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Emily Sonestedt

Emily Sonestedt

Associate senior lecturer

Emily Sonestedt

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


  • Andrea Kulezic
  • Sara Bergwall
  • Shahab Fatemi
  • Emily Sonestedt
  • Moncef Zarrouk
  • Anders Gottsäter
  • Stefan Acosta

Summary, in English

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.


  • Vascular Diseases - Clinical Research
  • EpiHealth: Epidemiology for Health
  • Nutrition Epidemiology
  • EXODIAB: Excellence of Diabetes Research in Sweden

Publishing year







Vascular Medicine (United Kingdom)





Document type

Journal article


SAGE Publications


  • Cardiac and Cardiovascular Systems
  • Nutrition and Dietetics


  • 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



Research group

  • Vascular Diseases - Clinical Research
  • Nutrition Epidemiology


  • ISSN: 1358-863X