Exploring the association between dietary fiber intake and hepatic steatosis: insights from NHANES.

PURPOSE: The link between dietary fiber intake and Non-alcoholic fatty liver disease (NAFLD) is under exploration, yielding inconsistent findings. Considering the limitations of previous research and the significance of dietary fiber in hepatic steatosis, this study investigates the association between dietary fiber intake and Controlled Attenuation Parameter (CAP) among 5935 participants from the National Health and Nutrition Examination Survey (NHANES). MATERIALS AND METHODS: Multivariable regression was used to evaluate the association between dietary fiber intake and CAP. Smoothed curve fitting and threshold effect analysis techniques were applied to illustrate non-linear relationships. RESULTS: After adjusting for other variables, a negative correlation emerged between dietary fiber intake and CAP. Subgroup analysis by gender and race/ethnicity revealed a sustained negative association between dietary fiber intake and CAP among females and Whites. Additionally, an inverted U-shaped relationship was observed between dietary fiber intake and CAP among women and other race, with inflection points at 13.80 g/day and 33.45 g/day, respectively. CONCLUSION: Our research indicates that in the majority of Americans, there is an inverse relationship between dietary fiber intake and hepatic steatosis. This relationship exhibits an inverted U-shaped curve in women and other race, with a threshold effect. The findings of this study hold potential significance for clinical nutrition interventions, personalized dietary guidance, and advancing research into the diet-disease mechanism relationship.

Sex difference in the association of dietary fiber intake with visceral fat volume in Japanese adults.

PURPOSE: Dietary fiber is a possible nutritional component which aids in the prevention of visceral fat accumulation. We examined the association between dietary fiber intake and visceral fat volume (VFV) by sex, and further analysed the association by major food sources of dietary fiber. METHODS: In this cross-sectional study, we measured VFV in 2779 Japanese (1564 men and 1215 women) aged 40-89 who underwent positron emission tomography/computed tomography for cancer screening between 2004 and 2005. Dietary fiber intake was calculated based on a validated semi-quantitative food frequency questionnaire. The association between dietary fiber intake and VFV was investigated using multivariate linear regression models after adjustment for potential confounders. RESULTS: Total, soluble, and insoluble fiber intakes were inversely associated with VFV in men (Q1: 3740 cm3, Q4: 3517 cm3, Ptrend: 0.0006 for total fiber), but not in women (Q1: 2207 cm3, Q4: 2193 cm3,Ptrend: 0.88 for total fiber). Statistically significant sex difference was observed (Pinteraction = 0.001 for total fiber). Subgroup analyses by major food sources revealed that dietary fiber intakes from beans, vegetables and fruits showed an inverse association with VFV in men, while cereal fiber intake showed a tendency toward a positive association in both sexes (Q1: 3520 cm3, Q4: 3671 cm3, Ptrend: 0.05 in men, Q1: 2147 cm3, Q4: 2227 cm3, Ptrend: 0.10 in women). CONCLUSION: We observed a sex-specific association between dietary fiber intake and VFV in Japanese adults. This study suggests that efforts against visceral fat accumulation should take account of the source of dietary fiber.

Relationship between diabetes diet-related quality of life and dietary fiber intake among people with type 2 diabetes: a cross-sectional study.

Diet therapy is one of the most important treatments for people with type 2 diabetes (T2D). However, dietary restrictions due to diet therapy may reduce quality of life (QOL). This cross-sectional study aimed to investigate the association between diabetes diet-related QOL and dietary fiber intake in 238 people with T2D. The Diabetes Diet-related Quality of Life-Revised version (DDRQOL-9-R) and the brief-type self-administered diet history questionnaire were used to evaluate diabetes diet-related QOL and nutritional intake, respectively. Higher scores of each DDRQOL-9-R subscale means greater satisfaction with diet, perceived merits of diet therapy, and lower burden of diet therapy, which indicates good QOL. The median scores for perceived merits of diet therapy, satisfaction with diet, and burden of diet therapy were 58.3 [41.7-75.0], 75.0 [66.7-91.7], and 66.7 [50.0-75.0] points, respectively. HbA1c levels in people with high perceived merits of diet therapy (7.3 [6.7-7.8] vs. 7.5 [7.1-8.2] %, p = 0.007) and people with high satisfaction with diet (7.3 [6.8-7.8] vs. 7.5 [7.1-8.4] %, p = 0.010) were lower than those without. Dietary fiber intake was higher in people with high perceived merits of diet therapy (11.6 [8.8-16.7] vs. 10.0 [7.9-13.8] g/day, p = 0.010), high satisfaction with diet (11.4 [8.8-16.1] vs. 9.7 [7.8-13.2] g/day, p = 0.007), and low burden of diet therapy (11.8 [8.7-16.5] vs. 9.7 [7.8-12.6] g/day, p = 0.004) than in those without. Dietary fiber intake was related to perceived merits of diet therapy (Odds ratio [OR]1.07 [95%CI: 1.00-1.15], p = 0.049), burden of diet therapy (OR 0.90 [95%CI: 0.82-0.98], p = 0.022), and satisfaction with diet (OR 1.18 [95%CI: 1.09-1.27], p < 0.001) after adjusting for covariates. Dietary fiber intake is associated with diabetes diet-related QOL in people with T2D.

