Whole-grain and fiber intake and the incidence of type 2 diabetes

Montonen, Jukka; Knekt, Paul; Järvinen, Ritva; Aromaa, Arpo; Reunanen, Antti

doi:10.1093/ajcn/77.3.622

Cited by 534 publications

(386 citation statements)

References 25 publications

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“…Despite some evidence therefore to suggest that an increased intake of soluble fibre improves glycaemic control, soluble fibre intake is not associated with incident T2DM in prospective studies Montonen et al, 2003). A possible explanation is that the quantity of fibre consumed in an average diet does not contain sufficient soluble fibre, particularly of the gel-forming type, to have a distinguishable effect on glycaemic control.…”

Section: Fibrementioning

confidence: 96%

“…After adjustment for potential confounding factors, people consuming around 3 servings per day of whole grain products had a risk reduction in the order of 20-30% compared with low consumers of whole grain products with a dose-response across quintiles of whole grain food intake (Liu et al, 2000;Meyer et al, 2000;Fung et al, 2002). A smaller study carried out in Finland did not find a statistically significant difference in incident T2DM when comparing consumers of whole grain foods above and below the extreme quartiles of intake, although there was a trend suggesting a reduced risk of developing T2DM among larger consumers of whole grain foods (Montonen et al, 2003). Adding dietary glycaemic load into the models did not change the association between whole grain food intake and incident T2DM (Liu et al, 2000;Meyer et al, 2000).…”

Section: Prospective Studiesmentioning

confidence: 99%

“…Montonen et al (2003) used a definition of whole grain foods that was restricted to products that contained grains (as opposed to bran products) and applied mainly to breads, flours and minimally disrupted grain products such as porridge, gruel and a traditional rice pudding. It was suggested that this difference in classification better differentiated whole grain intake from refined grain intake than in previous studies.…”

Section: Prospective Studiesmentioning

confidence: 99%

“…Cereal fibre was inversely associated with risk of diabetes in white and African-American subjects but statistically significant only in white people with a hazard ratio of 0.75 for diabetes (95% CI: 0.60, 0.92) comparing people above or below the extreme quintiles of cereal fibre intake. Of the prospective studies that analysed dietary intakes for different forms of fibre, none found an association between soluble fibre and/or fibre derived largely from fruit and vegetables, and incident T2DM (Salmeron et al, 1997a, b;Meyer et al, 2000;Stevens et al, 2002;Montonen et al, 2003).…”

Section: Prospective Studiesmentioning

confidence: 99%

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Cereal grains, legumes and diabetes

2004

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This review examines the evidence for the role of whole grain foods and legumes in the aetiology and management of diabetes. MedLine and SilverPlatter ('Nutrition' and 'Food Science FSTA') databases were searched to identify epidemiological and experimental studies relating to the effects of whole grain foods and legumes on indicators of carbohydrate metabolism. Epidemiological studies strongly support the suggestion that high intakes of whole grain foods protect against the development of type II diabetes mellitus (T2DM). People who consume B3 servings per day of whole grain foods are less likely to develop T2DM than low consumers (o3 servings per week) with a risk reduction in the order of 20-30%. The role of legumes in the prevention of diabetes is less clear, possibly because of the relatively low intake of leguminous foods in the populations studied. However, legumes share several qualities with whole grains of potential benefit to glycaemic control including slow release carbohydrate and a high fibre content. A substantial increase in dietary intake of legumes as replacement food for more rapidly digested carbohydrate might therefore be expected to improve glycaemic control and thus reduce incident diabetes. This is consistent with the results of dietary intervention studies that have found improvements in glycaemic control after increasing the dietary intake of whole grain foods, legumes, vegetables and fruit. The benefit has been attributed to an increase in soluble fibre intake. However, prospective studies have found that soluble fibre intake is not associated with a lower incidence of T2DM. On the contrary, it is cereal fibre that is largely insoluble that is associated with a reduced risk of developing T2DM. Despite this, the addition of wheat bran to the diets of diabetic people has not improved indicators of glycaemic control. These apparently contradictory findings might be explained by metabolic studies that have indicated improvement in glucose handling is associated with the intact structure of food. For both grains and legumes, fine grinding disrupts cell structures and renders starch more readily accessible for digestion. The extent to which the intact structure of grains and legumes or the composition of foods in terms of dietary fibre and other constituents contribute to the beneficial effect remains to be quantified. Other mechanisms to help explain improvements in glycaemic control when consuming whole grains and legumes relate to cooking, type of starch, satiety and nutrient retention. Thus, there is strong evidence to suggest that eating a variety of whole grain foods and legumes is beneficial in the prevention and management of diabetes. This is compatible with advice from around the world that recommends consumption of a wide range of carbohydrate foods from cereals, vegetables, legumes and fruits both for the general population and for people with diabetes.

