New Female-centric Research Provides Dietary Guidance for Preventing Diverticulitis

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href="/digestive-health/specialty.aspx?id=1007">Digestive Health</a> </li> <li class="tag__item"> <a class="tag__link" href="/digestive-health/topic.aspx?id=1104">Diverticulitis</a> </li> </ul> </div> <h1 class="content-header__heading" itemprop="name">New Female-centric Research Provides Dietary Guidance for Preventing Diverticulitis</h1> <div class="content-header__metadata"> <p class="content-metadata"> <span class="content-metadata__media -journal">Journal</span> <time class="date" datetime="2019-12-02" itemprop="datePublished">Published on December 2, 2019 </time> </p> <p data-module="share-links"> </p> <p class="citation"> Originally published on <cite itemprop="citation"><a href="https://journals.lww.com/ajg/Fulltext/2019/09000/Intake_of_Dietary_Fiber,_Fruits,_and_Vegetables.22.aspx">The American Journal of Gastroenterology</a></cite> </p> </div> </div> </header> <div class="-padding--vertical -padding--horizontal"> <div class="layout-columns -width--wide -centered"> <div class="layout-columns__main"> <div class="layout-columns__main__content"> <div class="content-summary"> <h3 class="content-summary__heading">Key findings</h3> <ul> <li>In a prospective cohort of U.S. women, followed for 24 years, higher fiber intake was associated with reduced risk of incident diverticulitis</li> <li>The amount of fiber from fruits and cereals, but not vegetables, was inversely associated with the risk of diverticulitis</li> <li>Greater consumption of apples/pears and prunes was associated with a lower risk of diverticulitis</li> </ul> </div> <p></p><div class="article__signup-container"> <div class="email-signup-inline__container -background--white"> <style> #email-signup-inline { /* 540px */ background-image: url(/assets/raw/email-signup/cardiovascular-sub-callout.jpg); } @media only screen and (-webkit-min-device-pixel-ratio: 2), only screen and (min--moz-device-pixel-ratio: 2), only screen and (-moz-min-device-pixel-ratio: 2), only screen and 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value="5" name="tfa_dbVersionId" id="tfa_dbVersionId"> <input type="hidden" value="" name="tfa_switchedoff" id="tfa_switchedoff"> </form> </div> </div> </div> <script id="analytics-collector-script" type="text/javascript" src="https://massgeneral.tfaforms.net/dist/analytics/data-collector.b669b669e4e65b402126.js" data-customer-id="1118" data-endpoint="https://analytics.formassembly.com/v1/traces" ></script> <script src="https://massgeneral.tfaforms.net/api_v2/sst/copy-and-paste"></script> </div> </div> </div> <p>In 2017, researchers at Massachusetts General Hospital reported in <em><a href="https://journals.lww.com/ajg/Abstract/2017/12000/Adherence_to_a_Healthy_Lifestyle_is_Associated.22.aspx" target="_blank" rel="noopener noreferrer">Nature</a></em> that adherence to a healthy lifestyle, including higher fiber intake, is linked to a substantial decrease in the risk of diverticulitis in men. <a href="https://advances.massgeneral.org/contributors/contributor.aspx?id=1318">Andrew T. Chan, MD, MPH</a>, professor of medicine, director for Cancer Epidemiology in the <a href="https://www.massgeneral.org/cancer-center/">Mass General Cancer Center</a>, chief of the <a href="https://www.massgeneral.org/mongan-institute/centers/cteu/">Clinical and Translational Epidemiology Unit</a> (CTEU) in the <a href="https://www.massgeneral.org/medicine/">Department of Medicine</a> and vice chief for clinical research in the <a href="https://www.massgeneral.org/gastroenterology/">Division of Gastroenterology</a>, and colleagues found that the association included both the less severe forms of diverticulitis treated in the outpatient setting and more severe cases that led to hospitalization.</p> <p>Women are more likely than men to develop severe diverticulitis, especially at older ages. Even so, little is known about how fiber intake influences the risk of the disease in women.</p> <p>In <a href="https://journals.lww.com/ajg/Fulltext/2019/09000/Intake_of_Dietary_Fiber,_Fruits,_and_Vegetables.22.aspx" target="_blank" rel="noopener noreferrer"><em>The American Journal of Gastroenterology</em></a>, Dr. Chan, <a href="https://advances.massgeneral.org/contributors/contributor.aspx?id=1319">Wenjie Ma, MBBS, ScD</a>, research fellow at Massachusetts General Hospital, and colleagues now report that higher intake of fiber is associated with a lower incidence of diverticulitis in women, with apparent variations in the effects of fiber from different food sources.