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Cereal, fruit, and vegetable fiber intake and the risk of cardiovascular disease in elderly individuals.

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.

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  • Authors+Show Affiliations

    ,

    Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Wash, USA. darymd@hotmail.com

    , , , ,

    Source

    JAMA 289:13 2003 Apr 02 pg 1659-66

    MeSH

    Aged
    Cardiovascular Diseases
    Dietary Fiber
    Edible Grain
    Female
    Fruit
    Humans
    Male
    Nutrition Assessment
    Prospective Studies
    Risk
    Vegetables

    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/full_citation L2 - https://jamanetwork.com/journals/jama/fullarticle/vol/289/pg/1659 DB - PRIME DP - Unbound Medicine ER -