = 1.30; 95% confidence interval, 1.13-1.50). Risk increased when calculated based on intake of total fiber, fiber from grains, soluble fiber, and insoluble fiber. Constipation was not a risk factor. Compared to individuals with <7 bowel movements per week, individuals with >15 bowel movements per week had a 70% greater risk for diverticulosis (prevalence ratio = 1.70; 95% confidence interval, 1.24-2.34). Neither physical inactivity nor intake of fat or red meat was associated with diverticulosis.

CONCLUSIONS

A high-fiber diet and increased frequency of bowel movements are associated with greater, rather than lower, prevalence of diverticulosis. Hypotheses regarding risk factors for asymptomatic diverticulosis should be reconsidered.

Authors+Show Affiliations

Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina 27599-7555, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

22062360

Citation

Peery, Anne F., et al. "A High-fiber Diet Does Not Protect Against Asymptomatic Diverticulosis." Gastroenterology, vol. 142, no. 2, 2012, pp. 266-72.e1.
Peery AF, Barrett PR, Park D, et al. A high-fiber diet does not protect against asymptomatic diverticulosis. Gastroenterology. 2012;142(2):266-72.e1.
Peery, A. F., Barrett, P. R., Park, D., Rogers, A. J., Galanko, J. A., Martin, C. F., & Sandler, R. S. (2012). A high-fiber diet does not protect against asymptomatic diverticulosis. Gastroenterology, 142(2), pp. 266-72.e1. doi:10.1053/j.gastro.2011.10.035.
Peery AF, et al. A High-fiber Diet Does Not Protect Against Asymptomatic Diverticulosis. Gastroenterology. 2012;142(2):266-72.e1. PubMed PMID: 22062360.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A high-fiber diet does not protect against asymptomatic diverticulosis. AU - Peery,Anne F, AU - Barrett,Patrick R, AU - Park,Doyun, AU - Rogers,Albert J, AU - Galanko,Joseph A, AU - Martin,Christopher F, AU - Sandler,Robert S, Y1 - 2011/11/04/ PY - 2011/06/17/received PY - 2011/10/05/revised PY - 2011/10/24/accepted PY - 2011/11/9/entrez PY - 2011/11/9/pubmed PY - 2012/5/9/medline SP - 266 EP - 72.e1 JF - Gastroenterology JO - Gastroenterology VL - 142 IS - 2 N2 - BACKGROUND & AIMS: The complications of diverticulosis cause considerable morbidity in the United States; health care expenditures for this disorder are estimated to be $2.5 billion per year. Many physicians and patients believe that a high-fiber diet and frequent bowel movements prevent the development of diverticulosis. Evidence for these associations is poor. We sought to determine whether low-fiber or high-fat diets, diets that include large quantities of red meat, constipation, or physical inactivity increase risk for asymptomatic diverticulosis. METHODS: We performed a cross-sectional study of 2104 participants, 30-80 years old, who underwent outpatient colonoscopy from 1998 to 2010. Diet and physical activity were assessed in interviews using validated instruments. RESULTS: The prevalence of diverticulosis increased with age, as expected. High intake of fiber did not reduce the prevalence of diverticulosis. Instead, the quartile with the highest fiber intake had a greater prevalence of diverticulosis than the lowest (prevalence ratio = 1.30; 95% confidence interval, 1.13-1.50). Risk increased when calculated based on intake of total fiber, fiber from grains, soluble fiber, and insoluble fiber. Constipation was not a risk factor. Compared to individuals with <7 bowel movements per week, individuals with >15 bowel movements per week had a 70% greater risk for diverticulosis (prevalence ratio = 1.70; 95% confidence interval, 1.24-2.34). Neither physical inactivity nor intake of fat or red meat was associated with diverticulosis. CONCLUSIONS: A high-fiber diet and increased frequency of bowel movements are associated with greater, rather than lower, prevalence of diverticulosis. Hypotheses regarding risk factors for asymptomatic diverticulosis should be reconsidered. SN - 1528-0012 UR - https://www.unboundmedicine.com/medline/citation/22062360/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(11)01509-5 DB - PRIME DP - Unbound Medicine ER -