Diverticulitis may be prevented or treated by diet modifications, reducing foods that increase intestinal inflammation, according to a study published in Clinical Gastroenterology and Hepatology.1

The etiopathogenesis of diverticulitis is not completely understood; however recent evidence has indicated that chronic inflammation and alterations in the gut microbiome may be key factors for the development of diverticulitis.2,3 A growing body of evidence has identified modifiable lifestyle and dietary risk factors for diverticulitis, such as obesity, smoking, physical inactivity, and low fiber intake, which are linked closely to chronic inflammation.1

Researchers performed a prospective study of associations among the inflammatory potential of diets, circulating markers of inflammation, and the incidence of diverticulitis by following 46,418 men, initially free of diverticulitis, from 1986 through 2014 in the Health Professionals Follow-Up Study. The researchers documented 1110 cases of incident diverticulitis over 992,589 person-years of follow-up. Compared with participants in the lowest quintile of empiric dietary inflammatory pattern scores, men in the highest quintile had a multivariable-adjusted hazard ratio for diverticulitis of 1.31 (95% CI, 1.07-1.60; Ptrend =.01). The association did not differ significantly by strata of body mass index or vigorous activity (P for interaction >.05 for each).

In a nested case-control study, investigators evaluated blood samples collected between 1993 and 1995 from 18,225 participants. Within this group, 310 incident cases of diverticulitis were identified during follow-up; researchers randomly selected 1 diverticulitis-free control for each case to evaluate. Plasma levels of C-reactive protein (CRP) and interleukin-6 (IL-6) were associated with risk of diverticulitis. When researchers compared extreme quintiles, the multivariable-adjusted relative risk for diverticulitis was 1.85 for CRP (95% CI, 1.04–3.30) and 2.04 for IL-6 (95% CI, 1.09–3.84).


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Study limitations include the collection of only 1 baseline measure of circulating inflammation markers, as well as a study population comprised almost entirely of men.

“In conclusion, a diet with higher inflammatory potential and higher circulating markers of inflammation [was] associated with an increased risk of diverticulitis, supporting the importance of low-grade chronic inflammation as a mechanistic pathway for the disease,” stated the authors.1

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

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References

1. Ma W, Jovani M, Nguyen LH, et al.  Association between inflammatory diets, circulating markers of inflammation, and risk of diverticulitis. Clin Gastroenterol Hepatol. 2020;18:2279-2286.e3.

2. Strate LL, Morris AM. Epidemiology, pathophysiology, and treatment of diverticulitis. Gastroenterology. 2019;156(5):1282-1298.

3. Ceresoli M, Lo Bianco G, Gianotti L, Nespoli L. Inflammation management in acute diverticulitis: current perspectives. J Inflamm Res. 2018;11:239-246.