Different dietary fibre sources and risks of colorectal cancer and adenoma: A dose-response meta-analysis of prospective studies

Hannah Oh, Hanseul Kim, Dong Hoon Lee, Ariel Lee, Edward L. Giovannucci, Seok Seong Kang, Nana Keum

Research output: Contribution to journalArticlepeer-review

36 Citations (Scopus)


Dietary fibre is believed to provide important health benefits including protection from colorectal cancer. However, the evidence on the relationships with different dietary fibre sources is mixed and little is known about which fibre source provides the greatest benefits. We conducted a dose-response meta-analysis of prospective cohorts to summarise the relationships of different fibre sources with colorectal cancer and adenoma risks. Analyses were restricted to publications that reported all fibre sources (cereals, vegetables, fruits, legumes) to increase comparability between results. PubMed and Embase were searched through August 2018 to identify relevant studies. The summary relative risks (RR) and 95 % CI were estimated using a random-effects model. This analysis included a total of ten prospective studies. The summary RR of colorectal cancer associated with each 10 g/d increase in fibre intake were 0·91 (95 % CI 0·82, 1·00; I 2 = 0 %) for cereal fibre, 0·95 (95 % CI 0·87, 1·03, I 2 = 0 %) for vegetable fibre, 0·91 (95 % CI 0·78, 1·06, I 2 = 43 %) for fruit fibre and 0·84 (95 % CI 0·63, 1·13, I 2 = 45 %) for legume fibre. For cereal fibre, the association with colorectal cancer risk remained statistically significant after adjustment for folate intake (RR 0·89, 95 % CI 0·80, 0·99, I 2 = 2 %). For vegetable and fruit fibres, the dose-response curve suggested evidence of non-linearity. All fibre sources were inversely associated with incident adenoma (per 10 g/d increase: RR 0·81 (95 % CI 0·54, 1·21) cereals, 0·84 (95 % CI 0·71, 0·98) for vegetables, 0·78 (95 % CI 0·65, 0·93) for fruits) but not associated with recurrent adenoma. Our data suggest that, although all fibre sources may provide some benefits, the evidence for colorectal cancer prevention is strongest for fibre from cereals/grains.

Original languageEnglish
Pages (from-to)605-615
Number of pages11
JournalBritish Journal of Nutrition
Issue number6
Publication statusPublished - 2019 Sept 28

Bibliographical note

Funding Information:
H. O. is supported by a Korea University Grant K1808781; N. K. was supported by funding from the National Research Foundation of Korea (NRF-2018R1C1B6008822; NRF-2018R1A4A1022589) and the Dongguk University Research Fund of 2017.

Publisher Copyright:
© 2019 The Authors.


  • Colorectal adenoma
  • Colorectal cancer
  • Fibre
  • Meta-analyses

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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