Introduction
A sedentary lifestyle, poor fiber intake and other unhealthy dietary habits have been associated with diverticular disease (DD). On the contrary, the Mediterranean Diet (MD), which involves factors such as consuming locally grown food products, family meals, conviviality, involvement in the preparation of meals, as well as high intake of vegetables, legumes, fruit and cereals, medium intake of fish, low intake of meat and saturated fat, high intake of unsaturated fat (particularly olive oil), a medium-low intake of dairy products (yogurt and cheese), and a moderate intake of wine, seems to protect against DD. Moreover, populations that follow the MD pattern show a 50% lower rate of cardiovascular mortality due to cardiovascular disease and show highest longevity. (1)
Aims & Methods
Aim: to compare adherence to MD as a whole and its different components in subjects with and without diverticular disease.
Materials and methods: all patients undergoing colonoscopy at our Endoscopy Unit of a Tertiary Hospital in Northeastern Italy from January to June 2022 were invited to participate in the study, completing three questionnaires including personal/medical history and medications, symptoms, physical activity questionnaire, and Medi-Lite (ML) questionnaire for the assessment of adherence to MD. Subjects were then divided in two groups based on the endoscopic diagnosis of diverticular disease (DD).
Results
A total of 3757 patients underwent colonoscopy at our center during the 6-month study period, 1112 of whom completed the questionnaires and therefore constituted the study population. Overweight (BMI>25 kg/cm2) was observed in 61% of males and 40.2% of females, and correlated inversely (OR<1) with higher education attainment, daily physical activity of at least 30 minutes, and, in females, the performance of a structured physical activity/sport for at least 60 minutes a week. Moreover, being married or widowed and consuming meals preferably at home, as opposed to consuming meals at restaurants or cafeterias, were significantly associated with overweight (OR>1), especially in female patients. In the overall population, normal weight was more frequently associated with consumption of meat, while in females, it is associated with greater consumption of raw vegetables. Overweight was more frequently associated with consumption of salami and cheese, especially in the female population, and it correlated with the presence of cardiovascular diseases (especially hypertension). DD was present in 400/1112 (35.9%) of subjects and this condition was significantly associated with (OR>1) male sex, older age (61-75 years), overweight (BMI>25 kg/cm2), cardiovascular disease, polypharmacy, cigarette smoking, alcohol use, cheese consumption, abdominal pain as the chief complaint, and lower education attainment. No correlation was found between DD and the MD score or its components. In patients with DD, abdominal pain was inversely and significantly associated with an elevated ML score (OR=0.085) and consumption of meat (OR=0,096) and legumes (OR=0,079) (p<0.05).
Conclusion
Subjects undergoing colonoscopy share similar dietary and lifestyle habits, while in the presence of DD, ingestion of certain products seems to have an impact on symptoms.
References
1. Sofi F, Cesari F, Abbate R, Gensini GF, Casini A. Adherence to Mediterranean diet and health status: meta-analysis. BMJ. 2008 Sep 11;337:a1344.
