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from Heartwire — a professional news service of WebMD
March 14, 2007 — Fiber in the diet can reduce C-reactive protein (CRP) levels, a new study suggests. Writing in the March 12 issue of the Archives of Internal Medicine, Dana King, MD, and colleagues from the Medical University of South Carolina in Charleston report that both a high-fiber diet, as well as a fiber-supplemented diet, significantly — if modestly — reduced baseline CRP levels during a 3-week period.
"The study adds prospective trial data to the previous literature on dietary fiber and CRP," Dr. King told heartwire . "The findings support current American Heart Association and other group's guidelines that promote adequate intake of fiber in the diet to promote good health. Clinicians should continue to counsel patients to eat foods high in fiber, or take a supplement to reach their fiber intake goals."
The study is one of the first to specifically examine a cause and effect role for fiber and CRP level in a randomized fashion, the authors add.
The study enrolled 28 women and 7 men whose baseline fiber intake was approximately 12 g/day, measured during a 3-week run-in period. The participants were then randomized to either the DASH (Dietary Approaches to Stop Hypertension), high-fiber diet (mean intake, nearly 28 g of fiber per day), or to a fiber supplement (psyllium) on top of their regular diet (mean intake, totaling 27 g/day). After 3 weeks on one diet, participants crossed over to the other fiber diet.
On both diets, CRP levels dropped below baseline values, a statistically significant change in both groups. The absolute reduction was greater in the supplemented diet group, but there were no statistically significant differences in the CRP changes between the 2 groups.
| Group | Change in CRP: Dietary Fiber | P From Baseline | Change in CRP: Supplemental Fiber | P From Baseline |
|---|---|---|---|---|
| All participants (n = 35) | -13.7% | .046 | -18.1% | .03 |
*CRP indicates C-reactive protein.
Source: Arch Intern Med. 2007;167:502-506.
Changes in CRP levels were greater in lean, normotensive subjects than in obese, hypertensive subjects. This finding was "surprising" the authors note, because previous work had suggested that fiber affects CRP levels by modulating metabolism in abdominal fat such that overweight or obese subjects would seem more likely to be affected by fiber consumption.
| Group | Baseline CRP (mg/L) | Follow-up CRP: High-Fiber Diet (mg/L) | P From Baseline | Change in CRP: Supplemental Fiber (mg/L) | P From Baseline |
|---|---|---|---|---|---|
| Lean normotensive patients (n = 18) | 2.0 | 1.4 | < .05 | 1.2 | < .05 |
| Obese hypertensive patients (n = 17) | 7.2 | 6.5 | NS | 6.2 | NS |
*CRP indicates C-reactive protein; NS, not significant.
Source: Arch Intern Med. 2007;167:502-506.
"The finding of a lower relative reduction in obese participants was both surprising and disappointing," Dr. King told heartwire . "Surprising, because we had not noted a differential impact previously [and] disappointing due to the fact that CRP and inflammatory markers are elevated higher, on average, in people with obesity, so our hope was that fiber would work even better in such individuals. Instead, it appears that dietary fiber has a lesser impact on obese individuals."
A longer intervention period or a higher fiber intake in obese subjects might have led to a greater impact on CRP levels, the authors suggest, noting that future studies could address these questions. "Nevertheless, the findings indicate that modification of dietary fiber may be helpful in modulating inflammation to a certain degree," with possible benefits for cardiovascular risk, they conclude.
Elaborating to heartwire , Dr. King acknowledged, "There has been no cause-and-effect link proven between CRP and cardiovascular risk, thus our cautious but hopeful statement. If a link is more firmly established, dietary fiber may play a role in helping to reduce the cardiovascular risk attributable to CRP and inflammation."
Commenting on the study for heartwire , Paul Ridker, MD, from the Brigham and Women's Hospital in Boston, Massachusetts said, "These data add to a growing knowledge base that diet alone can have a substantive effect on lowering CRP levels. Physicians should remember that advice on diet, exercise, and smoking cessation remains crucial for our high CRP patients."
Arch Intern Med. 2007;167:502-506.
The complete contents of Heartwire , a professional news service of WebMD, can be found at www.theheart.org, a Web site for cardiovascular healthcare professionals.
Current evidence supports that higher levels of inflammatory markers, such as CRP, are associated with an increased risk for cardiovascular events. Elevation of CRP levels has specifically been linked to insulin resistance, hypertension, the development of diabetes mellitus, and metabolic syndrome. A proposed intervention to lower levels of inflammatory markers is a high-fiber diet.
The aim of this study was to examine whether a high-fiber diet would reduce inflammatory markers and to compare the results from a diet supplemented with fiber vs a diet that is naturally high in fiber.
