Abstract

Background: Dietary fiber is associated with lower risk of coronary heart disease in healthy populations. It is unclear whether higher consumption of dietary fiber after myocardial infarction (MI) is associated with lower mortality. Objective: To evaluate the associations of dietary fiber post-MI and changes from pre- to post- with all-cause and cardiovascular mortality. Design: The Nurses’ Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS) are two large prospective cohort studies of US women and men with repeated dietary measurements. We included 2,258 women and 1,840 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 MI onset, and provided both pre-MI and at least one post-MI food frequency questionnaire. We evaluated the associations of dietary fiber post-MI and changes from pre- to post- with all-cause and cardiovascular mortality using Cox proportional hazards models, adjusting for medication use, medical history, and lifestyles factors. Results: Higher post-MI fiber intake was significantly associated with lower all-cause mortality (Comparing extreme quintiles, pooled hazard ratio (HR) = 0.75, 95%CI: 0.58-0.97). Greater intake of cereal fiber was more strongly associated with all-cause mortality (Pooled HR=0.73, 95%CI: 0.58-0.91) than were other sources of dietary fiber. Increased fiber intake from pre- to post- was significantly associated with lower all-cause mortality (Pooled HR=0.69, 95%CI: 0.55-0.87). Conclusions: In this prospective study of MI survivors, greater post-MI intake of dietary fiber, especially cereal fiber, was inversely associated with all-cause mortality. In addition, increasing consumption of fiber from pre- to post-MI periods was significantly associated with lower all-cause and cardiovascular mortality.

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