Beneficial Effects Of High Dietary Fiber Intake In Patients With Type 2 Diabetes

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Beneficial Effects Of High Dietary Fiber Intake In Patients With

Type 2 Diabetes Mellitus

 

Author:

 

Chandalia M, Garg A, Lutjohann D, von Bergmann K, Grundy SM,

Brinkley LJ

 

Source:

 

N Engl J Med. 2000;342:1392-1398.

http://www.enzy.com/abstracts/display.asp?id=2378

Abstract:

 

BACKGROUND: The effect of increasing the intake of dietary fiber on

glycemic control in patients with type 2 diabetes mellitus is

controversial.

 

METHODS: In a randomized, crossover study, we assigned 13 patients

with type 2 diabetes mellitus to follow two diets, each for six

weeks: a diet containing moderate amounts of fiber (total, 24 g; 8 g

of soluble fiber and 16 g of insoluble fiber), as recommended by the

American Diabetes Association (ADA), and a high-fiber diet (total,

50 g; 25 g of soluble fiber and 25 g of insoluble fiber) containing

foods not fortified with fiber (unfortified foods). Both diets,

prepared in a research kitchen, had the same macronutrient and

energy content.

 

We compared the effects of the two diets on glycemic

control and plasma lipid concentrations.

 

 

RESULTS: Compliance with the diets was excellent. During the sixth

week of the high-fiber diet, as compared with the sixth week of the

ADA diet, mean daily preprandial plasma glucose concentrations were

13 mg per deciliter (0.7 mmol per liter) lower (95 percent

confidence interval, 1 to 24 mg per deciliter [0.1 to 1.3 mmol per

liter]; P=0.04) and mean daily urinary glucose excretion was 1.3 g

lower (median difference, 0.23 g; 95 percent confidence interval,

0.03 to 1.83; P=0.008).

 

The high-fiber diet also lowered the area

under the curve for 24-hour plasma glucose and insulin

concentrations, which were measured every two hours, by 10 percent

(P=0.02) and 12 percent (P=0.05), respectively.

 

The high-fiber diet

reduced plasma total cholesterol concentrations by 6.7 percent

(P=0.02), triglyceride concentrations by 10.2 percent (P=0.02), and

very-low-density lipoprotein cholesterol concentrations by 12.5

percent (P=0.01).

 

 

CONCLUSIONS: A high intake of dietary fiber, particularly of the

soluble type, above the level recommended by the ADA, improves

glycemic control, decreases hyperinsulinemia, and lowers plasma

lipid concentrations in patients with type 2 diabetes.