Dietary fiber and health outcomes: an umbrella review of systematic reviews and meta-analyses

Nicola Veronese, Marco Solmi, Maria Gabriella Caruso, Gianluigi Giannelli, Alberto R Osella, Evangelos Evangelou, Stefania Maggi, Luigi Fontana, Brendon Stubbs, Ioanna Tzoulaki

Research output: Contribution to journalArticle

Abstract

Background: Several studies have suggested that higher consumption of dietary fiber is beneficial for a variety of health outcomes. However, many results have been inconclusive and, to our knowledge, there has been no attempt to systematically capture the breadth of outcomes associated with dietary fiber intake or to systematically assess the quality and the strength of the evidence on the associations of dietary fiber intake and different health outcomes or medical conditions.

Objective: The aim of this study was to describe the diverse health outcomes convincingly associated with dietary fiber consumption.

Design: This was an umbrella review of systematic reviews with meta-analysis of observational studies. For each association, random-effects summary effect size, 95% CIs, and 95% prediction intervals were estimated. We also assessed heterogeneity, evidence for small-study effect, and evidence for excess significance bias. We used these metrics to evaluate the credibility of the identified evidence.

Results: Our literature search identified 1351 abstracts. Of these, 18 meta-analyses including a total of 298 prospective observational studies and 21 outcomes were included. Outcomes studied included cancer and precancer lesions (n = 12), cardiovascular diseases (CVDs; n = 3), all-cause and specific-cause mortality (n = 4), type 2 diabetes (n = 1), and Crohn disease (n = 1). Overall, 6 (29%) of the 21 eligible outcomes reported highly significant summary results (P < 1 × 10-6); these included CVD and CVD mortality, coronary artery disease, pancreatic cancer, and gastric cancer. Overall, 3 of 21 (14%) outcomes presented convincing evidence (pancreatic cancer, CVD mortality, and all-cause mortality), but only CVD and all-cause mortality were based on prospective studies. Two other outcomes (10%), CVD and coronary artery disease, presented highly suggestive evidence based on prospective studies.

Conclusion: Our results support dietary recommendations that promote higher fiber intake as part of a healthy diet.

Original languageEnglish
Pages (from-to)436-444
Number of pages9
JournalAmerican Journal of Clinical Nutrition
Volume107
Issue number3
DOIs
Publication statusPublished - Mar 1 2018

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Dietary Fiber
Meta-Analysis
Mortality
Health
Prospective Studies
Pancreatic Neoplasms
Stomach Neoplasms
Observational Studies
Coronary Artery Disease
Crohn Disease
Type 2 Diabetes Mellitus
Cardiovascular Diseases
Neoplasms

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Dietary fiber and health outcomes : an umbrella review of systematic reviews and meta-analyses. / Veronese, Nicola; Solmi, Marco; Caruso, Maria Gabriella; Giannelli, Gianluigi; Osella, Alberto R; Evangelou, Evangelos; Maggi, Stefania; Fontana, Luigi; Stubbs, Brendon; Tzoulaki, Ioanna.

In: American Journal of Clinical Nutrition, Vol. 107, No. 3, 01.03.2018, p. 436-444.

Research output: Contribution to journalArticle

Veronese, Nicola ; Solmi, Marco ; Caruso, Maria Gabriella ; Giannelli, Gianluigi ; Osella, Alberto R ; Evangelou, Evangelos ; Maggi, Stefania ; Fontana, Luigi ; Stubbs, Brendon ; Tzoulaki, Ioanna. / Dietary fiber and health outcomes : an umbrella review of systematic reviews and meta-analyses. In: American Journal of Clinical Nutrition. 2018 ; Vol. 107, No. 3. pp. 436-444.
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abstract = "Background: Several studies have suggested that higher consumption of dietary fiber is beneficial for a variety of health outcomes. However, many results have been inconclusive and, to our knowledge, there has been no attempt to systematically capture the breadth of outcomes associated with dietary fiber intake or to systematically assess the quality and the strength of the evidence on the associations of dietary fiber intake and different health outcomes or medical conditions.Objective: The aim of this study was to describe the diverse health outcomes convincingly associated with dietary fiber consumption.Design: This was an umbrella review of systematic reviews with meta-analysis of observational studies. For each association, random-effects summary effect size, 95{\%} CIs, and 95{\%} prediction intervals were estimated. We also assessed heterogeneity, evidence for small-study effect, and evidence for excess significance bias. We used these metrics to evaluate the credibility of the identified evidence.Results: Our literature search identified 1351 abstracts. Of these, 18 meta-analyses including a total of 298 prospective observational studies and 21 outcomes were included. Outcomes studied included cancer and precancer lesions (n = 12), cardiovascular diseases (CVDs; n = 3), all-cause and specific-cause mortality (n = 4), type 2 diabetes (n = 1), and Crohn disease (n = 1). Overall, 6 (29{\%}) of the 21 eligible outcomes reported highly significant summary results (P < 1 × 10-6); these included CVD and CVD mortality, coronary artery disease, pancreatic cancer, and gastric cancer. Overall, 3 of 21 (14{\%}) outcomes presented convincing evidence (pancreatic cancer, CVD mortality, and all-cause mortality), but only CVD and all-cause mortality were based on prospective studies. Two other outcomes (10{\%}), CVD and coronary artery disease, presented highly suggestive evidence based on prospective studies.Conclusion: Our results support dietary recommendations that promote higher fiber intake as part of a healthy diet.",
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T2 - an umbrella review of systematic reviews and meta-analyses

