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. 2022 Sep 12:9:972399.
doi: 10.3389/fnut.2022.972399. eCollection 2022.

Associations between dietary fiber intake and cardiovascular risk factors: An umbrella review of meta-analyses of randomized controlled trials

Lingmeng Fu  1 , Guobing Zhang  1 , Shasha Qian  1 , Qin Zhang  1 , Mingming Tan  1
Affiliations

Associations between dietary fiber intake and cardiovascular risk factors: An umbrella review of meta-analyses of randomized controlled trials

Lingmeng Fu et al. Front Nutr. .

Abstract

Although several meta-analyses have revealed the beneficial effects of dietary fiber intake on human health, some have reported inconsistent findings. The purpose of this work was to perform an umbrella meta-analysis to evaluate the relevant evidence and elucidate the effect of dietary fiber intake on glycemic control, lipid profiles, systematic inflammation, and blood pressure. Eligible studies were searched in several electronic databases, including Web of Science, PubMed, Scopus, and the Cochrane Library, up to March 2022. A total of 52 meta-analyses involving 47,197 subjects were identified to assess the pooled effect size. Overall, higher dietary fiber intake was significantly associated with reductions in parameters involving glycemic control, including fasting plasma glucose (ES = -0.55, 95% CI: -0.73, -0.38, P < 0.001), fasting plasma insulin (ES = -1.22, 95% CI: -1.63, -0.82, P < 0.001), homeostasis model assessment of insulin resistance (HOMA-IR) (ES = -0.43, 95% CI: -0.60, -0.27, P < 0.001), and glycosylated hemoglobin (HbA1c) (ES = -0.38, 95% CI: -0.50, -0.26, P < 0.001). In terms of lipid profiles, higher dietary fiber intake was associated with significant reductions in the serum level of total cholesterol (ES = -0.28, 95% CI: -0.39, -0.16, P < 0.001) and low-density lipoprotein cholesterol (ES = -0.25, 95% CI: -0.34, -0.16, P < 0.001), but not triglycerides (ES = -0.001, 95% CI: -0.006, 0.004, P = 0.759) and high-density lipoprotein cholesterol (ES = -0.002, 95% CI: -0.004, 0.000, P = 0.087). Higher dietary fiber intake was also significantly associated with improved tumor necrosis factor-alpha serum levels (ES = -0.78, 95% CI: -1.39, -0.16, P = 0.013), while no significant effect was observed for C-reactive protein (ES = -0.14, 95% CI: -0.33, 0.05, P = 0.156). Finally, blood pressure was also significantly improved following higher dietary fiber intake (systolic blood pressure: ES = -1.72, 95% CI: -2.13, -1.30, P < 0.001; diastolic blood pressure: ES = -0.67, 95% CI: -0.96, -0.37, P < 0.001). Subgroup analysis revealed that the study population and type of dietary fiber could be partial sources of heterogeneity. In conclusion, the present umbrella meta-analysis provides evidence for the role of dietary fiber supplementation in the improvement of established cardiovascular risk factors.

Keywords: blood pressure; dietary fiber; glycolipid metabolism; inflammation; umbrella meta-analysis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The flow diagram for present umbrella meta-analysis.
Figure 2
Figure 2
Forest plot of the effect of dietary fiber intake on FPG (A), assessment of publication bias and “trim and fill” analysis for FPG (B); *Each black circle represents one imputed study.
Figure 3
Figure 3
Forest plot of the effect of dietary fiber intake on FPI (A), assessment of publication bias and “trim and fill” analysis for FPI (B); *Each black circle represents one imputed study.
Figure 4
Figure 4
Forest plot of the effect of dietary fiber intake on HOMA-IR (A), assessment of publication bias and “trim and fill” analysis for HOMA-IR (B); *Each black circle represents one imputed study.
Figure 5
Figure 5
Forest plot of the effect of dietary fiber intake on HbA1c (A), assessment of publication bias and “trim and fill” analysis for HbA1c (B); *Each black circle represents one imputed study.
Figure 6
Figure 6
Forest plot of the effect of dietary fiber intake on TC (A), assessment of publication bias and “trim and fill” analysis for TC (B); *Each black circle represents one imputed study.
Figure 7
Figure 7
Forest plot of the effect of dietary fiber intake on TG (A), assessment of publication bias and “trim and fill” analysis for TG (B); *Each black circle represents one imputed study.
Figure 8
Figure 8
Forest plot of the effect of dietary fiber intake on HDL-C (A), assessment of publication bias and “trim and fill” analysis for HDL-C (B); *Each black circle represents one imputed study.
Figure 9
Figure 9
Forest plot of the effect of dietary fiber intake on LDL-C (A), assessment of publication bias and “trim and fill” analysis for LDL-C (B); *Each black circle represents one imputed study.
Figure 10
Figure 10
Forest plot of the effect of dietary fiber intake on TNF-α (A), assessment of publication bias and “trim and fill” analysis for TNF-α (B); *Each black circle represents one imputed study.
Figure 11
Figure 11
Forest plot of the effect of dietary fiber intake on CRP (A), assessment of publication bias and “trim and fill” analysis for CRP (B); *Each black circle represents one imputed study.
Figure 12
Figure 12
Forest plot of the effect of dietary fiber intake on SBP (A), assessment of publication bias and “trim and fill” analysis for SBP (B); *Each black circle represents one imputed study.
Figure 13
Figure 13
Forest plot of the effect of dietary fiber intake on DBP (A), assessment of publication bias for DBP (B).
See this image and copyright information in PMC

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