Dietary Fiber Intake Is Associated with Reduced Risk of Mortality from Cardiovascular Disease among Japanese Men and Women

Dietary fiber protects against coronary heart disease (CHD), but evidence in Asia is limited. We examined the association between dietary fiber intake and mortality from cardiovascular disease (CVD) in a Japanese population in a prospective study of 58,730 Japanese men and women aged 40-79 y in which dietary fiber intake was determined by a self-administered FFQ. The participants were followed up from 1988-1990 to the end of 2003. Hazard ratios (HR) and 95% Cl of mortality were calculated per quintile of fiber intake. During the 14-y follow-up, a total of 2080 CVD deaths (983 strokes, 422 CHD, and 675 other CVD) were documented. Total, insoluble, and soluble dietary fiber intakes were inversely associated with risk of mortality from CHD and total CVD for both men and women. For men, the multivariable HR (95% Cl) for CHD in the highest vs. the lowest quintiles were 0.81 [(95% Cl, 0.61-1.09); P-trend = 0.02], 0.48 [(95% Cl, 0.27-0.84); P-trend < 0.001], and 0.71 [(95% Cl, 0.41-0.97); P-trend = 0.04] for total, insoluble, and soluble fiber, respectively. The respective HR (95% Cl) for women were 0.80 [(95% Cl, 0.57-0.97); P-trend = 0.01], 0.49 [(95% Cl, 0.27-0.86); P-trend = 0.004], and 0.72 [(95% Cl, 0.34-0.99); P-trend = 0.03], respectively. For fiber sources, intakes of fruit and cereal fibers but not vegetable fiber were inversely associated with risk of mortality from CHD. In conclusion, dietary intakes of fiber, both insoluble and soluble fibers, and especially fruit and cereal fibers, may reduce risk of mortality from CHD. J. Nutr. 140: 1445-1453, 2010.