A randomized trial of a low fat high fibre diet in the recurrence of colorectal polyps. Toronto Polyp Prevention Group.
After polypectomy for adenomatous colorectal polyps, 201 persons were randomized to receive counselling on a diet low in fat (the lesser of 50 g/day or 20% of energy) and high in fibre (50 g/day) (LFHF), or to follow a normal western diet (ND), high in fat and low in fibre. After 12 months of counselling, fat consumption was about 25% of energy in the LFHF group and 33% in the ND group; fibre consumption was 35 g and 16 g respectively. After an average of two years of follow-up, an intention to treat analysis led to a ratio of cumulative incidence rates of 1.2 (95% CL 0.6-2.2) for recurrence of neoplastic polyps, a finding which suggests no significant difference between dietary groups over the period of observation. An exploratory analysis conducted among 142 persons with substantial diet counselling indicated a reduced risk of neoplastic polyp recurrence in women (RR = 0.5), associated with reduced concentrations of faecal bile acids while on the LFHF diet, but indicated an increased risk of recurrence in men (RR = 2.1), associated with increased faecal bile acids. Although a larger study would be needed to rule out the role of chance, these findings of gender-specific associations between diet counselling and both faecal bile acid concentrations and recurrence of colorectal neoplasia are consistent with recently published evidence of differences between genders.
McKeown-Eyssen
G E
GE
Department of Preventive Medicine and Biostatistics, University of Toronto, Ontario, Canada.
Bright-See
E
E
Bruce
W R
WR
Jazmaji
V
V
Cohen
L B
LB
Pappas
S C
SC
Saibil
F G
FG
D018256:Adenomatous Polyps / Q000209:etiology / Q000517:prevention & control*; D001647:Bile Acids and Salts / Q000032:analysis; D003111:Colonic Polyps / Q000209:etiology / Q000517:prevention & control*; D015179:Colorectal Neoplasms / Q000209:etiology / Q000517:prevention & control*; D018752:Diet, Fat-Restricted; D004043:Dietary Fiber; D005243:Feces / Q000737:chemistry; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012737:Sex Factors
D001647:Bile Acids and Salts; D004043:Dietary Fiber