AU - Veronese, Nicola

AU - Solmi, Marco

AU - Caruso, Maria Gabriella

AU - Giannelli, Gianluigi

AU - Osella, Alberto R

AU - Evangelou, Evangelos

AU - Maggi, Stefania

AU - Fontana, Luigi

AU - Stubbs, Brendon

AU - Tzoulaki, Ioanna

PY - 2018/3/1

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N2 - Background: Several studies have suggested that higher consumption of dietary fiber is beneficial for a variety of health outcomes. However, many results have been inconclusive and, to our knowledge, there has been no attempt to systematically capture the breadth of outcomes associated with dietary fiber intake or to systematically assess the quality and the strength of the evidence on the associations of dietary fiber intake and different health outcomes or medical conditions.Objective: The aim of this study was to describe the diverse health outcomes convincingly associated with dietary fiber consumption.Design: This was an umbrella review of systematic reviews with meta-analysis of observational studies. For each association, random-effects summary effect size, 95% CIs, and 95% prediction intervals were estimated. We also assessed heterogeneity, evidence for small-study effect, and evidence for excess significance bias. We used these metrics to evaluate the credibility of the identified evidence.Results: Our literature search identified 1351 abstracts. Of these, 18 meta-analyses including a total of 298 prospective observational studies and 21 outcomes were included. Outcomes studied included cancer and precancer lesions (n = 12), cardiovascular diseases (CVDs; n = 3), all-cause and specific-cause mortality (n = 4), type 2 diabetes (n = 1), and Crohn disease (n = 1). Overall, 6 (29%) of the 21 eligible outcomes reported highly significant summary results (P < 1 × 10-6); these included CVD and CVD mortality, coronary artery disease, pancreatic cancer, and gastric cancer. Overall, 3 of 21 (14%) outcomes presented convincing evidence (pancreatic cancer, CVD mortality, and all-cause mortality), but only CVD and all-cause mortality were based on prospective studies. Two other outcomes (10%), CVD and coronary artery disease, presented highly suggestive evidence based on prospective studies.Conclusion: Our results support dietary recommendations that promote higher fiber intake as part of a healthy diet.

AB - Background: Several studies have suggested that higher consumption of dietary fiber is beneficial for a variety of health outcomes. However, many results have been inconclusive and, to our knowledge, there has been no attempt to systematically capture the breadth of outcomes associated with dietary fiber intake or to systematically assess the quality and the strength of the evidence on the associations of dietary fiber intake and different health outcomes or medical conditions.Objective: The aim of this study was to describe the diverse health outcomes convincingly associated with dietary fiber consumption.Design: This was an umbrella review of systematic reviews with meta-analysis of observational studies. For each association, random-effects summary effect size, 95% CIs, and 95% prediction intervals were estimated. We also assessed heterogeneity, evidence for small-study effect, and evidence for excess significance bias. We used these metrics to evaluate the credibility of the identified evidence.Results: Our literature search identified 1351 abstracts. Of these, 18 meta-analyses including a total of 298 prospective observational studies and 21 outcomes were included. Outcomes studied included cancer and precancer lesions (n = 12), cardiovascular diseases (CVDs; n = 3), all-cause and specific-cause mortality (n = 4), type 2 diabetes (n = 1), and Crohn disease (n = 1). Overall, 6 (29%) of the 21 eligible outcomes reported highly significant summary results (P < 1 × 10-6); these included CVD and CVD mortality, coronary artery disease, pancreatic cancer, and gastric cancer. Overall, 3 of 21 (14%) outcomes presented convincing evidence (pancreatic cancer, CVD mortality, and all-cause mortality), but only CVD and all-cause mortality were based on prospective studies. Two other outcomes (10%), CVD and coronary artery disease, presented highly suggestive evidence based on prospective studies.Conclusion: Our results support dietary recommendations that promote higher fiber intake as part of a healthy diet.

U2 - 10.1093/ajcn/nqx082

DO - 10.1093/ajcn/nqx082

M3 - Article

C2 - 29566200

VL - 107

SP - 436

EP - 444

JO - American Journal of Clinical Nutrition

JF - American Journal of Clinical Nutrition

SN - 0002-9165

IS - 3

ER -