Vegetarian diet could lower risk of Diverticular Disease

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According to the results of a prospective cohort study that was reported online via the BMJ this week, following a vegetarian diet and having a high intake of dietary fibre are associated with a lower risk for diverticular disease.

“Diverticular disease has been termed a ‘disease of western civilisation’ because of its high prevalence in countries like the United Kingdom and United States compared with certain parts of Africa,” states Francesca L. Crowe, nutritional epidemiologist at the Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford. “We examined the associations of vegetarianism and the intake of dietary fibre (defined as non-starch polysaccharides) with the risk of diverticular disease using information from hospital admission data and death certificates for England and Scotland in men and women taking part in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Oxford cohort.”

The extensive study cohort consisted of 47,033 men and women living in England or Scotland and enrolled in EPIC-Oxford. Of these, 15,459 (33%) reported consuming a vegetarian diet at baseline. A 130-item, validated, food frequency questionnaire was used to estimate dietary fibre intake for each of the participants.

A process of linking hospital records with death certificates was then completed, allowing for the identification of cases of diverticular disease. Multivariate Cox proportional hazards regression models allowed estimation of hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk for diverticular disease by diet group and quintiles of dietary fibre intake.

Of the 812 cases of diverticular disease that were identified during follow-up (mean duration, 11.6 years), 806 were hospital admissions and 6 were deaths. The results demonstrated that when compared with meat eaters, vegetarians had a 31% lower risk for diverticular disease, after adjustment for confounding variables including smoking, alcohol use, and body mass index had been made. Meat eaters between the ages of 50 and 70 years had a 4.4% cumulative probability of hospitalization or death from diverticular disease, where as vegetarians had a cumulative probability of 3.0%.

The risk for diverticular disease was also inversely associated with dietary fibre intake. Compared with participants in the lowest quintile of dietary fibre intake, those in the highest quintile had a 41% lower risk for diverticular disease.

Vegetarian diet and higher fibre intake were thus each significantly associated with a lower risk for diverticular disease, after mutual adjustment.

“Consuming a vegetarian diet and a high intake of dietary fibre were both associated with a lower risk of admission to hospital or death from diverticular disease,” the study authors write.
In an accompanying editorial, David J. Humes and Joe West from Nottingham University Hospital note that the findings must be interpreted in the light of a number of reported study limitations.

“At a population level, if the available absolute risks are converted into a number needed to treat, about 71 meat eaters would have to become vegetarians to prevent one diagnosis of diverticular disease as measured in this study,” Drs. Humes and West write. “…Overall the opportunity for preventing the occurrence of diverticular disease and other conditions, such as colorectal cancer, probably lies in the modification of diet, at either a population or an individual level. However, far more evidence is needed before dietary recommendations can be made to the general public.”

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