Association between dietary fiber intake and atherosclerotic cardiovascular disease risk in adults: a cross-sectional study of 14,947 population based on the National Health and Nutrition Examination Surveys.

BACKGROUND: This study aimed to investigate the association between dietary fiber intake and long-term cardiovascular disease (CVD) risk based on the National Health and Nutrition Examination Survey (NHANES) database. METHODS: A total of 14,947 participants aged 20-79 from the NHANES database were included in this study between 2009 and 2018. The atherosclerotic cardiovascular disease (ASCVD) score was utilized to predict the 10-year risk of CVD in individuals (low, borderline, intermediate, and high risk). Weighted univariate and multinomial multivariate logistic regression analyses were used to analyze the association between dietary fiber intake and long-term CVD risk. RESULTS: Higher dietary fiber density may be associated with a reduced ASCVD risk in participants with intermediate risk [odds ratio (OR) = 0.76; 95% confidence interval (CI), 0.61-0.94] and high risk (OR = 0.60; 95%CI, 0.45-0.81) compared with those in the group with low risk. Higher total dietary fiber intake may also reduce ASCVD risk in participants with high risk (OR = 0.84; 95%CI, 0.75-0.95). Subgroup analyses showed that higher dietary fiber density may be related to reduced ASCVD risk in intermediate-risk participants aged 20-39 (OR = 0.62; 95%CI, 0.43-0.89) and 40-59 (OR = 0.67; 95%CI, 0.49-0.94). In high-risk participants, higher dietary fiber density may reduce ASCVD risk in 20-39-year-old (OR = 0.38; 95%CI, 0.19-0.77), 40-59-year-old (OR = 0.37; 95%CI, 0.20-0.70), male (OR = 0.47; 95%CI, 0.23-0.97) and female (OR = 0.57; 95%CI, 0.38-0.86) participants. CONCLUSION: Higher dietary fiber density and total dietary fiber intake were associated with a lower long-term CVD risk, especially in the 20-39 and 40-59 age groups, where the reduction was most significant.

Dietary fiber intake and risk of gastric cancer: The Japan Public Health Center-based prospective study.

Evidence of the association between dietary fiber intake and gastric cancer (GC) risk from prospective studies is limited. We examined the association between dietary fiber intake and GC risk in a large prospective study. A total of 91 946 eligible Japanese aged 45 to 74 years (42 773 men and 49 173 women) participated in a population-based cohort study (Japan Public Health Center-based prospective study). From a validated food frequency questionnaire with 138 food items, total and food source-specific dietary fiber intake was calculated as exposure. The hazard ratio (HR) and the 95% confidence interval (CI) of GC incidence according to quintile of dietary fiber intake were examined after adjusting for confounding factors. In total, 2228 GC cases (1559 men and 669 women) were observed during the 15.0 years follow-up. Total dietary fiber intake was not associated with GC risk; however, a marginally increased risk trend because of high HR in the highest quintile of total fiber intake was found in women (HR [95% CI] in Q5 vs Q1: 0.95 [0.79-1.14], P for trend .30 in men, HR [95% CI] 1.25 [0.98-1.61], P for trend .05 in women). Stratification by tumor location did not change the results. A marginal but not significant inverse trend was observed regarding cereal fiber intake and GC risk in men. Total dietary fiber intake was not associated with GC risk. Further studies are warranted to confirm this association.

