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 The pattern held true even after researchers
accounted for medications that lower cholesterol, suggesting it’s
important not to rely just on drugs to cut future risks, the authors
said.
“There are additional benefits that come from eating healthy,” said
Shanshan Li, the study’s lead author and an epidemiologist at the
Harvard School of Public Health in Boston.
Diet plays an important role in the development of heart and artery
disease, Li and her co-authors write in the journal BMJ, but little
is known about the difference dietary fiber might make after a heart
attack.
The researchers analyzed data from the Nurses’ Health Study and the
Health Professionals Follow-up Study, two long-term studies that
follow the health and risk factors of women and men across the
United States.
At the beginning of the study period the 2,258 women and 1,840 men
included in the analysis had survived a first heart attack and had
never had a stroke.
Before and after their heart attacks, all participants had filled
out questionnaires about how often they ate common foods over the
previous year, ranking them from “never” to “six or more times per
day.”
Researchers used this information to calculate total fiber intake
and kept track of whether each participant’s fiber came from grains,
fruits or vegetables.
Participants were followed for a median of about nine years; in that
time, 336 women and 451 men died from heart disease-related causes,
such as a second heart attack, clogged arteries in the heart and
stroke. A total of 682 women and 451 men died of any cause.
The study also took into account factors that could by themselves
affect mortality, such as weight, exercise and taking medicines to
lower cholesterol.
Li and her team found that for every 10-gram increase in total fiber
intake, the risk of death from any cause dropped by 15 percent. The
recommended daily fiber intake for women is 25 grams and 38 grams
for men.
The authors point out that only fiber from grains, including
cereals, was linked to lowered risk, and a high intake of this type
of fiber was associated with a 28 percent lower risk of death
compared to people who ate the least fiber.
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Notably, the amount of fiber participants ate
regularly before the first heart attack was not related to the odds
of dying later. However, the more a person boosted fiber intake
after the heart attack, the lower their risk of death.
The results line up with what was already known about fiber intake
and heart disease, said Vivian Mo, a cardiologist and director of
the Women's Cardiovascular Center at the University of Southern
California in Los Angeles.
A high-fiber diet has been linked to lower cholesterol levels, which
is associated with a lower risk of heart disease, Mo said.
Still, the study goes beyond that by showing that eating more fiber
is associated with a lower risk of death – although it doesn’t prove
that it’s the fiber itself that makes the difference, she said.
For example, people who eat lots of fiber likely practice healthy
habits and eat an overall healthy diet as compared to those who
don’t eat much fiber, she said.
“There are so many differences between people who eat more or less
fiber; it’s not just the fiber,” Mo told Reuters Health. But the
fact that people who changed their diet the most after a heart
attack had the lowest risk of death is encouraging.
“It’s never too late to make a change, such as starting to eat
healthier,” Li said.
SOURCE: bit.ly/1mdE91s BMJ, online April 29, 2014.
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