Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Am J Gastroenterol. 2019 Sep;114(9):1531-1538. doi: 10.14309/ajg.0000000000000363.
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.
尽管低纤维摄入被认为是憩室炎的一个风险因素，但鉴于女性患该病的负担不成比例，尽管有大量前瞻性证据，但针对女性的证据有限，而且对于根据食物来源憩室炎保护作用的差异知之甚少。我们评估了纤维摄入量以及纤维的主要食物来源（包括水果和蔬菜）与大量女性憩室炎风险之间的关联。
我们对参加护士健康研究（1990-2014 年）的 50019 名年龄在 43-70 岁且基线时无憩室炎、癌症和炎症性肠病的女性进行了随访。通过自我报告记录憩室炎的发病情况，通过审查病历对其进行有效性确认。
我们记录了 4343 例憩室炎新发病例，共随访了 1106402 人年。与最低五分位数组相比，总纤维摄入量最高五分位数组的憩室炎多变量危险比为 0.86（95%置信区间：0.78-0.95；P 趋势=0.002）。水果和谷物纤维，但不是蔬菜纤维，与憩室炎风险降低相关。此外，总全水果摄入量和特定水果（如苹果/梨和李子）的摄入量与憩室炎风险降低相关，全水果摄入量每天每增加一份，憩室炎的多变量危险比为 0.95（0.92-0.98；P 趋势 <0.001）。
膳食纤维和不同食物来源纤维（除蔬菜纤维外）的摄入量较高与女性憩室炎风险降低相关。摄入更多的全水果也与降低风险相关。