Risk Factors for Constipation in Adults: A Cross-Sectional Study.

Aim: The objective of this study was to determine associations between physical activity, dietary fiber intake, water and fluid intake, and constipation as well as other possible risk factors for constipation in adults.Method: A cross-sectional study was conducted in 4561 (1812 male and 2749 female) adults, aged between 18-65 years, living in Ankara, Turkey. Participants having three or fewer bowel movements per week were considered constipated. Dietary fiber and fluid intake data were ascertained from a 62-item food frequency questionnaire (FFQ). The International Physical Activity Questionnaire-Short Form (IPAQ-SF) was used to evaluate participant physical activity.Results: Of the total cohort, 16.6% were diagnosed with constipation (13.6% males, 18.5% females). Logistic regression analysis showed a significantly greater risk of constipation in participants with female gender, advancing age, being obese. Participants who were moderately active (OR: 0.77, 95% CI: 0.62-0.91) and active (OR: 0.74, 95% CI: 0.59-0.90) had a decreased likelihood of constipation, when compared with inactive participants (p < 0.05). Participants in the middle upper quartile for water intake (OR: 0.71, 95% CI: 0.57-0.88), had a decreased likelihood of constipation, when compared with participants in the lowest quartile. Participants in the middle upper quartile (OR: 0.74, 95% CI: 0.58-0.92) and the highest quartile for dietary fiber intake (OR: 0.66, 95% CI: 0.52-0.84), had a decreased likelihood of constipation, when compared with participants in the lowest quartile (p < 0.05).Conclusion: Constipation is common in the Turkish adult population. Insufficient physical activity, decreasing fiber and water intake, obesity, advancing age and female gender were associated with increased constipation risks. Combining regular physical activity and increasing fiber and water intake may protect from constipation, and relieve constipation symptoms.

Association between dietary fiber intake and risk of incident aortic stenosis.

BACKGROUND AND AIMS: Although aortic stenosis is the most common valvular heart disease requiring intervention in Europe, the role that diet plays in development of the disease is largely unknown. The pathophysiology of aortic stenosis is however similar to other cardiovascular diseases that fiber intake has been associated with. The aim of this study was consequently to investigate the association between dietary fiber intake as well as the main food sources of fiber, i.e. fruit and vegetables and whole grains, and risk of incident aortic stenosis. METHODS AND RESULTS: The Malmö Diet and Cancer Study is a Swedish prospective population-based cohort study with baseline data collection performed between year 1991-1996. Dietary habits were recorded through seven-day food diaries, 168-item diet questionnaires, and interviews, and data on incident aortic stenosis was collected through national registers. Among the 26,063 participants, 672 cases were ascertained during a mean follow-up period of 20 years. Cox regression was used to estimate the association between dietary intakes and incident aortic stenosis. No associations were found between incident aortic stenosis and intake of dietary fiber (HR for the highest vs lowest quintile: 0.93; 95% CI: 0.72-1.24), fruit and vegetables (HR: 0.98; 95% CI: 0.76-1.28), or whole grains (HR: 1.00; 95% CI: 0.79-1.26) in the main model. CONCLUSION: The findings of this study do not indicate that consumption of dietary fiber or fiber rich foods are associated with incident aortic stenosis.

Dietary fiber intake and head and neck cancer risk: A pooled analysis in the International Head and Neck Cancer Epidemiology consortium.

The possible role of dietary fiber in the etiology of head neck cancers (HNCs) is unclear. We used individual-level pooled data from ten case-control studies (5959 cases and 12,248 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium, to examine the association between fiber intake and cancer of the oral cavity/pharynx and larynx. Odds Ratios (ORs) and their 95% Confidence Intervals (CIs) were estimated using unconditional multiple logistic regression applied to quintile categories of non-alcohol energy-adjusted fiber intake and adjusted for tobacco and alcohol use and other known or putative confounders. Fiber intake was inversely associated with oral and pharyngeal cancer combined (OR for 5th vs. 1st quintile category = 0.49, 95% CI: 0.40-0.59; p for trend <0.001) and with laryngeal cancer (OR = 0.66, 95% CI: 0.54-0.82, p for trend <0.001). There was, however, appreciable heterogeneity of the estimated effect across studies for oral and pharyngeal cancer combined. Nonetheless, inverse associations were consistently observed for the subsites of oral and pharyngeal cancers and within most strata of the considered covariates, for both cancer sites. Our findings from a multicenter large-scale pooled analysis suggest that, although in the presence of between-study heterogeneity, a greater intake of fiber may lower HNC risk.

