Diverticular disease in Greece

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An epidemiological study looking at biosocial factors and diet in Athens was undertaken by Manousos et al. (1985) using the dietary availability that is known in Greece, which enables an epidemiological study to be satisfactorily undertaken. A hundred cases of diverticulosis confirmed by barium enema radiological studies were hospitalized in Athens. These were consecutive cases who had been diagnosed for the first time with diverticulosis. Dietary histories were obtained and also socioeconomic and demographic details.

Specifically, in this study, the dietary intake was a prime factor and patients were asked about their food consumption. Eighty food items and beverages were categorized and patients were asked about the consumption of these items in categories of daily, weekly and monthly consumption. The food items were grouped and individualized as described by Davidson and Passmore (1979). The frequency and consumption of food were itemized in terms of the number of times per month that the food was consumed. Assignment values were given to foods eaten daily, twice a week, once a week, once a month and not often at all. Of the 100 cases with diverticulosis 66 were aged 60 years or more and lived in Athens or another urban area. This population has a substantial dietary variability and the outcome of the study supports the theory that diet is of importance in diverticular disease.

A fibre increase does not necessarily mean that there will be a reduction in the risk of symptomatic diverticulosis because the disease is not just a fibre-deficient disease. There is a role played by lamb and beef and dairy products in possibly influencing the development of symptomatic diverticular disease. Therefore, the involvement of several dietary factors in the aetiology of diverticular disease may help to explain why vegetarians have a lower asymptomatic prevalence of diverticulosis. The findings of the Athens study are that people who attend hospital with abdominal complaints and undergo radiological tests, such as barium enema, which show diverticulosis, appear to have dietary habits with a considerable difference from those attending hospital for orthopaedic problems and used as a control group. In looking for the cause of a common western disease, case-control studies in a population with varied dietary habits, homogeneous make-up and a low incidence of western disease should be of value (Heaton, 1985).

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