Submitted to: Journal of Cardiovascular Nursing
Publication Type: Review Article
Publication Acceptance Date: 11/1/2005
Publication Date: 1/1/2006
Citation: Erkkila, A.T., Lichtenstein, A.H. 2006. Fiber and cardiovascular disease risk: how strong is the evidence?. Journal of Cardiovascular Nursing. 21(1):3-8.
Technical Abstract: Dietary fiber consists of edible parts of plants or analogous carbohydrates that are resistant to digestion and absorption in human small intestine. Fiber can be classified on the basis of dietary source (cereal, fruit, vegetable or legume) or being supplemental. Based on chemical properties, fiber can be divided to water soluble (e.g. b-glucans, pectin and guar) and insoluble (e.g. cellulose and lignin) forms. An increasing number of observational findings have reported a lower incidence of coronary heart disease in subjects who report consuming diets high in fiber. Dietary fiber is thought to affect several cardiovascular disease (CVD) risk factors. Results from many trials have shown that soluble fiber decreases serum total and low density lipoprotein (LDL) cholesterol concentrations and improves insulin resistance. The effect of fiber on inflammatory markers and coagulation is not yet well established. While soluble, gel-forming fiber has beneficially affected CVD risk factors, food sources of mainly insoluble fibers, namely cereal products, have been the most consistently associated with lower incidence rates of CVD. Despite this contradiction, the evidence promotes a food based approach favoring increased intake of whole-grain cereals, fruit, vegetables and legumes providing a mixture of different types of fibers. Additionally, these selections are likely to lower the caloric density of the diet.