Dietary fiber and coronary heart disease in middle-aged hypercholesterolemic men

We assessed the association of dietary fiber with coronary heart disease (CHD) among middle-aged hypercholesterolemic men. Nutrient intakes were averaged over two baseline 24-hour diet recalls collected during the prerandomization phase of the Lipid Research Clinic Coronary Primary Prevention Trial. During the 9.6-year follow-up period, 249 suspect or definite CHD events occurred among 1,801 men in the placebo arm of the trial. When we included fiber as a continuous variable in Cox proportional hazards models, we found CHD risk to vary inversely with crude fiber intake (beta = -0.0840, standard error = 0.0432) after adjustment for age, smoking, total calories, blood pressure, and high-density lipoprotein and low-density lipoprotein cholesterol. Further adjustment for body mass, exercise, educational status, types of dietary fats, and postchallenge glucose levels did not change the estimates for fiber. Although the relative risk for fiber is modest in this study, the inverse association with CHD is consistent with the findings in previous observational studies, not restricted to hypercholesterolemic subjects, of the fiber:CHD hypothesis.