FIBRE AND COLORECTAL CARCINOMA
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Colorectal carcinoma (CRC) is the third most common cancer globally. Gianfredi and colleagues published a systematic review and meta-analysis to explore the association between dietary fibre and risk of CRC through a comparison between individuals with the highest and lowest dietary fibre intake. Of 376 papers, 25 datasets were included in the analysis, which revealed a protective role of dietary fibre intake on risk of CRC, with a highly significant effect size of 0.74 (95% CI: 0.67–0.82) and a moderate level of statistical heterogeneity. A further case-control study on the effects of dietary fibre on CRC in a Chinese population of >260 cases and >250 controls was reported by Song and colleagues. In this study, compared with CRC cases, the control group consumed significantly more vegetables, soy food and total fibre. There were significant inverse associations between risk for CRC and total fibre intake and consumption of vegetable fibre, soluble and insoluble fibre. Interestingly, consumption of fruit, meat and sea-food were equivalent between cases and controls. In a further review of the existing literature, with identification of RCTs on the effect of dietary fibre on the recurrence of colorectal adenomatous polyps in those with a history of adenomatous polyps, and incidence of CRC compared with placebo, Yao and colleagues used a fixed-effect model based on >4700 participants from seven studies. The authors showed no evidence to support dietary fibre intake in the prevention of recurrence of adenomatous polyps in those with a history of adenomatous polyps over a 2–8-year duration, although an attrition bias may have affected the data. Based on current evidence, a protective role for dietary fibre on the development of CRC seems likely, although there is a need for more focused and prospectively designed RCTs to provide further evidence to support advocating a high fibre diet for prevention of CRC in the general population, particularly those with existing colonic adenomatous disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7589116/#sec5-nutrients-12-03209title (5.8 COLORECTAL CARCINOMA)