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Meta-Analysis
. 2019 Jul 12;11(7):1579.
doi: 10.3390/nu11071579.

Rectal Cancer: 20% Risk Reduction Thanks to Dietary Fibre Intake. Systematic Review and Meta-Analysis

Vincenza Gianfredi  1 , Daniele Nucci  2 , Tania Salvatori  3 , Giulia Dallagiacoma  4 , Cristina Fatigoni  3 , Massimo Moretti  3 , Stefano Realdon  5
Affiliations
Meta-Analysis

Rectal Cancer: 20% Risk Reduction Thanks to Dietary Fibre Intake. Systematic Review and Meta-Analysis

Vincenza Gianfredi et al. Nutrients. .

Abstract

The aim of this systematic review and meta-analysis was to evaluate the association between dietary fibre intake and rectal cancer (RC) risk. In January 2019, a structured computer search on PubMed/Medline, Excerpta Medica dataBASE (EMBASE) and Scopus was performed for studies reporting the results of primary research evaluating dietary fibre intake in women and men as well as the risk of developing RC. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations were followed. Highest vs. lowest fibre concentrations was compared. The Egger test was used to estimate publication bias. Heterogeneity between studies was evaluated with I2 statistics. The search strategy identified 912 papers, 22 of which were included in our meta-analysis. Having evaluated a total of 2,876,136 subjects, the results suggest a protective effect of dietary fibre intake on RC prevention. The effect Size (ES) was [0.77 (95% CI = 0.66-0.89), p-value = 0.001)]. Moderate statistical heterogeneity (Chi2 = 51.36, df = 21, I2 = 59.11%, p-value = 0.000) was found. However, no publication bias was found, as confirmed by Egger's linear regression test (Intercept -0.21, t = -0.24, p = 0.816). The findings suggest that dietary fibre intake could be protective against RC, with a clinically relevant reduction of RC risk. Identifying preventive measures to avoid the development of RC, especially by following a healthy lifestyle including healthy diet, is pivotal.

Keywords: diet; dietary fibre; fibre; rectal cancer.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram of studies selection process.
Figure 2
Figure 2
(a) Forest plot and (b) funnel plot of the meta-analysis comparing dietary fibre intake (lower vs. higher intake) in the prevention of rectal cancer.
Figure 3
Figure 3
(a) Forest plot and (b) funnel plot of the meta-analysis comparing dietary fibre intake in the prevention of rectal cancer in men.
Figure 4
Figure 4
(a) Forest plot and (b) funnel plot of the meta-analysis comparing dietary fibre intake in the prevention of rectal cancer considering cohort studies. (c) Forest plot and (d) funnel plot of the meta-analysis comparing dietary fibre intake in the prevention of rectal cancer considering case-control studies.
Figure 4
Figure 4
(a) Forest plot and (b) funnel plot of the meta-analysis comparing dietary fibre intake in the prevention of rectal cancer considering cohort studies. (c) Forest plot and (d) funnel plot of the meta-analysis comparing dietary fibre intake in the prevention of rectal cancer considering case-control studies.
Figure 5
Figure 5
(a) Forest plot and (b) funnel plot of the meta-analysis comparing dietary fibre intake in the prevention of rectal cancer considering only studies with at least 10 years of observation.
Figure 6
Figure 6
(a) Forest plot of the meta-analysis considering only studies conducted in Europe, (b) forest plot of the meta-analysis considering only studies conducted in America and (c) forest plot of the meta-analysis considering only studies conducted in Asia.
See this image and copyright information in PMC

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