title: Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis.
abstract: OBJECTIVE
  To investigate dietary fibre intake and any potential dose-response association with coronary heart disease and cardiovascular disease.
  
  
  METHODS
  Systematic review of available literature and dose-response meta-analysis of cohort studies using random effects models.
  
  
  METHODS
  The Cochrane Library, Medline, Medline in-process, Embase, CAB Abstracts, ISI Web of Science, BIOSIS, and hand searching.
  Prospective studies reporting associations between fibre intake and coronary heart disease or cardiovascular disease, with a minimum follow-up of three years and published in English between 1 January 1990 and 6 August 2013.
  
  
  RESULTS
  22 cohort study publications met inclusion criteria and reported total dietary fibre intake, fibre subtypes, or fibre from food sources and primary events of cardiovascular disease or coronary heart disease. Total dietary fibre intake was inversely associated with risk of cardiovascular disease (risk ratio 0.91 per 7 g/day (95% confidence intervals 0.88 to 0.94)) and coronary heart disease (0.91 (0.87 to 0.94)). There was evidence of some heterogeneity between pooled studies for cardiovascular disease (I(2)=45% (0% to 74%)) and coronary heart disease (I(2)=33% (0% to 66%)). Insoluble fibre and fibre from cereal and vegetable sources were inversely associated with risk of coronary heart disease and cardiovascular disease. Fruit fibre intake was inversely associated with risk of cardiovascular disease.
  
  
  CONCLUSIONS
  Greater dietary fibre intake is associated with a lower risk of both cardiovascular disease and coronary heart disease. Findings are aligned with general recommendations to increase fibre intake. The differing strengths of association by fibre type or source highlight the need for a better understanding of the mode of action of fibre components.
authors.affiliation: Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
authors.forename: Diane E
authors.initials: DE
authors.lastname: Threapleton
authors.forename: Darren C
authors.initials: DC
authors.lastname: Greenwood
authors.forename: Charlotte E L
authors.initials: CE
authors.lastname: Evans
authors.forename: Christine L
authors.initials: CL
authors.lastname: Cleghorn
authors.forename: Camilla
authors.initials: C
authors.lastname: Nykjaer
authors.forename: Charlotte
authors.initials: C
authors.lastname: Woodhead
authors.forename: Janet E
authors.initials: JE
authors.lastname: Cade
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Gale
authors.forename: Victoria J
authors.initials: VJ
authors.lastname: Burley
mesh_terms: D002318:Cardiovascular Diseases / Q000178:diet therapy / Q000517:prevention & control*; D003327:Coronary Disease / Q000517:prevention & control; D004043:Dietary Fiber / Q000008:administration & dosage*; D002523:Edible Grain; D019317:Evidence-Based Medicine; D006801:Humans; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D014675:Vegetables