Dietary fiber intake and risk of breast cancer defined by estrogen and progesterone receptor status: the Japan Public Health Center-based Prospective Study.

PURPOSE: Epidemiological studies have suggested a protective effect of dietary fiber intake on breast cancer risk while the results have been inconsistent. Our study aimed to investigate the association between dietary fiber intake and breast cancer risk and to explore whether this association is modified by reproductive factors and hormone receptor status of the tumor. METHODS: A total of 44,444 women aged 45 to 74 years from the Japan Public Health Center-based Prospective Study were included in analyses. Dietary intake assessment was performed using a validated 138-item food frequency questionnaire (FFQ). Hazard ratios (HRs) and 95% confidence intervals (CIs) for breast cancer incidence were calculated by multivariate Cox proportional hazards regression models. RESULTS: During 624,423 person-years of follow-up period, 681 breast cancer cases were identified. After adjusting for major confounders for breast cancer risk, inverse trends were observed but statistically non-significant. Extremely high intake of fiber was associated with decreased risk of breast cancer but this should be interpreted with caution due to limited statistical power. In stratified analyses by menopausal and hormone receptor status, null associations were observed except for ER-PR- status. CONCLUSIONS: Our findings suggest that extreme high fiber intake may be associated with decreased risk of breast cancer but the level of dietary fiber intake among Japanese population might not be sufficient to examine the association between dietary fiber intake and breast cancer risk.

Association Between Dietary Fiber Intake and Prevalence of Chronic Obstructive Pulmonary Disease in a Middle-Aged and Elderly Population: a Study Based on the National Health and Nutrition Examination Survey Database.

Objective: This study aimed to investigate dietary fiber (DF) intake with the prevalence of chronic obstructive pulmonary disease (COPD) in the middle-aged and elderly population through analysis of the National Health and Nutrition Examination Survey (NHANES) data. Methods: The study utilized data from 3 cycles of the NHANES database (2007-2012). The exposure variable was DF intake, and the outcome variable was COPD prevalence. Weighted logistic regression was utilized to construct relationship models between the 2 variables. Confounding factors were adjusted, and subgroup analysis was to explore the association of DF intake with COPD. Restricted cubic spline (RCS) analysis investigated the nonlinear relationship between DF intake and COPD. Finally, mediation analysis was performed to determine whether the influence of DF intake on COPD prevalence is mediated through the alteration of white blood cell (WBC) counts. Results: This study included a total of 7301 eligible participants aged >40 years. The results of the study indicated that an increase in DF intake significantly reduced the prevalence of COPD (odds ratio: 0.98, 95% confidence interval: 0.96-0.99, p<0.001), and DF intake was correlated with lung function indicators (e.g., forced expiratory volume in 1 second). Stratified analysis revealed that an increased DF intake significantly reduced the risk of COPD in male individuals, middle-aged individuals (aged 40-59 years), those with a body mass index ≤30 kg/m2, individuals with a history of smoking, and alcohol consumers (p<0.05). Through RCS analysis exploring the nonlinear association between DF intake and COPD prevalence, the critical threshold for the impact of DF intake on COPD prevalence was 15.10 gm. When DF intake was ≥15.10 g/d, it effectively reduced the prevalence of COPD. Mediation analysis results indicated that the WBC count partially mediated the association between DF intake and COPD, with a mediation proportion of 9.89% (p=0.006). Conclusion: Increased DF intake was linked to decreased prevalence of COPD, particularly in men and middle-aged people. WBC counts may be an important pathway linking DF intake and COPD.

Association between preconception dietary fiber intake and hypertensive disorders of pregnancy: The Japan Environment and Children's Study.

