Decreased dietary fiber intake and structural alteration of gut microbiota in patients with advanced colorectal adenoma

Am J Clin Nutr. 2013 May;97(5):1044-52. doi: 10.3945/ajcn.112.046607. Epub 2013 Apr 3.


Background: Accumulating evidence indicates that diet is one of the most important environmental factors involved in the progression from advanced colorectal adenoma (A-CRA) to colorectal cancer.

Objective: We evaluated the possible effects of dietary fiber on the fecal microbiota of patients with A-CRA.

Design: Patients with a diagnosis of A-CRA by pathological examination were enrolled in the A-CRA group. Patients with no obvious abnormalities or histopathological changes were enrolled in the healthy control (HC) group. Dietary fiber intake was assessed in all patients. Short-chain fatty acids (SCFAs) in feces were detected by gas chromatography. The fecal microbiota community was analyzed by 454 pyrosequencing based on 16S ribosomal RNA.

Results: Lower dietary fiber patterns and consistently lower SCFA production were observed in the A-CRA group (n = 344). Principal component analysis showed distinct differences in the fecal microbiota communities of the 2 groups. Clostridium, Roseburia, and Eubacterium spp. were significantly less prevalent in the A-CRA group (n = 47) than in the HC group (n = 47), whereas Enterococcus and Streptococcus spp. were more prevalent in the A-CRA group (n = 47) (all P < 0.05). Butyrate and butyrate-producing bacteria were more prevalent in a subgroup of HC subjects with a high fiber intake than in those in both the low-fiber HC subgroup and the high-fiber A-CRA subgroup (all P < 0.05).

Conclusion: A high-fiber dietary pattern and subsequent consistent production of SCFAs and healthy gut microbiota are associated with a reduced risk of A-CRA. This trial was registered at as ChiCTR-TRC-00000123.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Butyrates / metabolism
  • Case-Control Studies
  • China / epidemiology
  • Chromatography, Gas
  • Colorectal Neoplasms / epidemiology*
  • Colorectal Neoplasms / microbiology
  • Colorectal Neoplasms / physiopathology
  • Cross-Sectional Studies
  • DNA, Bacterial / genetics
  • Diet
  • Dietary Fiber / administration & dosage*
  • Fatty Acids, Volatile / analysis
  • Feces / chemistry
  • Feces / microbiology
  • Female
  • Gastrointestinal Tract / microbiology*
  • Gram-Positive Bacteria / genetics
  • Gram-Positive Bacteria / isolation & purification
  • Humans
  • Life Style
  • Logistic Models
  • Male
  • Metagenome*
  • Middle Aged
  • Multivariate Analysis
  • RNA, Ribosomal, 16S / genetics
  • Sequence Analysis, DNA
  • Surveys and Questionnaires


  • Butyrates
  • DNA, Bacterial
  • Dietary Fiber
  • Fatty Acids, Volatile
  • RNA, Ribosomal, 16S