this ppt presented the relationship between dietary fiber and CVD

1. Dietary Fiber and Cardiovascular
Diseases Among Adults
Presented by: Shaikha Hilal Ali Al-Ismaili
ID: s102456

2. Outline
o Definition of dietary fiber
o Dietary fiber and cardiovascular disease
o Meta-analysis
o Conclusion
o References

3. Definition of dietary fiber
o “A group of carbohydrate polymers and oligomers (and lignin)
that escape digestion in the small intestine and pass into the large
bowel, where they are partially, or completely, fermented by gut
microbiota”.1

4. Dietary Fiber and Cardiovascular Disease
– At least 21% and 28% of adult in United State have elevated serum cholesterol
concentration > 240 mg/dl and hypertension respectively
– These two conditions considered as risks factor for cardiovascular disease and
contribute to 38% of total CVD deaths in US2
– Other risk factors associated with CVD include age, gender, smoking, and obesity3
– Modifiable risk factor such as hypercholesterinemia, hypertension, obesity could be
managed by eating healthy diet
– Adequate consumption of dietary fiber found to be strongly associated with the
reduction of coronary and CVD-related death risk4

5. Dietary Fiber and Cardiovascular Disease
– Epidemiologic studies found, adequate daily intake of dietary fiber cause
a reduction in CVD incidence
– Specifically, an increase of dietary fiber 7g/day lead to 9% reduction CVD risk5
– Accumulating evidence from epidemiological studied has found that protective
effects of dietary fiber produced by the consumption of recommended amount
of dietary fiber by the dietary reference intake (DRI) which is about 14g/1000kcal
or 25g for adult men and 38g for adult women6

6. Dietary Fiber and Cardiovascular Disease
Mechanism
– Adequate consumption of dietary fiber may decrease CVD risk by different
mechanism:
By reducing
o Serum lipid concentration
o Blood pressure
o Inflammation

7. Dietary Fiber and Cardiovascular Disease
Mechanism
1. Lowering Serum lipid concentration
– According to Anderson et al viscous fibers can lower serum cholesterol by 5-10%7
– It helps increase bile acids fecal excretion which induce liver to produce new bile
acid from serum LDL cholesterol reduce circulating plasma LDL cholesterol
– Short chain fatty acids produced from fermented fiber by colonic bacteria can
be absorbed and that can lead to inhibit liver enzyme HMG-CoA reductase
responsible for rate limiting cholesterol synthesis

8. Dietary Fiber and Cardiovascular Disease
Mechanism
2. Lowering blood pressure
– Two meta-analysis found that only there was a significant decrease 1.65- and 1.77-
mm Hg in diastolic blood pressure with high adequate fiber consumption
– This small reduction of diastolic blood pressure can reduce the risk of developing CD
up to 7%2
– A cross-sectional study found inversely association between systolic blood pressure and
dietary fiber intake in adult men and women subjects6

9. Dietary Fiber and Cardiovascular Disease
Mechanism of
– Two possible mechanism:
1. Related to fiber ability to form a gel in the stomach and small intestine cause a
slow absorption of blood glucose and inhibit postprandial hyperglycemia which
improve insulin sensitivity by decrease insulin secretion
A study showed that hyperglycemia has a mechanistic role in the risk of developing
hypertension
2. High intake of dietary fiber associated with high potassium and magnesium which
have a small effect on lowering blood pressure2

10. Dietary Fiber and Cardiovascular Disease
Mechanism
3. Reducing of inflammation
– Diet high in dietary fiber associated with a reduction of inflammatory markers
– The exact mechanism is still unclear
– Dietary fiber is a source of phytochemicals such as polyphenols which believed
to influence the inhibition of nuclear factor kB cause a reduction on:
- c-reactive protein
- tumor necrosis factor α interleukin 6
reduce the inflammation and CVD risk2

11. Dietary Fiber and Cardiovascular Disease
Mechanism
Figure 1: proposed mechanisms underlying the observed association between individuals with the
highest dietary intake of fiber and their reduced rates in cardiovascular disease incidence and mortality2

12. Dietary Fiber and Cardiovascular
Disease: Meta-Analyses
Table 1: Effect of High Vs Low Fiber Intake on The Incidence of Developing Cardiovascular Disease2.

13. Dietary Fiber and Cardiovascular
Disease: Meta-Analyses
Table 2: Effect of High vs Low Fiber Intake on Cardiovascular Disease Mortality2.

14. Conclusion
Tips to achieve dietary fiber requirement
– A recommendation by Scientific Advisory Committee on Nutrition (SACN) was made
to increase population fiber intake for adult to 30g/day due to dietary fiber health benefits.
– Adults possible to achieve dietary fiber requirement by consumption of :
1. Five portion of fruits and vegetables
2. Two slices of whole meal bread
3. A portion of breakfast cereals high in fiber content
4. A portion of whole wheat pasta, or baked potato especially with skin8

15. Conclusion
Tips to achieve dietary
fiber requirement
– There are varieties of food with different
dietary fiber content that individual can select
to consume high fiber and healthy diet.
– Table three illustrates varieties of food and
dietary fiber content. 9

16. Conclusion
– Consumption of high dietary fiber intake of micronutrient, phytochemicals which
serve as additional benefit for health8
– There are some barriers related to fiber consumption cited by consumer
1. Price was the main factor determining product choice
2. Availability
3. Convenience
4. Waste (e.g. quick spoilage of fruit)
5. Unwillingness to change existing food choices and habits9

17. References
1. Fuller, S.; Beck, E.; Salman, H.; Tapsell, L. New horizons for the study of dietary fiber and health: a
review. Plant Foods for Human Nutrition 71: 1-12; 2016.
2. McRae, M. Dietary fiber is beneficial for the prevention of cardiovascular disease: an umbrella review
of meta-analyses. Journal of Chiropractic Medicine 16: 289-299; 2017
3. Wu, Y.; Qian, Y.; Pan, Y.; Li, P.; Yang, J.; Ye, X.; Xu, G. association between dietary fiber intake and
risk of coronary heart disease: A meta-analysis. Clinical Nutrition 34: 603-611; 2015.
4. Veronese, N.; Solmi, M.; Caruso, M.; Giannelli, G.; Osella, A.; Evangelou, E.; Tzoulaki, I. Dietary
fiber and health outcomes: an umbrella review of systematic reviews and meta-analyses. The American
Journal of Clinical Nutrition, 107: 436-444; 2018.
5. Kim, Y.; Je, Y. Dietary fiber intake and mortality from cardiovascular disease and all cancers: a meta-
analysis of prospective cohort studies. Archives of Cardiovascular Diseases 109: 39-54; 2016

18. References
6. Mirmiran, P.; Bahadoran, Z.; Khalili Moghadam, S.; Zadeh Vakili, A.; Azizi, F. A prospective study of
different types of dietary fiber and risk of cardiovascular disease: tehran lipid and glucose
study. Nutrients 8: 686; 2016.
7. Alissa, M.; Ferns, A. Dietary fruits and vegetables and cardiovascular diseases risk. Critical Reviews
in Food Science and Nutrition 57: 1950-1962; 2017..
8. Hooper, B.; Spiro, A.; Stanner, S. 30 g of fiber a day: An achievable recommendation? Nutrition
Bulletin 40: 118-129; 2015.
9. Lockyer, S.; Spiro, A.; Stanner, S. Dietary fiber and the prevention of chronic disease - should health
professionals be doing more to raise awareness? Nutrition Bulletin 41: 214-231; 2016.

19. Thank you
Any question?