Intake of Dietary Fiber, Fruits, and Vegetables and Risk of Diverticulitis. 2019

Wenjie Ma, and Long H Nguyen, and Mingyang Song, and Manol Jovani, and Po-Hong Liu, and Yin Cao, and Idy Tam, and Kana Wu, and Edward L Giovannucci, and Lisa L Strate, and Andrew T Chan
Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Although low fiber intake has been considered a risk factor for diverticulitis, prospective evidence is limited in women despite having a disproportionate burden of disease, with little known about variation in the protective effects according to food sources. We assessed the associations of intakes of fiber and major food sources of fiber including fruits and vegetables with risk of diverticulitis in a large cohort of women. We followed 50,019 women in the Nurses' Health Study (1990-2014) who were aged 43-70 years and free of diverticulitis, cancer, and inflammatory bowel disease at baseline. Incident diverticulitis was identified through self-report with validity confirmed by review of medical records. We documented 4,343 incident cases of diverticulitis, encompassing 1,106,402 person-years of follow-up. Compared with participants in the lowest quintile, the multivariable hazard ratio of diverticulitis in the highest quintile of total fiber intake was 0.86 (95% confidence interval: 0.78-0.95; P-trend = 0.002). Fiber from fruits and cereals, but not vegetables, was associated with a decreased risk of diverticulitis. Furthermore, intake of total whole fruit intake and specific fruits such as apples/pears and prunes were associated with reduced risk of diverticulitis with a multivariable hazard ratio for diverticulitis of 0.95 (0.92-0.98; P-trend < 0.001) for every serving increase of total whole fruit intake per day. Higher intake of dietary fiber and fiber from different food sources, except for vegetable fiber, are associated with a lower risk of diverticulitis in women. A greater intake of whole fruit is also associated with reduced risk.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D002523 Edible Grain SEEDS used as a major nutritional source, most often the grain from the POACEAE family. Cereals,Cereal Grain,Cereal,Cereal Grains,Edible Grains,Grain, Cereal,Grain, Edible,Grains, Cereal,Grains, Edible
D004032 Diet Regular course of eating and drinking adopted by a person or animal. Diets
D004043 Dietary Fiber The remnants of plant cell walls that are resistant to digestion by the alimentary enzymes of man. It comprises various polysaccharides and lignins. Fiber, Dietary,Roughage,Wheat Bran,Bran, Wheat,Brans, Wheat,Dietary Fibers,Fibers, Dietary,Roughages,Wheat Brans
D004239 Diverticulitis, Colonic Inflammation of the COLONIC DIVERTICULA, generally with abscess formation and subsequent perforation. Colonic Diverticulitis
D005260 Female Females
D005638 Fruit The fleshy or dry ripened ovary of a plant, enclosing the seed or seeds. Berries,Legume Pod,Plant Aril,Plant Capsule,Aril, Plant,Arils, Plant,Berry,Capsule, Plant,Capsules, Plant,Fruits,Legume Pods,Plant Arils,Plant Capsules,Pod, Legume,Pods, Legume
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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