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Item
#7
Dietary Fiber, Glycemic Load,
and Risk of Type 2 Diabetes
Fiber
reduces the incidence of a large glycemic response
OBJECTIVE:
Intake of carbohydrates that provide a large glycemic response
has been hypothesized to increase the risk of TYPE 2
DIABETES, whereas dietary fiber is suspected to reduce
incidence. These hypotheses have not been evaluated
prospectively.
RESEARCH
DESIGN AND METHODS: We examined the relationship
between diet and risk of TYPE 2 DIABETES in a cohort of 42,759 men
without TYPE 2 DIABETES or cardiovascular disease, who
were 40-75 years of age in 1986. Diet was assessed at
baseline by a validated semiquantitative food frequency
questionnaire. During 6-years of follow-up, 523 incident cases of
TYPE 2 DIABETES were documented.
RESULTS: The
dietary glycemic index (an indicator of carbohydrate's
ability to raise blood glucose levels) was positively
associated with risk of Type 2 diabetes after adjustment for age,
BMI, smoking, physical activity, family history of
diabetes, alcohol consumption, cereal fiber, and total
energy intake. Comparing the highest and lowest quintiles,
the relative risk (RR) of TYPE 2 DIABETES was 1.37 (95% CI,
1.02-1.83, P trend = 0.03). Cereal fiber was inversely
associated with risk of TYPE 2 DIABETES (RR = 0.70; 95%
CI, 0.51-0.96, P trend = 0.007; for > 8.1 g/day vs. < 3.2 g/day).
The combination of a high glycemic load and a low cereal
fiber intake further increased the risk of Type 2
diabetes (RR = 2.17, 95% CI, 1.04-4.54) when compared
with a low glycemic load and high cereal fiber intake.
CONCLUSIONS:
These findings support the hypothesis that diets with a high
glycemic load and a low fiber content increase risk of TYPE
2 DIABETES in men. Further, they suggest that grains
should be consumed in a minimally refined form to
reduce the incidence of Type 2 diabetes.
Department of Nutrition, Harvard School of Public Health, Boston,
Massachusetts
Diabetes
Care, Vol 20, Issue 4 545-550
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Did You Know:
Physical
activity is so critical to cardiovascular health that the American
Heart Association recognizes physical inactivity as one of the
major risk factors for CVD.
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