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  • Original Article
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Carbohydrates, glycemic index and diabetes mellitus

Relationship between plasma fibrinogen and fiber intake in the EPIC-Norfolk cohort

European Journal of Clinical Nutrition volume 66, pages 443–451 (2012)Cite this article

Abstract

Background/Objectives:

Fiber-rich diets have been proposed to lower circulating levels of inflammatory makers. Our objective was to investigate cross-sectional relationships between fiber intake and plasma fibrinogen.

Subjects/Methods:

We examined the relationship between plasma fibrinogen and dietary fiber in 20 960 men and women, aged 45–75 years old, living in Norfolk, UK. Fiber intake was assessed using a food frequency questionnaire.

Results:

Mean fibrinogen levels were lower across the increasing quartiles of the fiber intake after adjusting for age, sex, body mass index, physical activity, smoking status and alcohol consumption, and total calories, percentage of energy intake from carbohydrate, protein and fat, with a difference of 0.08 g/l fibrinogen between first and fourth quartiles (P for trend <0.001) for the whole population. When categorized by sex, the results for men were the same and for women, the results failed to be significant. In linear regression models, fibrinogen levels were significantly related to fiber intake for the whole population (−0.056 g/l, s.e.=0.012 per 10 g increase in fiber intake, P<0.001), but although the relations were in the same direction after adjusting for the same covariates above, they failed to be significant when smokers or women not using post-menopause hormone therapy were separately considered.

Conclusions:

Plasma fibrinogen levels appear to be inversely related to dietary fiber intake in middle-aged and older men and women.

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References

  • Ajani UA, Ford ES, Mokdad AH (2004). Dietary fiber and C-reactive protein: findings from National Health and Nutrition Examination Survey data. J Nutr 134, 1181–1185.

    Article  CAS  PubMed  Google Scholar 

  • Bengmark S (2004). Acute and ‘chronic’ phase reaction - a mother of disease. Clin Nutr 23, 1256–1266.

    Article  PubMed  Google Scholar 

  • Berg AH, Scherer PE (2005). Adipose tissue, inflammation, and cardiovascular disease. Circ Res 96, 939–949.

    Article  CAS  PubMed  Google Scholar 

  • Bingham SA, Welch AA, McTaggart A, Mulligan AA, Runswick SA, Luben R et al. (2001). Nutritional methods in the European Prospective Investigation of Cancer in Norfolk. Public Health Nutr 4, 847–858.

    Article  CAS  PubMed  Google Scholar 

  • Bo M, Raspo S, Morra F, Cassader M, Isaia G, Poli L (2004). Body fat is the main predictor of fibrinogen levels in healthy non-obese men. Metabolism 53, 984–988.

    Article  CAS  PubMed  Google Scholar 

  • Bo S, Durazzo M, Guidi S, Carello M, Sacerdote C, Silli B et al. (2006). Dietary magnesium and fiber intakes and inflammatory and metabolic indicators in middle-aged subjects from a population-based cohort. Am J Clin Nutr 84, 1062–1069.

    Article  CAS  PubMed  Google Scholar 

  • Clauss A (1957). Rapid physiological coagulation method in determination of fibrinogen. Acta Haematol 17, 237–246.

    Article  CAS  PubMed  Google Scholar 

  • Danesh J, Lewington S, Thompson SG, Lowe GD, Collins R, Kostis JB et al. (2005). Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant meta-analysis. JAMA 294, 1799–1809.

    CAS  PubMed  Google Scholar 

  • Esposito K, Marfella R, Ciotola M, Di PC, Giugliano F, Giugliano G et al. (2004). Effect of a mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 292, 1440–1446.

    Article  CAS  PubMed  Google Scholar 

  • Folsom AR, Wu KK, Davis CE, Conlan MG, Sorlie PD, Szklo M (1991). Population correlates of plasma fibrinogen and factor VII. Putative cardiovascular risk factors. Artherosclerosis 91, 191–205.

    Article  CAS  Google Scholar 

  • Friedewald WT, Levy RI, Fredrickson DS (1972). Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18, 499–502.

    CAS  PubMed  Google Scholar 

  • Iacoviello L, Zito F, Di Castelnuovo A, De Maat M, Kluft C, Donati MB (1998). Contribution of factor VII, fibrinogen and fibrinolytic components to the risk of ischaemic cardiovascular disease: Their genetic determinants. Fibrinolysis Proteol 12, 259–276.

    Article  CAS  Google Scholar 

  • James S, Vorster HH, Venter CS, Kruger HS, Nell TA, Veldman FJ et al. (2000). Nutritional status influences plasma fibrinogen concentration: evidence from the THUSA survey. Thrombosis Res 98, 383–394.

