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

The Botnia Dietary Study

¹ Department of Applied Chemistry and Microbiology, Division of Nutrition, University of Helsinki, Helsinki, Finland
² Department of Medicine, Helsinki University Hospital, Helsinki, Finland
³ Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland
⁴ Department of Endocrinology, University of Lund, Malmö, Sweden
⁵ Department of Health and Functional Capacity, National Public Health Institute, Helsinki, Finland
⁶ Tampere School of Public Health, University of Tampere, Tampere, Finland

Address correspondence and reprint requests to Katriina Ylönen, MSc, Department of Applied Chemistry and Microbiology, Division of Nutrition, P.O. Box 27, FIN-00014 University of Helsinki, Helsinki, Finland. E-mail: katriina.ylonen{at}helsinki.fi.

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: -0.17 (0.07), P = 0.012; -0.15 (0.07), P = 0.024; and -0.14 (0.07), P = 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.

Abbreviations: HOMA, homeostasis model assessment • IAUC, incremental area under the curve • MET, metabolic unit value • NEFA, nonesterified fatty acid

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