Strate Lisa L, Liu Yan L, Syngal Sapna, Aldoori Walid H, Giovannucci Edward L
University of Washington School of Medicine, Seattle, USA.
JAMA. 2008 Aug 27;300(8):907-14. doi: 10.1001/jama.300.8.907.
Patients with diverticular disease are frequently advised to avoid eating nuts, corn, popcorn, and seeds to reduce the risk of complications. However, there is little evidence to support this recommendation.
To determine whether nut, corn, or popcorn consumption is associated with diverticulitis and diverticular bleeding.
The Health Professionals Follow-up Study is a cohort of US men followed up prospectively from 1986 to 2004 via self-administered questionnaires about medical (biennial) and dietary (every 4 years) information. Men reporting newly diagnosed diverticulosis or diverticulitis were mailed supplemental questionnaires.
The study included 47,228 men aged 40 to 75 years who at baseline were free of diverticulosis or its complications, cancer, and inflammatory bowel disease and returned a food-frequency questionnaire.
Incident diverticulitis and diverticular bleeding.
During 18 years of follow-up, there were 801 incident cases of diverticulitis and 383 incident cases of diverticular bleeding. We found inverse associations between nut and popcorn consumption and the risk of diverticulitis. The multivariate hazard ratios for men with the highest intake of each food (at least twice per week) compared with men with the lowest intake (less than once per month) were 0.80 (95% confidence interval, 0.63-1.01; P for trend = .04) for nuts and 0.72 (95% confidence interval, 0.56-0.92; P for trend = .007) for popcorn. No associations were seen between corn consumption and diverticulitis or between nut, corn, or popcorn consumption and diverticular bleeding or uncomplicated diverticulosis.
In this large, prospective study of men without known diverticular disease, nut, corn, and popcorn consumption did not increase the risk of diverticulosis or diverticular complications. The recommendation to avoid these foods to prevent diverticular complications should be reconsidered.
憩室病患者常被建议避免食用坚果、玉米、爆米花和种子，以降低并发症风险。然而，几乎没有证据支持这一建议。
确定食用坚果、玉米或爆米花是否与憩室炎和憩室出血有关。
健康专业人员随访研究是一项对美国男性的队列研究，从1986年至2004年通过自我填写的问卷对医疗（每两年一次）和饮食（每四年一次）信息进行前瞻性随访。报告新诊断出憩室病或憩室炎的男性会收到补充问卷。
该研究纳入了47228名年龄在40至75岁之间的男性，他们在基线时没有憩室病或其并发症、癌症和炎症性肠病，并返回了食物频率问卷。
新发憩室炎和憩室出血。
在18年的随访期间，有801例新发憩室炎病例和383例新发憩室出血病例。我们发现食用坚果和爆米花与憩室炎风险之间存在负相关。与摄入量最低（每月少于一次）的男性相比，每种食物摄入量最高（每周至少两次）的男性的多变量风险比，坚果为0.80（95%置信区间，0.63 - 1.01；趋势P值 = 0.04），爆米花为0.72（95%置信区间，0.56 - 0.92；趋势P值 = 0.007）。未发现食用玉米与憩室炎之间、食用坚果、玉米或爆米花与憩室出血或无并发症的憩室病之间存在关联。
在这项对无已知憩室病男性的大型前瞻性研究中，食用坚果、玉米和爆米花不会增加憩室病或憩室并发症的风险。应重新考虑为预防憩室并发症而避免食用这些食物的建议。
