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Dietary Fiber Intake and Risk of Stroke

  • Neurological Disease and Cognitive Function (G Logroscino, Section Editor)
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Abstract

Prospective studies show that a high intake of plant-derived foods, including fruits, vegetables, whole grains, and nuts, is associated with reduced risk of stroke. Among the many compounds present in these foods, dietary fiber may be an important mediator of the beneficial effects. Meta-analyses of prospective studies have reported an inverse association between intake of dietary fiber and risk of stroke. Findings from meta-analyses of randomized controlled trials show that fiber supplementation has a weak to modest beneficial effect on blood pressure as well as on total and low-density lipoprotein cholesterol concentrations. Epidemiological data also indicate that intake of fiber-rich foods may reduce systemic inflammation, postprandial glycemic response, and the probability of developing insulin resistance. While it remains unclear whether dietary fiber per se has a protective effect, compelling evidence indicates that increased intake of fiber-rich foods likely plays an important role in the prevention of stroke.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Mackay J, Mensah G. The Atlas of Heart Disease and Stroke. Geneva: World Health Organization; 2004.

    Google Scholar 

  2. Goldstein LB, Bushnell CD, Adams RJ, et al. Guidelines for the primary prevention of stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42:517–84. This is an excellent overview of the evidence on established and emerging risk factors for stroke. It summarizes evidence-based recommendations for primary prevention of stroke.

    Article  PubMed  Google Scholar 

  3. Larsson SC, Virtamo J, Wolk A. Total and specific fruit and vegetable consumption and risk of stroke: a prospective study. Atherosclerosis. 2013;227:147–52.

    Article  PubMed  CAS  Google Scholar 

  4. Bernstein AM, Sun Q, Hu FB, et al. Major dietary protein sources and risk of coronary heart disease in women. Circulation. 2010;122:876–83.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  5. Liu S, Manson JE, Stampfer MJ, et al. Whole grain consumption and risk of ischemic stroke in women: a prospective study. JAMA. 2000;284:1534–40.

    Article  PubMed  CAS  Google Scholar 

  6. He FJ, Nowson CA, MacGregor GA. Fruit and vegetable consumption and stroke: meta-analysis of cohort studies. Lancet. 2006;367:320–6.

    Article  PubMed  Google Scholar 

  7. A Report of the Panel on Macronutrients, Subcommittees on Upper Reference Levels of Nutrients and Interpretation and Uses of Dietary Reference Intakes, and the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. In Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: The National Academies Press; 2005.

  8. King DE, Mainous 3rd AG, Lambourne CA. Trends in dietary fiber intake in the United States, 1999-2008. J Acad Nutr Diet. 2012;112:642–8.

    Article  PubMed  Google Scholar 

  9. Clemens R, Kranz S, Mobley AR, et al. Filling America’s fiber intake gap: summary of a roundtable to probe realistic solutions with a focus on grain-based foods. J Nutr. 2012;142:1390S–401S.

    Article  PubMed  CAS  Google Scholar 

  10. Eastwood MA, Passmore R. Dietary fibre. Lancet. 1983;2:202–6.

    Article  PubMed  CAS  Google Scholar 

  11. Zhang Z, Xu G, Liu D, et al. Dietary fiber consumption and risk of stroke. Eur J Epidemiol. 2013;28:119–30. This is a meta-analysis of 11 prospective studies on dietary fiber intake and risk of stroke. The authors present results for all studies combined and across various subgroups.

    Article  PubMed  CAS  Google Scholar 

  12. Chen GC, Lv DB, Pang Z, Dong JY, Liu QF. Dietary fiber intake and stroke risk: a meta-analysis of prospective cohort studies. Eur J Clin Nutr. 2013;67:96–100. This is a meta-analysis of 6 prospective studies on dietary fiber intake and risk of stroke. The authors present results for all studies combined and by sex and stroke types.

