Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies

By D. Aune, D. Chan, R. Lau, R. Vieira, D. Greenwood, E. Kampman, T. Norat. British medical journal, 2011

1,100 citations recorded by the source corpus.

Objective To investigate the association between intake of dietary fibre and whole grains and risk of colorectal cancer. Design Systematic review and meta-analysis of prospective observational studies. Data sources PubMed and several other databases up to December 2010 and the reference lists of studies included in the analysis as well as those listed in published meta-analyses. Study selection Prospective cohort and nested case-control studies of dietary fibre or whole grain intake and incidence of colorectal cancer. Results 25 prospective studies were included in the analysis. The summary relative risk of developing colorectal cancer for 10 g daily of total dietary fibre (16 studies) was 0.90 (95% confidence interval 0.86 to 0.94, I2=0%), for fruit fibre (n=9) was 0.93 (0.82 to 1.05, I2=23%), for vegetable fibre (n=9) was 0.98 (0.91 to 1.06, I2=0%), for legume fibre (n=4) was 0.62 (0.27 to 1.42, I2=58%), and for cereal fibre (n=8) was 0.90 (0.83 to 0.97, I2=0%). The summary relative risk for an increment of three servings daily of whole grains (n=6) was 0.83 (0.78 to 0.89, I2=18%). Conclusion A high intake of dietary fibre, in particular cereal fibre and whole grains, was associated with a reduced risk of colorectal cancer. Further studies should report more detailed results, including those for subtypes of fibre and be stratified by other risk factors to rule out residual confounding. Further assessment of the impact of measurement errors on the risk estimates is also warranted.

Subfields: Nutrition and Dietetics, Pathology and Forensic Medicine, Public Health, Environmental and Occupational Health

View Paper: https://www.semanticscholar.org/paper/0fd481ba9cc4805219f6b6d129b0b109aa1eaf99

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In Nutrition and Dietetics

1. A. Jemal
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In Pathology and Forensic Medicine

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2. R. Siegel

In Public Health, Environmental and Occupational Health

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Citations in the corpus

• The Western Diet–Microbiome-Host Interaction and Its Role in Metabolic Disease (2018, neutral): “The microbial angle could also offer a plausible explanation for the conflicting outcomes of human studies of health effects from fibre and whole grains [104,105].”
• Does wheat make us fat and sick (2013, background): “Exclusion of these and other fermentable oligo-, di- and monosaccharides as well as polyols; (also referred to as “FODMAPs”) from the diet has been reported to reduce intestinal distress to similar extents as gluten free diets (Barrett and Gibson, 2012). It is therefore still unclear whether gluten ”
• Dietary fibre in Europe: current state of knowledge on definitions, sources, recommendations, intakes and relationships to health (2017, background): “More recently, and since the publication of the meta-analysis by Aune et al.((71)), the results from EPIC on the relationship between total and fibre sources and risk of colorectal cancer have been published((72)).”
• Shared Risk Factors in Cardiovascular Disease and Cancer (2016, background): “The AICR/WCRF reports a causal reduction in colorectal cancer risk with diets high in fiber.(32) The”
• The Gut Microbiome Modulates Colon Tumorigenesis (2013, positive): “This is supported by extensive epidemiological data that demonstrate a link between diets high in fiber and a decreased CRC risk (33).”
• Colorectal Cancer and Nutrition (2019, background): “A meta-analysis showed that cereal fiber and whole grains had the most benefit against CRC [41].”
• The Impact of Diet and Lifestyle on Gut Microbiota and Human Health (2014, background): “Epidemiological and experimental studies show that DF is both preventative and therapeutic for many large bowel disorders and other conditions or diseases, including cardiovascular diseases, type II diabetes and obesity [67–71].”
• Colorectal Cancer Incidence Patterns in the United States, 1974–2013 (2017, background): “Established lifestyle factors associated with CRC include excess body weight, high consumption of processed meat and alcohol, low levels of physical activity and fiber consumption, and cigarette smoking (23,24).”