Wolk A, Manson J E, Stampfer M J, Colditz G A, Hu F B, Speizer F E, Hennekens C H, Willett W C
Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden.
JAMA. 1999 Jun 2;281(21):1998-2004. doi: 10.1001/jama.281.21.1998.
Epidemiological studies of men suggest that dietary fiber intake protects against coronary heart disease (CHD), but data on this association in women are sparse.
To examine the association between long-term intake of total dietary fiber as well as fiber from different sources and risk of CHD in women.
The Nurses' Health Study, a large, prospective cohort study of US women followed up for 10 years from 1984. Dietary data were collected in 1984, 1986, and 1990, using a validated semiquantitative food frequency questionnaire.
A total of 68782 women aged 37 to 64 years without previously diagnosed angina, myocardial infarction (MI), stroke, cancer, hypercholesterolemia, or diabetes at baseline.
Incidence of acute MI or death due to CHD by amount of fiber intake.
Response rate averaged 80% to 90% during the 10-year follow-up. We documented 591 major CHD events (429 nonfatal MIs and 162 CHD deaths). The age-adjusted relative risk (RR) for major CHD events was 0.53 (95% confidence interval [CI], 0.40-0.69) for women in the highest quintile of total dietary fiber intake (median, 22.9 g/d) compared with women in the lowest quintile (median, 11.5 g/d). After controlling for age, cardiovascular risk factors, dietary factors, and multivitamin supplement use, the RR was 0.77 (95% CI, 0.57-1.04). For a 10-g/d increase in total fiber intake (the difference between the lowest and highest quintiles), the multivariate RR of total CHD events was 0.81 (95% CI, 0.66-0.99). Among different sources of dietary fiber (eg, cereal, vegetables, fruit), only cereal fiber was strongly associated with a reduced risk of CHD (multivariate RR, 0.63; 95% CI, 0.49-0.81 for each 5-g/d increase in cereal fiber).
Our findings in women support the hypothesis that higher fiber intake, particularly from cereal sources, reduces the risk of CHD.
针对男性的流行病学研究表明，膳食纤维摄入可预防冠心病（CHD），但关于女性这一关联的数据较少。
研究女性长期总膳食纤维摄入量以及不同来源膳食纤维与冠心病风险之间的关联。
护士健康研究，这是一项针对美国女性的大型前瞻性队列研究，从1984年开始随访10年。1984年、1986年和1990年使用经过验证的半定量食物频率问卷收集饮食数据。
共有68782名年龄在37至64岁之间的女性，她们在基线时未被诊断出患有心绞痛、心肌梗死（MI）、中风、癌症、高胆固醇血症或糖尿病。
根据膳食纤维摄入量记录急性心肌梗死或冠心病死亡的发生率。
在10年随访期间，平均回复率为80%至90%。我们记录了591例主要冠心病事件（429例非致命性心肌梗死和162例冠心病死亡）。总膳食纤维摄入量最高五分位数组（中位数为22.9克/天）的女性与最低五分位数组（中位数为11.5克/天）的女性相比，年龄调整后的主要冠心病事件相对风险（RR）为0.53（95%置信区间[CI]，0.40 - 0.69）。在控制年龄、心血管危险因素、饮食因素和多种维生素补充剂使用情况后，RR为0.77（95% CI，0.57 - 1.04）。总膳食纤维摄入量每增加10克/天（最低和最高五分位数之间的差异），冠心病事件的多变量RR为0.81（95% CI，0.66 - 0.99）。在不同来源的膳食纤维（如谷物、蔬菜、水果）中，只有谷物纤维与冠心病风险降低密切相关（多变量RR，0.63；谷物纤维每增加5克/天，95% CI，0.49 - 0.81）。
我们在女性中的研究结果支持以下假设，即较高的膳食纤维摄入量，特别是来自谷物来源的膳食纤维，可降低冠心病风险。
