A randomized controlled trial addressing this dietary issue is unlikely—and probably unnecessary. This study provides the strongest evidence on this topic by far. We think many patients have been unnecessarily deprived of these foods.
The study did not enroll young patients or women. However, diverticulosis is rare before the age of 40.2,9 And, because no clear sex difference has been observed in diverticular disease, we see no reason why this evidence should not apply equally to female patients.2,13
Also of note: This study did not assess total seed intake, per se. Rather, it assessed the consumption of strawberries and blueberries, the source of the seeds. The researchers found no association between strawberries and blueberries and diverticular complications, and we see no reason to tell patients to avoid them.
CHALLENGES TO IMPLEMENTATION: There are no obstacles to implementation
Dietary advice is an integral part of primary care practice. We see no challenges to implementing this practice changer, which should come as welcome news to patients at risk of diverticular disease or its complications.
Acknowledgements
The PURLs Surveillance System is supported in part by Grant Number UL1RR024999 from the National Center for Research Resources, a Clinical Translational Science Award to the University of Chicago. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health.
PURLs methodology
This study was selected and evaluated using FPIN’s Priority Updates from the Research Literature (PURL) Surveillance System methodology. The criteria and findings leading to the selection of this study as a PURL can be accessed at www.jfponline.com/purls.