Low dietary fiber and high protein intakes associated with newly diagnosed diabetes in a remote aboriginal community

Wolever, Thomas M. S.; Hamad, Safa; Gittelsohn, Joel; Gao, Joe; Hanley, Anthony J.; Harris, Stewart B.; Zinman, Bernard

doi:10.1093/ajcn/66.6.1470

Cited by 52 publications

(35 citation statements)

References 26 publications

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“…A study in Papua New Guinea (11) found a weak direct association between dietary fiber and newly diagnosed type 2 diabetes. In contrast, among a remote aboriginal community in Ontario, a high intake of dietary fiber was found to be associated with reduced risk of newly diagnosed diabetes (34).…”

Section: Research Design and Methods -The Botnia Dietarymentioning

confidence: 75%

Associations of Dietary Fiber With Glucose Metabolism in Nondiabetic Relatives of Subjects With Type 2 Diabetes

Ylönen

Saloranta²,

Kronberg-Kippilä³

et al. 2003

Diabetes Care

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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...

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Section: Research Design and Methods -The Botnia Dietarymentioning

confidence: 75%

Associations of Dietary Fiber With Glucose Metabolism in Nondiabetic Relatives of Subjects With Type 2 Diabetes

Ylönen

Saloranta²,

Kronberg-Kippilä³

et al. 2003

Diabetes Care

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“…Recent studies have provided preliminary evidence for reduced risk of diabetes with increased intake of whole grains and dietary fiber (27,696,697). In both the Nurses' Health Study (27) and the Iowa Women's Health Study (697), increased intake of whole grain food was associated with significant reductions in incidence of type 2 diabetes.…”

Section: Whole Grains/fibermentioning

confidence: 99%

Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications

et al. 2002

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“…The initial survey and screening helped determine the areas on which to focus prevention activities Wolever et al, 1997;Gittelsohn et al, 1998;Hegele et al, 1999). Based on survey findings and additional formative research, the community diabetes program was developed.…”

Section: Introductionmentioning

confidence: 99%

Development of an integrated diabetes prevention program with First Nations in Canada

Gittelsohn

Harris

et al. 2006

Health Promotion International

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SUMMARYType 2 diabetes mellitus is a major cause of morbidity and mortality among First Nations in Canada. We used multiple research methods to develop an integrated multiinstitutional diabetes prevention program based on the successful Sandy Lake Health and Diabetes Project and Apache Healthy Stores programs. In-depth interviews, a structured survey, demonstration and feedback sessions, group activities, and meetings with key stakeholders were used to generate knowledge about the needs and resources for each community, and to obtain feedback on SLHDP interventions. First Nations communities were eager to address the increasing epidemic of diabetes. Educating children through a school prevention program was the most popular proposed intervention. Remote communities had poorer access to healthy foods and more on-reserve media and services than the smaller semi-remote reserves. While the reserves shared similar risk factors for diabetes, variations in health beliefs and attitudes and environmental conditions required tailoring of programs to each reserve. In addition, it was necessary to balance community input with proven health promotion strategies. This study demonstrates the importance of formative research in developing integrated health promotion programs for multiple communities based on previously evaluated studies.

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Low dietary fiber and high protein intakes associated with newly diagnosed diabetes in a remote aboriginal community

Cited by 52 publications

References 26 publications

Associations of Dietary Fiber With Glucose Metabolism in Nondiabetic Relatives of Subjects With Type 2 Diabetes

Associations of Dietary Fiber With Glucose Metabolism in Nondiabetic Relatives of Subjects With Type 2 Diabetes

Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications

Development of an integrated diabetes prevention program with First Nations in Canada

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