Abstract
Background: Few
observational studies have examined the effect of dietary fiber intake
and fruit and vegetable consumption on total mortality and have reported
inconsistent results. All of the studies have been conducted in the
general population and typically used only a single assessment of diet.
Objective:
We investigated the association of fiber intake and whole-grain, fruit,
and vegetable consumption with all-cause mortality in a Mediterranean
cohort of elderly adults at high cardiovascular disease (CVD) risk by
using repeated measurements of dietary information and taking into
account the effect of a dietary intervention.
Design:
We followed up 7216 men (55–75 y old) and women (60–75 y old) at high
CVD risk in the Prevención con Dieta Mediterránea (PREDIMED) trial for a
mean of 5.9 y. Data were analyzed as an observational cohort.
Participants were initially free of CVD. A 137-item validated
food-frequency questionnaire administered by dietitians was repeated
annually to assess dietary exposures (fiber, fruit, vegetable, and
whole-grain intakes). Deaths were identified through the continuing
medical care of participants and the National Death Index. An
independent, blinded Event Adjudication Committee adjudicated causes of
death. Cox regression models were used to estimate HRs of death during
follow-up according to baseline dietary exposures and their yearly
updated changes.
Results: In up to 8.7 y
of follow-up, 425 participants died. Baseline fiber intake and fruit
consumption were significantly associated with lower risk of death [HRs
for the fifth compared with the first quintile: 0.63 (95% CI: 0.46,
0.86; P = 0.015) and 0.59 (95% CI: 0.42, 0.82; P =
0.004), respectively]. When the updated dietary information was
considered, participants with fruit consumption >210 g/d had 41%
lower risk of all-cause mortality (HR: 0.59; 95% CI: 0.44, 0.78).
Associations were strongest for CVD mortality than other causes of
death.
En résumé:
La consommation de plus de 210g/j de fruits (équivalent de 2 fruits) réduirait la mortalité totale de 40%.
La consommation de plus de 21g de fibres / J réduirait la mortalité totale de 25%.
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