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Section: Fibrementioning

confidence: 96%

Section: Prospective Studiesmentioning

confidence: 99%

Section: Prospective Studiesmentioning

confidence: 99%

Section: Prospective Studiesmentioning

confidence: 99%

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Cereal grains, legumes and diabetes

2004

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“…Consumption of fruit and vegetables (Snowdon & Phillips, 1985;Colditz et al, 1992;Feskens et al, 1995;Ford & Mokdad, 2001) and whole grains (Liu et al, 2000;Meyer et al, 2000;Fung et al, 2002;Montonen et al, 2003) have shown inverse associations with the risk of diabetes. The associations are independent of obesity, a major risk factor for diabetes.…”

Section: Introductionmentioning

confidence: 99%

Food consumption and the incidence of type II diabetes mellitus

et al. 2005

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Objective: The consumption of different foods was studied for their ability to predict type II diabetes mellitus. Design: The study design was a cohort study, based on the Finnish Mobile Clinic Health Examination Survey. Setting: A total of 30 communities from different parts of Finland. Subjects: A total of 4304 men and women, 40-69 y of age and free of diabetes at baseline in 1967-1972 and followed up for incidence of diabetes medication during 23 y (383 incident cases). Results: Higher intakes of green vegetables, fruit and berries, oil and margarine, and poultry were found to predict a reduced risk of type II diabetes. The relative risks of developing type II diabetes between the extreme quartiles of the intakes were 0.69 (95% confidence interval (CI) ¼ 0.50-0.93; P for trend (P) ¼ 0.02) for green vegetables, 0.69 (CI ¼ 0.51-0.92; P ¼ 0.03) for fruit and berries, 0.71 (CI ¼ 0.52-0.98; P ¼ 0.01) for margarine and oil, and 0.71 (CI ¼ 0.54-0.94; P ¼ 0.01) for poultry. Conclusion:The results suggest that prevention of type II diabetes might be aided by consumption of certain foods that are rich in nutrients with hypothesized health benefits.

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Glycemic Index, Glycemic Load, and Cereal Fiber Intake and Risk of Type 2 Diabetes in US Black Women

Krishnan¹,

Rosenberg²,

Singer³

et al. 2007

Arch Intern Med

148

132

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Background: Previous studies of carbohydrate quality and risk of type 2 diabetes mellitus have yielded inconsistent findings. Because diet is in part culturally determined, a study of dietary factors in US black women is of interest. Methods: We used data from the Black Women's Health Study, a prospective cohort study of 59 000 US black women, to examine the association of glycemic load, glycemic index, and cereal fiber with risk of type 2 diabetes. Diet was assessed at baseline in 1995 with a modified version of the National Cancer Institute-Block food frequency questionnaire. Results: During 8 years of follow-up, there were 1938 incident cases of diabetes. Cox proportional hazards models were used to estimate incidence rate ratios (IRRs) for quintiles of dietary factors, while controlling for lifestyle and dietary factors. Glycemic index was positively associated with the risk of diabetes: the IRR for the highest quintile relative to the lowest was 1.23 (95% confidence interval [CI], 1.05-1.44). Cereal fiber intake was inversely associated with risk of diabetes, with an IRR of 0.82 (95% CI, 0.70-0.96) for the highest vs lowest quintiles of intake. Stronger associations were seen among women with a body mass index (calculated as weight in kilograms divided by height in meters squared) lower than 25: IRRs for the highest vs lowest quintile were 1.91 (95% CI, 1.16-3.16) for glycemic index (P value for interaction, .12) and 0.41 (95% CI, 0.24-0.72) for cereal fiber intake (P value for interaction, .05). Conclusion: Increasing cereal fiber in the diet may be an effective means of reducing the risk of type 2 diabetes, a disease that has reached epidemic proportions in black women.

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Whole-grain and fiber intake and the incidence of type 2 diabetes

Abstract: An inverse association between whole-grain intake and the risk of type 2 diabetes was found. The similar result for cereal fiber intake suggests that the whole-grain association is due to cereal fiber or another factor related to cereal fiber intake.

Cited by 534 publications

References 25 publications

Cereal grains, legumes and diabetes

Cereal grains, legumes and diabetes

Food consumption and the incidence of type II diabetes mellitus

Glycemic Index, Glycemic Load, and Cereal Fiber Intake and Risk of Type 2 Diabetes in US Black Women

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