- This study analyzed food frequency data reported by 549 patients, of whom 245 later developed diverticulosis
- Compared with people who ate less than five servings of vegetables per week, those who ate five to seven servings of vegetables per week had 16% less risk of diverticulosis, and those who ate more than one serving per day had 38% less risk
- Compared with people who ate less than five servings of fruit per week, those who ate five to seven servings of fruit per week had 19% less risk of diverticulosis, and those who ate more than one serving per day had 40% less risk
- No association was detected between prevalent diverticulosis and intake of red/processed meat
Nearly a third of U.S. adults over 50 develop colonic diverticulosis, with the potential for costly complications. The role of diet in this condition remains poorly understood, as previous studies have yielded conflicting results.
MD students Benjamin Maxner and Jessica McGoldrick, and Gastroenterologist Hamed Khalili, MD, MPH, all of the Division of Gastroenterology at Massachusetts General Hospital, analyzed food frequency data gathered before the detection of diverticula. Along with their colleagues, they determined that a greater intake of fruits and vegetables is associated with an increased risk of diverticulosis. Their report appears in BMC Gastroenterology.
Mass General maintains the Gastrointestinal Disease and Endoscopy Registry (GIDER), which stores results of comprehensive dietary, lifestyle and medical history questionnaires that patients complete before screening or surveillance colonoscopy. Patients are excluded if they have a history of gastrointestinal cancer, hereditary non-polyposis colorectal cancer, familial adenomatous polyposis, inflammatory bowel disease, known bleeding disorders or antibiotic use within the prior two months.
Rates of Diverticulosis
Among 549 patients enrolled in GIDER, the researchers confirmed diverticulosis in 245 (45%). The rate varied from 57% among those who consumed fruit and vegetables less than five times per week to 32% among those who consumed more than one serving per day. Fruit and vegetable intake were significantly associated with the prevalence of diverticulosis (Ptrend = .007 and .008, respectively).
The results were adjusted for other dietary patterns, age, sex, BMI, smoking, physical activity, regular use of nonsteroidal anti-inflammatory drugs and bowel movement frequency. Compared with participants who ate less than five servings per week, the prevalence ratio of diverticulosis was:
- 0.84 (95% CI, 0.60–1.17) for those who ate five to seven servings per week
- 0.62 (95% CI, 0.44–0.89) for more than one serving per day
- 0.81 (95% CI, 0.58–1.11) for five to seven servings of per week
- 0.60 (95% CI, 0.41–0.87) for more than one serving per day
For fruit and vegetable intake considered together, the prevalence ratio was 0.58 (95% CI, 0.39–0.87) for more than one serving per day compared with one serving or less.
No association was detected between prevalent diverticulosis and intake of red/processed meat.
As the proportion of older people in the U.S. continues to grow, the prevalence and cost of diverticulosis will probably increase. This eventuality makes reducing modifiable risk factors critical. Clinicians should call patients' attention to the role of fruit and vegetable intake in preventing diverticulosis.
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