Abstract
Large, prospective, epidemiologic studies show a protective effect of dietary fiber against coronary heart disease (CHD) and form the basis for new recommendations from the National Academy of Science for fiber intake (38 and 25 g/d for young men and women, respectively, based on an intake of 14 g of fiber per 1000 kcal). Mechanisms by which fibers may protect against CHD include lowering blood cholesterol (soluble fibers), attenuating blood triglyceride levels (mostly soluble fibers), decreasing hypertension (all fibers), and normalizing postprandial blood glucose levels (all fibers). An important consideration in making diet recommendations to protect against CHD is that the total amount of fiber from fiber-containing foods is important, and individuals should not just be counseled to focus on soluble fiber.
Similar content being viewed by others
References
Institute of Medicine: Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: National Academy Press; 2002.
U.S. Food and Drug Administration: Nutrition labeling of food; calorie content. Federal Register 1987, 52:28590–28691.
Institute of Medicine: Dietary Reference Intakes: Proposed Definition of Dietary Fiber. Washington, DC: National Academy Press; 2001.
Jacobs DR, Meyer KA, Kushi LH, Folsom AR: Whole-grain intake may reduce the risk of ischemic heart disease death in postmenopausal women: The Iowa Women’s Health Study. Am J Clin Nutr 1998, 68:248–257.
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.
Rimm EB, Ascherio A, Giovannucci E, et al.: Vegetable, fruit, and cereal fiber intake and risk of coronary heart disease among men. JAMA 1996, 275:447–451.
Wolk A, Manson JE, Stampfer MJ, et al.: Long-term intake of dietary fiber and decreased risk of coronary heart disease among women. JAMA 1999, 281:1998–2004.
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.
Liu S, Buring JE, Sesso HD, et al.: A prospective study of dietary fiber intake and risk of cardiovascular disease among women. J Am Coll Cardiol 2002, 39:49–56.
Fernandez ML: Soluble fiber and nondigestible carbohydrate effects on plasma lipids and cardiovascular risk. Curr Opin Lipidol 2001, 12:35–40.
U.S. Food & Drug Administration: Food labeling: health claims; soluble dietary fiber from certain foods and coronary heart disease. Interim final rule. Federal Register 2002, 67:61773–61783.
Vega-Lopez S, Vidal-Quintanar RL, Fernandez ML: Sex and hormonal status influence plasma lipid responses to psyllium. Am J Clin Nutr 2001, 74:435–441.
Davy BM, Davy KP, Ho RC, et al.: High-fiber oat cereal compared with wheat cereal consumption favorably alters LDL-cholesterol subclass and particle numbers in middle-aged and older men. Am J Clin Nutr 2002, 76:351–358.
Pins JJ, Geleva D, Keenan JM, et al.: Do whole-grain oat cereals reduce the need for antihypertensive medications and improve blood pressure control? J Fam Pract 2002, 51:353–359.
Truswell AS: Cereal grains and coronary heart disease. Eur J Clin Nutr 2002, 56:1–14.
Parks EJ: Dietary carbohydrate’s effects on lipogenesis and the relationship of lipogenesis to blood insulin and glucose concentrations. Br J Nutr 2002, 87(Suppl 2):S247-S253.
Anderson JW: Dietary fiber prevents carbohydrate-induced hypertriglyceridemia. Curr Atheroscler Rep 2000, 2:536–541.
Beilin LJ, Burke V, Puddey IB, et al.: Recent developments concerning diet and hypertension. Clin Exp Pharmacol Physiol 2001, 28:1078–1082.
He J, Whelton PK: Effect of dietary fiber and protein intake on blood pressure: a review of epidemiologic evidence. Clin Exp Hypertens 1999, 21:785–796.
Burke V, Hodgson JM, Beilin LJ, et al.: Dietary protein and soluble fiber reduce ambulatory blood pressure in treated hypertensives. Hypertension 2001, 38:821–826.
Keenan JM, Pins JJ, Frazel C, et al.: Oat ingestion reduces systolic and diastolic blood pressure in patients with mild or borderline hypertension: a pilot trial. J Fam Pract 2002, 51:369.
