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Fiber intake and total and cause-specific mortality in the European Prospective Investigation into Cancer and Nutrition cohort

  • Shu-Chun Chuang
  • Teresa Norat
  • Neil Murphy
  • Anja Olsen
  • Anne Tjonneland
  • Kim Overvad
  • Marie Christine Boutron-Ruault
  • Florence Perquier
  • Laureen Dartois
  • Rudolf Kaaks
  • Birgit Teucher
  • Manuela M. Bergmann
  • Heiner Boeing
  • Antonia Trichopoulou
  • Pagona Lagiou
  • Dimitrios Trichopoulos
  • Sara Grioni
  • Carlotta Sacerdote
  • Salvatore Panico
  • Domenico Palli
  • Rosario Tumino
  • Petra H. M. Peeters
  • Bas Bueno-de-Mesquita
  • Martine M. Ros
  • Magritt Brustad
  • Lene Angell Asli
  • Guri Skeie
  • J. Ramon Quiros
  • Carlos A. Gonzalez
  • Maria-Jose Sanchez
  • Carmen Navarro
  • Eva Ardanaz Aicua
  • Miren Dorronsoro
  • Isabel Drake
  • Emily Sonestedt
  • Ingegerd Johansson
  • Goeran Hallmans
  • Timothy Key
  • Francesca Crowe
  • Kay-Tee Khaw
  • Nicholas Wareham
  • Pietro Ferrari
  • Nadia Slimani
  • Isabelle Romieu
  • Valentina Gallo
  • Elio Riboli
  • Paolo Vineis
Publishing year: 2012
Language: English
Pages: 164-174
Publication/Series: American Journal of Clinical Nutrition
Volume: 96
Issue: 1
Document type: Journal article
Publisher: American Society for Clinical Nutrition

Abstract english

Background: Previous studies have shown that high fiber intake is associated with lower mortality. However, little is known about the association of dietary fiber with specific causes of death other than cardiovascular disease (CVD). Objective: The aim of this study was to assess the relation between fiber intake, mortality, and cause-specific mortality in a large European prospective study of 452,7 I 7 men and women. Design: HRs and 95% CIs were estimated by using Cox proportional hazards models, stratified by age, sex, and center and adjusted for education, smoking, alcohol consumption, BMI, physical activity, total energy intake, and, in women, ever use of menopausal hormone therapy. Results: During a mean follow-up of 12.7 y, a total of 23,582 deaths were recorded. Fiber intake was inversely associated with total mortality (HRper (10-g/d) (increase): 0.90; 95% Cl: 0.88, 0.92); with mortality from circulatory (HRper (10-g/d increase): 0.90 and 0.88 for men and women, respectively), digestive (HR: 0.61 and 0.64), respiratory (HR: 0.77 and 0.62), and non-CVD noncancer inflammatory (HR: 0.85 and 0.80) diseases; and with smoking-related cancers (HR: 0.86 and 0.89) but not with non-smoking-related cancers (HR: 1.05 and 0.97). The associations were more evident for fiber from cereals and vegetables than from fruit. The associations were similar across BMI and physical activity categories but were stronger in smokers and participants who consumed >18 g alcohol/d. Conclusions: Higher fiber intake is associated with lower mortality, particularly from circulatory, digestive, and non-CVD noncancer inflammatory diseases. Our results support current recommendations of high dietary fiber intake for health maintenance. Am J Clin Nutr 2012;96:164-74.


  • Nutrition and Dietetics


  • Nutrition Epidemiology
  • ISSN: 1938-3207
Emily Sonestedt
E-mail: emily [dot] sonestedt [at] med [dot] lu [dot] se

Associate senior lecturer

Nutrition Epidemiology

+46 40 39 13 25

+46 73 700 71 45


Jan Waldenströms gata 35, CRC 60:13, Malmö


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