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Nutrients. 2018 May 16;10(5). pii: E628. doi: 10.3390/nu10050628.

The Association of Dietary Fiber Intake with Cardiometabolic Risk in Four Countries across the Epidemiologic Transition.

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Public Health Sciences, Stritch School of Medicine, Maywood, IL 60153, USA.
Public Health Sciences, Stritch School of Medicine, Maywood, IL 60153, USA.
Solutions for Developing Countries, University of West Indies, Mona, Kingston, Jamaica.
Department of Physiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Unit for the Prevention and Control of Cardiovascular Disease, Ministry of Health, Victoria, Mahè Island, Republic of Seychelles.
Institute of Social and Preventive Medicine, University of Lausanne, Lausanne 1010, Switzerland.
Division for Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town 7700, South Africa.
Division of Endocrinology, Diabetes and Metabolism, University of Illinois at Chicago, Chicago, IL 60612, USA.
Section of Endocrinology, Department of Medicine, Jesse Brown VA Medical Center, Chicago, IL 60612, USA.
Public Health Sciences, Stritch School of Medicine, Maywood, IL 60153, USA.
Public Health Sciences, Stritch School of Medicine, Maywood, IL 60153, USA.


The greatest burden of cardiovascular disease is now carried by developing countries with cardiometabolic conditions such as metabolic syndrome, obesity and inflammation believed to be the driving force behind this epidemic. Dietary fiber is known to have protective effects against obesity, type 2 diabetes, cardiovascular disease and the metabolic syndrome. Considering the emerging prevalence of these cardiometabolic disease states across the epidemiologic transition, the objective of this study is to explore these associations of dietary fiber with cardiometabolic risk factors in four countries across the epidemiologic transition. We examined population-based samples of men and women, aged 25⁻45 of African origin from Ghana, Jamaica, the Seychelles and the USA. Ghanaians had the lowest prevalence of obesity (10%), while Jamaicans had the lowest prevalence of metabolic syndrome (5%) across all the sites. Participants from the US presented with the highest prevalence of obesity (52%), and metabolic syndrome (22%). Overall, the Ghanaians consumed the highest dietary fiber (24.9 ± 9.7 g), followed by Jamaica (16.0 ± 8.3 g), the Seychelles (13.6 ± 7.2 g) and the lowest in the USA (14.2 ± 7.1 g). Consequently, 43% of Ghanaians met the fiber dietary guidelines (14 g/1000 kcal/day), 9% of Jamaicans, 6% of Seychellois, and only 3% of US adults. Across all sites, cardiometabolic risk (metabolic syndrome, inflammation and obesity) was inversely associated with dietary fiber intake, such that the prevalence of metabolic syndrome was 13% for those in the lowest quartile of fiber intake, compared to 9% those in the highest quartile of fiber intake. Notably, twice as many of participants (38%) in the lowest quartile were obese compared to those in the highest quartile of fiber intake (18%). These findings further support the need to incorporate strategies and policies to promote increased dietary fiber intake as one component for the prevention of cardiometabolic risk in all countries spanning the epidemiologic transition.


cardiometabolic risk; dietary fiber; epidemiologic transition; metabolic syndrome; obesity

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