Risk of Incident Diverticulitis Increases With Western Dietary Pattern and Decreases With Prudent Dietary Pattern
Gastroenterology
TAKE-HOME MESSAGE
- This prospective cohort study included 46,295 men without diverticulitis in 1986 and assessed diet every 4 years using a validated food frequency questionnaire to evaluate the association of major dietary patterns and risk of incident diverticulitis. The authors identified 1063 incident diverticulitis cases during 894,468 person-years of follow-up. Men in the highest quintile of western dietary pattern score exhibited increased risk for diverticulitis compared with men in the lowest quintile (HR, 1.55). Furthermore, high prudent dietary scores were associated with a decreased diverticulitis risk (HR, 0.74). The association between diverticulitis and dietary patterns was highly attributable to the intake of red meat and fiber.
- Taken together, these findings may inform dietary interventions for preventing diverticulitis.
Abstract
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.
METHODS
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 endpoint was incident diverticulitis.
RESULTS
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 (HR) 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 HR 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.
CONCLUSIONS
In a prospective cohort study of 46,295 men, a western dietary pattern was associated with increased risk of diverticulitis, whereas a prudent pattern was associated with decreased risk. These data may guide dietary interventions for the prevention of diverticulitis.