Elsevier

The American Journal of Medicine

Volume 126, Issue 12, December 2013, Pages 1059-1067.e4
The American Journal of Medicine

Clinical research study
Dietary Fiber Intake and Cardiometabolic Risks among US Adults, NHANES 1999-2010

https://doi.org/10.1016/j.amjmed.2013.07.023 Get rights and content

Abstract

Background

Dietary fiber may decrease the risk of cardiovascular disease and associated risk factors. We examined trends in dietary fiber intake among diverse US adults between 1999 and 2010, and investigated associations between dietary fiber intake and cardiometabolic risks including metabolic syndrome, cardiovascular inflammation, and obesity.

Methods

Our cross-sectional analysis included 23,168 men and nonpregnant women aged 20+ years from the 1999-2010 National Health and Nutrition Examination Survey. We used weighted multivariable logistic regression models to estimate predicted marginal risk ratios and 95% confidence intervals for the risks of having the metabolic syndrome, inflammation, and obesity associated with quintiles of dietary fiber intake.

Results

Consistently, dietary fiber intake remained below recommended adequate intake levels for total fiber defined by the Institute of Medicine. Mean dietary fiber intake averaged 15.7-17.0 g. Mexican Americans (18.8 g) consumed more fiber than non-Hispanic whites (16.3 g) and non-Hispanic blacks (13.1 g). Comparing the highest with the lowest quintiles of dietary fiber intake, adjusted predicted marginal risk ratios (95% confidence interval) for the metabolic syndrome, inflammation, and obesity were 0.78 (0.69-0.88), 0.66 (0.61-0.72), and 0.77 (0.71-0.84), respectively. Dietary fiber was associated with lower levels of inflammation within each racial and ethnic group, although statistically significant associations between dietary fiber and either obesity or metabolic syndrome were seen only among whites.

Conclusions

Low dietary fiber intake from 1999-2010 in the US, and associations between higher dietary fiber and a lower prevalence of cardiometabolic risks suggest the need to develop new strategies and policies to increase dietary fiber intake.

Section snippets

Study Population

Our study examines data from the 1999-2010 NHANES. The NHANES is a cross-sectional, nationally representative sample of the US noninstitutionalized civilian population.17 The NHANES population was recruited using a multistage, stratified sampling design.17 Our study population included all nonpregnant participants, aged 20 years and older in the 1999 to 2010 NHANES cohorts (n = 30,433). Those with complete data for all covariates including dietary fiber intake, C-reactive protein (CRP), and

Study Population Characteristics

Study population characteristics are listed in Table 1 by mean dietary fiber intake. Reported dietary fiber intake among all nonpregnant adults ranged between 6.3 grams per day (g/d) (10th percentile) and 29.0 g/d (90th percentile). Mean dietary fiber intake was 16.2 g/d (Table 1). In comparison with those who consumed lower amounts of dietary fiber, participants who consumed higher amounts of dietary fiber were more likely to be older (51 years and older), male, Mexican-American, highly

Discussion

Our findings indicate that, among a nationally representative sample of nonpregnant US adults in NHANES 1999-2010, the consumption of dietary fiber was consistently below the recommended total adequate intake levels across survey years. Our study also confirms persistent differences in dietary fiber intake among sex, socioeconomic status, and racial/ethnic subpopulations over time.33 On average, young males consumed almost 20 g less dietary fiber than recommended amounts, with particularly low

Acknowledgments

This research received institutional support from the Center for Community Health and Health Equity at Brigham and Women's Hospital and Partners HealthCare, Inc. The authors would like to acknowledge the kind intellectual and institutional support of Ms. Wanda McClain from the Community Health and Health Equity and Ms. Ronnie Sanders from Partners HealthCare.

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    Funding: Institutional financial support was provided from Partners HealthCare and the Brigham and Women's Hospital Center for Community Health and Health Equity. CRC was supported by funding from the National Institute on Aging (NIH K08 AG 032357).

    Conflict of Interest: None.

    Authorship: All authors had access to the study data and contributed to the findings and conclusions of this manuscript.

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