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Healthy diet and fiber intake are associated with decreased risk of incident symptomatic peripheral artery disease – A prospective cohort study

Kulezic, Andrea ; Bergwall, Sara LU ; Fatemi, Shahab LU ; Sonestedt, Emily LU orcid ; Zarrouk, Moncef LU ; Gottsäter, Anders LU and Acosta, Stefan LU orcid (2019) In Vascular Medicine (United Kingdom) 24(6). p.511-518
Abstract

Peripheral artery disease (PAD) is caused by atherosclerosis and associated with an increased risk of leg amputation, cardiovascular disease, and death. A healthy diet has been shown to reduce the risk of cardiovascular events, but relationships between diet, fiber intake, and incidence of PAD are virtually unknown. The aim was to investigate the long-term impact of diet on the development of PAD among 26,010 middle-aged individuals in the prospective Malmö Diet and Cancer study (MDCS). Data on dietary intake were collected through a 7-day food diary combined with a food questionnaire and a 1-hour interview. Adherence to a recommended intake of six dietary components – saturated fat, polyunsaturated fat, fish and shellfish, fiber, fruit... (More)

Peripheral artery disease (PAD) is caused by atherosclerosis and associated with an increased risk of leg amputation, cardiovascular disease, and death. A healthy diet has been shown to reduce the risk of cardiovascular events, but relationships between diet, fiber intake, and incidence of PAD are virtually unknown. The aim was to investigate the long-term impact of diet on the development of PAD among 26,010 middle-aged individuals in the prospective Malmö Diet and Cancer study (MDCS). Data on dietary intake were collected through a 7-day food diary combined with a food questionnaire and a 1-hour interview. Adherence to a recommended intake of six dietary components – saturated fat, polyunsaturated fat, fish and shellfish, fiber, fruit and vegetables, and sucrose – was scored (sum 0–6 points) to assess a diet quality index, adjusting for potential confounders. Cox regression analysis was used to estimate associations between diet variables and PAD incidence expressed in hazard ratios (HR) with 95% CI. During a median follow-up of 21.7 years, 1122 participants developed PAD. Diet score was associated with a reduced risk of PAD in multivariable analysis (p = 0.03). When mutually adjusting for all dietary variables, only adherence to recommended levels of fiber intake was associated with a reduced risk of incident PAD (HR 0.84; 95% CI 0.72–0.99). In this prospective, population-based study including 26,010 participants with over 20 years of follow-up, a healthy diet, especially a high intake of fiber, was associated with a reduced risk of PAD. Primary prevention programs directed against PAD should therefore include a fiber recommendation.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Aged, Diet, Healthy, Dietary Fiber/administration & dosage, Feeding Behavior, Female, Humans, Incidence, Male, Middle Aged, Nutritive Value, Peripheral Arterial Disease/diagnosis, Prognosis, Prospective Studies, Protective Factors, Recommended Dietary Allowances, Risk Assessment, Risk Factors, Risk Reduction Behavior, Sweden/epidemiology, Time Factors
in
Vascular Medicine (United Kingdom)
volume
24
issue
6
pages
511 - 518
publisher
SAGE Publications
external identifiers
  • scopus:85071580347
  • pmid:31431146
ISSN
1358-863X
DOI
10.1177/1358863X19867393
language
English
LU publication?
yes
id
e5cf5904-4858-4024-8080-86e196ce7603
date added to LUP
2019-09-23 12:44:04
date last changed
2024-04-02 18:10:31
@article{e5cf5904-4858-4024-8080-86e196ce7603,
  abstract     = {{<p>Peripheral artery disease (PAD) is caused by atherosclerosis and associated with an increased risk of leg amputation, cardiovascular disease, and death. A healthy diet has been shown to reduce the risk of cardiovascular events, but relationships between diet, fiber intake, and incidence of PAD are virtually unknown. The aim was to investigate the long-term impact of diet on the development of PAD among 26,010 middle-aged individuals in the prospective Malmö Diet and Cancer study (MDCS). Data on dietary intake were collected through a 7-day food diary combined with a food questionnaire and a 1-hour interview. Adherence to a recommended intake of six dietary components – saturated fat, polyunsaturated fat, fish and shellfish, fiber, fruit and vegetables, and sucrose – was scored (sum 0–6 points) to assess a diet quality index, adjusting for potential confounders. Cox regression analysis was used to estimate associations between diet variables and PAD incidence expressed in hazard ratios (HR) with 95% CI. During a median follow-up of 21.7 years, 1122 participants developed PAD. Diet score was associated with a reduced risk of PAD in multivariable analysis (p = 0.03). When mutually adjusting for all dietary variables, only adherence to recommended levels of fiber intake was associated with a reduced risk of incident PAD (HR 0.84; 95% CI 0.72–0.99). In this prospective, population-based study including 26,010 participants with over 20 years of follow-up, a healthy diet, especially a high intake of fiber, was associated with a reduced risk of PAD. Primary prevention programs directed against PAD should therefore include a fiber recommendation.</p>}},
  author       = {{Kulezic, Andrea and Bergwall, Sara and Fatemi, Shahab and Sonestedt, Emily and Zarrouk, Moncef and Gottsäter, Anders and Acosta, Stefan}},
  issn         = {{1358-863X}},
  keywords     = {{Aged; Diet, Healthy; Dietary Fiber/administration & dosage; Feeding Behavior; Female; Humans; Incidence; Male; Middle Aged; Nutritive Value; Peripheral Arterial Disease/diagnosis; Prognosis; Prospective Studies; Protective Factors; Recommended Dietary Allowances; Risk Assessment; Risk Factors; Risk Reduction Behavior; Sweden/epidemiology; Time Factors}},
  language     = {{eng}},
  month        = {{08}},
  number       = {{6}},
  pages        = {{511--518}},
  publisher    = {{SAGE Publications}},
  series       = {{Vascular Medicine (United Kingdom)}},
  title        = {{Healthy diet and fiber intake are associated with decreased risk of incident symptomatic peripheral artery disease – A prospective cohort study}},
  url          = {{http://dx.doi.org/10.1177/1358863X19867393}},
  doi          = {{10.1177/1358863X19867393}},
  volume       = {{24}},
  year         = {{2019}},
}