The Philippine Star

High consumptio­n of red meat increased diverticul­itis risk in men

- CHARLES C. CHANTE, MD

M en who consume higher quantities of red meat are at an increased risk of developing diverticul­itis, especially if they’re eating unprocesse­d red meat, according to a new study published.

“In our prior analysis from a large prospectiv­e cohort study, the Health Profession­als Follow -Up Study found that red meat intake, independen­t of fiber may be associated with a composite outcome of symptomati­c diverticul­ar disease,” wrote the authors of Massachuse­tts General Hospital, Boston. The new analysis “allowed us to prospectiv­ely examine the associatio­n between consumptio­n of meat ... with risk of incident diverticul­itis in 764 cases over 26 years of follow-up.”

They conducted a prospectiv­e cohort study using subjects from the ongoing HPFS. Men who already had a diagnosis of diverticul­itis, associated complicati­ons, inflammato­ry bowel disease, or a GI-related cancer at baseline were excluded from this analysis, leaving 46,461 eligible subjects. Of those, 764 developed diverticul­itis.

Subjects in the HPFS responded to questionna­ires regarding their dietary habits, with questions specifical­ly asking if they consumed red meat and/or unprocesse­d meat and at what frequency. Nine responses to each question were possible, with the lowest being “never or less than once per month” to” six or more times per day.” These questionna­ires were sent out every two years during the follow-up period, with more extensive follow-up – at which investigat­ors would monitor medical history, disease outcomes, and so on – occurring every four years during the follow-up period. Red meat consumptio­n was divided in quintiles of 1.5, with one being the lowest amount and five being the highest.

The entirety of the follow-up period constitute­d 651,970 person-years. Average servings of total red meat per week were 1.2 in quintile 1, compared to 5.3 in quintile 3 and 13.5 in quintile 5. Those in the highest quintile had a multivaria­ble risk ratio of 1.58, indicating a significan­tly higher risk for developing diverticul­itis. In terms of unprocesse­d red meat, the average number of servings per week was 0.8 for the lower quintile, 3.2 for quintile 3, and 8.6 for quintile 5, yielding a risk ratio of 1.51 when comparing the highest and lowest cohorts. The increase in risk, however, leveled off after about six servings of red meat per week, and was found to be nonlinear. Those who ate more servings of poultry or fish did not have a higher risk of diverticul­itis.

It is also observed that unprocesse­d red meat, but not processed red meat, was the primary driver for the associatio­n between total red meat and risk of diverticul­itis. Compared with processed meat, unprocesse­d meat (e.g., steak) is usually consumed in larger portions, which could lead to a larger undigested piece in the large bowel and induce different changes in colonic microbiota [and] higher cooking temperatur­es used in the preparatio­n of unprocesse­d meat may influence bacterial compositio­n or proinflamm­atory mediators in colon.

Although medical informatio­n and self-reports were validated, there are inherent possible limitation­s to self -reported data, such as misremembe­ring the amount of meat consumed or reporting incorrect amounts. Residual confoundin­g may have occurred despite adjustment of the data to account for it.

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