    Article  CAS  Google Scholar 

  • Jensen MK, Koh-Banerjee P, Franz M, Sampson L, Grønbæk M, Rimm EB (2006). Whole grains, bran, and germ in relation to homocysteine and markers of glycemic control, lipids, and inflammation. Am J Clin Nutr 83, 275–283.

    Article  CAS  PubMed  Google Scholar 

  • Karpanon EA, Vyssoulis GP, Toutouza MG, Georgoudi DG, Toutouzas PK (1992). Plasma fibrinogen changes in the menstrual cycle of hypertensive women. A multivariate approach. In: Ernst E, Koenig W, Lowe GDO, Meade TW (eds). Fibrinogen: A ‘New’ Cardiovascular Risk Factor. Blackwell-MZV: Vienna. pp 350–355.

    Google Scholar 

  • Khaw KT, Bingham S, Welch A, Luben R, O’Brien E, Wareham N et al. (2004). Blood pressure and urinary sodium in men and women: the Norfolk Cohort of the European Prospective Investigation into Cancer (EPIC-Norfolk). Am J Clin Nutr 80, 1397–1403.

    Article  CAS  PubMed  Google Scholar 

  • King DE, Egan BM, Geesey ME (2003). Relation of dietary fat and fiber to elevation of C-reactive protein. Am J Cardiol 92, 1335–1339.

    Article  CAS  PubMed  Google Scholar 

  • King DE (2005). Dietary fiber, inflammation, and cardiovascular disease. Mol Nutr Food Res 49, 594–600.

    Article  PubMed  Google Scholar 

  • King DE, Egan BM, Woolson RF, Mainous III AG, Al-Solaiman Y, Jesri A (2007). Effect of a high-fiber diet vs a fiber-supplemented diet on C-reactive protein level. Arch Intern Med 167, 502–506.

    Article  CAS  PubMed  Google Scholar 

  • King DE, Mainous III AG, Egan BM, Woolson RF, Geesey ME (2008). Effect of psyllium fiber supplementation on C-reactive protein: the trial to reduce inflammatory markers (TRIM). Ann Fam Med 6, 100–106.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lee AJ, Lowe GDO, Smith WCS, Tunstall-Pedoe H (1992). Plasma fibrinogen: Its relationship with oral contraception, the menopause, and hormone replacement therapy. Clin Biochem 25, 403–405.

    Article  CAS  PubMed  Google Scholar 

  • Lowe GD (1992). Blood viscosity and cardiovascular disease. Thromb Haemost 67, 494–498.

    Article  CAS  PubMed  Google Scholar 

  • Lowe GD (2005). Circulating inflammatory markers and risks of cardiovascular and non-cardiovascular disease. J Thromb Haemost 3, 1618–1627.

    Article  CAS  PubMed  Google Scholar 

  • Ma Y, Hebert JR, Li W, Bertone-Johnson ER, Olendzki B, Pagoto SL et al. (2008). Association between dietary fiber and markers of systemic inflammation in the Women's Health Initiative Observational Study. Nutrition 24, 941–949.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ma Y, Griffith JA, Chasan-Taber L, Olendzki BC, Jackson E, Stanek III EJ et al. (2006). Association between dietary fiber and serum C-reactive protein. Am J Clin Nutr 83, 760–766.

    Article  CAS  PubMed  Google Scholar 

  • Masters RC, Liese AD, Haffner SM, Wagenknecht LE, Hanley AJ (2010). Whole and refined grain intakes are related to inflammatory protein concentrations in human plasma. J Nutr 140, 587–594.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Meade TW, Vickers MV, Thompson SG, Seghatchian MJ (1985a). The effect of physiological levels of fibrinogen on platelet aggregation. Thromb Res 38, 527–534.

    Article  CAS  PubMed  Google Scholar 

  • Meade TW, Vickers MV, Thompson SG, Stirling Y, Haines AP, Miller GJ (1985b). Epidemiological characteristics of platelet aggregability. Br Med J (Clin Res Ed) 290, 428–432.

    Article  CAS  Google Scholar 

  • Meilahn EN, Kuller LH, Matthews KA, Kiss JE (1992). Hemostatic factors according to menopausal status and use of hormone replacement therapy. Ann Epidemiol 2, 445–455.

    Article  CAS  PubMed  Google Scholar 

  • North C, Venter C, Jerling J (2009). The effects of dietary fibre on C-reactive protein, an iflammation marker predicting cardiovascular disease. Eur J Clin Nutr 63, 921–933.

