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Dietary fibre intake and ischaemic heart disease mortality: the European Prospective Investigation into Cancer and Nutrition-Heart study



Evidence from prospective studies is consistent in showing an inverse association between dietary fibre intake and risk of ischaemic heart disease (IHD), but whether dietary fibre from various food sources differ in their effect on IHD risk is less clear. The objective of this study was to assess the associations of total and food sources of dietary fibre with IHD mortality in the European Prospective Investigation into Cancer and Nutrition-Heart study.


Participants were 306 331 men and women from eight European countries. Dietary fibre intake was assessed using centre or country-specific diet questionnaires and calibrated using a 24-h diet recall.


After an average follow-up of 11.5 years, there were 2381 IHD deaths among participants without cardiovascular disease at baseline. The calibrated intake of dietary fibre was inversely related with IHD mortality; each 10 g/day was associated with a 15% lower risk (relative risk (RR) 0.85; 95% confidence interval (CI): 0.73–0.99, P=0.031). There was no difference in the associations of the individual food sources of dietary fibre with the risk of IHD mortality; RR for each 5 g/day higher cereal fibre intake was 0.91 (CI: 0.82–1.01), RR for each 2.5 g/day fruit fibre intake was 0.94 (CI: 0.88–1.01) and RR for each 2.5 g/day vegetable fibre intake was 0.90 (95% CI: 0.76–1.07).


A higher consumption of dietary fibre is associated with a lower risk of fatal IHD with no clear difference in the association with IHD for fibre from cereals, fruits or vegetables.

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The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Federal Ministry of Education and Research (Germany); Hellenic Health Foundation, the Stavros Niarchos Foundation and the Hellenic Ministry of Health (Greece); Italian Association for Research on Cancer (AIRC) and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (the Netherlands); Health Research Fund (FIS), Regional Governments of Andalucia, Asturias, Basque Country, Murcia and Navarra, RTICC (Red temática de investigación cooperativa en Cáncer) and CIBERESP (caber de salud Pública y Epidemiología); Swedish Cancer Society, Swedish Research Council, Regional Government of Skåne and Västerbotten and Swedish Heart Lung Foundation (Sweden); Cancer Research UK and the Medical Research Council (United Kingdom).

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Correspondence to F L Crowe.

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Crowe, F., Key, T., Appleby, P. et al. Dietary fibre intake and ischaemic heart disease mortality: the European Prospective Investigation into Cancer and Nutrition-Heart study. Eur J Clin Nutr 66, 950–956 (2012).

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  • dietary fibre
  • ischaemic heart disease
  • prospective cohort studies

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