Avoid Diverticulitis

A painful and threatening intestinal condition

Eat more fiber each day to keep the doctor away

Decades ago, I lived downstairs from an older couple. Both of them suffered from a painful intestinal condition called diverticulitis. In the evening, I often heard my friends moaning from the pain in their bellies. Believe me, you don’t want diverticulitis.

The human intestinal wall sometimes produces out-pouches called diverticula. Diverticulitis refers to inflammation, bleeding, or some other problem arising from diverticula in the large intestine. Acute diverticulitis can be exceedingly painful and dangerous. Plus, no current medical procedures or interventions prevent this disease.

Low dietary fiber intake appears to elevate the risk for diverticulitis. On the other hand, certain lifestyle factors, including red meat consumption, physical inactivity, smoking, low fiber intake, and obesity predict higher risk of diverticulitis in longitudinal studies. Thus, lifestyle modifications might be the most effective way to prevent diverticulitis. Researchers in Boston used data from 45,203 men in the Health Professionals Follow-up Study to see if the above factors predicted risk of developing diverticulitis over 25 years of follow-up. A low-risk lifestyle included: 1) low red meat intake (less than 51 grams per day), 2) lots of vigorous exercise (at least two hours per week), 3) high dietary fiber (at least 23 grams per day), 4) normal body weight (body-mass index between 18.5 and 24.9), and 5) never smoking.

Each of these low-risk factors predicted reduced risk of diverticulitis after controlling for the other low-risk factors. Strenuous exercise provided the greatest reduction in risk. The risk of diverticulitis declined in a step-wise manner as the number of low-risk lifestyle factors increased from zero to five. Compared to participants who had no low-risk lifestyle choices, participants who had all five low-risk factors had a 73 percent lower risk of developing diverticulitis during follow-up. The incidence of diverticulitis in this population could be cut in half if all participants embraced all five low-risk factors.

The study mentioned above showed that low-risk lifestyle factors individually and collectively predicted much lower risk of diverticulitis in men. But what about women? The same Boston-based research group used data from 50,019 female participants with an average age of 55 years at baseline in the Nurses’ Health Study to determine if increased fiber intake predicted reduced risk of diverticulitis.

Over 24 years of follow-up and compared to nurses in the lowest quintile of total fiber intake, nurses in the highest quintile had 14 percent lower risk of diverticulitis. More specifically, participants in the highest quintiles of fiber intake from fruits (especially apples, pears, and prunes) and cereals had 17 and 10 percent lower risks, respectively, of developing diverticulitis during follow-up. These results reflected adjustments for multiple confounding variables. Each one serving daily increase in whole fruits (but not fruit juice) resulted in a 5 percent lower risk of diverticulitis. High intake of vegetable fiber intake did not predict lower risk of diverticulitis. But high consumption of lentils and beans showed a trend in that direction. Overall, this study confirmed earlier findings that higher fiber intake predicts lower risk of diverticulitis. You can probably reduce your risk of diverticulitis by eating more fruits, whole grains, beans and lentils.

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