03409nas a2200349 4500008004100000022001400041245010900055210006900164260001600233300001200249490000800261520242900269653000902698653002802707653001802735653001702753653001102770653001002781653001102791653000902802653002502811653002402836653000902860653001502869100002502884700002602909700002402935700001902959700002202978700002403000856003503024 2003 eng d a0098-748400aCereal, fruit, and vegetable fiber intake and the risk of cardiovascular disease in elderly individuals.0 aCereal fruit and vegetable fiber intake and the risk of cardiova c2003 Apr 02 a1659-660 v2893 a

CONTEXT: People older than 65 years are the fastest-growing segment of the population and account for the majority of cardiovascular disease (CVD) morbidity, mortality, and health care expenditures. Additionally, the influence of dietary habits on risk may be less pronounced in elderly persons, when atherosclerosis is more advanced. However, few data address the influence of diet on CVD risk in this population.

OBJECTIVE: To determine whether fiber consumption from fruit, vegetable, and cereal sources (including whole grains and bran) is associated with incident CVD in elderly persons.

DESIGN: Prospective cohort study conducted from 1989 to June 2000.

SETTING AND PARTICIPANTS: Population-based, multicenter study among 3588 men and women aged 65 years or older and free of known CVD at baseline in 1989-1990. Usual dietary fiber consumption was assessed at baseline (mean participant age, 72 years) using a 99-item food frequency questionnaire.

MAIN OUTCOME MEASURE: Incident CVD (combined stroke, ischemic heart disease death, and nonfatal myocardial infarction).

RESULTS: During 8.6 years mean follow-up, there were 811 incident CVD events. After adjustment for age, sex, education, diabetes, ever smoking, pack-years of smoking, daily physical activity, exercise intensity, alcohol intake, and fruit and vegetable fiber consumption, cereal fiber consumption was inversely associated with incident CVD (P for trend =.02), with 21% lower risk (hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.62-0.99) in the highest quintile of intake, compared with the lowest quintile. In similar analyses, neither fruit fiber intake (P for trend =.98) nor vegetable fiber intake (P for trend =.95) were associated with incident CVD. When CVD events were separately evaluated, higher cereal fiber intake was associated with lower risk of total stroke and ischemic stroke and a trend toward lower risk of ischemic heart disease death. In a post hoc analysis, dark breads such as wheat, rye, or pumpernickel were associated with a lower risk of incident CVD (HR, 0.76; 95% CI, 0.64-0.90) rather than cereal fiber from other sources.

CONCLUSIONS: Cereal fiber consumption late in life is associated with lower risk of incident CVD, supporting recommendations for elderly individuals to increase consumption of dietary cereal fiber.

10aAged10aCardiovascular Diseases10aDietary Fiber10aEdible Grain10aFemale10aFruit10aHumans10aMale10aNutrition Assessment10aProspective Studies10aRisk10aVegetables1 aMozaffarian, Dariush1 aKumanyika, Shiriki, K1 aLemaitre, Rozenn, N1 aOlson, Jean, L1 aBurke, Gregory, L1 aSiscovick, David, S uhttps://chs-nhlbi.org/node/731