Dietary Fiber Intake and Mortality from All Causes, Cardiovascular Disease, Cancer, Infectious Diseases and Others: A Meta-Analysis of 42 Prospective Cohort Studies with 1,752,848 Participants
Keywords:
fiber, mortality, cancer, cardiovascular disease, meta-analysisAbstract
Results from observational studies on dietary fiber intake on total mortality and cause-specific mortality are inconsistent. The objective of the present meta-analysis was to investigate dietary fiber intake and mortality, and cause-specific mortality. Medline, EMBASE and web of science database was searched for cohort studies published from inception to February 2013. Studies were included if they provided a hazard ratio (HR) and corresponding 95% CI for mortality in relation to fiber consumption. A database was developed on the basis of 25 eligible studies and 42 cohorts, including 1,752,848 individuals with an average 12.4 years of follow-up. Compared with those who consumed lowest fiber, for individuals who ate highest fiber, mortality rate was lower by 23% (HR, 0.77; 95% CI, 0.72-0.81) for cardiovascular diseases (CVD), by 23% (HR, 0.77; 95% CI, 0.73-0.81) for all-cause mortality, by 17% (HR, 0.83; 95% CI, 0.74- 0.91) for cancer, by 68% for digestive diseases, by 58 % for infectious diseases, 43 % for inflammatory diseases. For each 10 g/d increase in fiber intake, the pooled HR was estimated to be 0.89 (95% CI, 0.86-0.93) for all-cause mortality, 0.91 (95% CI, 0.88-0.94) for cancer, 0.80 (95% CI, 0.72-0.88) for coronary heart disease (CHD) mortality, and 0.66 (95% CI, 0.40-0.92) for ischemic heart disease (IHD) mortality. Dietary fiber and CVD mortality showed a strong dose-response relation. For each 10 g/d increase in fiber intake, the pooled HR of CVD mortality was estimated to be 0.83 (95% CI, 0.80-0.87; P for trend=0.001). In conclusion, our meta-analysis results clearly show that high dietary fiber intake is associated with low all-cause mortality and mortality due to CVD, CHD, cancer, digestive disease, infectious diseases, and other inflammatory diseases.
References
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19. Liu SM, Buring JE, Sesso HD, Rimm EB, Willett WC, Manson JE. A prospective study of dietary fiber intake and risk of cardiovascular disease among women. J Am Coll Cardiol. 2002;39:49-56.
20. Mai V, Flood A, Peters U, Lacey JV, Schairer C, Schatzkin A. Dietary fibre and risk of colorectal cancer in the Breast Cancer Detection Demonstration Project (BCDDP) follow-up cohort. Int J Epidemiol. 2003;32:234-239.
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23. Eshak ES, Iso H, Date C, et al. Dietary Fiber Intake Is Associated with Reduced Risk of Mortality from Cardiovascular Disease among Japanese Men and Women. J Nutr. 2010;140:1445-1453.
24. He MA, van Dam RM, Rimm E, Hu FB, Qi L. Whole-Grain, Cereal Fiber, Bran, and Germ Intake and the Risks of All-Cause and Cardiovascular Disease-Specific Mortality Among Women With Type 2 Diabetes Mellitus. Circulation. 2010;121:2162-2168.
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26. Chuang SC, Norat T, Murphy N, et al. Fiber intake and total and cause-specific mortality in the European Prospective Investigation into Cancer and Nutrition cohort. Am J Clin Nutr. 2012;96:164-174.
27. Krishnamurthy VMR, Wei G, Baird BC, et al. High dietary fiber intake is associated with decreased inflammation and all-cause mortality in patients with chronic kidney disease. Kidney Int. 2012;81:300-306.
28. Schoenaker DAJM, Toeller M, Chaturvedi N, Fuller JH, Soedamah-Muthu SS, Complications EP. Dietary saturated fat and fibre and risk of cardiovascular disease and all-cause mortality among type 1 diabetic patients: the EURODIAB Prospective Complications Study. Diabetologia. 2012;55:2132-2141.
29. The World-Health-Organization Monica Project (Monitoring Trends and Determinants in Cardiovascular-Disease) - a Major International Collaboration. J Clin Epidemiol. 1988;41:105-114.
30. de Koning L, Hu FB. Do the Health Benefits of Dietary Fiber Extend Beyond Cardiovascular Disease? Arch Intern Med. 2011;171:1069-1070.
