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. 2022 Aug 2;20(1):344.
doi: 10.1186/s12967-022-03558-6.

Associations between dietary fiber intake and mortality from all causes, cardiovascular disease and cancer: a prospective study

Xin Xu  1 , Junmiao Zhang  2 , Yanhui Zhang  3 , Honggang Qi  4 , Ping Wang  5
Affiliations

Associations between dietary fiber intake and mortality from all causes, cardiovascular disease and cancer: a prospective study

Xin Xu et al. J Transl Med. .

Abstract

Objective: Several studies suggest that dietary fiber intake may reduce mortality risk, but this might depend on the fiber types and the evidence regarding the role of soluble fiber or insoluble fiber on death risk remain limited and inconsistent. Therefore, this study aimed to comprehensively evaluate multiple types of dietary fiber intake on mortality from all causes, cardiovascular disease and cancer in the large-scale Prostate, Lung, Colorectal, and Ovarian Cancer (PLCO) Screening Trial.

Methods: A multivariate Cox proportional hazards model was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

Results: This study finally included 86,642 participants with 17,536 all-cause deaths, 4842 cardiovascular deaths and 5760 cancer deaths identified after a total of 1,444,068 follow-up years. After adjusting for potential confounders, dietary total fiber intake was statistically significantly inversely associated with all-cause death (Q5 vs Q1: HR 0.71, 95% CI 0.66-0.75; P for trend < 0.001), cardiovascular death (Q5 vs Q1: HR 0.73, 95% CI 0.65-0.83; P for trend < 0.001) and cancer mortality (Q5 vs Q1: HR 0.77, 95% CI 0.69-0.86; P for trend < 0.001). Similar results were observed for both insoluble and soluble fiber intake. Restricted cubic spline model analysis suggested that there was a nonlinear association of dietary fiber intake with mortality risk (all P for nonlinearity < 0.05).

Conclusions: In this large nationally representative sample of US adult population, intakes of total fiber, soluble fiber, and insoluble fiber were associated with lower risks of all-cause, cardiovascular and cancer mortality.

Keywords: Cancer; Cardiovascular disease; Cohort; Fiber; PLCO.

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Conflict of interest statement

The authors have no competing interest.

Figures

Fig. 1
Fig. 1
Dose–response using restricted cubic spline model for the association between total fiber intake and mortality from all causes (A), cardiovascular disease (B) and cancer (C). Solid line represents point estimates and dashed lines represent 95% confidence intervals. Multivariable risk estimate was calculated by restricted cubic spline regression (using 3 knots at 10th, 50th, and 90th percentiles) adjusting for age, sex, race, body mass index, education, smoking status, marital status, alcohol drinking status, and total energy intake. The histograms show the percentage of participants (left y axis) consuming each level of fiber
Fig. 2
Fig. 2
Subgroup analyses by potential confounders including age (< 65 years vs. ≥ 65 years), sex (male vs. female), race (White, Non-Hispanic vs. Other), body mass index at the time of enrollment (< 25 kg/m2 vs. ≥ 25 kg/m2), education (≤ high school vs. ≥ some college), smoking status (never vs. former vs. current), and drinking status (never vs. former vs. current). The HRs (95% CIs) of per SD increment in the total fiber intake were calculated and showed. HRs hazard ratios; CIs confidence intervals; SD standard deviation
See this image and copyright information in PMC

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