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Dietary fiber intake and retinal vascular caliber in the Atherosclerosis Risk in Communities Study^1,2,3

¹ From the Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC (HK and SJL); the Departments of Nutrition and Epidemiology (JS) and the Department of Epidemiology (GH and KMR), School of Public Health, the University of North Carolina at Chapel Hill, NC); and the Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI (RK)

Background: Dietary fiber appears to decrease the risk of cardiovascular morbidity and mortality. Microvascular abnormalities can be observed by retinal examination and contribute to the pathogenesis of various cardiovascular diseases. The impact of dietary fiber on the retinal microvasculature is not known.

Objective: We aimed to examine the association between dietary fiber intake and retinal vascular caliber.

Design: At the third visit (1993–1995) of the Atherosclerosis Risk in Communities (ARIC) Study, a population-based cohort of adults in 4 US communities, the retinal vascular caliber of 10 659 participants was measured and summarized from digital retinal photographs. Usual dietary intake during the same period was assessed with a 66-item food-frequency questionnaire.

Results: After control for potential confounders including hypertension, diabetes, lipids, demographic factors, cigarette smoking, total energy intake, micronutrients intake, and other cardiovascular disease risk factors, higher intake of fiber from all sources and from cereal were significantly associated with wider retinal arteriolar caliber and narrower venular caliber. Participants in the highest quintile of fiber intake from all sources had a 1.05-µm larger arteriolar caliber (P for trend = 0.012) and a 1.11-µm smaller venular caliber (P for trend = 0.029).

Conclusions: Dietary fiber was related to wider retinal arteriolar caliber and narrower venular caliber, which are associated with a lower risk of cardiovascular disease. These data add to the growing evidence of the benefits of fiber intake on various aspects of cardiovascular pathogenesis.

Key Words: Dietary fiber • cardiovascular diseases • microcirculation • retinal abnormalities • cereal