A randomized trial of a low fat high fibre diet in the recurrence of colorectal polyps. Toronto Polyp Prevention Group

J Clin Epidemiol. 1994 May;47(5):525-36. doi: 10.1016/0895-4356(94)90299-2.


After polypectomy for adenomatous colorectal polyps, 201 persons were randomized to receive counselling on a diet low in fat (the lesser of 50 g/day or 20% of energy) and high in fibre (50 g/day) (LFHF), or to follow a normal western diet (ND), high in fat and low in fibre. After 12 months of counselling, fat consumption was about 25% of energy in the LFHF group and 33% in the ND group; fibre consumption was 35 g and 16 g respectively. After an average of two years of follow-up, an intention to treat analysis led to a ratio of cumulative incidence rates of 1.2 (95% CL 0.6-2.2) for recurrence of neoplastic polyps, a finding which suggests no significant difference between dietary groups over the period of observation. An exploratory analysis conducted among 142 persons with substantial diet counselling indicated a reduced risk of neoplastic polyp recurrence in women (RR = 0.5), associated with reduced concentrations of faecal bile acids while on the LFHF diet, but indicated an increased risk of recurrence in men (RR = 2.1), associated with increased faecal bile acids. Although a larger study would be needed to rule out the role of chance, these findings of gender-specific associations between diet counselling and both faecal bile acid concentrations and recurrence of colorectal neoplasia are consistent with recently published evidence of differences between genders.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenomatous Polyps / etiology
  • Adenomatous Polyps / prevention & control*
  • Bile Acids and Salts / analysis
  • Colonic Polyps / etiology
  • Colonic Polyps / prevention & control*
  • Colorectal Neoplasms / etiology
  • Colorectal Neoplasms / prevention & control*
  • Diet, Fat-Restricted*
  • Dietary Fiber*
  • Feces / chemistry
  • Female
  • Humans
  • Male
  • Middle Aged
  • Recurrence
  • Sex Factors


  • Bile Acids and Salts
  • Dietary Fiber