Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2011 Nov 10:343:d6617.
doi: 10.1136/bmj.d6617.

Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies

Dagfinn Aune  1 , Doris S M Chan, Rosa Lau, Rui Vieira, Darren C Greenwood, Ellen Kampman, Teresa Norat
Affiliations
Review

Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies

Dagfinn Aune et al. BMJ. .

Abstract

Objective: To investigate the association between intake of dietary fibre and whole grains and risk of colorectal cancer.

Design: Systematic review and meta-analysis of prospective observational studies.

Data sources: PubMed and several other databases up to December 2010 and the reference lists of studies included in the analysis as well as those listed in published meta-analyses.

Study selection: Prospective cohort and nested case-control studies of dietary fibre or whole grain intake and incidence of colorectal cancer.

Results: 25 prospective studies were included in the analysis. The summary relative risk of developing colorectal cancer for 10 g daily of total dietary fibre (16 studies) was 0.90 (95% confidence interval 0.86 to 0.94, I(2) = 0%), for fruit fibre (n = 9) was 0.93 (0.82 to 1.05, I(2) = 23%), for vegetable fibre (n = 9) was 0.98 (0.91 to 1.06, I(2) = 0%), for legume fibre (n = 4) was 0.62 (0.27 to 1.42, I(2) = 58%), and for cereal fibre (n = 8) was 0.90 (0.83 to 0.97, I(2) = 0%). The summary relative risk for an increment of three servings daily of whole grains (n = 6) was 0.83 (0.78 to 0.89, I(2) = 18%).

Conclusion: A high intake of dietary fibre, in particular cereal fibre and whole grains, was associated with a reduced risk of colorectal cancer. Further studies should report more detailed results, including those for subtypes of fibre and be stratified by other risk factors to rule out residual confounding. Further assessment of the impact of measurement errors on the risk estimates is also warranted.

PubMed Disclaimer

Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; and no other relationships or activities that could appear to have influenced the submitted work.

Figures

None
Fig 1 Flow chart of publications included in systematic review
None
Fig 2 Dose-response analyses between dietary fibre and risk of colorectal cancer. NHS=Nurses’ Health Study; HPFS=Health Professionals Follow-up Study
None
Fig 3 Risk of colorectal cancer according to fibre types. NHS=Nurses’ Health Study; HPFS=Health Professionals Follow-up Study
None
Fig 4 Dose-response analyses between whole grains and risk of colorectal cancer. NHS=Nurses’ Health Study; HPFS=Health Professionals Follow-up Study
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010;127:2893-917. - PubMed
    1. Armstrong B, Doll R. Environmental factors and cancer incidence and mortality in different countries, with special reference to dietary practices. Int J Cancer 1975;15:617-31. - PubMed
    1. Kolonel LN. Cancer patterns of four ethnic groups in Hawaii. J Natl Cancer Inst 1980;65:1127-39. - PubMed
    1. Kono S. Secular trend of colon cancer incidence and mortality in relation to fat and meat intake in Japan. Eur J Cancer Prev 2004;13:127-32. - PubMed
    1. World Cancer Research Fund/American Institute for Cancer Research. Food, nutrition, physical activity and the prevention of cancer: a global perspective. AICR, 2007.