Dietary Fiber Intake Reduces Risk for Colorectal Adenoma: a Meta-Analysis
A partir d'une revue de la littérature publiée jusqu'en juillet 2013 (20 études, 10 948 participants), cette méta-analyse met en évidence une association entre la consommation de fibres alimentaires et une diminution du risque d'adénome colorectal
Reports on the association between dietary fiber intake and risk of colorectal adenoma (CRA), the precursor of colorectal cancer, have been inconsistent. We conducted a meta-analysis of case-control and cohort studies to analyze this association. We searched the MEDLINE and EMBASE databases to identify relevant studies published through July 2013. A random effects model was used to estimate summary relative risks (SRRs) and 95% confidence intervals (CIs) for associations between fiber intake and CRA risk. Heterogeneity among studies was assessed using Cochran’s Q and I2 statistics. Our meta-analysis included 20 studies involving 10,948 subjects with CRA. The SRRs of CRA for total dietary fiber were 0.72 (95% CI, 0.63–0.83) in a high vs. low intake analysis and 0.91 (95% CI, 0.87–0.95) per 10-g/day increase in fiber intake in a dose–response model. Subgroup analyses indicated a significant inverse association between total fiber intake and CRA risk in case-control studies (SRR = 0.66; 95% CI, 0.56–0.77), but not in cohort studies (SRR = 0.92; 95% CI, 0.76–1.10). The SRRs of CRA were 0.84 for fruit fiber (95% CI, 0.76–0.94; n = 6 studies), 0.93 for vegetable fiber (95% CI, 0.84–1.04; n = 6studies), and 0.76 for cereal fiber (95% CI, 0.62–0.92; n = 9 studies) in high vs. low intake analyses. Our findings support the hypothesis that high dietary fiber intake is inversely associated with CRA risk. Further studies with prospective designs that use validated questionnaires and control for important confounders are warranted.
http://linkinghub.elsevier.com/retrieve/pii/S0016508513015862?showall=true