By
Suzanne Leigh, Medical Tribune News Service
Eating
cereal for breakfast each morning may help women minimize the
risk of heart disease, according to the results of a 10-year study.
In
an article published on Wednesday in the Journal of the American
Medical Association, researchers identified oat bran breakfast
cereals as playing a key role in reducing low-density lipoprotein
(LDL) cholesterol, the ``bad'' cholesterol.
The higher the level of LDL cholesterol, the greater the risk
for heart attacks.
In
the study, researchers led by Alicja Wolk of the Karolinska Institute
in Stockholm, Sweden, and Dr JoAnn Manson of Brigham and Women's
Hospital and Harvard Medical School in Boston, followed 68,782
healthy women, ages 37 to 64, from 1984 to 1994.
The
researchers found that 591 cases of serious heart disease, including
162 deaths, had occurred over the 10-year study period. When they
compared the eating habits of the heart-disease group with those
of the healthy women by reviewing questionnaires completed on
three occasions over the course of the study, they found that
those who consumed most dietary fiber had a 47-percent lower risk
of major heart conditions compared with the lowest fiber consumers.
After
adjusting for age, multivitamin use and other dietary habits,
they found the risk of heart disease was 23 percent lower for
the highest fiber group.
The researchers reported that the type of fiber found in cereal,
rather than that found in fruits and vegetables, was strongly
associated with reduced risk of heart disease. Although fiber
is known to reduce LDL cholesterol by increasing bile-acid excretion
and decreasing liver synthesis, this would not explain the extent
of the disparity between the heart-disease risk of the high fiber
and low-fiber groups in the study. A five-gram increase in cereal
fiber -- the equivalent of a half-cup serving of bran flakes and
50 percent of the fiber-intake difference between the lowest and
highest groups -- is expected to cut cholesterol by 1 to 2 percent
and reduce the risk of heart disease by approximately 2 to 7 percent.
This suggests that other biological mechanisms, in addition to
the cholesterol-lowering one, are responsible for the effect of
fiber in reducing the risk of heart disease, the authors concluded.
According
to David R. Jacobs, a professor of epidemiology at the School
of Public Health at the University of Minnesota in Minneapolis,
it is difficult to determine the exact role that fiber plays in
reducing heart disease. Jacobs' own study of 34,942 postmenopausal
women published last year in the American Journal of Clinical
Nutrition found a 30- to 36-percent reduction in heart disease
among those who consumed the most whole-grain foods compared with
those who took in the least.
``The
limitations of any epidemiological study are that conclusions
may be vague associations rather than absolutes,'' he said.
According
to the U.S. Department of Agriculture's food guide pyramid, adults
require 20 to 35 grams of fiber each day. Sources of fiber include
unpeeled fruit, raw vegetables, cereals and grain foods.
Fiber
is especially important for postmenopausal women, according to
the Dallas-based American Heart Association, because they are
more likely than men to have high cholesterol. Nearly twice as
many women die of heart disease and stroke than nearly all forms
of cancer.
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