31. Anderson JW, Baird P, Davis RH, et al. Health benefits of dietary fiber. Nutr Rev. 2009;67:188-205.
32. Pereira MA, O'Reilly E, Augustsson K, et al. Dietary fiber and risk of coronary heart disease: a pooled analysis of cohort studies. Arch Intern Med. 2004;164:370-376.
33. Park Y, Hunter DJ, Spiegelman D, et al. Dietary fiber intake and risk of colorectal cancer: a pooled analysis of prospective cohort studies. JAMA. 2005;294:2849-2857.
34. Bamia C, Trichopoulos D, Ferrari P, et al. Dietary patterns and survival of older Europeans: the EPIC-Elderly Study (European Prospective Investigation into Cancer and Nutrition). Public Health Nutr. 2007;10:590-598.
35. Bingham SA, Day NE, Luben R. Dietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study. Lancet. 2003;362:1000-1000.
36. Mendez MA, Pera G, Aguclo A, et al. Cereal fiber intake may reduce risk of gastric adenocarcinomas: The EPIC-EURGAST study. Int J Cancer. 2007;121:1618-1623.
37. Jacobs DR, Andersen LF, Blomhoff R. Whole-grain consumption is associated with a reduced risk of noncardiovascular, noncancer death attributed to inflammatory diseases in the Iowa Women's Health Study. Am J Clin Nutr. 2007;85:1606-1614.
38. Liu SM, Stampfer MJ, Hu FB, et al. Whole-grain consumption and risk of coronary heart disease: results from the Nurses' Health Study. Am J Clin Nutr. 1999;70:412-419.
39. Whelton SP, Hyre AD, Pedersen B, Yi Y, Whelton PK, He J. Effect of dietary fiber intake on blood pressure: a meta-analysis of randomized, controlled clinical trials. J hypertens. 2005;23:475-481.
40. Steffen LM, Jacobs DR, Stevens J, Shahar E, Carithers T, Folsom AR. Associations of whole-grain, refined-grain, and fruit and vegetable consumption with risks of all-cause mortality and incident coronary artery disease and ischemic stroke: the Atherosclerosis Risk in Communities (ARIC) study. Am J Clin Nutr. 2003;78:383-390.
41. Montonen J, Knekt P, Jarvinen R, Aromaa A, Reunanen A. Whole-grain and fiber intake and the incidence of type 2 diabetes. Am J Clin Nutr. 2003;77:622-629.
42. Lairon D, Arnault N, Bertrais S, et al. Dietary fiber intake and risk factors for cardiovascular disease in French adults. American Journal of Clinical Nutrition. 2005;82:1185-1194.
43. Brown L, Rosner B, Willett WW, Sacks FM. Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr.1999;69:30-42.
44. Watzl B, Girrbach S, Roller M. Inulin, oligofructose and immunomodulation. Br J Nutr. 2005;93:S49-S55.
45. Anderson JW, Randles KM, Kendall CWC, Jenkins DJA. Carbohydrate and fiber recommendations for individuals with diabetes: A quantitative assessment and meta-analysis of the evidence. J Am Coll Nutr. 2004;23:5-17.
46. Liu SM, Manson JE, Buring JE, Stampfer MJ, Willett WC, Ridker PM. Relation between a diet with a high glycemic load and plasma concentrations of high-sensitivity C-reactive protein in middle-aged women. Am J Clin Nutr. 2002;75:492-498.
47. Ma YS, Hebert JR, Li WJ, et al. Association between dietary fiber and markers of systemic inflammation in the Women's Health Initiative Observational Study. Nutrition. 2008;24:941-949.
48. King DE, Egan BM, Geesey ME. Relation of dietary fat and fiber to elevation of C-reactive protein. Am J Cardiol. 2003;92:1335-1339.
49. Ma YS, Griffith JA, Chasan-Taber L, et al. Association between dietary fiber and serum C-reactive protein. Am J Clin Nutr. 2006;83:760-766.
50. King DE, Egan BM, Woolson RF, Mainous AG, Al-Solaiman Y, Jesri A. Effect of a high-fiber diet vs a fiber-supplemented diet on C-reactive protein level. Arch Intern Med. 2007;167:502-506.
51. Qi L, Rimm E, Liu SM, Rifai N, Hu FB. Dietary glycemic index, glycemic load, cereal fiber, and plasma adiponectin concentration in diabetic men. Diabetes Care. 2005;28:1022-1028.
52. Story JA, Furumoto EJ, Buhman KK. Dietary fiber and bile acid metabolism - an update. Adv Exp Med Biol. 1997;427:259-266.
