title: Dietary fiber intake reduces risk for Barrett's esophagus and esophageal cancer.
abstract: BACKGROUND
  Observational studies suggest an association between dietary fiber intake and risk of Barrett's esophagus and esophageal cancer. However, the results are inconsistent.
  
  
  OBJECTIVE
  To conduct a meta-analysis of observational studies to assess this association.
  
  
  METHODS
  All eligible studies were identified by electronic searches in PubMed and Embase through February 2015. Dose-response, subgroup, sensitivity, and publication bias analyses were performed.
  
  
  RESULTS
  A total of 15 studies involving 16,885 subjects were included in the meta-analysis. The pooled odds ratio for the highest compared with the lowest dietary fiber intake was 0.52 (95% CI, 0.43-0.64). Stratified analyses for tumor subtype, study design, geographic location, fiber type, publication year, total sample size, and quality score yielded consistent results. Dose-response analysis indicated that a 10-g/d increment in dietary fiber intake was associated with a 31% reduction in Barrett's esophagus and esophageal cancer risk. Sensitivity analysis restricted to studies with control for conventional risk factors produced similar results, and omission of any single study had little effect on the overall risk estimate.
  
  
  CONCLUSIONS
  Our findings indicate that dietary fiber intake is inversely associated with risk of Barrett's esophagus and esophageal cancer. Further large prospective studies are warranted.
authors.affiliation: a Department of Neurology , Jinling Hospital, Medical School of Nanjing University , Nanjing Jiangsu Province , China.
authors.forename: Lingli
authors.initials: L
authors.lastname: Sun
authors.affiliation: a Department of Neurology , Jinling Hospital, Medical School of Nanjing University , Nanjing Jiangsu Province , China.
authors.forename: Zhizhong
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: b Molecular Oncology Research Institute, Tufts Medical Center, Tufts University , Boston , Massachusetts , USA.
authors.forename: Jian
authors.initials: J
authors.lastname: Xu
authors.affiliation: a Department of Neurology , Jinling Hospital, Medical School of Nanjing University , Nanjing Jiangsu Province , China.
authors.forename: Gelin
authors.initials: G
authors.lastname: Xu
authors.affiliation: a Department of Neurology , Jinling Hospital, Medical School of Nanjing University , Nanjing Jiangsu Province , China.
authors.forename: Xinfeng
authors.initials: X
authors.lastname: Liu
mesh_terms: D001471:Barrett Esophagus / Q000453:epidemiology*; D004043:Dietary Fiber / Q000008:administration & dosage* / Q000032:analysis; D004305:Dose-Response Relationship, Drug; D004938:Esophageal Neoplasms / Q000453:epidemiology*; D006801:Humans; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D004043:Dietary Fiber
keywords: Barrett's esophagus; Diet; epidemiology; esophageal cancer