Dietary fiber and progression of atherosclerosis: the Los Angeles Atherosclerosis Study

Am J Clin Nutr. 2003 Dec;78(6):1085-91. doi: 10.1093/ajcn/78.6.1085.


Background: Several epidemiologic studies found weak protective relations between dietary fiber intake and the risk of cardiovascular disease events. However, few of the studies addressed possible mechanisms of the effect.

Objective: In the present study, we estimated relations between the progression of atherosclerosis and the intake of selective dietary fiber fractions. Mediation of the relations by serum lipids was also investigated.

Design: Participants who were free of heart disease and aged 40-60 y were recruited into the cohort (n = 573; 47% women). The intima-media thickness (IMT) of the common carotid arteries was measured ultrasonographically at the baseline examination and at 2 follow-up examinations (n = 500), dietary intakes were assessed with six 24-h recalls (3 at baseline and 3 at the first follow-up examination), and blood samples were analyzed at baseline and at both follow-up examinations.

Results: A significant inverse association was observed between IMT progression and the intakes of viscous fiber (P = 0.05) and pectin (P = 0.01). Correction for measurement error increased the magnitude of these estimated effects. The ratio of total to HDL cholesterol was inversely related to the intakes of total fiber (P = 0.01), viscous fiber (P = 0.05), and pectin (P = 0.01). The magnitude of the association between IMT progression and the intakes of viscous fiber and pectin was attenuated by adjustment for serum lipids.

Conclusions: The intake of viscous fiber, especially pectin, appears to protect against IMT progression. Serum lipids may act as a mediator between dietary fiber intake and IMT progression.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Arteriosclerosis / blood
  • Arteriosclerosis / epidemiology*
  • Carotid Artery, Common / diagnostic imaging*
  • Carotid Artery, Common / pathology
  • Cholesterol / blood
  • Cohort Studies
  • Dietary Fiber / administration & dosage*
  • Dietary Fiber / analysis
  • Disease Progression
  • Female
  • Humans
  • Los Angeles / epidemiology
  • Male
  • Mental Recall
  • Middle Aged
  • Pectins / analysis
  • Triglycerides / blood
  • Tunica Intima / diagnostic imaging*
  • Tunica Intima / pathology
  • Tunica Media / diagnostic imaging*
  • Tunica Media / pathology
  • Ultrasonography
  • Viscosity


  • Dietary Fiber
  • Triglycerides
  • Pectins
  • Cholesterol