• BMJ · Jan 2013

    Review Meta Analysis

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

    • Diane E Threapleton, Darren C Greenwood, Charlotte E L Evans, Christine L Cleghorn, Camilla Nykjaer, Charlotte Woodhead, Janet E Cade, Christopher P Gale, and Victoria J Burley.
    • Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
    • BMJ. 2013 Jan 1;347:f6879.

    ObjectiveTo investigate dietary fibre intake and any potential dose-response association with coronary heart disease and cardiovascular disease.DesignSystematic review of available literature and dose-response meta-analysis of cohort studies using random effects models.Data SourcesThe Cochrane Library, Medline, Medline in-process, Embase, CAB Abstracts, ISI Web of Science, BIOSIS, and hand searching.Eligibility Criteria For StudiesProspective 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.Results22 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.ConclusionsGreater 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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