Saltzman E, Das SK, Lichtenstein AH, et al.: An oat-containing hypocaloric diet reduces systolic blood pressure and improves lipid profile beyond effects of weight loss in men and women. J Nutr 2001, 131:1465–1470.
Davy BM, Melby CL, Beske SD, et al.: Oat consumption does not affect resting casual and ambulatory 24-h arterial blood pressure in men with high-normal blood pressure to stage I hypertension. J Nutr 2002, 132:394–398.
Ludwig DD: The glycemic index—physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA 2002, 287:2414–2423.
Martinez-Gonzalez MA, Fernandez-Jarne E, Serrano-Martinez M, et al.: Mediterranean diet and reduction in the risk of a first acute myocardial infarction: an operational healthy dietary score. Eur J Nutr 2002, 41:153–160.
Bessesen DH: The role of carbohydrates in insulin resistance. J Nutr 2001, 131:2782S-2786S.
Pi-Sunyer FX: Glycemic index and disease. Am J Clin Nutr 2002, 76:290S-298S.
Vega-Lopez S, Conde-Knape K, Vidal-Quintanar RL, et al.: Sex and hormonal status influence the effects of psyllium on lipoprotein remodeling and composition. Metab Clin Exp 2002, 51:500–507.
Adam A, Lopez HW, Leuillet M, et al.: Whole wheat flour exerts cholesterol-lowering in rats in its native form and after use in bread-making. Food Chem 2003, 80:337–344.
Slavin JL, Jacobs D, Marquart L: Grain processing and nutrition. Crit Rev Biotechnol 2001, 21:49–66.
Slavin JL, Jacobs D, Marquart L, et al.: The role of whole grains in disease prevention. J Am Diet Assoc 2001, 101:780–785.
Schaefer EJ: Lipoproteins, nutrition, and heart disease. Am J Clin Nutr 2002, 75:191–212.
de Lorgeril M, Salen P, Paillard F, et al.: Mediterranean diet and the French paradox: two distinct biogeographic concepts for one consolidated scientific theory on the role of nutrition in coronary heart disease. Cardiovasc Res 2002, 54:503–515.
Jula A, Marniemi J, Huupponen R, et al.: Effects of diet and simvastatin on serum lipids, insulin, and antioxidants in hypercholesterolemic men—a randomized controlled trial. JAMA 2002, 287:598–605.
Stone NJ: Lowering low-density lipoprotein cholesterol with diet: the important role of functional foods as adjuncts. Coronary Artery Dis 2001, 12:547–552.
Kritchevsky D: Diet and atherosclerosis. J Nutr Health Aging 2001, 5:155–159.
Martinez-Gonzalez MA, Fernandez-Jarne E, Martinez-Losa E, et al.: Role of fibre and fruit in the Mediterranean diet to protect against myocardial infarction: a case-control study in Spain. Eur J Clin Nutr 2002, 56:715–722.
Livesey G: Approaches to health via lowering of postprandial glycaemia. Br J Nutr 2002, 88:741–744.
Jenkins DJ, Kendall CW, Vuksan V, et al.: Soluble fiber intake at a dose approved by the US Food and Drug Administration for a claim of health benefits: serum lipid risk factors for cardiovascular disease assessed in a randomized controlled crossover trial. Am J Clin Nutr 2002, 75:834–839.
Hu FB, Willett WC: Optimal diets for prevention of coronary heart disease. JAMA 2002, 288:2569–2578.
Hooper L, for the Health UKH, Thoracic Dietitians Interest G: Survey of UK dietetic departments: diet in secondary prevention of myocardial infarction. J Hum Nutr Diet 2001, 14:307–318.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lupton, J.R., Turner, N.D. Dietary fiber and coronary disease: Does the evidence support an association?. Curr Atheroscler Rep 5, 500–505 (2003). https://doi.org/10.1007/s11883-003-0041-y
Issue Date:
DOI: https://doi.org/10.1007/s11883-003-0041-y