Researchers from Massachusetts General Hospital found that both the inflammatory potential of diets and plasma levels of inflammatory markers are linked to risk for diverticulitis, according to a study published in Clinical Gastroenterology and Hepatology.
Andrew T. Chan, MD, MPH, and colleagues wrote that diets with higher inflammatory potential have been implicated in other conditions, like cardiovascular disease and colorectal cancer, and sought to explore the impact on diverticulitis.
“Traditional but largely unproven theories have suggested that diverticulitis results from mechanical trauma and obstruction of a diverticulum with subsequent ischemia, micro-perforation and infection,” they wrote. “However, recent evidence has indicated that chronic inflammation and alterations in the gut microbiome may be key factors predisposing to the development of diverticulitis.”
Researchers followed a cohort of 46,418 men who were initially free of diverticulitis from 1986 to 2014. They determined the inflammatory potential of the individuals’ diets by collecting data on empiric dietary inflammatory pattern scores and used blood samples from 18,225 individuals to evaluate prediagnostic levels of markers of inflammation, including C-reactive protein, interleukin-6 and TNF-receptor superfamily member 1B.
Of 1,110 total cases of diverticulitis, investigators used 310 cases to determine risk factors by matching them with 310 diverticulitis-free control individuals.
Compared with individuals in the lowest quintile of empiric dietary inflammatory pattern scores, men in the highest quintile were more likely to develop diverticulitis (adjusted HR = 1.31; 95% CI, 1.07–1.6). The results did not differ significantly after stratifying by BMI or vigorous activity level.
In their nest case-control study of plasma inflammatory markers, Chan and colleagues found that the highest levels of CRP (adjusted RR = 1.85; 95% CI, 1.04–3.3) and IL6 (aRR = 2.04; 95% CI, 1.09–3.84) were associated with higher risk for diverticulitis compared with the lowest.
Chan and colleagues wrote that their findings show that low-grade, chronic inflammation is an important pathway for diverticulitis.
“Our results suggest that an overall anti-inflammatory dietary pattern, including high intake of green leafy vegetables, dark-yellow vegetables, coffee and tea and low consumption of red meat, processed meat, refined grain and sugary beverages, may be a reasonable recommendation to reduce the risk for developing diverticulitis,” they wrote. – by Alex Young.
Disclosures: Chan reports previously serving as a consultant for Bayer Pharma, Janssen and Pfizer. All other authors report no relevant financial disclosures.