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• W2766404639 abstract "<h3>Importance</h3> Although high dietary fiber intake has been associated with a lower risk of colorectal cancer (CRC), it remains unknown whether fiber benefits CRC survivors. <h3>Objective</h3> To assess the association of postdiagnostic fiber intake with mortality. <h3>Design, Setting, and Participants</h3> A total of 1575 health care professionals with stage I to III CRC were evaluated in 2 prospective cohorts, Nurses’ Health Study and Health Professionals Follow-up Study. Colorectal cancer–specific and overall mortality were determined after adjusting for other potential predictors for cancer survival. The study was conducted from December 23, 2016, to August 23, 2017. <h3>Exposures</h3> Consumption of total fiber and different sources of fiber and whole grains assessed by a validated food frequency questionnaire between 6 months and 4 years after CRC diagnosis. <h3>Main Outcomes and Measures</h3> Hazard ratios (HRs) and 95% CIs of CRC-specific and overall mortality after adjusting for other potential predictors for cancer survival. <h3>Results</h3> Of the 1575 participants, 963 (61.1%) were women; mean (SD) age was 68.6 (8.9) years. During a median of 8 years of follow-up, 773 deaths were documented, including 174 from CRC. High intake of total fiber after diagnosis was associated with lower mortality. The multivariable HR per each 5-g increment in intake per day was 0.78 (95% CI, 0.65-0.93;<i>P</i> = .006) for CRC-specific mortality and 0.86 (95% CI, 0.79-0.93;<i>P</i> < .001) for all-cause mortality. Patients who increased their fiber intake after diagnosis from levels before diagnosis had a lower mortality, and each 5-g/d increase in intake was associated with 18% lower CRC-specific mortality (95% CI, 7%-28%;<i>P</i> = .002) and 14% lower all-cause mortality (95% CI, 8%-19%;<i>P</i> < .001). According to the source of fiber, cereal fiber was associated with lower CRC-specific mortality (HR per 5-g/d increment, 0.67; 95% CI, 0.50-0.90;<i>P</i> = .007) and all-cause mortality (HR, 0.78; 95% CI, 0.68-0.90;<i>P</i> < .001); vegetable fiber was associated with lower all-cause mortality (HR, 0.83; 95% CI, 0.72-0.96;<i>P</i> = .009) but not CRC-specific mortality (HR, 0.82; 95% CI, 0.60-1.13;<i>P</i> = .22); no association was found for fruit fiber. Whole grain intake was associated with lower CRC-specific mortality (HR per 20-g/d increment, 0.72; 95% CI, 0.59-0.88;<i>P</i> = .002), and this beneficial association was attenuated after adjusting for fiber intake (HR, 0.77; 95% CI, 0.62-0.96;<i>P</i> = .02). <h3>Conclusions and Relevance</h3> Higher fiber intake after the diagnosis of nonmetastatic CRC is associated with lower CRC-specific and overall mortality. Increasing fiber consumption after diagnosis may confer additional benefits to patients with CRC." @default.
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• W2766404639 date "2018-01-01" @default.
• W2766404639 modified "2023-10-14" @default.
• W2766404639 title "Fiber Intake and Survival After Colorectal Cancer Diagnosis" @default.
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• W2766404639 doi "https://doi.org/10.1001/jamaoncol.2017.3684" @default.
• W2766404639 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/5776713" @default.
• W2766404639 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/29098294" @default.
• W2766404639 hasPublicationYear "2018" @default.
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