title: Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies.
abstract: OBJECTIVE
  To investigate the association between intake of dietary fibre and whole grains and risk of colorectal cancer.
  
  
  METHODS
  Systematic review and meta-analysis of prospective observational studies.
  
  
  METHODS
  PubMed and several other databases up to December 2010 and the reference lists of studies included in the analysis as well as those listed in published meta-analyses.
  
  
  METHODS
  Prospective cohort and nested case-control studies of dietary fibre or whole grain intake and incidence of colorectal cancer.
  
  
  RESULTS
  25 prospective studies were included in the analysis. The summary relative risk of developing colorectal cancer for 10 g daily of total dietary fibre (16 studies) was 0.90 (95% confidence interval 0.86 to 0.94, I(2) = 0%), for fruit fibre (n = 9) was 0.93 (0.82 to 1.05, I(2) = 23%), for vegetable fibre (n = 9) was 0.98 (0.91 to 1.06, I(2) = 0%), for legume fibre (n = 4) was 0.62 (0.27 to 1.42, I(2) = 58%), and for cereal fibre (n = 8) was 0.90 (0.83 to 0.97, I(2) = 0%). The summary relative risk for an increment of three servings daily of whole grains (n = 6) was 0.83 (0.78 to 0.89, I(2) = 18%).
  
  
  CONCLUSIONS
  A high intake of dietary fibre, in particular cereal fibre and whole grains, was associated with a reduced risk of colorectal cancer. Further studies should report more detailed results, including those for subtypes of fibre and be stratified by other risk factors to rule out residual confounding. Further assessment of the impact of measurement errors on the risk estimates is also warranted.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London W2 1PG, UK. d.aune@imperial.ac.uk
authors.forename: Dagfinn
authors.initials: D
authors.lastname: Aune
authors.forename: Doris S M
authors.initials: DS
authors.lastname: Chan
authors.forename: Rosa
authors.initials: R
authors.lastname: Lau
authors.forename: Rui
authors.initials: R
authors.lastname: Vieira
authors.forename: Darren C
authors.initials: DC
authors.lastname: Greenwood
authors.forename: Ellen
authors.initials: E
authors.lastname: Kampman
authors.forename: Teresa
authors.initials: T
authors.lastname: Norat
mesh_terms: D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000517:prevention & control*; D004043:Dietary Fiber; D002523:Edible Grain; D005247:Feeding Behavior; D006801:Humans; D015994:Incidence; D011446:Prospective Studies; D012307:Risk Factors
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