</p> <h2>Study Design</h2> <p>The researchers analyzed data from the <a href="https://www.nurseshealthstudy.org/">Nurses' Health Study</a>, a cohort of U.S. female registered nurses who were 30 to 55 years old at enrollment in 1976. Every two years since then, participants have been mailed detailed questionnaires about their health. Every four years, participants are asked to complete 131-item food frequency questionnaires. In 2008, 2012 and 2014 they were asked questions about diverticulitis and diverticulosis.</p> <p>In this analysis, as a baseline, the researchers examined data on 50,019 women who had an average age of 55 starting in 1990. The participants were followed until June 2014.</p> <h2>Quintiles of Fiber Intake</h2> <p>The participants were first categorized into quintiles according to their energy-adjusted fiber intake. Compared with women in the lowest quintile of dietary fiber intake, the risk of diverticulitis was reduced by:</p> <ul> <li>14% for women in the highest quintile of total fiber intake</li> <li>10% for women in the highest quintile of cereal fiber intake</li> <li>17% for women in the highest quintile of fruit fiber intake</li> <li>8% for women in the highest quintile of vegetable fiber intake, which was not a statistically significant reduction</li> </ul> <h2>An Alternative Classification</h2> <p>In a separate analysis the researchers categorized participants into three groups according to daily fiber intake:</p> <ul> <li><18 g (18 g was the average intake at baseline)</li> <li>18 g to 24 g</li> <li>≥25 g (25 g is the recommended total fiber intake for women)</li> </ul> <p>Compared with women who consumed less than 18 g of fiber per day, those consuming ≥25 g had a 13% reduced risk of developing diverticulitis.</p> <h2>Specific Foods</h2> <p>The risk of diverticulitis was reduced by a significant 5% for every serving increase of total fruit intake daily. Increased intake of apples or pears, and increased intake of prunes, were significantly associated with a lower risk of diverticulitis, independent of total fruit intake.</p> <p>Fruit juice and vegetable intake were not significantly associated with the risk of diverticulitis.</p> <h2>Counseling Patients</h2> <p>These findings support the U.S. government's recommendation to maintain sufficient fiber intake from diet, especially cereals and fruit.</p> <p>Overall intake of fruit may be more important than individual fruits in influencing the risk of diverticulitis. Apples and pears did have the strongest associations, but in this study those fruits were by far the most commonly consumed, contributing to 26% of total fruit fiber intake.</p> <figure class="stat" data-plaintext="14% reduction in the risk of diverticulitis for women in the highest quintile of total fiber intake" data-module="stat"><span class="stat__number"><span data-stat-number="">14</span>%</span> <figcaption class="stat__caption">reduction in the risk of diverticulitis for women in the highest quintile of total fiber intake</figcaption> <p data-module="share-links"></p> </figure> <figure class="stat" data-plaintext="17% reduction in the risk of diverticulitis for women in the highest quintile of fruit fiber intake" data-module="stat"><span class="stat__number"><span data-stat-number="">17</span>%</span> <figcaption class="stat__caption">reduction in the risk of diverticulitis for women in the highest quintile of fruit fiber intake</figcaption> <p data-module="share-links"></p> </figure> <figure class="stat" data-plaintext="10% reduction in the risk of diverticulitis for women in the highest quintile of cereal fiber intake" data-module="stat"><span class="stat__number"><span data-stat-number="">10</span>%</span> <figcaption class="stat__caption">reduction in the risk of diverticulitis for women in the highest quintile of cereal fiber intake</figcaption> <p data-module="share-links"></p> </figure> <p></p> <p></p> <p></p> <p></p> <p></p> <p></p><p class="fat-link__wrapper u-text-right"> <a class="fat-link -caret -large" href="https://journals.lww.com/ajg/Fulltext/2019/09000/Intake_of_Dietary_Fiber,_Fruits,_and_Vegetables.22.aspx">view original journal article <em>Subscription may be required</em></a> </p> <div class="article-attribution" itemscope itemtype="http://schema.org/ScholarlyArticle"> <p class="article-attribution__logo" itemscope itemtype="http://schema.org/Periodical"> <a href="https://journals.lww.com/ajg/Fulltext/2019/09000/Intake_of_Dietary_Fiber,_Fruits,_and_Vegetables.22.aspx"> <span class="a11y-sr-only" itemprop="name">The American Journal of Gastroenterology</span> </a> </p> <p class="article-attribution__metadata" itemscope itemtype="http://schema.org/PublicationIssue"> <span> Journal Article Published: <time datetime="2019-08-07" itemprop="datePublished">August 7, 2019</time> </span> <span> Dates of Study: <time datetime="1990-01-01" itemprop="startDate">January 1, 1990</time> - <time datetime="2014-06-30" itemprop="endDate">June 30, 2014</time> </span> </p> </div> <p class="cta">Visit the <a href="https://www.massgeneral.org/medicine/gastroenterology">Division of