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From the Journals Clinical Guidelines

Dietary Fiber Linked to Reduced Diverticulitis Risk

High-fiber diets, particularly from fruits, grains, and legumes, reduce diverticulitis risk, per new AGA guidelines.

Conexiant

Recent findings emphasized the critical role of dietary fiber in reducing diverticulitis risk.

Analysis of the Nurses' Health Study, published in a report from U.S. News & World Report, revealed that higher dietary fiber intake correlated with reduced diverticulitis incidence, particularly through whole fruits and cereal fibers. Complementary data from the Health Professionals Follow-Up Study further highlighted that diets rich in fruits, vegetables, whole grains, legumes, poultry, and fish were associated with lower risk compared with standard American dietary patterns.

The American Gastroenterological Association (AGA) updated its dietary recommendations based on this robust evidence, promoting high-quality, fiber-rich diets. This marked a change from previous guidance that restricted foods like nuts, seeds, and popcorn. Newer evidence shows these foods may offer protective benefits.

The AGA’s Clinical Practice Update Expert Review identified several modifiable factors contributing to diverticulitis risk:

  • Smoking
  • Obesity
  • Physical inactivity
  • NSAID use
  • Low dietary quality.

Additionally, genetic factors play a significant role, countering earlier beliefs that attributed the condition solely to constipation.

Key foods associated with reduced diverticulitis risk include:

  • Whole grains: brown rice, quinoa, farro, bulgur, and oats
  • Fruits: apples, pears, and prunes
  • Pulses: beans, lentils, and chickpeas
  • Tree nuts and seeds: almonds, walnuts, sunflower seeds, and flaxseeds
  • Cruciferous vegetables: broccoli and Brussels sprouts.

During flare-ups, patients may benefit from a low-fiber or low-residue diet, transitioning to clear liquids if necessary. Once symptoms resolve, gradual fiber reintroduction can support intestinal health and optimal transit.

Decades-old advice to avoid popcorn, corn, nuts, and seeds has been invalidated. An 18-year longitudinal study found that these high-fiber foods may protect against diverticulitis rather than exacerbate it.

Current recommendations emphasize limiting:

  • Processed and red meats
  • High-fat fried foods
  • Sugary snacks and beverages
  • Refined carbohydrates.

These updates stemmed from large-scale studies, including the Nurses' Health Study and the Health Professionals Follow-Up Study, providing a strong evidence base for clinical practice.

Reference: Helm J. Best Diets for Diverticulitis. US News & World Report.