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Nutritional Epidemiology

Dietary Fiber Reduces Peripheral Arterial Disease Risk in Men¹

Anwar T. Merchant^*,,2, Frank B. Hu^*,**, Donna Spiegelman^**,, Walter C. Willett^*,**,, Eric B. Rimm^*,**, and Alberto Ascherio^*,,

^* Department of Nutrition, Harvard School of Public Health; Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine; ^** Departments of Epidemiology and Biostatistics, Harvard School of Public Health; and The Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115

²To whom correspondence should be addressed. Email: amerchan{at}hsph.harvard.edu.

We prospectively evaluated the relationship between dietary fiber and peripheral arterial disease risk (PAD) among 46,032 men, aged 40 to 75 y, in 1986. Subjects answered a vascular disease questionnaire and completed a validated 131-item food frequency questionnaire, and were free of PAD, cardiovascular disease and diabetes. During 12 y of follow-up 308 incident PAD cases were documented. After adjusting for age, smoking, hypertension, hypercholesterolemia, family history of early coronary heart disease, alcohol consumption, BMI, physical activity and energy intake, PAD risk in each quintile of cereal fiber intake compared with the lowest quintile was 0.69, 95% CI 0.49–0.97 for quintile 2; 0.65, 95% CI 0.45–0.94 for quintile 3; 0.68, 95% CI 0.47–0.98 for quintile 4; and 0.67, 95% CI 0.47–0.97 for quintile 5. In a nonlinear model the overall inverse association (P = 0.02) and nonlinear components (P = 0.03) were significant. Fruit, vegetable and total fiber intakes were not associated with PAD risk. These results suggest an inverse association between cereal fiber intake and PAD risk in men. Increasing cereal fiber intake may prevent PAD.

KEY WORDS: • dietary fiber • peripheral arterial disease • cereal fiber • prospective study

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