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Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f6879 (Published 19 December 2013) Cite this as: BMJ 2013;347:f6879

Rapid Response:

Re: Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis

Thank you for this thorough and much needed review identifying a dose-response association between dietary fibre intake and cardiovascular disease risk. Just a few points to consider:

The authors hypothesize a causal link between fibre and cardiovascular disease, yet their explanation for a biologically plausible effect is limited to soluble fibre, which in this study was not significantly associated with cardiovascular or coronary heart disease.

Only 3 of the 22 included studies adjusted for ethnicity. Ethnicity is a recognised risk factor for cardiovascular disease and would certainly impact on dietary habits making it an important confounding variable.

Lastly, given that there was no search for unpublished studies, the authors should have acknowledged the potential impact of publication bias on the study's findings.

Competing interests: No competing interests

05 February 2014
Varun Anand
Academic FY2 Doctor
Nottingham University Hospitals NHS Trust
Queen's Medical Centre, Derby Road, Nottingham, NG7 2UH