***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background Few studies have investigated the association between whole-grain intake and colorectal cancer . Because whole-grain intake estimation might be prone to measurement errors , more objective measures ( eg , biomarkers ) could assist in investigating such associations . Methods The association between alkylresorcinols , biomarkers of whole-grain rye and wheat intake , and colorectal cancer incidence were investigated using prediagnostic plasma sample s from colorectal cancer case patients and matched control subjects nested within the European Prospect i ve Investigation into Cancer and Nutrition . We included 1372 incident colorectal cancer case patients and 1372 individual matched control subjects and calculated the incidence rate ratios ( IRRs ) for overall and anatomical subsites of colorectal cancer using conditional logistic regression adjusted for potential confounders . Regional differences ( Sc and inavia , the Mediterranean , Central Europe ) were also explored . Results High plasma total alkylresorcinol concentration was associated with lower incidence of distal colon cancer ; the adjusted incidence rate ratio of distal colon cancer for the highest vs lowest quartile of plasma total alkylresorcinols was 0.48 ( 95 % confidence interval [ CI ] = 0.28 to 0.83 ) . An inverse association between plasma total alkylresorcinol concentrations and colon cancer was found for Sc and inavian participants ( IRR per doubling = 0.83 ; 95 % CI = 0.70 to 0.98 ) . However , plasma total alkylresorcinol concentrations were not associated with overall colorectal cancer , proximal colon cancer , or rectal cancer . Plasma alkylresorcinols concentrations were associated with colon and distal colon cancer only in Central Europe and Sc and inavia ( ie , areas where alkylresorcinol levels were higher ) . Conclusions High concentrations of plasma alkylresorcinols were associated with a lower incidence of distal colon cancer but not with overall colorectal cancer , proximal colon cancer , and rectal cancer After a two-week basal period , 24 patients were r and omly allocated to receive , with a crossover double-blind design , for two consecutive four-week periods , bran ( 20 g/24 hr ) or placebo . The daily intake of water and dietary fibers was st and ardized . Symptomatology , oroanal transit time , bowel frequency , and stool weight were assessed in basal conditions and at week 4 and 8 of the treatment . Oroanal transit time decreased and bowel frequency and stool weight increased significantly during both bran and placebo administration in comparison with basal period . Bran treatment was more effective than placebo in improving bowel frequency and oroanal transit . During bran treatment oroanal transit time became normal only in patients with slow colonic transit and not in those with slow rectal transit . Neither the occurrence nor the severity of the most frequent accompanying symptoms of chronic constipation differed significantly between placebo and bran treatments BACKGROUND Even though dietary fiber has been hypothesized to reduce the risk of coronary heart disease , few large epidemiological studies have examined this relation with good methodology . METHODS AND RESULTS The Alpha-Tocopherol , Beta-Carotene Cancer Prevention Study was a r and omized , double-blind , placebo-controlled trial with daily supplementation of alpha-tocopherol and /or beta-carotene . Of the participants , 21930 smoking men aged 50 to 69 years who were free of diagnosed cardiovascular disease and had completed a vali date d dietary question naire at baseline were followed for 6.1 years . We monitored the incidence of major coronary events ( a combination of first nonfatal myocardial infa rct ion and coronary heart disease death ; n = 1399 ) and mortality from coronary heart disease ( n = 635 ) . Both entities had a significant inverse association with  dietary fiber  , but the association was stronger for coronary death . For men in the highest quintile of total dietary fiber intake ( median , 34.8 g/d ) , the relative risk for coronary death was 0.69 ( 95 % confidence interval , 0.54 to 0.88 ; P < .001 for trend ) compared with men in the lowest quintile of intake ( median , 16.1 g/d ) . With an adjustment for known cardiovascular risk factors , intake of saturated fatty acids , beta-carotene , vitamin C , and vitamin E did not material ly change the result . Water-soluble fiber was slightly more strongly associated with reduced coronary death than water-insoluble fiber , and cereal fiber also had a stronger association than vegetable or fruit fiber . CONCLUSIONS These findings suggest that independent of other risk factors , greater intake of foods rich in fiber can substantially reduce the risk of coronary heart disease , and particularly coronary death , in middle-aged , smoking men BACKGROUND We tested the hypothesis that dietary intervention can inhibit the development of recurrent colorectal adenomas , which are precursors of most large-bowel cancers . METHODS We r and omly assigned 2079 men and women who were 35 years of age or older and who had had one or more histologically confirmed colorectal adenomas removed within six months before r and omization to one of two groups : an intervention group given intensive counseling and assigned to follow a diet that was low in fat ( 20 percent of total calories ) and high in fiber ( 18 g of dietary fiber per 1000 kcal ) and fruits and vegetables ( 3.5 servings per 1000 kcal ) , and a control group given a st and ard brochure on healthy eating and assigned to follow their usual diet . Subjects entered the study after undergoing complete colonoscopy and removal of adenomatous polyps ; they remained in the study for approximately four years , undergoing colonoscopy one and four years after r and omization . RESULTS A total of 1905 of the r and omized subjects ( 91.6 percent ) completed the study . Of the 958 subjects in the intervention group and the 947 in the control group who completed the study , 39.7 percent and 39.5 percent , respectively , had at least one recurrent adenoma ; the unadjusted risk ratio was 1.00 ( 95 percent confidence interval , 0.90 to 1.12 ) . Among subjects with recurrent adenomas , the mean ( + /-SE ) number of such lesions was 1.85+/-0.08 in the intervention group and 1.84+/-0.07 in the control group . The rate of recurrence of large adenomas ( with a maximal diameter of at least 1 cm ) and advanced adenomas ( defined as lesions that had a maximal diameter of at least 1 cm or at least 25 percent villous elements or evidence of high- grade dysplasia , including carcinoma ) did not differ significantly between the two groups . CONCLUSIONS Adopting a diet that is low in fat and high in fiber , fruits , and vegetables does not influence the risk of recurrence of colorectal adenomas We examined prospect ively the association between whole grain consumption and  colorectal cancer risk  in the population -based Swedish Mammography Cohort . A total of 61 433 women completed a food-frequency question naire at baseline ( 1987–1990 ) and , through linkage with the Swedish Cancer Registry , 805 incident cases of colorectal cancer were identified during a mean follow-up of 14.8 years . High consumption of whole grains was associated with a lower risk of colon cancer , but not of rectal cancer . The multivariate rate ratio ( RR ) of colon cancer for the top category of whole grain consumption ( ⩾4.5 servings day−1 ) compared with the bottom category ( < 1.5 servings day−1 ) was 0.67 ( 95 % confidence interval ( CI ) , 0.47–0.96 ; P-value for trend=0.06 ) . The corresponding RR after excluding cases occurring within the first 2 years of follow-up was 0.65 ( 95 % CI , 0.45–0.94 ; P-value for trend=0.04 ) . Our findings suggest that high consumption of whole grains  may decrease the risk of colon cancer in women CONTEXT Epidemiological studies of men suggest that dietary fiber intake protects against coronary heart disease ( CHD ) , but data on this association in women are sparse . OBJECTIVE To examine the association between long-term intake of total dietary fiber as well as fiber from different sources and risk of CHD in women . DESIGN AND SETTING The Nurses ' Health Study , a large , prospect i ve cohort study of US women followed up for 10 years from 1984 . Dietary data were collected in 1984 , 1986 , and 1990 , using a vali date d semiquantitative food frequency question naire . PARTICIPANTS A total of 68782 women aged 37 to 64 years without previously diagnosed angina , myocardial infa rct ion ( MI ) , stroke , cancer , hypercholesterolemia , or diabetes at baseline . MAIN OUTCOME MEASURE Incidence of acute MI or death due to CHD by amount of fiber intake . RESULTS Response rate averaged 80 % to 90 % during the 10-year follow-up . We documented 591 major CHD events ( 429 nonfatal