53. Spiller RC. Cholesterol, fibre, and bile acids. Lancet.1996;347:415-416.
54. Sun Q, Spiegelman D, van Dam RM, et al. White Rice, Brown Rice, and Risk of Type 2 Diabetes in US Men and Women. Arch Intern Med. 2010;170:961-969.
55. Lindstrom J, Peltonen M, Eriksson JG, et al. High-fibre, low-fat diet predicts long-term weight loss and decreased type 2 diabetes risk: the Finnish Diabetes Prevention Study. Diabetologia. 2006;49:912-920.
56. Buyken AE, Toeller M, Heitkamp G, et al. Glycemic index in the diet of European outpatients with type 1 diabetes: relations to glycated hemoglobin and serum lipids. Am J Clin Nutr. 2001;73:574-581.
57. Toeller M. Fibre consumption, metabolic effects and prevention of complications in diabetic patients: epidemiological evidence. Dig Liver Dis. 2002;34:S145-S149.
2. Park Y, Subar AF, Hollenbeck A, Schatzkin A. Dietary fiber intake and mortality in the NIH-AARP diet and health study. Arch Intern Med. 2011;171:1061-1068.
3. Todd S, Woodward M, Tunstall-Pedoe H, Bolton-Smith C. Dietary antioxidant vitamins and fiber in the etiology of cardiovascular disease and all-causes mortality: results from the Scottish Heart Health Study. Am J Epidemiol. 1999;150:1073-1080.
4. Streppel MT, Ocke MC, Boshuizen HC, Kok FJ, Kromhout D. Dietary fiber intake in relation to coronary heart disease and all-cause mortality over 40 y: the Zutphen Study. Am J Clin Nutr. 2008;88:1119-1125.
5. Bazzano LA, He J, Ogden LG, et al. Dietary fiber intake and reduced risk of coronary heart disease in US men and women: the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. Arch Intern Med. 2003;163:1897-1904.
6. Midgette AS, Wong JB, Beshansky JR, Porath A, Fleming C, Pauker SG. Cost-effectiveness of streptokinase for acute myocardial infarction: A combined meta-analysis and decision analysis of the effects of infarct location and of likelihood of infarction. Med Decis Making. 1994;14:108-117.
7. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177-188.
8. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629-634.
9. Khaw KT, Barrett-Connor E. Dietary fiber and reduced ischemic heart disease mortality rates in men and women: a 12-year prospective study. Am J Epidemiol. 1987;126:1093-1102.
10. Fraser GE, Sabate J, Beeson WL, Strahan TM. A possible protective effect of nut consumption on risk of coronary heart disease. The Adventist Health Study. Arch Intern Med. 1992;152:1416-1424.
11. Knekt P, Reunanen A, Jarvinen R, Seppanen R, Heliovaara M, Aromaa A. Antioxidant vitamin intake and coronary mortality in a longitudinal population study. Am J Epidemiol. 1994;139:1180-1189.
12. Barefoot JC, Larsen S, von der Lieth L, Schroll M. Hostility, incidence of acute myocardial infarction, and mortality in a sample of older Danish men and women. Am J Epidemiol. 1995;142:477-484.
13. Pietinen P, Rimm EB, Korhonen P, et al. Intake of dietary fiber and risk of coronary heart disease in a cohort of Finnish men. The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Circulation. 1996;94:2720-2727.
14. Rimm EB, Ascherio A, Giovannucci E, Spiegelman D, Stampfer MJ, Willett WC. Vegetable, fruit, and cereal fiber intake and risk of coronary heart disease among men. JAMA. 1996;275:447-451.
15. Kushi LH, Folsom AR, Prineas RJ, Mink PJ, Wu Y, Bostick RM. Dietary antioxidant vitamins and death from coronary heart disease in postmenopausal women. New Engl J Med. 1996;334:1156-1162.
16. Folsom AR, Arnett DK, Hutchinson RG, Liao FZ, Clegg LX, Cooper LS. Physical activity and incidence of coronary heart disease in middle-aged women and men. Med Sci Sports Exerc. 1997;29:901-909.
17. Jansen MCJF, Bueno-de-Mesquita HB, Buzina R, et al. Dietary fiber and plant foods in relation to colorectal cancer mortality: The seven countries study. Int J Cancer. 1999;81:174-179.
18. Wolk A, Manson JE, Stampfer MJ, et al. Long-term intake of dietary fiber and decreased risk of coronary heart disease among women. Jama-J Am Med Assoc. 1999;281:1998-2004.
