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Dietary Fiber and Risk of Coronary Heart Disease
A Pooled Analysis of Cohort Studies
Mark A. Pereira, PhD;
Eilis O'Reilly, MSc;
Katarina Augustsson, PhD;
Gary E. Fraser, MBChB, PhD;
Uri Goldbourt, PhD;
Berit L. Heitmann, PhD;
Goran Hallmans, MD, PhD;
Paul Knekt, PhD;
Simin Liu, MD, ScD;
Pirjo Pietinen, DSc;
Donna Spiegelman, ScD;
June Stevens, MS, PhD;
Jarmo Virtamo, MD;
Walter C. Willett, MD;
Alberto Ascherio, MD
Arch Intern Med. 2004;164:370-376.
Background Few epidemiologic studies of dietary fiber intake and risk of coronary heart disease have compared fiber types (cereal, fruit, and vegetable) or included sex-specific results. The purpose of this study was to conduct a pooled analysis of dietary fiber and its subtypes and risk of coronary heart disease.
Methods We analyzed the original data from 10 prospective cohort studies from the United States and Europe to estimate the association between dietary fiber intake and the risk of coronary heart disease.
Results Over 6 to 10 years of follow-up, 5249 incident total coronary cases and 2011 coronary deaths occurred among 91 058 men and 245 186 women. After adjustment for demographics, body mass index, and lifestyle factors, each 10-g/d increment of energy-adjusted and measurement error–corrected total dietary fiber was associated with a 14% (relative risk [RR], 0.86; 95% confidence interval [CI], 0.78-0.96) decrease in risk of all coronary events and a 27% (RR, 0.73; 95% CI, 0.61-0.87) decrease in risk of coronary death. For cereal, fruit, and vegetable fiber intake (not error corrected), RRs corresponding to 10-g/d increments were 0.90 (95% CI, 0.77-1.07), 0.84 (95% CI, 0.70-0.99), and 1.00 (95% CI, 0.88-1.13), respectively, for all coronary events and 0.75 (95% CI, 0.63-0.91), 0.70 (95% CI, 0.55-0.89), and 1.00 (95% CI, 0.82-1.23), respectively, for deaths. Results were similar for men and women.
Conclusion Consumption of dietary fiber from cereals and fruits is inversely associated with risk of coronary heart disease.
From the Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis (Dr Pereira); Departments of Nutrition (Ms O'Reilly and Drs Willett and Ascherio), Epidemiology (Drs Spiegelman, Willett, and Ascherio), and Biostatistics (Dr Spiegelman), Harvard School of Public Health, Harvard Center for Cancer Prevention (Dr Willett), Channing Laboratory, Department of Medicine (Dr Willett), and Division of Preventive Medicine (Dr Liu), Brigham and Women's Hospital and Harvard Medical School, Boston, Mass; Department of Medical Epidemiology, Karolinska Institute, Stockholm, Sweden (Dr Augustsson); Center for Health Research, Loma Linda University School of Medicine, Loma Linda, Calif (Dr Fraser); Section of Epidemiology and Biostatistics, Henry N. Neufeld Cardiac Research Institute, Sheba Medical Center, Tel Hashomer, Israel (Dr Goldbourt); Institute of Preventive Medicine, Copenhagan University Hospital, Copenhagan, Denmark (Dr Heitmann); Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden (Dr Hallmans); National Public Health Institute, Helsinki, Finland (Drs Knekt, Pietinen, and Virtamo); and Departments of Nutrition and Epidemiology, School of Public Health, University of North Carolina, Chapel Hill (Dr Stevens). The authors have no relevant financial interest in this article.
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