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Epidemiology

Dietary fibre intake and ischaemic heart disease mortality: the European Prospective Investigation into Cancer and Nutrition-Heart study

European Journal of Clinical Nutrition volume 66, pages 950–956 (2012)Cite this article

Subjects

Abstract

Background/objectives:

Evidence from prospective studies is consistent in showing an inverse association between dietary fibre intake and risk of ischaemic heart disease (IHD), but whether dietary fibre from various food sources differ in their effect on IHD risk is less clear. The objective of this study was to assess the associations of total and food sources of dietary fibre with IHD mortality in the European Prospective Investigation into Cancer and Nutrition-Heart study.

Subjects/methods:

Participants were 306 331 men and women from eight European countries. Dietary fibre intake was assessed using centre or country-specific diet questionnaires and calibrated using a 24-h diet recall.

Results:

After an average follow-up of 11.5 years, there were 2381 IHD deaths among participants without cardiovascular disease at baseline. The calibrated intake of dietary fibre was inversely related with IHD mortality; each 10 g/day was associated with a 15% lower risk (relative risk (RR) 0.85; 95% confidence interval (CI): 0.73–0.99, P=0.031). There was no difference in the associations of the individual food sources of dietary fibre with the risk of IHD mortality; RR for each 5 g/day higher cereal fibre intake was 0.91 (CI: 0.82–1.01), RR for each 2.5 g/day fruit fibre intake was 0.94 (CI: 0.88–1.01) and RR for each 2.5 g/day vegetable fibre intake was 0.90 (95% CI: 0.76–1.07).

Conclusion:

A higher consumption of dietary fibre is associated with a lower risk of fatal IHD with no clear difference in the association with IHD for fibre from cereals, fruits or vegetables.

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Acknowledgements

The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Federal Ministry of Education and Research (Germany); Hellenic Health Foundation, the Stavros Niarchos Foundation and the Hellenic Ministry of Health (Greece); Italian Association for Research on Cancer (AIRC) and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (the Netherlands); Health Research Fund (FIS), Regional Governments of Andalucia, Asturias, Basque Country, Murcia and Navarra, RTICC (Red temática de investigación cooperativa en Cáncer) and CIBERESP (caber de salud Pública y Epidemiología); Swedish Cancer Society, Swedish Research Council, Regional Government of Skåne and Västerbotten and Swedish Heart Lung Foundation (Sweden); Cancer Research UK and the Medical Research Council (United Kingdom).

Author information

Authors and Affiliations

  1. Nuffield Department of Clinical Medicine, Cancer Epidemiology Unit, University of Oxford, Oxford, UK

    F L Crowe, T J Key & P N Appleby

  2. Department of Epidemiology, School of Public Health, Aarhus University, Aarhus, Denmark

    K Overvad

  3. Department of Cardiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark

    K Overvad & E B Schmidt

  4. Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark

    R Egeberg & A Tjønneland

  5. Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany

    R Kaaks & B Teucher

  6. German Institute of Human Nutrition, Nuthetal, Germany

    H Boeing & C Weikert

  7. Hellenic Health Foundation, Athens, Greece

    A Trichopoulou, V Ouranos & E Valanou

  8. Department of Hygiene, WHO Collaborating Centre for Food and Nutrition Policies, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece

    A Trichopoulou

  9. Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute—ISPO, Florence, Italy

    G Masala

  10. Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Via Venezian, Milano, Italy

    S Sieri

  11. Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy

    S Panico

  12. Cancer Registry and Histopathology Unit, ‘Civile—M.P.Arezzo’ Hospital, Ragusa, Italy

    R Tumino

  13. Italy and Department of Genetics, Human Genetics Foundation (HuGeF), Turin, Biology and Biochemistry, University of Turin, Turin, Italy

    G Matullo

  14. National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

    H B Bueno-de-Mesquita & J M A Boer

  15. Department of Gastroenterology and Hepatology, University Medical Centre Utrecht (UMCU), Utrecht, The Netherlands

    H B Bueno-de-Mesquita

  16. Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands

    J W J Beulens & Y T van der Schouw

  17. Public Health Directorate, Asturias, Spain

    J R Quirós

  18. Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain

    G Buckland

  19. Andalusian School of Public Health, Granada, Spain

    M-J Sánchez

  20. CIBER de Epidemiología y Salud Pública (CIBERESP), Spain

    M-J Sánchez, M Dorronsoro, J M Huerta & C Moreno-Iribas

  21. Public Health Department of Gipuzkoa, Basque Government, San Sebastián, Spain

    M Dorronsoro

  22. Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain

    J M Huerta

  23. Navarre Public Health Institute, Pamplona, Spain

    C Moreno-Iribas

  24. Cardiovascular Epidemiology CRC, Skane University Hospital, Malmö, Sweden

    B Hedblad

  25. Department of Medicine, Skellefteå County Hospital, Skellefteå, Sweden

    J H Jansson

  26. Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

    P Wennberg

  27. Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK

    K-T Khaw

  28. MRC Epidemiology Unit, University of Cambridge, Cambridge, UK

    N Wareham

  29. International Agency for Research on Cancer (IARC-WHO), Lyon, France

    P Ferrari & A-K Illner

  30. Department of Epidemiology and Biostatistics, Imperial College, London, UK

    S-C Chuang

  31. School of Public Health, Imperial College, London, UK

    T Norat & E Riboli

  32. Department of Public Health and Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, UK

    J Danesh

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  1. F L Crowe
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  2. T J Key
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Corresponding author

Correspondence to F L Crowe.

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Crowe, F., Key, T., Appleby, P. et al. Dietary fibre intake and ischaemic heart disease mortality: the European Prospective Investigation into Cancer and Nutrition-Heart study. Eur J Clin Nutr 66, 950–956 (2012). https://doi.org/10.1038/ejcn.2012.51

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