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July 30, 2010

Greater fiber intake associated with reduced heart disease mortality in men and women

Greater fiber intake associated with reduced heart disease mortality in men and women

The August, 2010 issue of the Journal of Nutrition reports a reduction in the risk of dying from coronary heart disease among men and women who consumed high fiber diets.

Japanese researchers evaluated data from 58,730 participants who were aged 40 to 79 upon enrollment in The Japan Collaborative Cohort Study for Evaluation of Cancer Risks, a prospective study carried out between 1988 and 1990. Dietary questionnaires were analyzed for total dietary fiber, insoluble dietary fiber and soluble dietary fiber. Follow up was conducted until the end of 2003, during which 422 deaths from coronary heart disease, 983 from stroke and 675 from other cardiovascular disease were documented.

A reduction in deaths from cardiovascular was observed in relation to increased fiber intake, which proved to be inversely associated with coronary heart disease. For men whose total, insoluble, and soluble fiber intakes were among the highest one-fifth of participants, there was a 19 percent, 52 percent, and 29 percent lower risk of dying of heart disease compared to those whose intakes were among the lowest fifth. Similar risk reductions were observed among women. Fiber from fruit and cereal appeared to be responsible for the protective benefit observed in this study.

The authors list fiber's cholesterol and blood pressure-reducing effects, as well as its ability to improve insulin sensitivity, inhibit post-meal rises in glucose and triglycerides, and increase fibrinolytic activity, as mechanisms that prevent or delay the development of atherosclerosis, thereby reducing heart disease mortality. While soluble fiber may have a stronger effect on cholesterol, a greater clotting factor reduction effect was attributed to insoluble fiber.

"Reports of epidemiologic studies in Western countries have strongly suggested that dietary fiber intake offers protection against coronary heart disease (CHD), but evidence has been limited in Asia," the authors write. "Our results constitute supporting evidence that higher intake of both insoluble and soluble fiber, especially fruit and cereal fibers may contribute to the prevention of CHD in Japanese men and women," they conclude.

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Health Concern Life Extension Highlight

Coronary artery disease

For years, many people believed that atherosclerosis primarily affected men. In reality, however, heart disease is the leading killer of women in the United States. Atherosclerosis tends to affect men and women differently and at different times in their lives. Before menopause, women suffer less from heart disease than men of comparable age. After menopause, however, the gap closes with age until eventually women become more likely than men to suffer from heart disease (Sans S et al 1997; LaRosa JC 1992).

Heart disease in women is often undiagnosed because its symptoms are often different from the symptoms men experience. Women are less likely to suffer from the chest pain traditionally associated with coronary artery disease in men (McSweeney JC et al 2003), and their heart attacks tend to be atypical (Sannito N et al 2002). Among women, the pain associated with reduced blood flow (ischemia) may be felt in the upper abdomen or back instead of the chest, and the symptoms of an actual heart attack (myocardial infarction) may also be different from those typically experienced by men.

The issue of women and heart disease is further complicated by conflicting messages about hormone replacement therapy sent by conventional medical research. For many years, doctors prescribed conventional hormone replacement therapy to reduce the risk of heart disease among menopausal women. In recent years, however, the wisdom of this approach has been called into question. Two arms of the large Women’s Health Initiative study were stopped early when researchers discovered that women on conventional hormone replacement therapy were at a higher risk for coronary artery disease, heart attack, stroke, and breast cancer than other women. As a result of these findings, which were reported around the world, many women stopped using hormone replacement therapy, despite the possible benefits of estrogen therapy in reducing cardiovascular risk (Rosano GM et al 2003; Benagiano G et al 2004). Unfortunately, this study examined women using conjugated equine estrogens, which are estrogens derived from the urine of pregnant mares (Rossouw JE et al 2002). Life Extension supports hormone replacement therapy for menopausal women—providing that blood tests are performed to establish proper individualized dosing and that only bioidentical hormones be used.

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