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Dietary fibre intake and the risk of diverticular disease: a systematic review and meta-analysis of prospective studies.
Eur J Nutr. 2020 Mar; 59(2):421-432.EJ

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, I2 = 0%) per 10 g/day. There was no evidence of a nonlinear association between dietary fibre intake and diverticular disease risk, pnonlinearity = 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, I2 = 60%, n = 4) for cereal fibre, 0.56 (95% CI 0.37-0.84, I2 = 73%, n = 2) for fruit fibre, and 0.80 (95% CI 0.45-1.44, I2 = 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.

Authors+Show Affiliations

Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK. d.aune@imperial.ac.uk. Department of Nutrition, Bjørknes University College, Oslo, Norway. d.aune@imperial.ac.uk. Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway. d.aune@imperial.ac.uk.Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK.Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

31037341

Citation

Aune, Dagfinn, et al. "Dietary Fibre Intake and the Risk of Diverticular Disease: a Systematic Review and Meta-analysis of Prospective Studies." European Journal of Nutrition, vol. 59, no. 2, 2020, pp. 421-432.
Aune D, Sen A, Norat T, et al. Dietary fibre intake and the risk of diverticular disease: a systematic review and meta-analysis of prospective studies. Eur J Nutr. 2020;59(2):421-432.
Aune, D., Sen, A., Norat, T., & Riboli, E. (2020). Dietary fibre intake and the risk of diverticular disease: a systematic review and meta-analysis of prospective studies. European Journal of Nutrition, 59(2), 421-432. https://doi.org/10.1007/s00394-019-01967-w
Aune D, et al. Dietary Fibre Intake and the Risk of Diverticular Disease: a Systematic Review and Meta-analysis of Prospective Studies. Eur J Nutr. 2020;59(2):421-432. PubMed PMID: 31037341.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary fibre intake and the risk of diverticular disease: a systematic review and meta-analysis of prospective studies. AU - Aune,Dagfinn, AU - Sen,Abhijit, AU - Norat,Teresa, AU - Riboli,Elio, Y1 - 2019/04/29/ PY - 2018/09/20/received PY - 2019/04/08/accepted PY - 2019/5/1/pubmed PY - 2021/1/7/medline PY - 2019/5/1/entrez KW - Diverticular disease KW - Fibre KW - Meta-analysis KW - Systematic review SP - 421 EP - 432 JF - European journal of nutrition JO - Eur J Nutr VL - 59 IS - 2 N2 - 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, I2 = 0%) per 10 g/day. There was no evidence of a nonlinear association between dietary fibre intake and diverticular disease risk, pnonlinearity = 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, I2 = 60%, n = 4) for cereal fibre, 0.56 (95% CI 0.37-0.84, I2 = 73%, n = 2) for fruit fibre, and 0.80 (95% CI 0.45-1.44, I2 = 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. SN - 1436-6215 UR - https://www.unboundmedicine.com/medline/citation/31037341/Dietary_fibre_intake_and_the_risk_of_diverticular_disease:_a_systematic_review_and_meta_analysis_of_prospective_studies_ L2 - https://dx.doi.org/10.1007/s00394-019-01967-w DB - PRIME DP - Unbound Medicine ER -