TABLE 2.
Relative risks of CHD by quintiles of carbohydrate, starch and total, cereal, fruit and vegetable fiber intake among 42,865 men in the HPFS and 75,020 women in the NHS1
| Quintiles of energy-adjusted intake | ||||||
|---|---|---|---|---|---|---|
| Variable | 1 | 2 | 3 | 4 | 5 | P-trend2 |
| Carbohydrate | ||||||
| HPFS | ||||||
| Median, g/d | 191 | 221 | 241 | 261 | 290 | |
| Cases/person-years | 812/171,422 | 818/186,219 | 808/191,878 | 796/189,560 | 819/182,896 | |
| Model 1 | 1.00 (Ref) | 0.95 (0.87, 1.05) | 0.91 (0.82, 1.00) | 0.89 (0.81, 0.98) | 0.93 (0.84, 1.02) | 0.06 |
| Model 2 | 1.00 (Ref) | 1.02 (0.92, 1.12) | 0.98 (0.89, 1.09) | 0.99 (0.89, 1.11) | 1.07 (0.96, 1.20) | 0.33 |
| NHS | ||||||
| Median, g/d | 159 | 182 | 196 | 210 | 230 | |
| Cases/person-years | 681/367,365 | 652/397,606 | 664/397,590 | 655/391,329 | 615/351,157 | |
| Model 1 | 1.00 (Ref) | 0.88 (0.79, 0.98) | 0.87 (0.78, 0.97) | 0.85 (0.76, 0.94) | 0.83 (0.74, 0.92) | 0.0006 |
| Model 2 | 1.00 (Ref) | 0.95 (0.85, 1.06) | 0.99 (0.88, 1.11) | 1.00 (0.89, 1.13) | 1.01 (0.89, 1.14) | 0.74 |
| Pooled, MV adjusted | 1.00 (Ref) | 0.99 (0.92, 1.06) | 0.99 (0.91, 1.06) | 1.00 (0.92, 1.08) | 1.04 (0.96, 1.14) | 0.31 |
| Starch | ||||||
| HPFS | ||||||
| Median, g/d | 50 | 66 | 76 | 86 | 102 | |
| Cases/person-years | 888/148,458 | 846/179,393 | 823/193,650 | 783/200,715 | 713/199,759 | |
| Model 1 | 1.00 (Ref) | 0.83 (0.75, 0.91) | 0.78 (0.70, 0.85) | 0.74 (0.67, 0.81) | 0.70 (0.63, 0.77) | <0.0001 |
| Model 2 | 1.00 (Ref) | 0.89 (0.81, 0.98) | 0.88 (0.79, 0.97) | 0.86 (0.77, 0.96) | 0.83 (0.74, 0.94) | 0.004 |
| NHS | ||||||
| Median, g/d | 46 | 56 | 63 | 70 | 81 | |
| Cases/person-years | 757/352,229 | 698/391,095 | 645/402,791 | 619/400,356 | 548/358,577 | |
| Model 1 | 1.00 (Ref) | 0.87 (0.78, 0.96) | 0.81 (0.73, 0.90) | 0.81 (0.73, 0.90) | 0.83 (0.74, 0.92) | <0.0001 |
| Model 2 | 1.00 (Ref) | 1.00 (0.90, 1.11) | 1.00 (0.89, 1.12) | 1.05 (0.93, 1.18) | 1.11 (0.97, 1.27) | 0.13 |
| Pooled, MV adjusted | 1.00 (Ref) | 0.94 (0.87, 1.01) | 0.93 (0.86, 1.00) | 0.94 (0.86, 1.02) | 0.94 (0.86, 1.03) | 0.11 |
| Total Fiber | ||||||
| HPFS | ||||||
| Median, g/d | 14.4 | 18 | 20.9 | 24.2 | 30 | |
| Cases/person-years | 852/180,528 | 790/188,781 | 788/190,448 | 851/186,031 | 772/176,187 | |
| Model 1 | 1.00 (Ref) | 0.84 (0.76, 0.93) | 0.79 (0.71, 0.87) | 0.82 (0.74, 0.90) | 0.74 (0.67, 0.82) | <0.0001 |
| Model 2 | 1.00 (Ref) | 0.96 (0.87, 1.06) | 0.95 (0.86, 1.06) | 1.05 (0.94, 1.17) | 1.00 (0.88, 1.13) | 0.59 |
| NHS | ||||||
| Median, g/d | 12.3 | 15.0 | 17.2 | 19.6 | 23.6 | |
| Cases/person-years | 745/370,695 | 624/394,828 | 648/393,596 | 655/385,190 | 595/360,739 | |
| Model 1 | 1.00 (Ref) | 0.73 (0.66, 0.81) | 0.72 (0.64, 0.80) | 0.68 (0.61, 0.75) | 0.60 (0.54, 0.67) | <0.0001 |
| Model 2 | 1.00 (Ref) | 0.87 (0.78, 0.97) | 0.93 (0.83, 1.04) | 0.94 (0.83, 1.05) | 0.87 (0.76, 0.99) | 0.13 |
| Pooled, MV adjusted | 1.00 (Ref) | 0.92 (0.85, 0.99) | 0.94 (0.87, 1.02) | 0.99 (0.92, 1.08) | 0.94 (0.85, 1.03) | 0.72 |
| Cereal fiber | ||||||
| HPFS | ||||||
| Median, g/d | 3.0 | 4.4 | 5.8 | 7.4 | 10.3 | |
| Cases/person-years | 894/166,779 | 877/181,703 | 799/195,223 | 744/193,356 | 739/184,914 | |
| Model 1 | 1.00 (Ref) | 0.92 (0.84, 1.01) | 0.77 (0.70, 0.85) | 0.69 (0.63, 0.76) | 0.70 (0.63, 0.77) | <0.0001 |
