Barlowe Trevor, Anderson Chelsea, Nichols Hazel B, Salvador Anna C, Sandler Robert S, Sandler Dale P, Peery Anne F
Center for Gastrointestinal Biology and Disease, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (T.B., C.A., A.C.S., R.S.S., A.F.P.).
Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (H.B.N.).
Ann Intern Med. 2025 Jun;178(6):788-795. doi: 10.7326/ANNALS-24-03353. Epub 2025 May 6.
BACKGROUND: Patients with diverticulitis often attempt to control their diet with a particular focus on avoiding nuts and seeds. However, whether dietary patterns or dietary intake of nuts and seeds are associated with diverticulitis risk is poorly studied, particularly in women. OBJECTIVE: To determine whether select diets affect incident diverticulitis risk in women. DESIGN: Prospective cohort study. SETTING: Cohort study in the United States and Puerto Rico. PARTICIPANTS: Women aged 35 to 74 years at enrollment who responded to food frequency and diverticulitis questionnaires and had no history of inflammatory bowel disease, cancer, or diverticulitis ( = 29 916). INTERVENTION: Food frequency questionnaires were used to calculate dietary index scores and to assess intake of nuts, seeds, and corn. MEASUREMENTS: Cox proportional hazards regression was used to estimate adjusted hazard ratios (aHRs) and 95% CIs for the associations between each dietary component or dietary index and diverticulitis risk. RESULTS: 1531 cases of incident diverticulitis for 415 103 person-years of follow-up were identified. Intake of peanuts, nuts, and seeds (aHR,1.07 [95% CI, 0.91 to 1.25]) and fresh fruits with edible seeds (aHR,1.06 [CI, 0.90 to 1.24]) was not associated with incident diverticulitis. There was a reduced risk for incident diverticulitis in women in the highest quartile of healthy diets compared with the lowest quartile: the Dietary Approaches to Stop Hypertension diet (aHR, 0.77 [CI, 0.65 to 0.90]), the Healthy Eating Index (aHR, 0.78 [CI, 0.66 to 0.91]), the Alternative Healthy Eating Index (aHR, 0.81 [CI, 0.69 to 0.95]), and the Alternative Mediterranean diet (aHR, 0.91 [CI, 0.78 to 1.06]). LIMITATION: Confounding, selection bias, and measurement bias are possible. CONCLUSION: Healthy diets were associated with a reduced risk for incident diverticulitis in women. Consumption of nuts and seeds was not associated with diverticulitis risk. PRIMARY FUNDING SOURCE: National Institutes of Health.
背景:憩室炎患者常试图通过控制饮食来预防,尤其注重避免食用坚果和种子。然而,关于饮食模式或坚果和种子的摄入量与憩室炎风险之间的关联,相关研究较少,特别是在女性群体中。 目的:确定特定饮食是否会影响女性患憩室炎的风险。 设计:前瞻性队列研究。 地点:美国和波多黎各的队列研究。 参与者:入组时年龄在35至74岁之间,对食物频率和憩室炎问卷做出回应,且无炎症性肠病、癌症或憩室炎病史的女性(n = 29916)。 干预措施:使用食物频率问卷计算饮食指数得分,并评估坚果、种子和玉米的摄入量。 测量方法:采用Cox比例风险回归来估计每种饮食成分或饮食指数与憩室炎风险之间关联的调整风险比(aHR)和95%置信区间(CI)。 结果:在415103人年的随访中,共确诊1531例憩室炎新发病例。食用花生、坚果和种子(aHR,1.07 [95% CI,0.91至1.25])以及带可食用种子的新鲜水果(aHR,1.06 [CI,0.90至1.24])与憩室炎新发病例无关。与最低四分位数相比,处于健康饮食最高四分位数的女性患憩室炎的风险降低:终止高血压饮食法(aHR,0.77 [CI,0.65至0.90])、健康饮食指数(aHR,0.78 [CI,0.66至0.91])、替代健康饮食指数(aHR,0.81 [CI,0.69至0.95])和替代地中海饮食(aHR,0.91 [CI,0.78至1.06])。 局限性:可能存在混杂因素、选择偏倚和测量偏倚。 结论:健康饮食与女性患憩室炎的风险降低有关。食用坚果和种子与憩室炎风险无关。 主要资金来源:美国国立卫生研究院。
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