OBJECTIVES: Hypertensive disorders of pregnancy (HDP) are a significant cause of morbidity and mortality. This study aimed to investigate whether preconception dietary fiber intake is associated with new-onset HDP. STUDY DESIGN: We identified 84,873 (primipara, 33,712; multipara, 51,161) normotensive participants from the Japan Environmental Children's Study database who delivered between 2011 and 2014. The participants were subsequently categorized into five groups based on their preconception dietary fiber intake quintiles (Q1-Q5). MAIN OUTCOME MEASURES: The main obstetric outcome was HDP, and the secondary obstetric outcomes included early-onset (Eo, <34 weeks)-HDP, late-onset (Lo, ≥34 weeks)-HDP, small for gestational age (SGA) births, and HDP with/without SGA. RESULTS: Multiple logistic regression analysis showed that in primiparas, the risks of HDP, Lo-HDP, and HDP without SGA were lower in the Q5 group compared with the Q3 group (HDP: adjusted odds ratio [aOR] = 0.73, 95 % confidence intervals [95 % CI] = 0.58-0.93; Lo-HDP: aOR = 0.72, 95 % CI = 0.55-0.94; and HDP without SGA: aOR = 0.68, 95 % CI = 0.53-0.88). However, the risks of Eo-HDP and HDP with SGA were higher in the Q1 group compared with the Q3 group (Eo-HDP: aOR = 1.66, 95 % CI = 1.02-2.70; and HDP with SGA: aOR = 1.81, 95 % CI = 1.04-3.17). In multiparas, the risks of Lo-HDP and SGA were higher in the Q1 group compared with the Q3 group (Lo-HDP: aOR = 1.47, 95 % CI = 1.10-1.97; SGA: aOR = 1.17, 95 % CI = 1.02-1.35). CONCLUSIONS: Preconception dietary fiber intake is beneficial in preventing HDP onset. Therefore, new recommendations should be considered to encourage higher dietary fiber intake as part of preconception care.

Assessing the impact of dietary choices on fiber deficiency: insights from the 2017-2020 Polish national adult nutrition survey.

Introduction: Dietary fiber is a key component of a healthy diet, associated with a reduced risk of cardiovascular disease, obesity, type 2 diabetes, certain cancers, chronic inflammation, or depression. The aim of the study was to perform an in-depth analysis of dietary fiber intake in the Polish population, taking account of the consumption of groups of products that are fiber sources and identify any age-related differences in the dietary fiber intake of the subjects. Methods: We analyzed data obtained from two representative cross-sectional studies on the diet and nutritional status of adult Polish residents including the total of 4,000 individuals aged 19 years and more. Two 24-h recalls were used per individual to assess the diet using the computer-assisted personal interview (CAPI) technique. Total fiber content and fiber contained in cereal products, vegetables, fruits, legumes, nuts and seeds were calculated. Fiber intake was compared to the recommendations: 25 g/d for adults up to 65 years of age and 20 g/d for those aged 66 years and older. All statistical analyses, including the Pearson's chi-squared test, the Student's t-test, and the Analysis of Variance (ANOVA), were conducted using STATISTICA™ version 13.3, with the results being adjusted for demographic distribution biases to enhance the representativeness. Results: The average daily fiber intake was 17.83 ± 0.14 g/day (78% of the recommended intake), with 20.5% of respondents meeting the requirement. More men than women (27.05% vs. 14.3%;) met the requirement and men were characterized by a higher average intake (19.34 ± 0.20 g/day) than women (16.43 ± 0.19 g/day). The main fiber sources were cereals (44.1%), vegetables (23.6%), and fruits (16.0%). As regards men, the sources included refined bread (25.8%), vegetables (23.1%), and fruits (10.2%) and for women, they were vegetables (24.0%), fruits (17.2%), and refined bread (16.3%). Although refined bread is not recommended as a primary fiber source due to its lower fiber content compared to whole grain bread, its high consumption significantly contributed to the total fiber intake. Conclusion: The prevalence of widespread dietary fiber deficiency calls for the intensification of educational efforts that address the health advantages and sources of dietary fiber, as well as methods for its inclusion in daily meals.

Association between dietary fiber intake and peripheral artery disease in hypertensive patients.

