Western Dietary Pattern Increases, and Prudent Dietary Pattern Decreases, Risk of Incident Diverticulitis in a Prospective Cohort Study.
Western Dietary Pattern Increases, and Prudent Dietary Pattern Decreases, Risk of Incident Diverticulitis in a Prospective Cohort Study.
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DOI：
10.1053/j.gastro.2016.12.038
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发表时间：
2017-04
期刊：
影响因子：
29.4
通讯作者：
Chan AT
中科院分区：
文献类型：
--
作者：
Strate LL;Keeley BR;Cao Y;Wu K;Giovannucci EL;Chan AT
膳食纤维被认为是憩室炎的危险因素。对饮食模式的分析可以提供除个别食物或营养素之外的风险信息。我们研究了主要的饮食模式是否与憩室炎发生的风险相关。我们对1986年无憩室炎和已知憩室病（基线）的46,295名男性进行了一项前瞻性队列研究，使用的数据来自卫生专业人员随访研究。每位研究参与者在基线时完成了详细的医疗和饮食调查问卷。我们在两年一次的随访问卷中向报告憩室炎事件的男性发送补充问卷。我们使用有效的食物频率问卷每4年评估一次饮食。使用主成分分析确定了西方（大量食用红肉、精制谷物和高脂肪乳制品）和谨慎（大量食用水果、蔬菜和全谷物）的饮食模式。随访时间从1986年基线问卷返回之日算起，直到诊断为憩室炎、憩室病或憩室出血；死亡;或2012年12月31日。主要终点是偶发性憩室炎。在894,468人年的随访中，我们发现1063例憩室炎事件。在对其他危险因素进行调整后，西方饮食模式评分最高的五分位数男性与最低五分位数男性相比，憩室炎的多因素风险比（HR）为1.55 （95% CI, 1.20-1.99）。谨慎评分高与低与憩室炎风险降低相关（多变量风险比0.74;95% CI, 0.60-0.91）。饮食模式与憩室炎之间的联系主要归因于纤维和红肉的摄入。在一项46,295名男性的前瞻性队列研究中，西方饮食模式与憩室炎风险增加相关，而谨慎饮食模式与风险降低相关。这些数据可以指导预防憩室炎的饮食干预。
Dietary fiber is implicated as a risk factor for diverticulitis. Analyses of dietary patterns may provide information on risk beyond those of individual foods or nutrients. We examined whether major dietary patterns are associated with risk of incident diverticulitis. We performed a prospective cohort study of 46,295 men who were free of diverticulitis and known diverticulosis in 1986 (baseline) using data from the Health Professionals Follow-up Study. Each study participant completed a detailed medical and dietary questionnaire at baseline. We sent supplemental questionnaires to men reporting incident diverticulitis on biennial follow-up questionnaires. We assessed diet every 4 years using a validated food frequency questionnaire. Western (high in red meat, refined grains, and high-fat dairy) and prudent (high in fruits, vegetables, and whole grains) dietary patterns were identified using principal component analysis. Follow-up time accrued from the date of return of the baseline questionnaire in 1986 until a diagnosis of diverticulitis, diverticulosis or diverticular bleeding; death; or December 31, 2012. The primary endpoint was incident diverticulitis. During 894,468 person years of follow-up, we identified 1063 incident cases of diverticulitis. After adjustment for other risk factors, men in the highest quintile of western dietary pattern score had a multivariate hazard ratio (HR) of 1.55 (95% CI, 1.20–1.99) for diverticulitis compared to men in the lowest quintile. High vs low prudent scores were associated with decreased risk of diverticulitis (multivariate HR 0.74; 95% CI, 0.60–0.91). The association between dietary patterns and diverticulitis was predominantly attributable to intake of fiber and red meat. In a prospective cohort study of 46,295 men, a western dietary pattern was associated with increased risk of diverticulitis, whereas a prudent pattern was associated with decreased risk. These data may guide dietary interventions for the prevention of diverticulitis.