Strate Lisa L, Keeley Brieze R, Cao Yin, Wu Kana, Giovannucci Edward L, Chan Andrew T
Division of Gastroenterology, Harborview Medical Center, University of Washington School of Medicine, Seattle, Washington.
Departent of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Gastroenterology. 2017 Apr;152(5):1023-1030.e2. doi: 10.1053/j.gastro.2016.12.038. Epub 2017 Jan 5.
BACKGROUND & AIMS: 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 end point 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 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 hazard ratio, 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, and a prudent pattern was associated with decreased risk. These data can guide dietary interventions for the prevention of diverticulitis.
膳食纤维被认为是憩室炎的一个风险因素。对饮食模式的分析可能会提供超出单一食物或营养素的风险信息。我们研究了主要饮食模式是否与憩室炎发病风险相关。
我们利用健康专业人员随访研究的数据，对1986年（基线）无憩室炎和已知憩室病的46295名男性进行了一项前瞻性队列研究。每位研究参与者在基线时完成了一份详细的医学和饮食问卷。我们向在每两年一次的随访问卷中报告憩室炎发病的男性发送补充问卷。我们每4年使用一份经过验证的食物频率问卷评估一次饮食。使用主成分分析确定了西方饮食模式（红肉、精制谷物和高脂肪乳制品含量高）和谨慎饮食模式（水果、蔬菜和全谷物含量高）。随访时间从1986年基线问卷返回之日起计算，直至诊断出憩室炎、憩室病或憩室出血；死亡；或2012年12月31日。主要终点是憩室炎发病。
在894468人年的随访期间，我们确定了1063例憩室炎发病病例。在调整其他风险因素后，西方饮食模式得分最高五分位数的男性患憩室炎的多变量风险比为1.55（95%CI，1.20 - 1.99），而得分最低五分位数的男性为参照。谨慎饮食模式得分高与低相比，憩室炎风险降低（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关联主要归因于纤维和红肉的摄入量。
在对46295名男性进行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。这些数据可为预防憩室炎的饮食干预提供指导。
