Fiber intake and risk of nonfatal acute myocardial infarction

Abstract

Objective: To investigate the association between fiber intake and risk of acute myocardial infarction (AMI), also according to type and source of fiber, in a Mediterranean country. Design: Hospital-based case-control study. Setting: Northern Italy. Subjects: A total of 507 cases of first nonfatal AMI and 478 controls in hospital for acute conditions. Interventions: Subjects were interviewed with a questionnaire that included a validated food frequency section. Odds ratios (OR) were obtained using multiple logistic regression, and adjusted for several recognized risk factors for AMI. Fiber was measured as non-starch polysaccharides. Results: Compared with the lowest one, the OR in the highest tertile was 0.72 for total fiber, 0.64 for soluble fiber, 0.77 for total insoluble fiber, 0.71 for cellulose, 0.81 for insoluble non-cellulosic polysaccharides, 0.82 for vegetable fiber, 0.64 for fruit fiber and 1.11 for cereal fiber, and the estimates were statistically significant for soluble and fruit fiber. When further adjusted for bcarotene, vitamin C and vitamin E intake, the fruit fiber still showed the strongest inverse relation, although the association was no longer significant. The protective effect of fiber was more marked in, or restricted to, subjects with other AMI risk factors, such as smokers, diabetics and hypertensives. Conclusions: Though an inverse association between fiber intake and AMI risk appears established, the causality of this association is still open to debate. In this population, cereal fiber derives chiefly from refined grains, and this may explain the lack of protection by this type of fiber. Sponsorship: Partially supported by the Italian Ministry of Health.

Frequency of fruit and vegetable consumption and coronary heart disease in France and Northern Ireland: the PRIME study

“…In the PRIME study there was no significant relationship between cardiovascular risk and vegetable intake. Similarly, in Southern Europe, case -control studies have found favourable relationships between the risk of MI and fruit but not with vegetable intake (Sasazuki, 2001;Martinez-Gonzalez et al 2002;Negri et al 2003). In contrast, Joshipura et al (2001) and Pietinen et al (1996) reported lower coronary risk among vegetable consumers in the USA and Finland, respectively.…”

“…Yet, most data presented to date have been collected in North America or Northern Europe, two regions with elevated CHD rates (Tunstall-Pedoe et al 1999). In Italy, Greece and Spain, low intakes of fruit have been reported in survivors of MI enrolled in case -control studies (Martinez-Gonzalez et al 2002;Negri et al 2003;Panagiotakos et al 2003). To our knowledge, there have been no reports of cohort studies in countries from Central and Southern Europe.…”

Dietary lignans: physiology and potential for cardiovascular disease risk reduction

“…Dietary fiber may be responsible, in part, for the associations observed with lignan intake. Dietary fiber, 162–166 particularly soluble fiber, 164,167–169 reduces risk of cardiovascular disease. Dietary fiber lowers blood pressure, 170,171 decreases C‐reactive protein levels, 172–176 decreases metabolic syndrome, 177–179 and decreases insulin resistance 180 .…”

“…Cereal fiber consists more of insoluble fibers (lignins) than soluble fibers. Cereal fiber is associated with decreased insulin resistance, 192 lower serum lipids, 193 lower blood pressure, 194,195 less progression of coronary atherosclerosis in postmenopausal women with established coronary artery disease, 196 and reduced risk of coronary heart disease, 165,197,198 cardiovascular disease, 199 and stroke 200 in many 201 but not all studies 164,202,203 . Insoluble fiber is associated with lower blood pressure, 189 lower C‐reactive protein levels, 176 lower insulin resistance, 180 and lower risk of both cardiovascular disease 168 and myocardial infarction 164,168 …”