Lack of Effect of a High-Fiber Cereal Supplement on the Recurrence of Colorectal Adenomas

Alberts, David S.; Martı́nez, Marı́a Elena; Roe, Denise J.; Guillen-Rodriguez, José; Marshall, James R.; Leeuwen, J. Barbara Van; Reid, Mary E.; Ritenbaugh, Cheryl; Vargas, Perla A.; Bhattacharyya, Achyut; Earnest, David L.; Sampliner, Richard E.

doi:10.1056/nejm200004203421602

Cited by 727 publications

(382 citation statements)

References 21 publications

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“…The results of this study and two recently published trials of increased fibre intake in people with colorectal adenomas (Alberts et al, 2000;Bonithon-Kopp et al, 2000), however, suggest that increasing cereal fibre intake does not confer any immediate survival advantage.…”

Section: Discussioncontrasting

confidence: 73%

The long-term effect of dietary advice in men with coronary disease: follow-up of the Diet and Reinfarction trial (DART)

et al. 2002

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Objective: To assess the long-term effect of dietary advice on diet and mortality after a randomised trial of men with a recent history of myocardial infarction. Design: Questionnaire survey and mortality follow-up after a trial of dietary advice. Setting: Twenty-one hospitals in south Wales and south-west England. Subjects: Former participants in the Diet and Reinfarction Trial. Main outcome measures: Current fish intake and cereal fibre intake. All-cause mortality, stroke mortality and coronary mortality. Results: By February 2000, after 21 147 person years of follow-up, 1083 (53%) of the men had died. Completed questionnaires were obtained from 879 (85%) of the 1030 men alive at the beginning of 1999. Relative increases in fish and fibre intake were still present at 10 y but were much smaller. The early reduction in all-cause mortality observed in those given fish advice (unadjusted hazard 0.70 (95% CI 0.54, 0.92)) was followed by an increased risk over the next 3 y (unadjusted hazard 1.31 (95% CI 1.01, 1.70). Fat and fibre advice had no clear effect on coronary or all-cause mortality. The risk of stroke death was increased in the fat advice group -the overall unadjusted hazard was 2.03 (95% CI 1.14, 3.63). Conclusions: In this follow-up of a trial of intensive dietary advice following myocardial infarction we did not observe any substantial long-term survival benefit. Further trials of fish and fibre advice are feasible and necessary to clarify the role of these foods in coronary disease.

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Section: Discussioncontrasting

confidence: 73%

The long-term effect of dietary advice in men with coronary disease: follow-up of the Diet and Reinfarction trial (DART)

et al. 2002

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“…Indeed, we found no evidence that a high intake of fruit or vegetables is associated with a reduced risk of colorectal cancer death. Further, results from randomised controlled trials have not shown that a diet low in fat and high in fibre and fruit and vegetables can reduce the recurrence of colorectal adenomas (Alberts et al, 2000;BonithonKopp et al, 2000;Schatzkin et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

Vegetables and fruit intake and cancer mortality in the Hiroshima/Nagasaki Life Span Study

et al. 2003

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The association between green-yellow vegetables and fruit consumption and risk of cancer death was investigated in a prospective study of 38 540 men and women who were atomic-bomb survivors in Hiroshima and Nagasaki, Japan. Study participants completed a dietary questionnaire in 1980 -1981 and were followed-up for cancer deaths until March 1998, during which time 3136 cancer deaths were identified. Daily or almost daily fruit consumption was associated with a significant 12% reduction in total cancer mortality (RR ¼ 0.88; 95% CI, 0.80 -0.96 for daily intake compared with intake once per week or less). Daily or almost daily greenyellow vegetables consumption was associated with a marginally significant 8% reduction in total cancer mortality (0.92; 0.94 -1.01). Green-yellow vegetables consumption was associated with a significant reduction in liver cancer mortality (0.75; 0.60 -0.95). Fruit consumption was associated with a significantly reduced risk of stomach cancer and lung cancer mortality (0.80; 0.65 -0.98). Greenyellow vegetables and fruit consumption was associated with a reduction in oesophageal cancer, but these associations were not statistically significant. Neither green-yellow vegetables nor fruit consumption was associated with colorectal cancer or breast cancer mortality. These results support the evidence that daily consumption of fruit and vegetables reduces the risk of total cancer, and specifically cancers of the stomach, liver, and lung.

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“…Among patients that have had colorectal adenomas, recognized predictors of subsequent lesions include age, adenoma size, histology and multiplicity of the lesions at detection 1 . Depending on the age of the population, between 20 and 50% of those patients with adenomas will recur within a 3-5 year period, with 10-20% of recurrent lesions possessing clinically advanced features (larger size, villous histology, and/or high-grade dysplasia) [2][3][4][5][6] . The current recommendation for patients presenting with small polyps (less than 1 cm) is to have a followup colonoscopy 5-10 years after the initial procedure 1 .…”

Section: Introductionmentioning

confidence: 99%

Association Between Body Size and Colorectal Adenoma Recurrence

Jacobs

Martı́nez

Alberts

et al. 2007

Clinical Gastroenterology and Hepatology

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Lack of Effect of a High-Fiber Cereal Supplement on the Recurrence of Colorectal Adenomas

Abstract: As used in this study, a dietary supplement of wheat-bran fiber does not protect against recurrent colorectal adenomas.

Cited by 727 publications

References 21 publications

The long-term effect of dietary advice in men with coronary disease: follow-up of the Diet and Reinfarction trial (DART)

The long-term effect of dietary advice in men with coronary disease: follow-up of the Diet and Reinfarction trial (DART)

Vegetables and fruit intake and cancer mortality in the Hiroshima/Nagasaki Life Span Study

Association Between Body Size and Colorectal Adenoma Recurrence

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