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Metabolic Syndrome/Insulin Resistance Syndrome/Pre-Diabetes

Glycemic Index and Dietary Fiber and the Risk of Type 2 Diabetes

  1. Allison M. Hodge, MENVSC1,
  2. Dallas R. English, PHD1,
  3. Kerin O’Dea, PHD2 and
  4. Graham G. Giles, PHD1
  1. 1Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Australia
  2. 2Menzies School of Health Research, and Institute of Advanced Studies, Charles Darwin University, Darwin, Australia
  1. Address correspondence and reprint requests to Allison M. Hodge, The Cancer Council, Victoria, 1 Rathdowne St., Carlton, Victoria 3053, Australia. E-mail: allison.hodge{at}cancervic.org.au
Diabetes Care 2004 Nov; 27(11): 2701-2706. https://doi.org/10.2337/diacare.27.11.2701
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Abstract

OBJECTIVE—To examine associations between type 2 diabetes and fiber, glycemic load (GL), dietary glycemic index (GI), and fiber-rich foods.

RESEARCH DESIGN AND METHODS—This was a prospective study of 36,787 men and women aged 40–69 years without diabetes. For all self-reported cases of diabetes at 4-year follow-up, confirmation of diagnosis was sought from medical practitioners. Case subjects were those who reported diabetes at follow-up and for whom there was no evidence that they did not have type 2 diabetes. Data were analyzed with logistic regression, adjusting for country of birth, physical activity, family history of diabetes, alcohol and energy intake, education, 5-year weight change, sex, and age.

RESULTS—Follow-up was completed by 31,641 (86%) participants, and 365 cases were identified. The odds ratio (OR) for the highest quartile of white bread intake compared with the lowest was 1.37 (95% CI 1.04–1.81; P for trend = 0.001). Intakes of carbohydrate (OR per 200 g/day 0.58, 0.36–0.95), sugars (OR per 100 g/day 0.61, 0.47–0.79), and magnesium (OR per 500 mg/day 0.62, 0.43–0.90) were inversely associated with incidence of diabetes, whereas intake of starch (OR per 100 g/day 1.47, 1.06–2.05) and dietary GI (OR per 10 units 1.32, 1.05–1.66) were positively associated with diabetes. These relationships were attenuated after adjustment for BMI and waist-to-hip ratio.

CONCLUSIONS—Reducing dietary GI while maintaining a high carbohydrate intake may reduce the risk of type 2 diabetes. One way to achieve this would be to substitute white bread with low-GI breads.

  • FFQ, food frequency questionnaire
  • GI, glycemic index
  • GL, glycemic load
  • WHR, waist-to-hip ratio

Footnotes

  • Additional information for this article can be found in an online appendix at http://care.diabetesjournals.org.

    A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    • Accepted July 23, 2004.
    • Received May 20, 2004.
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Diabetes Care: 27 (11)

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November 2004, 27(11)
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Glycemic Index and Dietary Fiber and the Risk of Type 2 Diabetes
Allison M. Hodge, Dallas R. English, Kerin O’Dea, Graham G. Giles
Diabetes Care Nov 2004, 27 (11) 2701-2706; DOI: 10.2337/diacare.27.11.2701

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Glycemic Index and Dietary Fiber and the Risk of Type 2 Diabetes
Allison M. Hodge, Dallas R. English, Kerin O’Dea, Graham G. Giles
Diabetes Care Nov 2004, 27 (11) 2701-2706; DOI: 10.2337/diacare.27.11.2701
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  • Alcohol Consumption and Risk of Type 2 Diabetes Among Older Women
  • Hepatic Enzymes, the Metabolic Syndrome, and the Risk of Type 2 Diabetes in Older Men
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