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Cereal, fruit, and vegetable fiber intake and the risk of cardiovascular disease in elderly individuals.
JAMA 2003; 289(13):1659-66JAMA

Abstract

CONTEXT

People older than 65 years are the fastest-growing segment of the population and account for the majority of cardiovascular disease (CVD) morbidity, mortality, and health care expenditures. Additionally, the influence of dietary habits on risk may be less pronounced in elderly persons, when atherosclerosis is more advanced. However, few data address the influence of diet on CVD risk in this population.

OBJECTIVE

To determine whether fiber consumption from fruit, vegetable, and cereal sources (including whole grains and bran) is associated with incident CVD in elderly persons.

DESIGN

Prospective cohort study conducted from 1989 to June 2000.

SETTING AND PARTICIPANTS

Population-based, multicenter study among 3588 men and women aged 65 years or older and free of known CVD at baseline in 1989-1990. Usual dietary fiber consumption was assessed at baseline (mean participant age, 72 years) using a 99-item food frequency questionnaire.

MAIN OUTCOME MEASURE

Incident CVD (combined stroke, ischemic heart disease death, and nonfatal myocardial infarction).

RESULTS

During 8.6 years mean follow-up, there were 811 incident CVD events. After adjustment for age, sex, education, diabetes, ever smoking, pack-years of smoking, daily physical activity, exercise intensity, alcohol intake, and fruit and vegetable fiber consumption, cereal fiber consumption was inversely associated with incident CVD (P for trend =.02), with 21% lower risk (hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.62-0.99) in the highest quintile of intake, compared with the lowest quintile. In similar analyses, neither fruit fiber intake (P for trend =.98) nor vegetable fiber intake (P for trend =.95) were associated with incident CVD. When CVD events were separately evaluated, higher cereal fiber intake was associated with lower risk of total stroke and ischemic stroke and a trend toward lower risk of ischemic heart disease death. In a post hoc analysis, dark breads such as wheat, rye, or pumpernickel were associated with a lower risk of incident CVD (HR, 0.76; 95% CI, 0.64-0.90) rather than cereal fiber from other sources.

CONCLUSIONS

Cereal fiber consumption late in life is associated with lower risk of incident CVD, supporting recommendations for elderly individuals to increase consumption of dietary cereal fiber.

Authors+Show Affiliations

Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Wash, USA. darymd@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

12672734

Citation

Mozaffarian, Dariush, et al. "Cereal, Fruit, and Vegetable Fiber Intake and the Risk of Cardiovascular Disease in Elderly Individuals." JAMA, vol. 289, no. 13, 2003, pp. 1659-66.
Mozaffarian D, Kumanyika SK, Lemaitre RN, et al. Cereal, fruit, and vegetable fiber intake and the risk of cardiovascular disease in elderly individuals. JAMA. 2003;289(13):1659-66.
Mozaffarian, D., Kumanyika, S. K., Lemaitre, R. N., Olson, J. L., Burke, G. L., & Siscovick, D. S. (2003). Cereal, fruit, and vegetable fiber intake and the risk of cardiovascular disease in elderly individuals. JAMA, 289(13), pp. 1659-66.
Mozaffarian D, et al. Cereal, Fruit, and Vegetable Fiber Intake and the Risk of Cardiovascular Disease in Elderly Individuals. JAMA. 2003 Apr 2;289(13):1659-66. PubMed PMID: 12672734.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cereal, fruit, and vegetable fiber intake and the risk of cardiovascular disease in elderly individuals. AU - Mozaffarian,Dariush, AU - Kumanyika,Shiriki K, AU - Lemaitre,Rozenn N, AU - Olson,Jean L, AU - Burke,Gregory L, AU - Siscovick,David S, PY - 2003/4/4/pubmed PY - 2003/4/16/medline PY - 2003/4/4/entrez SP - 1659 EP - 66 JF - JAMA JO - JAMA VL - 289 IS - 13 N2 - CONTEXT: People older than 65 years are the fastest-growing segment of the population and account for the majority of cardiovascular disease (CVD) morbidity, mortality, and health care expenditures. Additionally, the influence of dietary habits on risk may be less pronounced in elderly persons, when atherosclerosis is more advanced. However, few data address the influence of diet on CVD risk in this population. OBJECTIVE: To determine whether fiber consumption from fruit, vegetable, and cereal sources (including whole grains and bran) is associated with incident CVD in elderly persons. DESIGN: Prospective cohort study conducted from 1989 to June 2000. SETTING AND PARTICIPANTS: Population-based, multicenter study among 3588 men and women aged 65 years or older and free of known CVD at baseline in 1989-1990. Usual dietary fiber consumption was assessed at baseline (mean participant age, 72 years) using a 99-item food frequency questionnaire. MAIN OUTCOME MEASURE: Incident CVD (combined stroke, ischemic heart disease death, and nonfatal myocardial infarction). RESULTS: During 8.6 years mean follow-up, there were 811 incident CVD events. After adjustment for age, sex, education, diabetes, ever smoking, pack-years of smoking, daily physical activity, exercise intensity, alcohol intake, and fruit and vegetable fiber consumption, cereal fiber consumption was inversely associated with incident CVD (P for trend =.02), with 21% lower risk (hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.62-0.99) in the highest quintile of intake, compared with the lowest quintile. In similar analyses, neither fruit fiber intake (P for trend =.98) nor vegetable fiber intake (P for trend =.95) were associated with incident CVD. When CVD events were separately evaluated, higher cereal fiber intake was associated with lower risk of total stroke and ischemic stroke and a trend toward lower risk of ischemic heart disease death. In a post hoc analysis, dark breads such as wheat, rye, or pumpernickel were associated with a lower risk of incident CVD (HR, 0.76; 95% CI, 0.64-0.90) rather than cereal fiber from other sources. CONCLUSIONS: Cereal fiber consumption late in life is associated with lower risk of incident CVD, supporting recommendations for elderly individuals to increase consumption of dietary cereal fiber. SN - 0098-7484 UR - https://www.unboundmedicine.com/medline/citation/12672734/Cereal_fruit_and_vegetable_fiber_intake_and_the_risk_of_cardiovascular_disease_in_elderly_individuals_ L2 - https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.289.13.1659 DB - PRIME DP - Unbound Medicine ER -