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Higher fiber intake improves survival time after a heart attack

At a Glance: A new study shows that people who survive heart attacks may improve their chance of survival by increasing their dietary intake of fiber.

Diet plays an important role in the development of heart disease, yet secondary prevention guidelines tend to emphasize pharmaceuticals over diet and lifestyle recommendations. Adequate dietary fiber intake is known to be associated with a lowered risk of many conditions, such as hypertension, obesity, diabetes, and cardiovascular disease. Whether, and to what extent, fiber intake impacts survival after a heart attack is less known.

In a new study published in the British Medical Journal, researchers analyzed data from two large studies, the Nurse's Health Study and the Health Professional Follow-Up Study, to determine whether increased fiber intake would improve chances of survival after a heart attack. Of the total of 173,229 patients in the study, researchers looked at 4,098 men and women who had survived a first heart attack and followed them for an average of nine years. Detailed questionnaires were completed several times during the follow-up period and used to analyze lifestyle habits.

Participants were separated into five groups (quintiles) according to their dietary fiber intake after their heart attack. Those who ate the most fiber had a 25% lower chance of dying from any cause in the nine years after their heart attack compared with those who ate the least fiber. When considering only cardiovascular causes of death (heart attack, stroke and coronary heart disease), the top quintile had a 13% lower mortality risk than those with the lowest intake. Researchers also found that every 10g per day increase in dietary fiber was associated with a 15% lower risk of death over the nine-year follow-up period.

When the specific type of dietary fiber was looked at individually (cereal, fruit or vegetable), only higher cereal fiber intake was strongly associated with an increase in long-term survival after a heart attack.

Currently, only 5% of Americans consume the minimum recommendation of dietary fiber of 25 g per day for women and 38 g per day for men. With more people surviving heart attacks, it is increasingly important to emphasize healthy lifestyle choices in addition to appropriate medication to improve long-term health and survival.

Shanshan Li et al. Dietary fiber intake and mortality among survivors of myocardial infarction: prospective cohort study BMJ 2014;348:g2659 doi: 10.1136/bmj.g2659


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