Dietary fiber intake and mortality among survivors of myocardial infarction: prospective cohort study | BMJ

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Dietary fiber intake and mortality among survivors of myocardial infarction: prospective cohort study | BMJ

RESEARCH

Dietary fiber intake and mortality 

among survivors of myocardial 

infarction: prospective cohort study

BMJ 2014; 348 doi: http://dx.doi.org/10.1136/bmj.g2659 (Published 29 April 2014)

Cite this as: BMJ 2014;348:g2659

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1. Shanshan Li, ‎doctoral candidate1, 
2. Alan Flint, research scientist2, 
3. Jennifer K Pai, assistant professor of medicine3, 
4. John P Forman, assistant professor of medicine4,
5. Frank B Hu, professor12, 
6. Walter C Willett, professor12, 
7. Kathryn M Rexrode, associate professor of medicine5, 
8. Kenneth J Mukamal, associate professor of medicine6, 
9. Eric B Rimm, associate professor12

Author Affiliations

1. Correspondence to: S Li shl607@mail.harvard.edu

• Accepted 31 March 2014

Abstract

Objective To evaluate the associations of dietary fiber after myocardial infarction (MI) and changes in dietary fiber intake from before to after MI with all cause and cardiovascular mortality.

Design Prospective cohort study.

Setting Two large prospective cohort studies of US women and men with repeated dietary measurements: the Nurses’ Health Study and the Health Professionals Follow-Up Study.

Participants 2258 women and 1840 men who were free of cardiovascular disease, stroke, or cancer at enrollment, survived a first MI during follow-up, were free of stroke at the time of initial onset of MI, and provided food frequency questionnaires pre-MI and at least one post-MI.

Main outcome measures Associations of dietary fiber post-MI and changes from before to after MI with all cause and cardiovascular mortality using Cox proportional hazards models, adjusting for drug use, medical history, and lifestyle factors.

Results Higher post-MI fiber intake was significantly associated with lower all cause mortality (comparing extreme fifths, pooled hazard ratio 0.75, 95% confidence interval 0.58 to 0.97). Greater intake of cereal fiber was more strongly associated with all cause mortality (pooled hazard ratio 0.73, 0.58 to 0.91) than were other sources of dietary fiber. Increased fiber intake from before to after MI was significantly associated with lower all cause mortality (pooled hazard ratio 0.69, 0.55 to 0.87).

Conclusions In this prospective study of patients who survived MI, a greater intake of dietary fiber after MI, especially cereal fiber, was inversely associated with all cause mortality. In addition, increasing consumption of fiber from before to after MI was significantly associated with lower all cause and cardiovascular mortality.