Carbohydrates and Health

(Salmeron et al., 1997a; Salmeron et al., 1997b; Meyer et al., 2000; Montonen et al.,
2003; Hodge et al., 2004; Schulze et al., 2004a; Barclay et al., 2007; Schulze et al.,
2007b; Wannamethee et al., 2009). One cohort study was subsequently identified
in the update search (Hopping et al., 2010) (Cardio-metabolic review, diabetes and
glycaemia chapter; Update search).
8.58 No significant association is indicated between consumption of vegetable fibre
and the incidence of type 2 diabetes mellitus (RR 0.99, 95% CI 0.94, 1.04 for each
4g/day increase; p=0.7). The study identified in the update search indicates higher
consumption of vegetable fibre is associated with reduced incidence of type 2
diabetes mellitus in men, but not women.
Vegetable fibre (g/day) and type 2 diabetes mellitus
• No association
• Adequate evidence
Colo-rectal cancer
8.59 Seven cohort studies were identified, in six publications, that presented evidence
on vegetable fibre and colo-rectal cancer, all of which were included in a metaanalysis
(Michels et al., 2005; Lin et al., 2005; Bingham et al., 2005; Wakai et al.,
2007; Nomura et al., 2007; Schatzkin et al., 2007). One cohort study that was
a later follow-up of the EPIC cohort (Bingham et al., 2005) was subsequently
identified in the update search, but it reported fruit and vegetable fibre combined
and could not be included in the meta-analysis (Murphy et al., 2012) (Colo-rectal
health review; Update search).
8.60 No significant association is indicated between vegetable fibre consumption and
incidence of colo-rectal cancer (RR 0.99, 95% CI 0.96, 1.02 for each 4g/day increase;
p=0.59). The study identified in the update search (Murphy et al., 2012) reports
follow-up data from the EPIC study included in the meta-analysis (Bingham et
al., 2005) and indicates consumption of combined fruit and vegetable fibre is not
associated with incidence of colo-rectal cancer.
Vegetable fibre (g/day) and colo-rectal cancer
• No association
• Adequate evidence
Fruit and vegetable fibre
Faecal weight and intestinal transit time
8.61 Six randomised controlled trials were identified that presented evidence on
fruit and vegetable fibre in relation to intestinal transit time and faecal weight
(Stasse-Wolthuis et al., 1980; Tinker et al., 1991; Lampe et al., 1992; Wisker et al.,
1994a; Wisker et al., 1994b; Cherbut et al., 1997). The data on dietary intakes were
insufficiently comparable to allow a meta-analysis. No further trials were identified
in the update search (Colo-rectal health review).
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