Gastroenterology</a></p> <p class="cta">Refer a patient to the <a href="https://www.massgeneral.org/medicine/gastroenterology/appointments-and-referrals/referral-request">Division of Gastroenterology</a></p> </div> </div> <aside class="layout-columns__sidebar -article__contributors"> <div class="layout-columns__sidebar__content"> <div class="profile-compact__wrapper"> <p class="u-no-margin"> <strong>Contributors</strong> </p> <div class="profile -compact" itemscope itemtype="http://schema.org/Person"> <div class="profile__content"> <h3 class="profile__name" itemprop="name"> <a href="/contributors/contributor.aspx?id=1318" itemprop="url">Andrew T. Chan, MD, MPH ›</a></h3><p class="profile__title" itemprop="jobTitle">Daniel K. Podolsky Professor of Medicine, Harvard Medical School, Director for Cancer Epidemiology, Mass General Cancer Center, Chief, Clinical and Translational Epidemiology Unit, Department of Medicine</p> </div> <p class="profile__image"> <img alt="Andrew Chan, MD, MPH" itemprop="image" srcset="/assets/images/contributors/david_chan_advances.png, /assets/images/contributors/david_chan_advances_2x.png 2x" src="/assets/images/contributors/david_chan_advances.png"> </p> </div> <div class="profile -compact" itemscope itemtype="http://schema.org/Person"> <div class="profile__content"> <h3 class="profile__name" itemprop="name"> <a href="/contributors/contributor.aspx?id=1319" itemprop="url">Wenjie Ma, MBBS, ScD ›</a></h3><p class="profile__title" itemprop="jobTitle">Instructor and Investigator in the Clinical and Translational Epidemiology Unit, Assistant in Epidemiology in the Division of Gastroenterology, Instructor in Medicine, Harvard Medical School</p> </div> </div> </div> </div> </aside> <section class="topics-layout -article__related"> <div class="topics-layout__inner"> <div class="topics-layout__sidebar"> <h2 class="section-heading">Related topics</h2> </div> <div class="topics-layout__main"> <ul class="topics-list" data-module="topics-list"> <li><a href="/digestive-health/topic.aspx?id=1040">Bowel Disease</a></li> <li><a href="/digestive-health/topic.aspx?id=1104">Diverticulitis</a></li> </ul> </div> </div> </section> <section class="-padding--horizontal -padding--vertical -article__related"> <div class="layout-columns -width--wide -centered"> <div class="layout-columns__pod--half"> <div class="content-tease" itemscope itemtype="http://schema.org/ScholarlyArticle"> <p class="content-tease__topic"> <span class="highlight">Related</span> </p> <h3 class="content-tease__heading" itemprop="name"> <a href="/digestive-health/journal.aspx?id=1237" itemprop="url">BMI Linked to Diverticulitis in Women</a> </h3> <p itemprop="description"> <p>Using data from the Nurses' Health Study, gastroenterologists at Massachusetts General Hospital found an independent association between BMI and risk of diverticulitis in women.</p></p> <p class="content-tease__related"> <a href="/digestive-health/topic.aspx?id=1040" itemprop="relatedLink">Bowel Disease</a>, <a href="/digestive-health/specialty.aspx?id=1007" itemprop="relatedLink">Digestive Health</a>, <a href="/digestive-health/topic.aspx?id=1104" itemprop="relatedLink">Diverticulitis</a> </p> <p class="content-metadata"> <span class="content-metadata__media -journal">Journal</span> <time class="date" datetime="2019-03-20" itemprop="datePublished">March 20, 2019</time> </p> </div> </div> <div class="layout-columns__pod--half"> <div class="content-tease" itemscope itemtype="http://schema.org/ScholarlyArticle"> <p class="content-tease__topic"> <span class="highlight">Related</span> </p> <h3 class="content-tease__heading" itemprop="name"> <a href="/digestive-health/journal.aspx?id=1250" itemprop="url">Antibiotic Use Linked to Colorectal Adenoma in Women</a> </h3> <p itemprop="description"> <p>Researchers at Massachusetts General Hospital have become the first to link the duration of antibiotic use to colorectal adenoma, the primary precursor of colorectal cancer.</p></p> <p class="content-tease__related"> <a href="/digestive-health/topic.aspx?id=1040" itemprop="relatedLink">Bowel Disease</a>, <a href="/oncology/topic.aspx?id=1059" itemprop="relatedLink">Colorectal Cancer</a>, <a href="/digestive-health/specialty.aspx?id=1007" itemprop="relatedLink">Digestive Health</a>, <a href="/oncology/specialty.aspx?id=1008" itemprop="relatedLink">Oncology</a> </p> <p class="content-metadata"> <span class="content-metadata__media -journal">Journal</span> <time class="date" datetime="2019-03-08" itemprop="datePublished">March 8, 2019</time> </p> </div> </div> </div> </section> </div> </div> </article> </div> </main>  <footer class="site-footer"> <div class="-padding--horizontal"> <nav aria-label="Footer links" 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New Female-centric Research Provides Dietary Guidance for Preventing Diverticulitis - Mass General Advances in Motion