19. Liu SM, Buring JE, Sesso HD, Rimm EB, Willett WC, Manson JE. A prospective study of dietary fiber intake and risk of cardiovascular disease among women. J Am Coll Cardiol. 2002;39:49-56.
20. Mai V, Flood A, Peters U, Lacey JV, Schairer C, Schatzkin A. Dietary fibre and risk of colorectal cancer in the Breast Cancer Detection Demonstration Project (BCDDP) follow-up cohort. Int J Epidemiol. 2003;32:234-239.
21. McEligot AJ, Largent J, Ziogas A, Peel D, Anton-Culver H. Dietary fat, fiber, vegetable, and micronutrients are associated with overall survival in postmenopausal women diagnosed with breast cancer. Nutr Cancer. 2006;55:132-140.
22. Crowe FL, Key TJ, Appleby PN, et al. Dietary fibre intake and ischaemic heart disease mortality: the European Prospective Investigation into Cancer and Nutrition-Heart study. Eur J Clin Nutr. 2012;66:950-956.
23. Eshak ES, Iso H, Date C, et al. Dietary Fiber Intake Is Associated with Reduced Risk of Mortality from Cardiovascular Disease among Japanese Men and Women. J Nutr. 2010;140:1445-1453.
24. He MA, van Dam RM, Rimm E, Hu FB, Qi L. Whole-Grain, Cereal Fiber, Bran, and Germ Intake and the Risks of All-Cause and Cardiovascular Disease-Specific Mortality Among Women With Type 2 Diabetes Mellitus. Circulation. 2010;121:2162-2168.
25. Burger KNJ, Beulens JWJ, van der Schouw YT, et al. Dietary Fiber, Carbohydrate Quality and Quantity, and Mortality Risk of Individuals with Diabetes Mellitus. Plos One. 2012;7.
26. Chuang SC, Norat T, Murphy N, et al. Fiber intake and total and cause-specific mortality in the European Prospective Investigation into Cancer and Nutrition cohort. Am J Clin Nutr. 2012;96:164-174.
27. Krishnamurthy VMR, Wei G, Baird BC, et al. High dietary fiber intake is associated with decreased inflammation and all-cause mortality in patients with chronic kidney disease. Kidney Int. 2012;81:300-306.
28. Schoenaker DAJM, Toeller M, Chaturvedi N, Fuller JH, Soedamah-Muthu SS, Complications EP. Dietary saturated fat and fibre and risk of cardiovascular disease and all-cause mortality among type 1 diabetic patients: the EURODIAB Prospective Complications Study. Diabetologia. 2012;55:2132-2141.
29. The World-Health-Organization Monica Project (Monitoring Trends and Determinants in Cardiovascular-Disease) - a Major International Collaboration. J Clin Epidemiol. 1988;41:105-114.
30. de Koning L, Hu FB. Do the Health Benefits of Dietary Fiber Extend Beyond Cardiovascular Disease? Arch Intern Med. 2011;171:1069-1070.
31. Anderson JW, Baird P, Davis RH, et al. Health benefits of dietary fiber. Nutr Rev. 2009;67:188-205.
32. Pereira MA, O'Reilly E, Augustsson K, et al. Dietary fiber and risk of coronary heart disease: a pooled analysis of cohort studies. Arch Intern Med. 2004;164:370-376.
33. Park Y, Hunter DJ, Spiegelman D, et al. Dietary fiber intake and risk of colorectal cancer: a pooled analysis of prospective cohort studies. JAMA. 2005;294:2849-2857.
34. Bamia C, Trichopoulos D, Ferrari P, et al. Dietary patterns and survival of older Europeans: the EPIC-Elderly Study (European Prospective Investigation into Cancer and Nutrition). Public Health Nutr. 2007;10:590-598.
35. Bingham SA, Day NE, Luben R. Dietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study. Lancet. 2003;362:1000-1000.
36. Mendez MA, Pera G, Aguclo A, et al. Cereal fiber intake may reduce risk of gastric adenocarcinomas: The EPIC-EURGAST study. Int J Cancer. 2007;121:1618-1623.
37. Jacobs DR, Andersen LF, Blomhoff R. Whole-grain consumption is associated with a reduced risk of noncardiovascular, noncancer death attributed to inflammatory diseases in the Iowa Women's Health Study. Am J Clin Nutr. 2007;85:1606-1614.
