Long-term intake of dietary fiber and decreased risk of coronary heart disease among women
Long-term intake of dietary fiber and decreased risk of coronary heart disease among women
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DOI：
10.1001/jama.281.21.1998
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发表时间：
1999-06-02
影响因子：
120.7
通讯作者：
Willett, WC
中科院分区：
文献类型：
--
作者：
Wolk, A;Manson, JE;Willett, WC
背景：对男性的流行病学研究表明，膳食纤维摄入可以预防冠心病（CHD），但在女性中这一关联的数据很少。目的研究长期摄入总膳食纤维和不同来源膳食纤维与女性冠心病风险之间的关系，设计和设置护士健康研究是一项大型前瞻性队列研究，从1984年开始对美国女性进行了10年的随访，使用半定量食物频率问卷收集了1984年、1986年和1990年的饮食数据。参与者共68782名女性，年龄在37至64岁之间，基线时未诊断为心绞痛、心肌梗死（MI）、中风、癌症、高胆固醇血症或糖尿病。主要观察指标：纤维摄入量与冠心病急性Anl或死亡发生率的关系。结果随访10年，有效率平均为80% ~ 90%。我们记录了591例主要冠心病事件（429例非致死性心肌梗死和162例冠心病死亡）。总膳食纤维摄入量最高的五分位数女性（中位数为22.9 g/d）与最低的五分位数女性（中位数为11.5 g/d）相比，主要冠心病事件的年龄调整相对危险度（RR）为0.53（95%可信区间[CI]， 0.40-0.69）。在控制了年龄、心血管危险因素、饮食因素和多种维生素补充剂的使用后，RR为0.77 （95% CI, 0.57-1.04）。对于总纤维摄入量增加10克/天（最低和最高五分位数之间的差异），总冠心病事件的多因素RR为0.81 （95% CI, 0.66-0.99）。在不同来源的膳食纤维（如谷物、蔬菜、水果）中，只有谷物纤维与冠心病风险降低密切相关（多因素RR， 0.63; 95% CI, 0.49-0.81，谷物纤维每增加5克/天）。结论：我们在女性中的研究结果支持这样的假设，即高纤维摄入，特别是来自谷物的纤维摄入，可以降低冠心病的风险。
Context Epidemiological studies of men suggest that dietary fiber intake protects against coronary heart disease (CHD), but data on this association in women are sparse.Objective To examine the association between long-term intake of total dietary fiber as well as fiber from different sources and risk of CHD in women,Design and Setting The Nurses' Health Study, a large, prospective cohort study of US women followed up for 10 years from 1984, Dietary data were collected in 1984, 1986, and 1990, using a validated semiquantitative food frequency questionnaire.Participants A total of 68 782 women aged 37 to 64 years without previously diagnosed angina, myocardial infarction (MI), stroke, cancer, hypercholesterolemia, or diabetes at baseline.Main Outcome Measure Incidence of acute Anl or death due to CHD by amount of fiber intake.Results Response rate averaged 80% to 90% during the 10-year follow-up. We documented 591 major CHD events (429 nonfatal MIs and 162 CHD deaths). The age-adjusted relative risk (RR) for major CHD events was 0.53 (95% confidence interval [CI], 0.40-0.69) for women in the highest quintile of total dietary fiber intake (median, 22.9 g/d) compared with women in the lowest quintile (median, 11.5 g/d), After controlling for age, cardiovascular risk factors, dietary factors, and multivitamin supplement use, the RR was 0.77 (95% CI, 0.57-1.04). For a 10-g/d increase in total fiber intake (the difference between the lowest and highest quintiles), the multivariate RR of total CHD events was 0.81 (95% CI, 0.66-0.99), Among different sources of dietary fiber (eg, cereal, vegetables, fruit), only cereal fiber was strongly associated with a reduced risk of CHD (multivariate RR, 0.63; 95% CI, 0.49-0.81 for each 5-g/d increase in cereal fiber).Conclusions Our findings in women support the hypothesis that higher fiber intake, particularly from cereal sources, reduces the risk of CHD.