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Dietary fiber intake and mortality in a Mediterranean population: the “Seguimiento Universidad de Navarra” (SUN) project

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Abstract

Purpose

To prospectively assess the association of dietary fiber intake (from different dietary sources) with all-cause mortality in a Mediterranean cohort.

Methods

We assessed 19,703 participants of the SUN (Seguimiento Universidad de Navarra) cohort (mean follow-up: 10.1 years). A validated 136-item FFQ was administered at baseline. We used Cox proportional hazards models adjusted for multiple socio-demographic, anthropometric, lifestyle factors, and prevalent conditions at baseline.

Results

We observed 323 deaths during 198,341 person-years of follow-up. A significantly inverse linear trend in Cox models was observed for the association of total dietary fiber intake and all-cause mortality after adjustment for confounders (p for trend 0.017). Each additional intake of 5 g/1000 kcal of dietary fiber was associated with a 9% relative reduction in all-cause mortality risk (HR 0.91, 95% CI 0.84–0.99). Considering separate dietary sources in separate models, a significant inverse trend was apparent for fiber derived from vegetables (p for trend 0.001), but it was non-significant for fiber derived from fruit, legumes, cereals, or other sources. Soluble fiber was significantly inversely associated with all-cause mortality in the fully adjusted model (p for trend 0.007), and insoluble fiber was marginally significant (p for trend 0.08).

Conclusions

A higher intake of total dietary fiber, and particularly fiber from vegetables, was related to a reduced all-cause mortality in our Mediterranean cohort. Dietary messages to increase the consumption of dietary patterns rich in fiber-rich foods should be broadly disseminated to decrease the alarming rate of chronic diseases and its derived mortality.

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Acknowledgements

The authors thank the participants of the SUN Project for their generous and enthusiastic collaboration.

Funding

The SUN Project has received funding from the Spanish Government-Instituto de Salud Carlos III, and the European Regional Development Fund (FEDER) (RD 06/0045), CIBER-OBN, Grants PI10/02658, PI10/02293, PI13/00615, PI14/01668, PI14/01798, PI14/01764, and G03/140, the Navarra Regional Government (45/2011, 122/2014), and the University of Navarra. Funding sources had no role in study design, data collection, analysis and interpretation of data, writing the report, and decision to submit the article for publication.

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Authors and Affiliations

  1. Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Viale F. Scaduto 6/c, 90144, Palermo, Italy

    Ligia J. Dominguez & Mario Barbagallo

  2. Department of Preventive Medicine and Public Health, University of Navarra-IDISNA, Pamplona, Spain

    Maira Bes-Rastrollo, Estefania Toledo, Alfredo Gea & Miguel A. Martínez-González

  3. CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain

    Maira Bes-Rastrollo, Estefania Toledo, Alfredo Gea & Miguel A. Martínez-González

  4. Environmental Nutrition Group, School of Public Health, Loma Linda University, Loma Linda, USA

    Ujue Fresán

  5. Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA

    Miguel A. Martínez-González

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  1. Ligia J. Dominguez
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  2. Maira Bes-Rastrollo
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  3. Estefania Toledo
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  4. Alfredo Gea
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  6. Mario Barbagallo
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Contributions

LJD and MAM-G designed research; MAM-G, MB-R, ET, and AG conducted research; MAM-G, LJD, AG, and UF analysed data and performed statistical analysis; LJD and MAM-G wrote the paper; LJD and MAM-G had primary responsibility for final content. All authors read and approved the final manuscript.

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Correspondence to Ligia J. Dominguez.

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The authors declare that they have no conflict of interest.

Ethical standards

The SUN study has been conducted in accordance with the Declaration of Helsinki, with the approval of the Institutional Review Board of the University of Navarra.

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Dominguez, L.J., Bes-Rastrollo, M., Toledo, E. et al. Dietary fiber intake and mortality in a Mediterranean population: the “Seguimiento Universidad de Navarra” (SUN) project. Eur J Nutr 58, 3009–3022 (2019). https://doi.org/10.1007/s00394-018-1846-3

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