Dietary Fiber Intake and Reduced Risk of Coronary Heart Disease in US Men and Women
We examined the relationship between dietary fiber intake and the risk of coronary heart disease (CHD) in 3,745 men and 6,031 women who participated in the NHANES I Epidemiologic Follow-up Study and were free of cardiovascular disease (CVD) at their baseline examination. A 24-hour dietary recall was administered at the participant’s baseline examination and nutrient intakes were recalculated using the ESHA databases. Other important risk factors for CVD including age, sex, race, serum cholesterol level, blood pressure, body mass index, history of diabetes, level of education, physical activity, cigarette smoking, and alcohol consumption were also measured at baseline. These risk factors and dietary intakes of saturated fat and total energy were used for adjustment in multivariate analyses. Data for estimation of CVD incidence were obtained from medical records and death certificates. Cox proportional hazard models were used to examine the relationship between dietary fiber intake and risk of CVD. Over an average of 19 years of follow-up, we documented 1,843 CHD events (668 fatal) and 3,762 CVD events (1,198 fatal). Compared with those in the lowest quartile of total dietary fiber intake (median, 4.6 g/d), participants in the highest quartile (median, 20.6 g/d) had an adjusted relative risk (RR) of 0.81 (95% confidence interval [CI], 0.67−0.97, p=.008 for trend) for CHD events and 0.85 (95% CI: 0.76−0.95, p=.001 for trend) for CVD events. The corresponding adjusted RR for those in the highest (median, 5.4 g/d) compared with those in the lowest (median, 0.7 g/d) quartile of water-soluble dietary fiber intake was 0.81 (95% CI, 0.71−0.93, p=.004 for trend) for CHD events and 0.88 (95% CI, 0.80−0.96, p=.02 for trend) for CVD events. Our findings support the hypothesis that a higher intake of dietary fiber, particularly water-soluble fiber, reduces the risk of CHD. Furthermore, our findings suggest that increasing dietary fiber intake may be an important component of dietary approaches to prevention of CHD in the community.