THE BOTNIA RESEARCH GROUP OBJECTIVE -To study cross-sectional associations of dietary fiber intake with insulin resistance, insulin secretion, and glucose tolerance in a population at high risk for type 2 diabetes.
RESEARCH DESIGN AND METHODS -The subjects consisted of 248 male and 304 female adult nondiabetic relatives of patients with type 2 diabetes. Dietary intake was measured by means of two 3-day food records. Associations of total, water-insoluble, and water-soluble fiber with measures of glucose metabolism based on an oral glucose tolerance test, were analyzed by multiple linear regression analysis adjusting for sex, age, length of education, physical activity, BMI, waist-to-hip ratio, systolic blood pressure, and serum triglyceride and HDL cholesterol concentrations. The homeostasis model assessment insulin resistance index, the incremental 30-min serum insulin concentration divided by the incremental 30-min glucose concentration, and fasting and 2-h glucose concentrations were the outcome variables.RESULTS -The dietary intake of total as well as water-insoluble and water-soluble fiber was inversely associated with insulin resistance: Ϫ0.17 (0.07), P ϭ 0.012; Ϫ0.15 (0.07), P ϭ 0.024; and Ϫ0.14 (0.07), P ϭ 0.049 [regression coefficients (SE)]. Fiber variables were unrelated to insulin secretion and plasma glucose concentrations.CONCLUSIONS -The results support evidence that a high intake of dietary fiber is associated with enhanced insulin sensitivity and therefore may have a role in the prevention of type 2 diabetes.
Diabetes Care 26:1979 -1985, 2003D iet is regarded as one of the environmental determinants of type 2 diabetes. A typical feature of the modern western lifestyle diet is a low fiber intake that has been implicated in several diseases of western civilization, including type 2 diabetes. Although experimental high-fiber diets have been associated with improved glucose metabolism (1,2), the results of epidemiological studies are inconsistent. Available data suggest a positive effect on insulin sensitivity (3-6), while association with glucose tolerance and diabetes risk has been more controversial (7-14).The beneficial effect of dietary fiber has mainly been ascribed to the watersoluble fiber fraction, while the role of water-insoluble fiber has been regarded as less convincing (15,16). However, some recent prospective studies (13,14, 17) suggest a protective role specific to water-insoluble dietary fiber against type 2 diabetes.In the present cross-sectional study, we sought to determine whether habitual dietary fiber intake (total, water-insoluble, and water-soluble fiber) was related to insulin resistance, insulin secretion, or glucose concentrations in a population at high risk for type 2 diabetes.
RESEARCH DESIGN AND METHODS -The Botnia DietaryStudy investigates relationships between diet and glucose metabolism in relatives of patients with type 2 diabetes. The study was conducted between October 1994 and June 1997 as part of the follow-up investigation of the Botnia Study, which is a pros...