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American Journal of Clinical Nutrition, Vol. 78, No. 6, 1085-1091, December 2003
© 2003 American Society for Clinical Nutrition


ORIGINAL RESEARCH COMMUNICATION

Dietary fiber and progression of atherosclerosis: the Los Angeles Atherosclerosis Study1,2,3

Huiyun Wu, Kathleen M Dwyer, Zhihong Fan, Anne Shircore, Jing Fan and James H Dwyer

1 From the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles.

Background: Several epidemiologic studies found weak protective relations between dietary fiber intake and the risk of cardiovascular disease events. However, few of the studies addressed possible mechanisms of the effect.

Objective: In the present study, we estimated relations between the progression of atherosclerosis and the intake of selective dietary fiber fractions. Mediation of the relations by serum lipids was also investigated.

Design: Participants who were free of heart disease and aged 40–60 y were recruited into the cohort (n = 573; 47% women). The intima-media thickness (IMT) of the common carotid arteries was measured ultrasonographically at the baseline examination and at 2 follow-up examinations (n = 500), dietary intakes were assessed with six 24-h recalls (3 at baseline and 3 at the first follow-up examination), and blood samples were analyzed at baseline and at both follow-up examinations.

Results: A significant inverse association was observed between IMT progression and the intakes of viscous fiber (P = 0.05) and pectin (P = 0.01). Correction for measurement error increased the magnitude of these estimated effects. The ratio of total to HDL cholesterol was inversely related to the intakes of total fiber (P = 0.01), viscous fiber (P = 0.05), and pectin (P = 0.01). The magnitude of the association between IMT progression and the intakes of viscous fiber and pectin was attenuated by adjustment for serum lipids.

Conclusions: The intake of viscous fiber, especially pectin, appears to protect against IMT progression. Serum lipids may act as a mediator between dietary fiber intake and IMT progression.

Key Words: Dietary fiber • measurement error • atherosclerosis • intima-media thickness • serum lipid • cohort study




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