    Article  PubMed  CAS  Google Scholar 

  13. Threapleton DE, Greenwood DC, Evans CE, et al. Dietary fiber intake and risk of first stroke: a systematic review and meta-analysis. Stroke. 2013;44:1360–8. This is a meta-analysis of 8 prospective studies on dietary fiber intake and risk of stroke. The authors present results for all studies combined and by stroke types and types of fiber.

    Article  PubMed  CAS  Google Scholar 

  14. Larsson SC, Männistö S, Virtanen MJ, et al. Dietary fiber and fiber-rich food intake in relation to risk of stroke in male smokers. Eur J Clin Nutr. 2009;63:1016–24.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  15. Ascherio A, Rimm EB, Hernan MA, et al. Intake of potassium, magnesium, calcium, and fiber and risk of stroke among US men. Circulation. 1998;98:1198–204.

    Article  PubMed  CAS  Google Scholar 

  16. Streppel MT, Arends LR, van’t Veer P, Grobbee DE, Geleijnse JM. Dietary fiber and blood pressure: a meta-analysis of randomized placebo-controlled trials. Arch Intern Med. 2005;165:150–6.

    Article  PubMed  Google Scholar 

  17. Whelton SP, Hyre AD, Pedersen B, et al. Effect of dietary fiber intake on blood pressure: a meta-analysis of randomized, controlled clinical trials. J Hypertens. 2005;23:475–81.

    Article  PubMed  CAS  Google Scholar 

  18. 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.

    PubMed  CAS  Google Scholar 

  19. Anderson JW, Allgood LD, Lawrence A, et al. Cholesterol-lowering effects of psyllium intake adjunctive to diet therapy in men and women with hypercholesterolemia: meta-analysis of 8 controlled trials. Am J Clin Nutr. 2000;71:472–9.

    PubMed  CAS  Google Scholar 

  20. Schneeman BO, Gallaher D. Effects of dietary fiber on digestive enzyme activity and bile acids in the small intestine. Proc Soc Exp Biol Med. 1985;180:409–14.

    Article  PubMed  CAS  Google Scholar 

  21. Hara H, Haga S, Aoyama Y, Kiriyama S. Short-chain fatty acids suppress cholesterol synthesis in rat liver and intestine. J Nutr. 1999;129:942–8.

    PubMed  CAS  Google Scholar 

  22. Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation. 2002;105:1135–43.

    Article  PubMed  CAS  Google Scholar 

  23. Kaptoge S, Di Angelantonio E, Lowe G, et al. C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. Lancet. 2010;375:132–40.

    Article  PubMed  CAS  Google Scholar 

  24. Grooms KN, Ommerborn MJ, Pham DQ, Djousse L, Clark CR. Dietary fiber intake and cardiometabolic risks among US Adults, NHANES 1999-2010. Am J Med. 2013;126:1059–67. This article presents trends in dietary fiber intake among diverse U.S. adults between 1999 and 2010, and results for dietary fiber intake in relation to cardiometabolic risk factors, including metabolic syndrome, obesity, and inflammation.

    Article  PubMed  CAS  Google Scholar 

  25. Ma Y, Hebert JR, Li W, et al. Association between dietary fiber and markers of systemic inflammation in the Women’s Health Initiative Observational Study. Nutrition. 2008;24:941–9.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  26. Ma Y, Griffith JA, Chasan-Taber L, et al. Association between dietary fiber and serum C-reactive protein. Am J Clin Nutr. 2006;83:760–6.

    PubMed Central  PubMed  CAS  Google Scholar 

  27. Qi L, van Dam RM, Liu S, et al. Whole-grain, bran, and cereal fiber intakes and markers of systemic inflammation in diabetic women. Diabetes Care. 2006;29:207–11.

    Article  PubMed  CAS  Google Scholar 

  28. North CJ, Venter CS, Jerling JC. The effects of dietary fibre on C-reactive protein, an inflammation marker predicting cardiovascular disease. Eur J Clin Nutr. 2009;63:921–33.

