Diverticular disease of the colon is very common in Western developed societies. It is associated with ageing and reduced intake of dietary fibre. Its incidence increases with age, and while it is uncommon before the age of 40 years, it is estimated to occur in about one-third of all individuals over 45 years of age, and in two-thirds of all those over 85 years. Different prevalence rates have been reported in various geographic areas and ethnic groups8'9. The high prevalence of diverticular disease in developed Western countries is in contrast with its rarity in many developing countries and in Japan. Geographic correlation and time trend analyses suggest that the condition is the result of low intake of dietary fibre, a hypothesis supported by experimental, epidemiological and therapeutic studies. Indeed, in a prospective cohort study on approximately 50 000 health professionals, a significant inverse correlation has been found between insoluble dietary fibre intake and the risk of subsequently developing symptomatic diverticular disease. Although the fibre-deficiency hypothesis has been widely quoted, conflicting findings and criticisms still exist.
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