Associations between consumption of dietary fibers and the risk of cardiovascular diseases, cancers, type 2 diabetes, and mortality in the prospective NutriNet-Santé cohort

Abstract

<jats:title>ABSTRACT</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Mounting evidence, yet with varying levels of proof, suggests that dietary fibers (DFs) may exert a protective role against various chronic diseases, but this might depend on the DF type and source.</jats:p> </jats:sec> <jats:sec> <jats:title>Objectives</jats:title> <jats:p>Our objectives were to assess the associations between the intake of DFs of different types [total (TDF), soluble (SF), insoluble (IF)] and from different sources (fruits, vegetables, whole grains, legumes, potatoes and tubers) and the risk of cardiovascular diseases (CVDs), cancer, type 2 diabetes (T2D), and mortality in the large-scale NutriNet-Santé prospective cohort (2009–2019).</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Overall, 107,377 participants were included. Usual DF intake was estimated from validated repeated 24-h dietary records over the first 2 y following inclusion in the cohort. Associations between sex-specific quintiles of DF intake and the risk of chronic diseases and mortality were assessed using multiadjusted Cox proportional hazards models.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>T2D risk was inversely associated with TDFs [HR for quintile 5 compared with quintile 1: 0.59 (95% CI: 0.42, 0.82), P-trend &amp;lt;0.001], SFs [HR: 0.77 (0.56, 1.08); P-trend = 0.02], and IFs [HR: 0.69 (0.50, 0.96); P-trend = 0.004]. SFs were associated with a decreased risk of CVD [HR: 0.80 (0.66, 0.98); P-trend = 0.01] and colorectal cancer [HR: 0.41 (0.21, 0.79); P-trend = 0.01]. IFs were inversely associated with mortality from cancer or CVDs [HR: 0.65 (0.45, 0.94); P-trend = 0.02]. TDF intake was associated with a decreased risk of breast cancer [HR:: 0.79 (0.54, 1.13); P-trend = 0.04]. DF intake from fruit was associated with the risk of several chronic diseases.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Our results suggest that DF intake, especially SFs and DFs from fruits, was inversely associated with the risk of several chronic diseases and with mortality. Further studies are needed, involving different types and sources of fiber. Meanwhile, more emphasis should be put on DFs in public health nutrition policies, as DF intake remains below the recommended levels in many countries. This trial was registered at clinicaltrials.gov as NCT03335644.</jats:p> </jats:sec>

5. Facilitating Behavior Change and Well-being to Improve Health Outcomes:Standards of Medical Care in Diabetes—2022

“…People with diabetes and those at risk for diabetes are encouraged to consume a minimum of 14 g of fiber/1,000 kcal, with at least half of grain consumption being whole, intact grains, according to the Dietary Guidelines for Americans (130). Regular intake of sufficient dietary fiber is associated with lower all-cause mortality in people with diabetes (131,132), and prospective cohort studies have found dietary fiber intake is inversely associated with risk of type 2 diabetes (133)(134)(135). The consumption of sugarsweetened beverages and processed food products with high amounts of refined grains and added sugars is strongly discouraged (130,(136)(137)(138), as these have the capacity to displace healthier, more nutrient-dense food choices.…”

Dietary patterns, dietary nutrients and cardiovascular disease

“…Total dietary fibre was inversely related to circulatory disease (HRs per 10 g/day increments: 0.90; 95% CI: 0.84, 0.97 in men and 0.88; 95% CI: 0.81, 0.97 in women). In a more recent study from France dietary fibre was evaluated in 107,377 participants [33]. Both soluble fibre and insoluble fibre were inversely related with CVD risk (HR for soluble fibre 0.80; 95% CI: 0.66, 0.98, p-trend = 0.01; for insoluble fibre HR 0.65; 95% CI: 0.45, 0.94, p-trend = 0.02).…”

The Role of Specific Components of a Plant-Based Diet in Management of Dyslipidemia and the Impact on Cardiovascular Risk

“…Both SFs and IFs were associated with lower risk of T2DM, while SFs were also associated with lower CVD risk. Amongst different DF sources, DFs from fruits were inversely associated with CVD risk [46]. Noteworthy, there are no RCTs on the effects of specific DF such as beta-glucan that have been shown that lowering LDL-C affects CVD outcomes.…”