    Article  PubMed  CAS  Google Scholar 

  29. Tosh SM. Review of human studies investigating the post-prandial blood-glucose lowering ability of oat and barley food products. Eur J Clin Nutr. 2013;67:310–7. This review article of 34 clinical trials suggests that whole grain,s as well as a variety of processed oat and barley foods, can significantly reduce postprandial blood glucose.

    Article  PubMed  CAS  Google Scholar 

  30. Silva FM, Kramer CK, de Almeida JC, et al. Fiber intake and glycemic control in patients with type 2 diabetes mellitus: a systematic review with meta-analysis of randomized controlled trials. Nutr Rev. 2013. This systematic review and meta-analysis of 11 randomized controlled trials examines the effect of dietary fiber intake on glycemic control in patients with type 2 diabetes.

  31. Livesey G, Tagami H. Interventions to lower the glycemic response to carbohydrate foods with a low-viscosity fiber (resistant maltodextrin): meta-analysis of randomized controlled trials. Am J Clin Nutr. 2009;89:114–25.

    Article  PubMed  CAS  Google Scholar 

  32. Breneman CB, Tucker L. Dietary fibre consumption and insulin resistance - the role of body fat and physical activity. Br J Nutr. 2013;110:375–83.

    Article  PubMed  CAS  Google Scholar 

  33. Lau C, Faerch K, Glumer C, et al. Dietary glycemic index, glycemic load, fiber, simple sugars, and insulin resistance: the Inter99 study. Diabetes Care. 2005;28:1397–403.

    Article  PubMed  CAS  Google Scholar 

  34. Feskens EJ, Loeber JG, Kromhout D. Diet and physical activity as determinants of hyperinsulinemia: the Zutphen Elderly Study. Am J Epidemiol. 1994;140:350–60.

    PubMed  CAS  Google Scholar 

  35. Ludwig DS, Pereira MA, Kroenke CH, et al. Dietary fiber, weight gain, and cardiovascular disease risk factors in young adults. JAMA. 1999;282:1539–46.

    Article  PubMed  CAS  Google Scholar 

  36. Cho SS, Qi L, Fahey Jr GC, Klurfeld DM. Consumption of cereal fiber, mixtures of whole grains and bran, and whole grains and risk reduction in type 2 diabetes, obesity, and cardiovascular disease. Am J Clin Nutr. 2013;98:594–619. This is a systematic review of prospective studies investigating the association between cereal fiber, mixtures of whole grains and bran, or whole grain consumption with risk of type 2 diabetes, cardiovascular disease, obesity, and body weight measures.

    Article  PubMed  CAS  Google Scholar 

  37. Lappi J, Kolehmainen M, Mykkanen H, Poutanen K. Do large intestinal events explain the protective effects of whole grain foods against type 2 diabetes? Crit Rev Food Sci Nutr. 2013;53:631–40.

    Article  PubMed  CAS  Google Scholar 

  38. Smith CE and Tucker KL. Health benefits of cereal fibre: a review of clinical trials. Nutr Res Rev. 2011:1-14. This review focuses on intervention trials with three primary aims: (1) understanding the mechanisms by which fiber intake improves health; (2) evaluation of qualitative factors that modify the effectiveness of fiber; and (3) identification of areas in which additional research is needed.

  39. Pol K, Christensen R, Bartels EM, et al. Whole grain and body weight changes in apparently healthy adults: a systematic review and meta-analysis of randomized controlled studies. Am J Clin Nutr. 2013;98:872–84. This systematic review and meta-analysis found that consumption of whole-grain foods as compared with non-whole-grain foods had no effect on body weight but seemed to have a small beneficial effect on the percentage of body fat.

    Article  PubMed  CAS  Google Scholar 

  40. Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2013

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Acknowledgments

The author’s research on stroke was funded by the Swedish Research Council for Health, Working Life and Welfare (Forte).

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Susanna C. Larsson declares that she has no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to Susanna C. Larsson.

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Larsson, S.C. Dietary Fiber Intake and Risk of Stroke. Curr Nutr Rep 3, 88–93 (2014). https://doi.org/10.1007/s13668-014-0074-6

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