MIs and 162 CHD deaths ) . The age-adjusted relative risk ( RR ) for major CHD events was 0.53 ( 95 % confidence interval [ CI ] , 0.40 - 0.69 ) for women in the highest quintile of total dietary fiber intake ( median , 22.9 g/d ) compared with women in the lowest quintile ( median , 11.5 g/d ) . After controlling for age , cardiovascular risk factors , dietary factors , and multivitamin supplement use , the RR was 0.77 ( 95 % CI , 0.57 - 1.04 ) . For a 10-g/d increase in  total fiber intake ( the difference between the lowest and highest quintiles ) , the multivariate RR of total CHD events was 0.81 ( 95 % CI , 0.66 - 0.99 ) . Among different sources of dietary fiber ( eg , cereal , vegetables , fruit ) , only cereal fiber was strongly associated with a reduced risk of CHD ( multivariate RR , 0.63 ; 95 % CI , 0.49 - 0.81 for each 5-g/d increase in cereal fiber ) . CONCLUSIONS Our findings in women support the hypothesis that higher fiber intake , particularly from cereal sources , reduces the risk of CHD In chronic renal failure ( CRF ) , plasma concentrations of the products of protein metabolism are increased . Current dietary management is to prescribe a decrease in protein intake . The use of dietary fiber to increase fecal excretion of retained metabolites in CRF may be a beneficial adjunct to a low-protein diet ( LPD ) . Colonic bacteria ferment dietary fiber , providing them with energy for growth and nitrogen incorporation , in turn , increasing nitrogen excretion in feces . Sixteen CRF patients consuming an LPD were r and omly assigned to receive a supplement of a highly fermentable fiber , gum arabic ( 50 g/d ) , or a placebo ( 1 g pectin/d ) in a prospect i ve , single-blind , crossover design . Fecal bacterial mass and fecal nitrogen content were significantly increased during supplementation with gum arabic compared with the baseline LPD or supplementation with pectin . Serum urea nitrogen was significantly decreased during supplementation with gum arabic compared with the baseline LPD or supplementation with pectin . Nitrogen balance did not change significantly Aims We aim ed to assess the effects of psyllium supplementation on insulin sensitivity and other parameters of the metabolic syndrome in an at risk adolescent population . Methods This study encompassed a participant-blinded , r and omized , placebo-controlled , crossover trial . Subjects were 47 healthy adolescent males aged 15–16 years , recruited from secondary schools in lower socio-economic areas with high rates of obesity . Participants received 6 g/day of psyllium or placebo for 6 weeks , with a two-week washout before crossing over . Fasting lipid profiles , ambulatory blood pressure , auxological data , body composition , activity levels , and three-day food records were collected at baseline and after each 6-week intervention . Insulin sensitivity was measured by the Matsuda method using glucose and insulin values from an oral glucose tolerance test . Results 45 subjects completed the study , and compliance was very high : 87 % of participants took > 80 % of prescribed capsules . At baseline , 44 % of subjects were overweight or obese . 28 % had decreased insulin sensitivity , but none had impaired glucose tolerance . Fibre supplementation led to a 4 % reduction in and roid fat to gynoid fat ratio ( p = 0.019 ) , as well as a 0.12 mmol/l ( 6 % ) reduction in LDL cholesterol ( p = 0.042 ) . No associated adverse events were recorded . Conclusions Dietary supplementation with 6 g/day of psyllium over 6 weeks improves fat distribution and lipid profile ( parameters of the metabolic syndrome ) in an at risk population of adolescent males . Trial Registration Australian New Zeal and Clinical Trials Registry BACKGROUND & AIMS Increased intake of dietary fiber has 
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RESULTS Different fiber types can be useful for the treatment of several gastrointestinal diseases like constipation , diarrhea , irritable bowel syndrome , ulcerative colitis remission or short bowel syndrome .
Patients diagnosed with diabetes , obesity , hyperlipidemia , hypertension and other cardiometabolic diseases can get a clinical improvement with soluble fiber intake .
Dietary fiber has demonstrated to play a role in the prevention of colorrectal cancer and other neoplastic diseases .
Patients with hepatic encephalopathy or chronic kidney disease will also benefit from fermentable fiber intake .