Key points: Recent data have indicated rates for cardiovascular disease (CVD) and coronary heart disease (CHD) are declining but still more than a third of all deaths in the US, and nearly half of the deaths in the EU, can be linked to heart disease.
Fiber has long been proposed as a possible cardioprotectant; there have been studies that assessed dietary fiber and its effects on hypertension, obesity, increased serum cholesterol and insulin sensitivity. It has been suggested that other components of high fiber foods may contribute to a cardioprotective effect including antioxidants and phytosterols, however most studies have been observational and with no clear evidence of association.
In this analysis, the authors evaluated the literature and data from prospective, dose response, studies for over two decades to assess not only the amount of total dietary fiber necessary for reducing CVD risk, but also the type of fiber that has been shown to reduce these risks.
The researchers reviewed 22 studies and literature that reported total dietary fiber intake, fiber subtypes, or fiber from food sources and primary events for CVD or CHD. Results of their analysis and data showed, in healthy people, total intake of 7 g/day of insoluble dietary fiber and fiber from whole grain cereal and vegetable sources was inversely associated with risk of CVD [RR 0.91 (95% CI 0.88 to 0.94)] and CHD [RR 0.91 (95% CI 0.87 to 0.94)]. The authors also reported an inverse relationship between CVD and fiber from whole fruit intake.
Why is this clinically relevant?
- Diets high in insoluble fiber (7g/day) from whole grain cereal or vegetables are linked to significantly lower risk of CVD and CHD in healthy people
- Increased fiber intake from whole fruits was associated with reduced risk of CVD in healthy adults
- The data from this meta-analysis support increased fiber consumption from whole foods (whole grain cereals, vegetables or fruits) and not fiber enriched food sources.