BACKGROUND: At present, no studies explored whether dietary fiber intake was associated with the risk of peripheral artery disease (PAD) in hypertensive patients. This study assessed the association between dietary fiber intake and PAD in hypertensive patients. METHODS: This cross-sectional study collected the data of 4628 participants with the measurement of ankle-brachial pressure index in the National Health and Nutrition Examination Surveys database. Univariate logistic regression analysis was applied to identify variables associated with PAD as confounding factors. Univariate and multivariable logistic regression analyses were used to explore the association between dietary fiber intake and PAD in hypertensive patients. Subgroup analysis was stratified by age, cardiovascular disease, dyslipidemia, diabetes, smoking, and physical activity. RESULTS: After adjusting for confounding factors, decreased risk of PAD was observed in hypertensive patients with dietary fiber intake > 21 g [odds ratio (OR) = 0.67, 95% confidence interval (CI) 0.46-0.99]. Compared with people with dietary fiber intake ≤ 21 g, those with dietary fiber intake > 21 g were associated with decreased risk of PAD in hypertensive patients < 60 years (OR = 0.23, 95%CI 0.08-0.66). In hypertensive patients without dyslipidemia, dietary fiber intake > 21 g were associated with reduced risk of PAD (OR = 0.33, 95%CI 0.12-0.95). Decreased risk of PAD was also found in hypertensive patients without diabetes in dietary fiber intake > 21 g group (OR = 0.50, 95%CI 0.31-0.78). Dietary fiber intake > 21 g was linked with reduced risk of PAD in hypertensive patients in never smoke group (OR = 0.46, 95%CI 0.24-0.86). CONCLUSION: Higher dietary fiber intake was associated with reduced risk of PAD in hypertensive patients, suggesting the importance of increase the daily dietary quality especially fiber intake in hypertensive people.

Dietary intake of total vegetable, fruit, cereal, soluble and insoluble fiber and risk of all-cause, cardiovascular, and cancer mortality: systematic review and dose-response meta-analysis of prospective cohort studies.

Objectives: To conduct a systematic review and meta-analysis of prospective cohort studies to investigate the association between total, vegetable, fruit, cereal, soluble and insoluble fiber intake and risk of all causes, cardiovascular disease (CVD), and cancer mortality and quantitatively assess the dose-response relation. Methods: Eligible studies were identified by searching PubMed, Embase and Web of science before August 2023. Random effects models were used to calculate summary relative risk (RR) and 95% confidence intervals (CI) and restricted cubic splines to model the linear/non-linear association. Results: The summary RR for all-cause, CVD and cancer mortality of dietary fiber was 0.90 (95% CI: 0.86,0.93), 0.87 (0.84,0.91), 0.91 (0.88,0.93), respectively. Significant association was observed for all-cause and CVD mortality with fruit, vegetable cereal and soluble fiber intake and cancer mortality with cereal fiber intake. No significant association was found for insoluble fiber, vegetable or fruit fiber intake and cancer mortality. Dose-response analysis showed a significant non-linear relation of dietary fiber intake with all-cause mortality, and linear relation for others. Conclusions: Higher dietary fiber including different type and food sources of fiber intake were associated with lower risk of mortality. Our findings provide more comprehensive evidence on dietary fiber intake with mortality. Systematic review registration: https://www.crd.york.ac.uk/prospero, identifier: CRD42022338837.

Dietary fiber intake is positively associated with health-related quality of life in patients with hypertension: The mediating role of anxiety in mental component summary.

Few studies have focused on the exploration of the relationship between dietary fiber intake (DFI) and health-related quality of life (HRQoL) and its mediators in hypertensive patients. This study is a cross-sectional survey and the data were obtained from hypertensive patients from Suzhou, China. The DFI, office systolic blood pressure and diastolic blood pressure, anxiety and depression, and HRQoL were investigated. We hypothesized that blood pressure, anxiety, and depression mediated the association between DFI and HRQoL, and used Pearson correlations, linear regression, and bootstrap tests to validate this relationship. A total of 211 hypertensive patients aged 20 to 64 years were included in this study. The average DFI was 12.4 ± 5.2 g/d, and the scores of physical component summary and mental component summary (MCS) were 46.5 ± 6.1 and 46.4 ± 6.4, respectively. DFI was positively correlated with physical component summary (r = 0.17, p = 0.014) and MCS (r = 0.27, P < .001). After controlling for sociodemographic and clinical characteristics, neither systolic blood pressure nor diastolic blood pressure showed mediating effects in the mediated model of DFI on MCS, whereas anxiety (b = -0.30; 95% confidence interval, -0.41 to -0.18) fully mediated the improvement in MCS by DFI (F = 11.14, P < .001). Because the MCS of HRQoL encompassed the assessment of depression, we did not analyze the mediating effect of depression in this model in order to avoid variable duplication. The decreased DFI is a risk factor for lower HRQoL, and anxiety mediated the relationship between DFI and MCS. Further research should focus on increasing DFI and reducing anxiety levels in hypertensive patients to improve their quality of life.

