ArticleGastroenterology2012
A high-fiber diet does not protect against asymptomatic diverticulosis.
Article in Gastroenterology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 133 papers, 9 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
133 citing papers in PubMed, 9 syntheses or guidelines pooled it, 290 citations in OpenAlex.
- Are Nuts Safe in Diverticulosis? A Mixed-Methods Systematic Review of Available Evidence.Nutrients · 2025Pooled it
- Genetic, epigenetic and environmental factors in diverticular disease: systematic review.BJS open · 2024Pooled it
- Surgical resection does not avoid the risk of diverticulitis recurrence-a systematic review of risk factors.International journal of colorectal disease · 2021Pooled it
- Epidemiology and risk factors for diverticular disease.Acta bio-medica : Atenei Parmensis · 2018Pooled it
- Pooled it
- Role of Fiber in Symptomatic Uncomplicated Diverticular Disease: A Systematic Review.Nutrients · 2017Pooled it
- Practice parameters for the treatment of colonic diverticular disease: Italian Society of Colon and Rectal Surgery (SICCR) guidelines.Techniques in coloproctology · 2015Guideline
- Colonic diverticular disease.BMJ clinical evidence · 2011Pooled it
- Smoking and risk of colonic diverticulosis: A meta-analysis.Journal of postgraduate medicinePooled it
- Effects of Burdock tea on recurrence of colonic diverticulitis and diverticular bleeding: An open-labelled randomized clinical trial.Scientific reports · 2019Trial
- Trial
- Colonic diverticular disease: a bibliometric and visual analysis of the top 50 cited publications.Annals of medicine and surgery (2012) · 2026Review
- Comprehensive review on the current management of lower-gut bleed.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Review
- Bowel Transit Time May Be Accelerated in Colonic Diverticulosis Independent of Mucosal Serotonin Signaling.Journal of clinical medicine · 2025Article
- Fibers and Polyphenols in Diverticular Disease: From Pathophysiology to Management.Neurogastroenterology and motility · 2025Review
- Novel polygenic risk score associates with diverticulitis in a multi-institutional, ancestrally diverse cohort.Scientific reports · 2025Article
- Impact of Diet on Gut Microbiota in Diverticular Disease of the Colon: An Exploratory Retrospective Study.Microorganisms · 2025Article
- Dietary Risk Factors: Fiber and Beyond.Clinics in colon and rectal surgery · 2025Review
- The Epidemiology of Diverticulitis.Clinics in colon and rectal surgery · 2025Review
- Risk Prediction in Diverticulitis.Clinics in colon and rectal surgery · 2025Review
73 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsThe complications of diverticulosis cause considerable morbidity in the United States; health care expenditures for this disorder are estimated to be $2.5 billion per year. Many physicians and patients believe that a high-fiber diet and frequent bowel movements prevent the development of diverticulosis. Evidence for these associations is poor. We sought to determine whether low-fiber or high-fat diets, diets that include large quantities of red meat, constipation, or physical inactivity increase risk for asymptomatic diverticulosis.
methodsWe performed a cross-sectional study of 2104 participants, 30-80 years old, who underwent outpatient colonoscopy from 1998 to 2010. Diet and physical activity were assessed in interviews using validated instruments.
resultsThe prevalence of diverticulosis increased with age, as expected. High intake of fiber did not reduce the prevalence of diverticulosis. Instead, the quartile with the highest fiber intake had a greater prevalence of diverticulosis than the lowest (prevalence ratio = 1.30; 95% confidence interval, 1.13-1.50). Risk increased when calculated based on intake of total fiber, fiber from grains, soluble fiber, and insoluble fiber. Constipation was not a risk factor. Compared to individuals with <7 bowel movements per week, individuals with >15 bowel movements per week had a 70% greater risk for diverticulosis (prevalence ratio = 1.70; 95% confidence interval, 1.24-2.34). Neither physical inactivity nor intake of fat or red meat was associated with diverticulosis.
conclusionsA high-fiber diet and increased frequency of bowel movements are associated with greater, rather than lower, prevalence of diverticulosis. Hypotheses regarding risk factors for asymptomatic diverticulosis should be reconsidered.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.