Elderly Get Same Fiber Benefit as Others

High-Fiber Breads, Cereals Reduce Heart Disease Risk

From the WebMD Archives

April 1, 2003 -- Eating just two slices of whole-wheat bread a day may help protect older adults against heart disease. Researchers found that elderly people who regularly ate high-fiber breads and cereals had modest decreases in risk, but high-fiber fruits and vegetables didn't produce the same effect.

The findings come from an ongoing study assessing heart disease and other health risks in roughly 6,000 people aged 65 and over. Earlier research has shown dietary fiber to be associated with reduced heart disease risk in middle-aged people, but this is the first study to show that the benefits extend to the elderly.

"There has been some question about whether the interventions known to reduce heart disease in younger populations are beneficial in older ones," lead researcher Dariush Mozaffarian, MD, MPH, tells WebMD. "This study suggests that the benefits of dietary fiber are the same for everyone."

Mozaffarian and colleagues analyzed data from food consumption questionnaires completed by 3,588 elderly people enrolled in the National Heart, Lung and Blood Institute's Cardiovascular Health Study (CHS). None had evidence of heart disease at enrollment, but 811 cardiovascular events were reported over the next 8.6 years. Their findings are reported in the April 2 issue of TheJournal of the American Medical Association.

After adjusting for other potential risk factors, eating more cereal fiber was found to be associated with a lower risk of heart disease. Those who ate the most cereal fiber had a 21% lower risk of developing the disease than those who ate the least cereal fiber. In a follow-up, the researchers reported that dark breads like whole wheat, rye, or pumpernickel was more protective than cereal fiber from other sources.

"While the observed difference in risk was not large, it was seen with a fairly modest difference in dietary intake, approximately equal to two slices of whole-grain bread per day," the researchers wrote. "Compared with medical interventions, nutritional changes are relatively low risk, low cost, and widely available."

Another nutritional change elderly people can make to lower their risk is adding more broiled or baked fish to their diets, Mozaffarian says. The research team recently reported that CHS participants who ate broiled or baked fish three or more times per week were half as likely to die of heart disease as those who ate fish less than once a month. The findings were reported March 18 in the journal Circulation.


Like the fiber data, the protective benefits of fish have been reported in studies involving younger people. But the CHS study showed that eating fried fish or fried-fish sandwiches wasn't helpful at all, and may have increased heart disease risk.

"The previous studies looking at fish and cardiovascular risk have not really addressed how fish is prepared," Mozaffarian says. "People may be getting the message that it is healthy to eat fast-food fried fish every day, but this study suggests the opposite is true."

More than 300 papers have been published using information from the Cardiovascular Health Study, and about half of the study participants are still living, project officer Jean L. Olson, MD, MPH, tells WebMD. One emerging theme from the data is that the lifestyle and medical interventions recommended for lowering heart disease risk in middle-age people remain important for the elderly, she says.

"Doctors are often hesitant about treating elderly people or recommending lifestyle changes for a variety of reasons," Olson says." They may feel that the damage has been done, or older patients may already be on too many other medications. But just because someone is older doesn't mean they can't still benefit from these interventions."

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SOURCES: The Journal of the American Medical Association, April 2, 2003. Dariush Mozaffarian, MD, MPH, fellow at the Puget Sound VA Healthcare Center, University of Washington, Seattle. Jean L. Olson, MD, MPH, project officer, Cardiovascular Health Study, National Heart, Lung and Blood Institute, National Institutes of Health.
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