Dietary Fiber Intake and Femoral Bone Mineral Density in Middle-Aged and Older US Adults: A Cross-Sectional Study of National Health and Nutrition Examination Survey 2013-2014.

Sufficient dietary fiber intake (DFI) is considered necessary for human health. However, the association between DFI and bone mineral density (BMD) remains unclear. Therefore, this study aimed to investigate the association between DFI and BMD and to determine whether sex modifies the association between DFI and BMD. Participants aged ≥ 40 years from the 2013-2014 National Health and Nutrition Examination Survey were included in the final analysis. The association between DFI and BMD was evaluated using a multivariate linear regression model. The non-linear relationship between DFI and BMD was characterized by smooth curve fittings and generalized additive models. Finally, 1,935 participants with a mean age of 58.12 ± 11.84 years were included in the final analysis. The results revealed that DFI was positively associated with femoral BMD in the unadjusted model. However, no correlation was observed between DFI and femoral BMD after adjusting for covariates. Moreover, the results showed an inverted U-shaped association between total DFI and femoral BMD among men but not women for the nonlinear relationship between DFI and femoral BMD. In conclusion, our results indicate that DFI might not follow a linear relationship with femoral BMD, and sex factors might modify the association between DFI and BMD. Particularly, high total DFI might contribute to lower femoral neck BMD. However, more studies are needed to investigate whether the negative effect of high DFI on femoral BMD does exist and whether high DFI has clear biological effects on bone metabolism, such as increasing the risk of osteoporosis.

Association between Dietary Fiber Intake and Mortality among Colorectal Cancer Survivors: Results from the Newfoundland Familial Colorectal Cancer Cohort Study and a Meta-Analysis of Prospective Studies.

We examined dietary fiber intake for its relevance to Colorectal cancer (CRC) survival in a cohort of CRC patients and a meta-analysis including results from four prospective cohort studies. We analyzed 504 CRC patients enrolled in the Newfoundland Familial Colorectal Cancer Study (NFCCS) who were newly diagnosed with CRC between 1999 and 2003. Follow-up for deaths was through April 2010. All participants completed a self-administered food frequency questionnaire to evaluate their dietary intakes one year before diagnosis. Multivariable Cox proportional hazard models were used to explore the associations of dietary fiber intake with all-cause mortality and CRC-specific mortality. In the meta-analysis, we identified prospective cohort studies published between January 1991 and December 2021 by searching PubMed, EMBASE, and Cochrane Library. Fixed-effects or random-effects models were used to combine the study-specific hazard ratio (HR) from our original analysis and three other cohorts. In the NFCCS, we found that CRC patients with the second quartile of dietary fiber intake had a 42% lower risk of all-cause mortality (HR: 0.58, 95% CI: 0.35-0.98) and 58% lower risk of CRC-specific mortality (HR: 0.42, 95% CI: 0.21-0.87) compared with those with the lowest quartile. In the meta-analysis, a similar inverse association between dietary fiber and total mortality was detected among CRC patients; each 10 g/day increase in dietary fiber intake was associated with a 16% decreased risk of total mortality. The dose-response meta-analysis showed a linear relationship between dietary fiber intake and all-cause mortality, with no sign of a plateau. For CRC-specific mortality, intriguingly, the benefit associated with increasing dietary fiber intake achieved its maximum at approximately 22 g/day, and no further reduction in CRC-specific mortality was observed beyond this intake level. Our results suggest that high dietary fiber intake may be associated with prolonged survival among CRC patients. Our findings add to the sparse literature on the role of dietary fiber in CRC survival.

Association Between Dietary Fiber Intake and Heart Failure Among Adults: National Health and Nutrition Examination Survey 2009-2018.

Objective: To explore the association between dietary fiber and heart failure (HF). Methods: Data were collected from the 2009-2018 National Health and Nutrition Examination Survey. Dietary fiber intake data were obtained from two 24-h dietary recall interviews. Logistic regression and restricted cubic spline models were used to explore the association of dietary intakes of total, cereal, fruit, and vegetable fiber with HF prevalence. Results: A total of 21869 adults were included in this study. After adjusting for multiple confounding factors, the odds ratios (OR) and 95% confidence intervals (CI) for HF was 0.49 (0.28 to 0.87, P for trend = 0.016) for the highest tertile versus lowest tertile of total fiber intake. Similar results were observed for cereal but not fruit and vegetable fiber intake. Dose-response analysis indicated that dietary intake of total and cereal fiber were inversely associated with HF in a linear manner. Conclusion: Intakes of total and cereal fiber were inversely associated with HF in adults.

