Effect of a High-Fiber Diet Compared With a Moderate-Fiber Diet on Calcium and Other Mineral Balances in Subjects With Type 2 Diabetes

  1. Meena Shah, PHD1,2,3,
  2. Manisha Chandalia, MD2,4,
  3. Beverley Adams-Huet, MS4,5,
  4. Linda J. Brinkley, RD4,
  5. Khashayar Sakhaee, MD4,
  6. Scott M. Grundy, MD, PHD2,4 and
  7. Abhimanyu Garg, MD1,2,4
  1. 1Division of Nutrition and Metabolic Diseases, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas;
  2. 2Center for Human Nutrition, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas;
  3. 3Department of Kinesiology, Texas Christian University, Fort Worth, Texas;
  4. 4Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas;
  5. 5Department of Clinical Sciences, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas.
  1. Corresponding author: Abhimanyu Garg, abhimanyu.garg{at}utsouthwestern.edu.

Abstract

OBJECTIVE High levels of dietary fiber, especially soluble fiber, are recommended to lower serum cholesterol levels and improve glycemic control in patients with type 2 diabetes. It is not clear, however, how high levels of fiber affect mineral balance.

RESEARCH DESIGN AND METHODS In a randomized crossover study, 13 patients with type 2 diabetes were fed a high-fiber (50 g total and 25 g soluble fiber) and a moderate-fiber (24 g total and 8 g soluble fiber) diet of the same energy, macronutrient, calcium, magnesium, and phosphorus content for 6 weeks each. Intestinal calcium absorption was determined by fecal recovery of 47Ca. Stool weight and mineral content were assessed during 3 days, and 24-h urinary mineral content and serum chemistry were assessed over 5 days at the end of each phase. The results were compared by repeated-measures ANOVA.

RESULTS Compared with the moderate-fiber diet, the high-fiber diet increased stool weight (165 ± 53 vs. 216 ± 63 g/day, P = 0.02) and reduced 24-h urinary calcium (3.3 ± 1.7 vs. 2.4 ± 1.2 mmol/day, P = 0.003) and phosphorus (29.2 ± 5.5 vs. 26.0 ± 3.2 mmol/day, P = 0.003) excretion and serum calcium concentration (2.33 ± 0.06 vs. 2.29 ± 0.07 mmol/l, P = 0.04). Calcium absorption, stool calcium, magnesium, and phosphorus content and serum phosphorus concentration were not significantly different with the two diets.

CONCLUSIONS A high-fiber diet rich in soluble fiber has a small impact on calcium and phosphorus balance in subjects with type 2 diabetes. It may be prudent to ensure adequate intake of calcium and other minerals in individuals consuming a high-fiber diet.

Footnotes

  • Clinical trial reg. no. NCT00825383, clinicaltrials.gov.

  • The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Received January 22, 2009.
    • Accepted March 1, 2009.

  • Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

« Previous | Next Article »Table of Contents

This Article

  1. Published online before print March 11, 2009, doi: 10.2337/dc09-0126 Diabetes Care June 2009 vol. 32 no. 6 990-995
  1. » Abstract
  2. Full Text
  3. Full Text (PDF)
  4. All Versions of this Article:
    1. dc09-0126v1
    2. 32/6/990 most recent

Current Issue

  1. February 2010, 33 (2)
  1. Current Issue
  1. Alert me to new issues of Diabetes Care