    Article  CAS  PubMed  Google Scholar 

  • Panagiotakos DB, Dimakopoulou K, Katsouyanni K, Bellander T, Grau M, Koenig W et al. (2009). Mediterranean diet and inflammatory response in myocardial infarction survivors. Int J Epidemiol 38, 856–866.

    Article  PubMed  Google Scholar 

  • Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon III RO, Criqui M et al. (2003). Markers of inflammation and cardiovascular disease: application to clinical and public health practice: A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 107, 499–511.

    Article  PubMed  Google Scholar 

  • Pereira MA, O’Reilly E, Augustsson K, Fraser GE, Goldbourt U, Heitmann BL et al. (2004). Dietary fiber and risk of coronary heart disease: a pooled analysis of cohort studies. Arch Intern Med 164, 370–376.

    Article  PubMed  Google Scholar 

  • The Fibrinogen Studies Collaboration (2007). Associations of plasma fibrinogen levels with established cardiovascular disease risk factors, inflammatory markers, and other characteristics: individual participant meta-analysis of 154,211 adults in 31 prospective studies: the fibrinogen studies collaboration. Am J Epidemiol 166, 867–879.

    Article  Google Scholar 

  • Van Horn L, McCoin M, Kris-Etherton PM, Burke F, Carson JA, Champagne CM et al. (2008). The evidence for dietary prevention and treatment of cardiovascular disease. J Am Diet Assoc 108, 287–331.

    Article  CAS  PubMed  Google Scholar 

  • Voster HH (1999). Fibrinogen and women's health. Thrombosis Res 95, 137–154.

    Article  Google Scholar 

  • Wareham NJ, Jakes RW, Rennie KL, Schuit J, Mitchell J, Hennings S et al. (2003). Validity and repeatability of a simple index derived from the short physical activity questionnaire used in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Public Health Nutr 6, 407–413.

    Article  PubMed  Google Scholar 

  • Weickert MO, Pfeiffer AFH (2008). Metabolic effects of dietary fiber consumption and prevention of diabetes. J Nutr 138, 439–442.

    Article  CAS  PubMed  Google Scholar 

  • Welch AA, Luben R, Khaw KT, Bingham SA (2005). The CAFE computer program for nutritional analysis of the EPIC-Norfolk food frequency questionnaire and identification of extreme nutrient values. J Hum Nutr Diet 18, 99–116.

    Article  CAS  PubMed  Google Scholar 

  • Welch AA, McTaggart A, Mulligan AA, Luben R, Walker N, Khaw KT et al. (2001). DINER (Data Into Nutrients for Epidemiological Research) - a new data-entry program for nutritional analysis in the EPIC-Norfolk cohort and the 7-day diary method. Public Health Nutr 4, 1253–1265.

    Article  CAS  PubMed  Google Scholar 

  • Woodward M, Lowe GD, Rumley A, Tunstall-Pedoe H (1998). Fibrinogen as a risk factor for coronary heart disease and mortality in middle-aged men and women. The Scottish Heart Health Study. Eur Heart J 19, 55–62.

    Article  CAS  PubMed  Google Scholar 

  • Yano K, Grove JS, Chen R, Rodriguez BL, Curb JD, Tracy RP (2001). Plasma fibrinogen as a predictor of total and cause-specific mortality in elderly Japanese-American men. Arterioscler Thromb Vasc Biol 21, 1065–1070.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

To Professor Sheila A Rodwell (Bingham) who participated in conceiving and designing the research, but sadly passed away while this work was being prepared. This work was supported by program grants from the Medical Research Council, UK, Cancer Research UK and Conselho Nacional de Desenvolvimento Científico e Tecnológico-CNPq, Brazil (fellowship to RNF).

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Authors and Affiliations

  1. DENCS, School of Nutrition and NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil

    R N Freitas

  2. Department of Public Health and Primary Care, MRC-CNC, Cambridge, UK

    R N Freitas & K-T Khaw

  3. Department of Public Health and Primary Care, EPIC Norfolk, University of Cambridge, Cambridge, UK

    R Luben & K-T Khaw

  4. MRC Epidemiology Unit, Cambridge, UK

    N J Wareham

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  1. R N Freitas
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  2. R Luben
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  4. K-T Khaw
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Correspondence to R N Freitas.

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Freitas, R., Luben, R., Wareham, N. et al. Relationship between plasma fibrinogen and fiber intake in the EPIC-Norfolk cohort. Eur J Clin Nutr 66, 443–451 (2012). https://doi.org/10.1038/ejcn.2011.194

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  • DOI: https://doi.org/10.1038/ejcn.2011.194

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