Role of fibre and fruit in the Mediterranean diet to protect against myocardial infarction: a case–control study in Spain

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Abstract
Objective: To assess the association between a first acute myocardial infarction and the consumption of fibre and fruit. Design: Hospital-based case–control study with incident cases. A validated semi-quantitative food frequency questionnaire (136 items) was used to assess food intake. Setting: Three third-level university hospitals in Pamplona (Spain). Subjects: Cases were subjects aged under 80, newly diagnosed with acute myocardial infarction. Each case patient (n=171) was matched to a control subject of the same gender and age (5 y bands) admitted to the same hospital. Results: An inverse association was apparent for the three upper quintiles of fibre intake. After adjustment for non-dietary and dietary confounders, an inverse linear trend was clearly significant, showing the highest relative reduction of risk (86%) for the fifth quintile (OR=0.14, 95% confidence interval: 0.03–0.67). An inverse association was also apparent for fruit intake, but not for vegetables or legumes. Conclusions: Our data suggest that a substantial part of the postulated benefits of the Mediterranean diet on coronary risk might be attributed to a high intake of fibre and fruit. Sponsorship: Partially funded by the National Department of Health (FIS 01/0619) and Navarre Regional Government (Project 24/99) and by another grant from Banco Santander-Central-Hispano.