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Relationship between carbohydrate and dietary fibre intake and the risk of cardiovascular disease mortality in Japanese: 24-year follow-up of NIPPON DATA80

European Journal of Clinical Nutrition (2019) | Download Citation



The association between carbohydrate intake and cardiovascular disease (CVD) risk has been investigated, but whether the quality of carbohydrate is more important than its amount is not known. We examined the associations between intake of dietary fibre (DF), carbohydrate, available carbohydrate, and starch with long-term CVD mortality in a Japanese population.


We prospectively followed 8925 participants (3916 men and 5009 women) aged 30–79 years without CVD at baseline who participated in the National Nutrition Survey in Japan. Cox proportional hazards models were used to estimate multivariable-adjusted hazard ratios (HRs) and their 95% confidence intervals (CIs) for CVD mortality by quartiles of exposure variables.


During 24 years of follow-up, 823 CVD deaths were observed. In men, the multivariable-adjusted HR for CVD mortality was lower in the highest quartile of DF intake (HR: 0.64; 95% CI: 0.47–0.87; Ptrend = 0.007) compared with the lowest quartile. This association was not significant in women. Multivariable-adjusted HR for total stroke mortality was lower in the highest quartile of DF intake (HR: 0.61; 95% CI: 0.38–0.98; Ptrend = 0.046) compared with the lowest quartile in women. Carbohydrate, available carbohydrate, and starch intake were not associated with CVD mortality.


Higher intake of DF was associated significantly with a lower risk of CVD mortality in men and lower risk of stroke mortality in women. Intake of carbohydrate, available carbohydrate, and starch were not associated with the risk of CVD mortality in men or women.

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We thank all members of the NIPPON DATA80 Research group as listed in the previous article [26]. We thank Edanz Group ( for editing a draft of this manuscript.


This study was supported by a Grant-in-Aid from the Ministry of Health, Labour and Welfare under the auspices of the Japanese Association for Cerebro-cardiovascular Disease Control, a Research Grant for Cardiovascular Diseases (7A-2) from the Ministry of Health, Labour and Welfare, and a Health and Labour Sciences Research Grant, Japan (Comprehensive Research on Aging and Health (H11-Chouju-046, H14-Chouju-003, H17-Chouju-012, H19-Chouju-Ippan-014) and Comprehensive Research on Life-Style Related Diseases including Cardiovascular Diseases and Diabetes Mellitus (H22-Jyunkankitou-Seisyu-Sitei-017, H25-Jyunkankitou-Seisyu-Sitei-022)).

Author information


  1. Department of Medicine, Shiga University of Medical Science, Otsu, 520-2192, Japan

    • Itsuko Miyazawa
  2. Department of Public Health, Shiga University of Medical Science, Otsu, 520-2192, Japan

    • Katsuyuki Miura
    • , Naoko Miyagawa
    • , Keiko Kondo
    • , Aya Kadota
    • , Akira Fujiyoshi
    •  & Hirotsugu Ueshima
  3. Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, 520-2192, Japan

    • Katsuyuki Miura
    • , Aya Kadota
    •  & Hirotsugu Ueshima
  4. International Center for Nutrition and Information, National Institute of Biomedical Innovation, Health and Nutrition, Tokyo, 162-8636, Japan

    • Naoko Miyagawa
  5. Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, 339-8539, Japan

    • Nagako Okuda
  6. Department of Hygiene, School of Medicine Wakayama Medical University, Wakayama, 641-8509, Japan

    • Akira Fujiyoshi
  7. Department of Public Health, Jichi Medical University, Shimotsuke, 329-0498, Japan

    • Izumi Chihara
    •  & Yosikazu Nakamura
  8. Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, 980-8573, Japan

    • Atsushi Hozawa
  9. Department of Food Science and Human Nutrition, Faculty of Agriculture, Ryukoku University, Otsu, 520-2194, Japan

    • Yasuyuki Nakamura
  10. Science of Nursing, Tsuruga Nursing University, Tsuruga, 914-0814, Japan

    • Yoshikuni Kita
  11. Department of Food Science and Nutrition, Graduate School of Human Life Science, Osaka City University, Osaka, 558-8585, Japan

    • Katsushi Yoshita
  12. Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, 160-8582, Japan

    • Tomonori Okamura
  13. Research Institute of Strategy for Prevention, Tokyo, 104-0033, Japan

    • Akira Okayama


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    The authors declare that they have no conflict of interest.

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    Correspondence to Itsuko Miyazawa.

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