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June 26, 1996

Dietary Fiber and Coronary Heart Disease Prevention

Author Affiliations

Harvard School of Public Health Boston, Mass

JAMA. 1996;275(24):1883. doi:10.1001/jama.1996.03530480025030

In Reply.  —Although we cannot address all of the factors associated with fiber discussed by Dr Frühbeck, we recently expanded the food composition database for our semiquantitative food-frequency questionnaire to include phytates and several flavonoid compounds (ie, quercetin, myricetin, kaempferol, luteolin, and apigenin). For each of these compounds, we derived average daily intake using food composition tables based on published analyses of flavonoids1,2 and phytates3 and supplemented these with values from additional US foods sent to the same reference laboratories. Adding quintiles of total flavonoid to our main multivariate model did not appreciably alter the relative risk (RR) for dietary fiber. When we added quintiles of phytate into our multivariate model, the RR for total dietary fiber was marginally attenuated from 0.64 (95% confidence interval [CI], 0.47-0.87) to 0.71 (95% CI, 0.50-1.00). Because the specific RR for a high vs low intake of phytate (RR, 0.90; 95% CI,