High-fiber diet reduces risk of heart disease in women
Women who eat a diet high in fiber, particularly
from breakfast cereals, have a reduced risk of coronary heart disease,
according to the results of a large prospective study published in the
June 2nd issue of The Journal of the American Medical Association.
Dr. Alicja M. Wolk, of the Karolinska Institute in
Stockholm, Sweden, and colleagues at Harvard Medical School and Harvard
School of Public Health, Boston, Massachusetts, analyzed data on 68.Women
who eat a diet high in fiber, partic782 female participants in the Nurses'
Health Study.
The subjects were 37 to 64 years old in 1984, at the
beginning of the study, and were followed for 10 years. Exclusion criteria
included a history of cancer, angina, MI, stroke, hypercholesterolemia
or diabetes at baseline. Dr. Wolk's group collected dietary information
on three occasions during the follow-up period to obtain estimates of
fiber intake.
The investigators report 591 major CHD events, including 162CHD-related
deaths, during the study period. According to the paper, the risk for
major CHD events among women who consumed the highest levels of dietary
fiber - a median of 22.9 grams per day - was 0.53 relative to those who
consumed the least fiber, a median of 11.5 grams per day.
"This inverse association was not explained by higher
dietary intakes of vitamin E, folate, vitamin B6, magnesium, vegetables,
or fruits," the research team writes.Dr. Wolk's team reports that
"among the different sources of dietary fiber...only cereal fiber was
strongly associated with a reduced risk of CHD," adding that the risk
of CHD was reduced by 37% for each 5-gram per day increase in cereal fiber
intake.
The authors note that fiber reduces both total and
LDL cholesterol but point out that "...the 37% reduction in CHD we
found for every 5-g/d increase in cereal fiber is larger than would be
expected from the beneficial effects on serum cholesterol level."
They believe that other mechanisms may be involved in the protective effects
of fiber, such as increased insulin sensitivity and decreased triglyceride
levels.
Dr. Wolk and colleagues comment that the findings are
"...further reason to replace refined forms of starch with whole-grain
products."
JAMA 1999;281:1998-2004.
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