Habitual Dietary Fiber Intake, Fecal Microbiota, and Hemoglobin A1c Level in Chinese Patients with Type 2 Diabetes.

High-fiber diet interventions have been proven to be beneficial for gut microbiota and glycemic control in diabetes patients. However, the effect of a low level of fiber in habitual diets remains unclear. This study aims to examine the associations of habitual dietary fiber intake with gut microbiome profiles among Chinese diabetes patients and identify differential taxa that mediated associations of dietary fiber with HbA1c level. Two cross-sectional studies and one longitudinal study were designed based on two follow-up surveys in a randomized trial conducted during 2015−2017. The study included 356 and 310 participants in the first and second follow-ups, respectively, with 293 participants in common in both surveys. Dietary fiber intake was calculated based on a 3-day 24-h diet recall at each survey and was classified into a lower or a higher group according to the levels taken based on the two surveys using 7.2 g/day as a cut-off value. HbA1c was assayed to assess glycemic status using a cut-off point of 7.0% and 8.0%. Microbiome was profiled by 16S rRNA sequencing. A high habitual dietary fiber intake was associated with a decrease in α-diversity in both the cross-sectional and longitudinal analyses. At the first follow−up, phylum Firmicutes and Fusobacteria were negatively associated with a higher dietary fiber intake (p < 0.05, Q < 0.15); at the second follow-up, genus Adlercreutzia, Prevotella, Ruminococcus, and Desulfovibrio were less abundant in patients taking higher dietary fiber (p < 0.05, Q < 0.15); genus Desulfovibrio and Ruminococcaceae (Unknown), two identified differential taxa by HbA1c level, were negatively associated with dietary fiber intake in both the cross-sectional and longitudinal analyses, and mediated the dietary fiber-HbA1c associations among patients taking dietary fiber ≥ 7.2 g/day (mediation effect ß [95%CI]: −0.019 [−0.043, −0.003], p = 0.018 and −0.019 [−0.046, −0.003], p = 0.016). Our results suggest that habitual dietary fiber intake has a beneficial effect on gut microbiota in Chinese diabetes patients. Further studies are needed to confirm our results.

Dietary Fiber Intake Is Related to Skeletal Muscle Mass, Body Fat Mass, and Muscle-to-Fat Ratio Among People With Type 2 Diabetes: A Cross-Sectional Study.

Objectives: To investigate the relationship between dietary fiber intake and skeletal muscle mass, body fat mass, and muscle-to-fat ratio (MFR) among men and women with type 2 diabetes (T2D). Methods: This cross-sectional study involved 260 men and 200 women with T2D. Percent skeletal muscle mass (%) or percent body fat mass (%) was calculated as (appendicular muscle mass [kg] or body fat mass [kg]/body weight [kg]) × 100. MFR was calculated as appendicular muscle mass divided by body fat mass. Information about dietary fiber intake (g/day) was obtained from a brief-type self-administered diet history questionnaire. Results: Dietary fiber intake was correlated with percent body fat mass (r = -0.163, p = 0.021), percent skeletal muscle mass (r = 0.176, p = 0.013), and MFR (r = 0.157, p = 0.026) in women. However, dietary fiber intake was not correlated with percent body fat mass (r = -0.100, p = 0.108), percent skeletal muscle mass (r = 0.055, p = 0.376), and MFR (r = 0.065, p = 0.295) in men. After adjusting for covariates, dietary fiber intake was correlated with percent body fat mass (ß = 0.229, p = 0.009), percent skeletal muscle mass (ß = 0.364, p < 0.001), and MFR (ß = 0.245, p = 0.006) in women. Further, dietary fiber intake was related to percent skeletal muscle mass (ß = 0.221, p = 0.008) and tended to be correlated with percent body fat mass (ß = 0.148, p = 0.071) in men. Conclusion: Dietary fiber intake was correlated with skeletal muscle mass, body fat mass, and MFR among women with T2D.