38. Liu SM, Stampfer MJ, Hu FB, et al. Whole-grain consumption and risk of coronary heart disease: results from the Nurses' Health Study. Am J Clin Nutr. 1999;70:412-419.
39. Whelton SP, Hyre AD, Pedersen B, Yi Y, Whelton PK, He J. Effect of dietary fiber intake on blood pressure: a meta-analysis of randomized, controlled clinical trials. J hypertens. 2005;23:475-481.
40. Steffen LM, Jacobs DR, Stevens J, Shahar E, Carithers T, Folsom AR. Associations of whole-grain, refined-grain, and fruit and vegetable consumption with risks of all-cause mortality and incident coronary artery disease and ischemic stroke: the Atherosclerosis Risk in Communities (ARIC) study. Am J Clin Nutr. 2003;78:383-390.
41. Montonen J, Knekt P, Jarvinen R, Aromaa A, Reunanen A. Whole-grain and fiber intake and the incidence of type 2 diabetes. Am J Clin Nutr. 2003;77:622-629.
42. Lairon D, Arnault N, Bertrais S, et al. Dietary fiber intake and risk factors for cardiovascular disease in French adults. American Journal of Clinical Nutrition. 2005;82:1185-1194.
43. Brown L, Rosner B, Willett WW, Sacks FM. Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr.1999;69:30-42.
44. Watzl B, Girrbach S, Roller M. Inulin, oligofructose and immunomodulation. Br J Nutr. 2005;93:S49-S55.
45. Anderson JW, Randles KM, Kendall CWC, Jenkins DJA. Carbohydrate and fiber recommendations for individuals with diabetes: A quantitative assessment and meta-analysis of the evidence. J Am Coll Nutr. 2004;23:5-17.
46. Liu SM, Manson JE, Buring JE, Stampfer MJ, Willett WC, Ridker PM. Relation between a diet with a high glycemic load and plasma concentrations of high-sensitivity C-reactive protein in middle-aged women. Am J Clin Nutr. 2002;75:492-498.
47. Ma YS, Hebert JR, Li WJ, et al. Association between dietary fiber and markers of systemic inflammation in the Women's Health Initiative Observational Study. Nutrition. 2008;24:941-949.
48. King DE, Egan BM, Geesey ME. Relation of dietary fat and fiber to elevation of C-reactive protein. Am J Cardiol. 2003;92:1335-1339.
49. Ma YS, Griffith JA, Chasan-Taber L, et al. Association between dietary fiber and serum C-reactive protein. Am J Clin Nutr. 2006;83:760-766.
50. King DE, Egan BM, Woolson RF, Mainous AG, Al-Solaiman Y, Jesri A. Effect of a high-fiber diet vs a fiber-supplemented diet on C-reactive protein level. Arch Intern Med. 2007;167:502-506.
51. Qi L, Rimm E, Liu SM, Rifai N, Hu FB. Dietary glycemic index, glycemic load, cereal fiber, and plasma adiponectin concentration in diabetic men. Diabetes Care. 2005;28:1022-1028.
52. Story JA, Furumoto EJ, Buhman KK. Dietary fiber and bile acid metabolism - an update. Adv Exp Med Biol. 1997;427:259-266.
53. Spiller RC. Cholesterol, fibre, and bile acids. Lancet.1996;347:415-416.
54. Sun Q, Spiegelman D, van Dam RM, et al. White Rice, Brown Rice, and Risk of Type 2 Diabetes in US Men and Women. Arch Intern Med. 2010;170:961-969.
55. Lindstrom J, Peltonen M, Eriksson JG, et al. High-fibre, low-fat diet predicts long-term weight loss and decreased type 2 diabetes risk: the Finnish Diabetes Prevention Study. Diabetologia. 2006;49:912-920.
56. Buyken AE, Toeller M, Heitkamp G, et al. Glycemic index in the diet of European outpatients with type 1 diabetes: relations to glycated hemoglobin and serum lipids. Am J Clin Nutr. 2001;73:574-581.
57. Toeller M. Fibre consumption, metabolic effects and prevention of complications in diabetic patients: epidemiological evidence. Dig Liver Dis. 2002;34:S145-S149.
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2015-05-01
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Huang, T., & Zhang, X. (2015). Dietary Fiber Intake and Mortality from All Causes, Cardiovascular Disease, Cancer, Infectious Diseases and Others: A Meta-Analysis of 42 Prospective Cohort Studies with 1,752,848 Participants. North American Journal of Medicine and Science, 8(2). Retrieved from https://najms.com/index.php/najms/article/view/51
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