A high-fiber diet does not protect against asymptomatic diverticulosis.
A high-fiber diet does not protect against asymptomatic diverticulosis.
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DOI：
10.1053/j.gastro.2011.10.035
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发表时间：
2012-02
期刊：
影响因子：
29.4
通讯作者：
Sandler RS
中科院分区：
文献类型：
--
作者：
Peery AF;Barrett PR;Park D;Rogers AJ;Galanko JA;Martin CF;Sandler RS
憩室病的并发症在美国引起相当大的发病率；据估计，每年用于治疗这种疾病的医疗保健支出为 25 亿美元。许多医生和患者认为，高纤维饮食和频繁排便可以预防憩室病的发生。这些关联的证据很少。我们试图确定低纤维或高脂肪饮食、含有大量红肉的饮食、便秘或缺乏身体活动是否会增加无症状憩室病的风险。我们对 2104 名 30-80 岁的参与者进行了一项横断面研究，他们在 1998 年至 2010 年期间接受了门诊结肠镜检查。使用经过验证的仪器在访谈中评估饮食和身体活动。正如预期的那样，憩室病的患病率随着年龄的增长而增加。高纤维摄入量并没有降低憩室病的患病率。相反，纤维摄入量最高的四分位数比最低的四分位数的憩室病患病率更高（患病率 = 1.30；95% 置信区间，1.13–1.50）。根据总纤维、谷物纤维、可溶性纤维和不溶性纤维的摄入量计算，风险会增加。便秘不是危险因素。与每周排便次数少于 7 次的个体相比，每周排便次数 > 15 次的个体患憩室病的风险要高出 70%（患病率 = 1.70；95% 置信区间，1.24–2.34）。缺乏身体活动以及摄入脂肪或红肉均与憩室病无关。高纤维饮食和排便频率增加与憩室病患病率升高而非降低相关。应重新考虑有关无症状憩室病危险因素的假设。
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. We performed a crosssectional 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. 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 bower 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. 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.
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