| Model 2 | 1.00 (Ref) | 1.00 (0.91, 1.10) | 0.89 (0.80, 0.99) | 0.83 (0.75, 0.93) | 0.84 (0.75, 0.94) | 0.0003 |
| NHS | ||||||
| Median, g/d | 2.5 | 3.6 | 4.4 | 5.5 | 7.6 | |
| Cases/person-years | 777/353,171 | 735/388,528 | 617/401,767 | 590/395,086 | 548/366,497 | |
| Model 1 | 1.00 (Ref) | 0.87 (0.78, 0.96) | 0.70 (0.63, 0.77) | 0.64 (0.57, 0.71) | 0.58 (0.52, 0.65) | <0.0001 |
| Model 2 | 1.00 (Ref) | 0.98 (0.88, 1.08) | 0.84 (0.75, 0.94) | 0.80 (0.71, 0.90) | 0.76 (0.67, 0.85) | <0.0001 |
| Pooled, MV adjusted | 1.00 (Ref) | 0.99 (0.92, 1.06) | 0.86 (0.80, 0.93) | 0.82 (0.76, 0.89) | 0.80 (0.74, 0.87) | <0.0001 |
| Fruit fiber | ||||||
| HPFS | ||||||
| Median, g/d | 1.5 | 2.9 | 4.2 | 5.7 | 8.6 | |
| Cases/person-years | 790/184,613 | 811/188,427 | 751/188,865 | 838/185,656 | 863/174,414 | |
| Model 1 | 1.00 (Ref) | 0.92 (0.83, 1.01) | 0.79 (0.72, 0.87) | 0.84 (0.76, 0.92) | 0.87 (0.79, 0.96) | 0.0156 |
| Model 2 | 1.00 (Ref) | 1.06 (0.96, 1.18) | 0.98 (0.88, 1.09) | 1.08 (0.97, 1.20) | 1.15 (1.02, 1.29) | 0.0147 |
| NHS | ||||||
| Median, g/d | 1.5 | 2.6 | 3.6 | 4.8 | 6.8 | |
| Cases/person-years | 689/380,953 | 621/400,867 | 650/392,111 | 648/380,614 | 659/350,504 | |
| Model 1 | 1.00 (Ref) | 0.77 (0.69, 0.86) | 0.74 (0.67, 0.83) | 0.70 (0.63, 0.78) | 0.69 (0.62, 0.77) | <0.0001 |
| Model 2 | 1.00 (Ref) | 0.94 (0.84, 1.05) | 1.01 (0.90, 1.13) | 1.00 (0.88, 1.12) | 0.99 (0.87, 1.13) | 0.82 |
| Pooled, MV adjusted | 1.00 (Ref) | 1.01 (0.93, 1.09) | 0.99 (0.92, 1.07) | 1.04 (0.96, 1.13) | 1.08 (0.99, 1.17) | 0.0305 |
| Vegetable fiber | ||||||
| HPFS | ||||||
| Median, g/d | 3.8 | 5.3 | 6.6 | 8.2 | 11.2 | |
| Cases/person-years | 820/175,937 | 797/188,927 | 808/192,035 | 841/186,633 | 787/178,444 | |
| Model 1 | 1.00 (Ref) | 0.90 (0.81, 0.99) | 0.88 (0.79, 0.96) | 0.92 (0.83, 1.01) | 0.87 (0.79, 0.96) | 0.0278 |
| Model 2 | 1.00 (Ref) | 0.98 (0.89, 1.08) | 0.99 (0.90, 1.10) | 1.07 (0.97, 1.19) | 1.02 (0.91, 1.13) | 0.42 |
| NHS | ||||||
| Median, g/d | 3.7 | 4.9 | 5.9 | 7.2 | 9.3 | |
| Cases/person-years | 681/362,502 | 630/389,829 | 646/399,069 | 657/389,815 | 653/363,833 | |
| Model 1 | 1.00 (Ref) | 0.83 (0.75, 0.93) | 0.82 (0.73, 0.91) | 0.82 (0.74, 0.92) | 0.84 (0.75, 0.93) | 0.009 |
| Model 2 | 1.00 (Ref) | 0.94 (0.84, 1.04) | 0.97 (0.87, 1.09) | 1.01 (0.90, 1.13) | 1.03 (0.91, 1.16) | 0.36 |
| Pooled, MV adjusted | 1.00 (Ref) | 0.96 (0.89, 1.03) | 0.98 (0.91, 1.06) | 1.04 (0.97, 1.12) | 1.02 (0.94, 1.11) | 0.24 |
1RRs and 95% CIs were calculated with the use of the Cox proportional hazards regression model. Model 1: age adjusted. Model 2: adjusted for age, BMI, family history of CHD, smoking status, alcohol intake, physical activity level, multivitamin use, aspirin use, vitamin E use, race, total energy, polyunsaturated fat–to–saturated fat ratio and trans fat (dietary variables all in quintiles). Model for starch was additionally adjusted for cereal fiber, sugar-sweetened beverages, and fruits and vegetables. Model for total fiber was additionally adjusted for glycemic load. Models for cereal, fruit, and vegetable fibers were additionally adjusted for glycemic load and the other two subtypes of fiber. CHD, coronary heart disease; HPFS, Health Professionals Follow-Up Study; NHS, Nurses' Health Study; Ref, reference.
2Test for trend based on variable containing median value for each quintile.