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Lack of effect of a low-fat , high-fiber diet on the recurrence of colorectal adenomas . Polyp Prevention Trial Study Group . BACKGROUND We tested the hypothesis that dietary intervention can inhibit the development of recurrent colorectal adenomas , which are precursors of most large-bowel cancers . METHODS We randomly assigned 2079 men and women who were 35 years of age or older and who had had one or more histologically confirmed colorectal adenomas removed within six months before randomization to one of two groups : an intervention group given intensive counseling and assigned to follow a diet that was low in fat ( 20 percent of total calories ) and high in fiber ( 18 g of dietary fiber per 1000 kcal ) and fruits and vegetables ( 3.5 servings per 1000 kcal ) , and a control group given a standard brochure on healthy eating and assigned to follow their usual diet . Subjects entered the study after undergoing complete colonoscopy and removal of adenomatous polyps ; they remained in the study for approximately four years , undergoing colonoscopy one and four years after randomization . RESULTS A total of 1905 of the randomized subjects ( 91.6 percent ) completed the study . Of the 958 subjects in the intervention group and the 947 in the control group who completed the study , 39.7 percent and 39.5 percent , respectively , had at least one recurrent adenoma ; the unadjusted risk ratio was 1.00 ( 95 percent confidence interval , 0.90 to 1.12 ) . Among subjects with recurrent adenomas , the mean ( +/-SE ) number of such lesions was 1.85+/-0.08 in the intervention group and 1.84+/-0.07 in the control group . The rate of recurrence of large adenomas ( with a maximal diameter of at least 1 cm ) and advanced adenomas ( defined as lesions that had a maximal diameter of at least 1 cm or at least 25 percent villous elements or evidence of high-grade dysplasia , including carcinoma ) did not differ significantly between the two groups . CONCLUSIONS Adopting a diet that is low in fat and high in fiber , fruits , and vegetables does not influence the risk of recurrence of colorectal adenomas .
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Intervention_Physical
low-fat , high-fiber diet
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Intervention_Educational
diet that was low in fat
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Intervention_Educational
high in fiber ( 18 g of dietary fiber per 1000 kcal )
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Intervention_Educational
fruits and vegetables
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Outcome_Physical
recurrence of colorectal adenomas
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Outcome_Physical
development of recurrent colorectal adenomas
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Outcome_Physical
one recurrent adenoma
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Outcome_Physical
unadjusted risk ratio
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Outcome_Physical
number of such lesions
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Outcome_Physical
recurrence of large adenomas
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Outcome_Physical
advanced adenomas
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Outcome_Physical
risk of recurrence
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Participant_Sample-size
2079
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Participant_Sex
men
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Participant_Sex
women
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Participant_Age
35
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Participant_Condition
colorectal adenomas
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Participant_Sample-size
1905