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Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis.

Abstract

OBJECTIVE

To investigate dietary fibre intake and any potential dose-response association with coronary heart disease and cardiovascular disease.

DESIGN

Systematic review of available literature and dose-response meta-analysis of cohort studies using random effects models.

DATA SOURCES

The Cochrane Library, Medline, Medline in-process, Embase, CAB Abstracts, ISI Web of Science, BIOSIS, and hand searching.

ELIGIBILITY CRITERIA FOR STUDIES

Prospective studies reporting associations between fibre intake and coronary heart disease or cardiovascular disease, with a minimum follow-up of three years and published in English between 1 January 1990 and 6 August 2013.

RESULTS

22 cohort study publications met inclusion criteria and reported total dietary fibre intake, fibre subtypes, or fibre from food sources and primary events of cardiovascular disease or coronary heart disease. Total dietary fibre intake was inversely associated with risk of cardiovascular disease (risk ratio 0.91 per 7 g/day (95% confidence intervals 0.88 to 0.94)) and coronary heart disease (0.91 (0.87 to 0.94)). There was evidence of some heterogeneity between pooled studies for cardiovascular disease (I(2)=45% (0% to 74%)) and coronary heart disease (I(2)=33% (0% to 66%)). Insoluble fibre and fibre from cereal and vegetable sources were inversely associated with risk of coronary heart disease and cardiovascular disease. Fruit fibre intake was inversely associated with risk of cardiovascular disease.

CONCLUSIONS

Greater dietary fibre intake is associated with a lower risk of both cardiovascular disease and coronary heart disease. Findings are aligned with general recommendations to increase fibre intake. The differing strengths of association by fibre type or source highlight the need for a better understanding of the mode of action of fibre components.

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  • Authors+Show Affiliations

    ,

    Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.

    , , , , , , ,

    Source

    BMJ (Clinical research ed.) 347: 2013 Dec 19 pg f6879

    MeSH

    Cardiovascular Diseases
    Coronary Disease
    Dietary Fiber
    Edible Grain
    Evidence-Based Medicine
    Humans
    Practice Guidelines as Topic
    Risk Assessment
    Risk Factors
    Vegetables

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    24355537

    Citation

    Threapleton, Diane E., et al. "Dietary Fibre Intake and Risk of Cardiovascular Disease: Systematic Review and Meta-analysis." BMJ (Clinical Research Ed.), vol. 347, 2013, pp. f6879.
    Threapleton DE, Greenwood DC, Evans CE, et al. Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis. BMJ. 2013;347:f6879.
    Threapleton, D. E., Greenwood, D. C., Evans, C. E., Cleghorn, C. L., Nykjaer, C., Woodhead, C., ... Burley, V. J. (2013). Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis. BMJ (Clinical Research Ed.), 347, pp. f6879. doi:10.1136/bmj.f6879.
    Threapleton DE, et al. Dietary Fibre Intake and Risk of Cardiovascular Disease: Systematic Review and Meta-analysis. BMJ. 2013 Dec 19;347:f6879. PubMed PMID: 24355537.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis. AU - Threapleton,Diane E, AU - Greenwood,Darren C, AU - Evans,Charlotte E L, AU - Cleghorn,Christine L, AU - Nykjaer,Camilla, AU - Woodhead,Charlotte, AU - Cade,Janet E, AU - Gale,Christopher P, AU - Burley,Victoria J, Y1 - 2013/12/19/ PY - 2013/12/21/entrez PY - 2013/12/21/pubmed PY - 2014/2/18/medline SP - f6879 EP - f6879 JF - BMJ (Clinical research ed.) JO - BMJ VL - 347 N2 - OBJECTIVE: To investigate dietary fibre intake and any potential dose-response association with coronary heart disease and cardiovascular disease. DESIGN: Systematic review of available literature and dose-response meta-analysis of cohort studies using random effects models. DATA SOURCES: The Cochrane Library, Medline, Medline in-process, Embase, CAB Abstracts, ISI Web of Science, BIOSIS, and hand searching. ELIGIBILITY CRITERIA FOR STUDIES: Prospective studies reporting associations between fibre intake and coronary heart disease or cardiovascular disease, with a minimum follow-up of three years and published in English between 1 January 1990 and 6 August 2013. RESULTS: 22 cohort study publications met inclusion criteria and reported total dietary fibre intake, fibre subtypes, or fibre from food sources and primary events of cardiovascular disease or coronary heart disease. Total dietary fibre intake was inversely associated with risk of cardiovascular disease (risk ratio 0.91 per 7 g/day (95% confidence intervals 0.88 to 0.94)) and coronary heart disease (0.91 (0.87 to 0.94)). There was evidence of some heterogeneity between pooled studies for cardiovascular disease (I(2)=45% (0% to 74%)) and coronary heart disease (I(2)=33% (0% to 66%)). Insoluble fibre and fibre from cereal and vegetable sources were inversely associated with risk of coronary heart disease and cardiovascular disease. Fruit fibre intake was inversely associated with risk of cardiovascular disease. CONCLUSIONS: Greater dietary fibre intake is associated with a lower risk of both cardiovascular disease and coronary heart disease. Findings are aligned with general recommendations to increase fibre intake. The differing strengths of association by fibre type or source highlight the need for a better understanding of the mode of action of fibre components. SN - 1756-1833 UR - https://www.unboundmedicine.com/medline/citation/24355537/Dietary_fibre_intake_and_risk_of_cardiovascular_disease:_systematic_review_and_meta_analysis_ L2 - http://www.bmj.com/cgi/pmidlookup?view=long&pmid=24355537 DB - PRIME DP - Unbound Medicine ER -