期刊
BRITISH JOURNAL OF NUTRITION
卷 116, 期 3, 页码 534-546出版社
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0007114516002099
关键词
CVD; Primary prevention; Dietary fibre; Fruits; Vegetables
资金
- official funding agency for biomedical research of the Spanish government
- Instituto de Salud Carlos III (ISCIII) [RTIC G03/140, RTIC RD 06/0045]
- Centro de Investigacion Biomedica en Red de Fisiopatologia de la Obesidad y Nutricion (CIBERobn)
- Centro Nacional de Investigaciones Cardiovasculares [CNIC 06/2007]
- Fondo de Investigacion Sanitaria-Fondo Europeo de Desarrollo Regional (Proyecto de Investigacion) [(PI) 04-2239, PI 05/2584, CP06/00100, PI07/0240, PI07/1138, PI07/0954, PI 07/0473, PI10/01407, PI10/02658, PI11/01647, P11/02505, PI13/00462]
- Ministerio de Ciencia e Innovacion (Recursos y teconologia agroalimentarias) [(AGL)-2009-13906-C02, AGL2010-22319-C03, AGL2013-49083-C3-1-R]
- Fundacion Mapfre
- Consejeria de Salud de la Junta de Andalucia [PI0105/2007]
- Public Health Division of the Department of Health of the Autonomous Government of Catalonia
- Generalitat Valenciana (Generalitat Valenciana Ayuda Complementatia) [(GVACOMP) 06109, GVACOMP2010-181, GVACOMP2011-151]
- Conselleria de Sanitat y AP
- Atencion Primaria [(CS) 2010-AP-111, CS2011-AP-042]
- Regional Government of Navarra [P27/2011]
- ISCIII, Spain [RTIC G03/140]
- CIBERobn, ISCIII, Spain
- California Walnut Commission, Sacramento, CA, USA
- Patrimonio Cultural Olivarero, Spain
- La Morella Nuts, Spain
- Borges SA, Spain
- Nut and Dried Foundation
- Instituto Danone
- Danone SA
- Research Foundation on Wine and Nutrition (FIVIN)
- Cerveceros de Espana
- California Walnut Commission (Sacramento, CA)
- Instituto de Salud Carlos III - FIS. Spain
- Menarini, Astra-Zeneca
- Instituto de Salud Carlos III
- Danone
- International Nut Council
Prospective studies assessing the association between fibre intake or fibre-rich food consumption and the risk of CVD have often been limited by baseline assessment of diet. Thus far, no study has used yearly repeated measurements of dietary changes during follow-up. Moreover, previous studies included healthy and selected participants who did not represent subjects at high cardiovascular risk. We used yearly repeated measurements of diet to investigate the association between fibre intake and CVD in a Mediterranean cohort of elderly adults at high cardiovascular risk. We followed-up 7216 men (55-80 years) and women (60-80 years) initially free of CVD for up to 7 years in the PREvencion con DIeta MEDiterranea study (registered as ISRCTN35739639). A 137-item validated FFQ was repeated yearly to assess diet. The primary end point, confirmed by a blinded ad hoc Event Adjudication Committee, was a composite of cardiovascular death, myocardial infarction and stroke. Time-dependent Cox's regression models were used to estimate the risk of CVD according to baseline dietary exposures and to their yearly updated changes. We found a significant inverse association for fibre (P-for trend = 0.020) and fruits (P-for trend = 0.024) in age-sex adjusted models, but the statistical significance was lost in fully adjusted models. However, we found a significant inverse association with CVD incidence for the sum of fruit and vegetable consumption. Participants who consumed in total nine or more servings/d of fruits plus vegetables had a hazard ratio 0.60 (95% CI 0.40, 0.96) of CVD in comparison with those consuming <5 servings/d.
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