Fiber intake prevents peripheral arterial disease

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

From Vascular Medicine

Cardiovascular atherosclerotic disease is a common denominator for atherosclerotic disease in the coronary, cerebral, carotid, and peripheral arteries, and have similar risk factors in all these arterial trees. Cardiovascular atherosclerotic disease is the world´s leading cause of morbidity and mortality.

Modification of risk factors such as diet quality, physical activity, and tobacco consumption has the potential to reduce the cardiovascular atherosclerotic burden, but data on dietary intake and future development of peripheral atherosclerotic disease is scarce. In this report, Kulezic et al investigated the influence of healthy diet and nutritional components, and life style factors such as physical activity and smoking on the risk of developing symptomatic atherosclerotic disease in the lower extremities, peripheral artery disease. 

The researchers used data from the prospective Malmö Diet and Cancer Study (MDCS) cohort including 26,010 middle-aged individuals with detailed information on dietary intake at start of study in the beginning of the 1990s. Data on diet variables and symptomatic peripheral arterial disease were validated. Six individual dietary components were used to calculate a healthy diet score. Less intake of saturated fat, moderate intake of polyunsaturated fat, high intake of fish and shellfish, fiber, fruit and vegetables, and low intake of sucrose, give high scores and better adherence to nutritional recommendations.

The study individuals were followed for 22 years, during which 1122 subjects developed peripheral artery disease. A healthy diet score and high intake of fiber were both associated with lower risk for development of peripheral artery disease. Intake of fish and shellfish was also found to protect from development of peripheral artery disease in a sensitivity analysis, after exclusion of dietary misreporters and dietary changers from the study.

Since peripheral artery disease may result in critical limb ischemia and leg amputation and is strongly linked with ischemic heart disease, myocardial infarction, carotid and cerebral artery disease, disabling stroke, and death, the findings in this study imply that primary dietary prevention programs including a healthy diet with high amount of fiber may generate good cardiovascular protection against atherosclerotic disease and contribute to a healthy and longer life.

Meal rich in fiber . Cereals with bananas.

Article details

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

First published August 20, 2019

DOI: 10.1177/1358863X19867393

Vascular Medicine


Standing from left: Sara Bergwall, PhD student, Emily Sonestedt, associate professor and research group leader in Nutritional Epidemiology, Shahab Fatemi, MD PhD Student, Anders Gottsäter, professor in Medicine. Seated from left: Stefan Acosta, professor of Vascular Surgery, Andrea Kulezic, MD and first author of the article, Moncef Zarrouk, MD PhD.

Fig 1 VMJ Authors.jpg