DF: Cardiovascular Disease (2008)
Dietary Fiber and Cardiovascular Disease
What is the evidence that dietary fiber from whole foods and dietary supplements is beneficial in cardiovascular disease?
High-fiber diets may be associated with lower blood pressure when consumed at doses of 12g to 22g of fiber per day and with lower serum lipids when consumed at 12g to 33g of fiber per day. These diets may also be associated with improvements in apolipoproteins and inflammation. The sources and types of fiber cannot be specified because different fiber sources and combinations of fiber-rich foods were used. Further study is required to identify specific recommendations for optimal dosage and types of fiber.
Fiber supplements in doses of 4g to 24g per day may be associated with lower blood pressure. Plasma lipids improved with doses of up to 42.5g per day, with greater reduction of LDL-C from soluble fiber than insoluble fiber. Fiber supplements may also be beneficial in improving measures of inflammation such as C-reactive protein and improving apolipoprotein levels. There is some evidence that cereal and fruit fibers reduce the risk of fatal and non-fatal CVD events. In addition, in some studies, the concurrent interventions of reduced energy or lower-fat diets or the presence of adiposity may have impacted the outcomes. Further study is required to identify specific recommendations for optimal dosage and types of fiber.
Based on current data, dietary fiber intake from whole foods or supplements may lower blood pressure, improve serum lipids and reduce indicators of inflammation. Benefits may occur with intakes of 12g to 33g per day from whole foods or up to 42.5g of fiber per day from supplements.
- Grade I means there is Good/Strong evidence supporting the statement;
- Grade II is Fair;
- Grade III is Limited/Weak;
- Grade IV is Expert Opinion Only;
- Grade V is Not Assignable.
Evidence Summary: Dietary fiber from whole foods and cardiovascular disease
- Quality Rating Summary
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- Davy BM, Melby CL, Beske SD, Ho RC, Davrath LR, Davy KP. Oat consumption does not affect resting casual and ambulatory 24-h arterial blood pressure in men with high-normal blood pressure to stage 1 hypertension. J Nutr. 2002; 132: 394-398.
- Jacobs DR Jr., Pereira MA, Stumpf K, Pins JJ, Adlercreutz H. Whole grain food intake elevates serum enterolactone. Br J Nutr. 2002 Aug; 88 (2): 111-116. PMID: 12144714.
- Juntunen, KS, Laaksonen DE, Poutanen KS, Niskanen LK, Mykkanen HM. High-fiber rye bread and insulin secretion and sensitivity in healthy postmenopausal women. Am J Clin Nutr. 2003; 77: 385-391.
- Kelly S, Summerbell CD, Brynes A, Whittaker V, Frost, G. Wholegrain cereals for coronary heart disease. Cochrane Database of Systematic Reviews. 2007; 2.
- King DE, Egan BM, Woolson RF, Mainous AG 3rd, Al-Solaiman Y, Jesri A. Effect of a high-fiber diet vs a fiber-supplemented diet on C-reactive protein level. Arch Intern Med. 2007 Mar 12; 167 (5): 502-506. PMID: 17353499.
- McKeown NC, Meigs JB, Liu S, et al. Carbohydrate nutrition, insulin resistance, and the prevalance of the metabolic syndrome in the Framingham offspring cohort, Diabetes Care. 2004; 27: 538-546.
- Pins JJ, Geleva D, Keenan JM, Frazel C, O'Connor PJ, Cherney LM. Do whole-grain oat cereals reduce the need for antihypertensive medications and improve blood pressure control? J Fam Practice. 2002; 51 (4): 353-359.
- Pittaway JK, Ahuja KD, Cehun M, Chronopoulos A, Robertson IK, Nestel PJ, Ball MJ. Dietary supplementation with chickpeas for at least five weeks results in small but significant reductions in serum total and low-density lipoprotein cholesterols in adult women and men. Ann Nutr Metab. 2006; 50(6): 512-518. Epub 2006 Dec 21. PMID: 17191025.
- Qi L, Vam Dam RM, Liu S, Franz M, Mantzoros C, Hu FB. Whole-grain, bran, and cereal fiber intakes and markers of systemic inflammation in diabetic women. Diabetics Care. 29: 207-211, 2006.
- Ripsin CM, Keenan JM, Jacobs DR Jr, Elmer PJ, Welch RR, Van Horn L, Liu K, Turnbull WH, Thye FW, Kestin M, et al. Oat products and lipid lowering: A meta-analysis. JAMA. 1992 Jun 24; 267(24): 3,317-3,325. Erratum in: JAMA. 1992; 268(21): 3,074.
Evidence Summary: What is the evidence that dietary fiber from dietary supplements is beneficial in cardiovascular disease?
- Quality Rating Summary
For a summary of the Quality Rating results, click here.
