July 18, 2011 -- A high-fiber, vegetarian-style diet may reduce the risk of developing diverticular disease, a new study suggests.
Diverticular disease is an umbrella term for diverticulosis, which is small pouches in the colon, and diverticulitis, which occurs when these pouches become inflamed or infected. Symptoms of diverticulitis include painful abdominal cramps, bloating, constipation, and diarrhea, and can last anywhere from a few hours to a week or more.
In the study, vegetarians were more than 30% less likely to develop diverticular disease when compared to their counterparts who ate meat.
The study appears in an online edition of BMJ.
Researchers from the Cancer Epidemiology Unit at the University of Oxford in the U.K. compared the risk of developing diverticular disease among 47,033 adults, including 15,459 who were vegetarians.
After 11.6 years, 812 people developed diverticular disease, resulting in 806 hospital admissions and six deaths. Vegetarians were less likely than meat eaters to develop diverticular disease, the study showed. What’s more, people who had a diet rich in fiber (about 25 grams a day) had a lower risk of being admitted to the hospital and/or dying from diverticular disease, compared with people who ate less than 14 grams of fiber a day.
These findings lend support to public health recommendations that encourage the consumption of foods high in fiber, such as whole wheat breads, whole-grain cereals, fruits, and vegetables, conclude study authors led by Francesca Crowe, a nutritional epidemiologist at the University of Oxford.
In an accompanying editorial, David J. Humes and Joe West of Nottingham University Hospitals NHS Trust in Nottingham, U.K., write that about 71 meat eaters would have to become vegetarians to prevent one diagnosis of diverticular disease.
“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,” they write. Still, “far more evidence is needed before dietary recommendations can be made to the general public.”
Fiber Is the Broom That Sweeps the Colon Clean
Fiber is the key to preventing diverticular disease, says Richard Desi, MD, a gastroenterologist at the Melissa L. Posner Institute for Digestive Health and Liver Disease at Mercy Medical Center in Baltimore.
“You tend to get more fiber with a vegetarian diet, so we think that this may decrease risk,” he says. “Fiber increases movement through the colon and decreases risk of developing diverticulosis.”
Rates of this digestive disorder are much higher in the U.K. and U.S., which is why it is often called “a disease of Western civilization,” he says. “Diverticular disease is part of our Western diet.”
Robynne Chutkan, MD, a gastroenterologist at Georgetown University in Washington, D.C., agrees.
“Diverticular disease is related to the Western diet and the fact that we don’t have enough fiber, and our diets are animal-based,” she says. “This is why Western stools are very small.”
“A high fiber, plant-based diet is like the broom that’s sweeps the colon clean,” she says.
Not all fiber is created equally. “We are not talking about muffins and breads and granola,” she says. “Plant-based fibers such as kale and nectarine and cabbage and broccoli are really good.”
A high-fiber diet can also help prevent a recurrence of diverticulitis if you already have a history, she says.
“Fiber keeps the stool moving so they don’t fester in pockets and set up an inflammatory reaction,” she says.
Anthony Starpoli, MD, a gastroenterologist at Lenox Hill Hospital in New York City, often pushes fiber supplementation to his patients who have a history of diverticular disease.
“If they have evidence of diverticulosis, I recommend supplementing fiber to prevent flares,” he says.