Diverticular diseases and western diet: Another metropolitan legend?

Abstract

Colonic diverticula are common in developed countries, and complications of colonic diverticulosis are responsible for a significant burden of disease. The link between Western diet and diverticulosis has been propagated in many arenas. Historically, the development of diverticula has been associated to Western diet and early studies focused on the role of fibers; low-fiber diets were thought to increase the intraluminal pressure leading to focal herniation of colonic mucosa. Also other nutrients have been thought to be associated to the development of diverticular disease and its complications. However, in the last decade, some evidences have led to reconsider the pathogenetic role of certain foods, while increasing evidences suggest the role of obesity and metabolic syndrome. In addition, diet-induced changes of gut microbiota may play a role in the pathogenesis of diverticular disease.