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- Birketvedt GS, Aaseth J, Florholmen JR, Ryttig K. Long-term effect of fibre supplement and reduced energy intake on body weight and blood lipids in overweight subjects. Acta Medica (Hradec Kralove). 2000; 43 (4): 129-132.
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- Jenkins DJ, Hegele RA, Jenkins AL, Connelly PW, Hallak K, Bracci P, Kashtan H, Corey P, Pintilia M, Stern H, et al. The apolipoprotein E gene and the serum low-density lipoprotein cholesterol response to dietary fiber. Metabolism. 1993 May; 42 (5): 585-593. PMID: 838
- Jenkins DJA, Kendall CWC, Vuksan V, Vidgen E, Parker T, Faulkner D, Mehling CC, Garsetti M, Testolin G, Cunnane SC, Ryan MA, Corey PN. Soluble fiber intake at a dose approved by the US Food and Drug Administration for a claim of health benefits: serum lipid risk factors for cardiovascular disease assessed in a randomized controlled crossover trial. Am J Clin Nutr. 2002; 75: 834-839.
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- Keenan JM, Wenz JB, Myers S, Ripsin C, Huang ZQ. Randomized, controlled, crossover trial of oat bran in hypercholesterolemic subjects. J Fam Pract. 1991 Dec; 33(6): 600-608.
- Kirsten R, Heintz B, Nelson K, Oremek G, Speck U. Influence of two guar preparations on glycosylated hemoglobin, total cholesterol and triglycerides in patients with diabetes mellitus. Int J Clin Pharmacol Ther Toxicol. 1992 Dec; 30 (12): 582-586. PMID: 1335441.
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- Rossner S, von Zweigbergk D, Ohlin A, Ryttig K. Weight reduction with dietary fibre supplements. Results of two double-blind randomized studies. Acta Med Scand. 1987; 222 (1) :83-88. PMID: 2820202.
- Ryttig KR, Tellnes G, Haegh L, Boe E, Fagerthun H. A dietary fibre supplement and weight maintenance after weight reduction: a randomized, double-blind, placebo- controlled long-term trial. Int J Obes. 1989; 13 (2):165-171.
- Schwab U, Louheranta A, Torronen A, Uusitupa M. Impact of sugar beet pectin and polydextrose on fasting and postprandial glycemia and fasting concentrations of serum total and lipoprotein lipids in middle-aged subjects with abnormal glucose metabolism. Eur J Clin Nutr. 2006 Sep; 60(9): 1,073-1,080. Epub 2006 Mar 8. PMID: 16523204.
- Shane JM, Walker PM. Corn bran supplementation of a low-fat controlled diet lowers serum lipids in men with hypercholesterolemia. J Am Diet Assoc. 1995 Jan; 95 (1): 40-45. PMID: 7798579.
- Sola R, Godas G, Ribalta J, Vallve JC, Girona J, Anguera A, Ostos M, Recalde D, Salazar J, Caslake M, Martin-Lujan F, Salas-Salvado J, Masana L. Effects of soluble fiber (Plantago ovata husk) on plasma lipids, lipoproteins, and apolipoproteins in men with ischemic heart disease. Am J Clin Nutr. 2007 Apr; 85 (4): 1,157-1,163. PMID: 17413119.
- Solum TT, Ryttig KR, Solum E, Larsen S. The influence of a high-fibre diet on body weight, serum lipids and blood pressure in slightly overweight persons. A randomized, double-blind, placebo-controlled investigation with diet and fibre tablets (DumoVital). Int J Obes. 1987; 11 Suppl. 1: 67-71.
- Stasse-Wolthuis M, Albers HF, van Jeveren JG, Wil de Jong J, Hautvast JG, Hermus RJ, Katan MB, Brydon WG, Eastwood MA. Influence of dietary fiber from vegetables and fruits, bran or citrus pectin on serum lipids, fecal lipids, and colonic function. Am J Clin Nutr. 1980 Aug; 33(8): 1,745-1,756.
- Tai ES, Fok AC, Chu R, Tan CE. A study to assess the effect of dietary supplementation with soluble fiber (Minolest) on lipid levels in normal subjects with hypercholesterolaemia. Ann Acad Med Singapore. 1999 Mar; 28 (2): 209-213. PMID: 10497668
- Vuksan V, Jenkins DJ, Spadafora P, Sievenpiper JL, Owen R, Vidgen E, Brighenti F, Josse R, Leiter LA, Bruce-Thompson C. Konjac-mannan (glucomannan) improves glycemia and other associated risk factors for coronary heart disease in type 2 diabetes. A randomized controlled metabolic trial. Diabetes Care. 1999 Jun; 22 (6): 913-919. PMID: 10372241.
Search Plan and Results: Dietary Fiber vs. Fiber Supplement: CVD