Rimm E B, Ascherio A, Giovannucci E, Spiegelman D, Stampfer M J, Willett W C
Department of Epidemiology, Harvard School of Public Health, Boston, Mass. 02115, USA.
JAMA. 1996 Feb 14;275(6):447-51. doi: 10.1001/jama.1996.03530300031036.
To examine prospectively the relationship between dietary fiber and risk of coronary heart disease.
Cohort study.
In 1986, a total of 43,757 US male health professionals 40 to 75 years of age and free from diagnosed cardiovascular disease and diabetes completed a detailed 131-item dietary questionnaire used to measure usual intake of total dietary fiber and specific food sources of fiber.
Fatal and nonfatal myocardial infarction (MI).
During 6 years of follow-up, we documented 734 cases of MI (229 were fatal coronary heart disease). The age-adjusted relative risk (RR) for total MI was 0.59 (95% confidence interval [CI], 0.46 to 0.76) among men in the highest quintile of total dietary fiber intake (median, 28.9 g/d) compared with men in the lowest quartile (median, 12.4 g/d). The inverse association was strongest for fatal coronary disease (RR, 0.45; 95% CI, 0.28 to 0.72). After controlling for smoking, physical activity and other known nondietary cardiovascular risk factors, dietary saturated fat, vitamin E, total energy intake, and alcohol intake, the RRs were only modestly attenuated. A 10-g increase in total dietary fiber corresponded to an RR for total MI of 0.81 (95% CI, 0.70 to 0.93). Within the three main food contributors to total fiber intake (vegetable, fruit, and cereal), cereal fiber was most strongly associated with a reduced risk of total MI (RR, 0.71; 95% CI, 0.55 to 0.91 for each 10-g increase in cereal fiber per day).
Our results suggest an inverse association between fiber intake and MI. These results support current national dietary guidelines to increase dietary fiber intake and suggest that fiber, independent of fat intake, is an important dietary component for the prevention of coronary disease.
前瞻性研究膳食纤维与冠心病风险之间的关系。
队列研究。
1986年，共有43757名40至75岁、未被诊断患有心血管疾病和糖尿病的美国男性健康专业人员完成了一份详细的包含131个条目的饮食问卷，该问卷用于测量膳食纤维的总摄入量以及特定食物来源的纤维摄入量。
致命性和非致命性心肌梗死（MI）。
在6年的随访期间，我们记录了734例心肌梗死病例（229例为致命性冠心病）。与膳食纤维总摄入量处于最低四分位数（中位数为12.4克/天）的男性相比，膳食纤维总摄入量处于最高五分位数（中位数为28.9克/天）的男性，经年龄调整后的总心肌梗死相对风险（RR）为0.59（95%置信区间[CI]，0.46至0.76）。这种负相关在致命性冠心病中最为明显（RR，0.45；95%CI，0.28至0.72）。在控制了吸烟、身体活动以及其他已知的非饮食性心血管危险因素、饮食中的饱和脂肪、维生素E、总能量摄入和酒精摄入后，相对风险仅略有降低。膳食纤维总摄入量每增加10克，总心肌梗死的RR为0.81（95%CI，0.70至0.93）。在膳食纤维总摄入量的三个主要食物来源（蔬菜、水果和谷物）中，谷物纤维与总心肌梗死风险降低的关联最为强烈（每天谷物纤维每增加10克，RR为0.71；95%CI，0.55至0.91）。
我们的结果表明纤维摄入量与心肌梗死之间存在负相关。这些结果支持当前国家饮食指南中增加膳食纤维摄入量的建议，并表明纤维独立于脂肪摄入，是预防冠心病的重要饮食成分。
