Long-term effect of dietary fibre intake on glycosylated haemoglobin A1c level and glycaemic control status among Chinese patients with type 2 diabetes mellitus

Abstract Objective Dietary fibre has been linked to lower levels of glycosylated haemoglobin A1c (HbA1c) among diabetes patients. The present study aimed to evaluate the long-term effect of dietary fibre on HbA1c levels among Chinese patients with type 2 diabetes mellitus. Design Two cross-sectional surveys were conducted in 2006 and 2011, with the second one being a repeat survey on a sub-sample from the initial one. In both surveys, an in-person interview was conducted to collect information on demographic characteristics and lifestyles following a similar protocol. Dietary intake was assessed with a validated FFQ. Anthropometric measures and biochemical assays were performed at the interview. Setting Communities in Pudong New Area of Shanghai, China. Subjects Chinese patients (n 934) with type 2 diabetes mellitus. Results An inverse association was observed between dietary fibre and glycaemic status indicated by HbA1c level in both surveys, although it was significant only in the first survey. Among 497 patients participating in both surveys, dietary fibre intake at the first survey was inversely associated with uncontrolled glycaemic status at the second survey, with adjusted odds ratios across the tertiles of intake being 1·00, 0·72 (95 % CI 0·43, 1·21) and 0·58 (95 % CI 0·34, 0·99; P trend = 0·048). The change in fibre intake was slightly associated with glycaemic status, with each increase in tertile scores of intake linked to a 0·138 % (β = −0·138; 95 % CI −0·002, 0·278) decrease in HbA1c value and a 19 % (OR = 0·81; 95 % CI 0·65, 1·02) reduced risk of uncontrolled glycaemic status at the second survey. Conclusions Dietary fibre may have a long-term beneficial effect on HbA1c level among Chinese diabetes patients.

[1]  References , 1971 .

[2]  B. Rolls,et al.  Energy density but not fat content of foods affected energy intake in lean and obese women. , 1999, The American journal of clinical nutrition.

[3]  James W. Anderson,et al.  Effects of psyllium on glucose and serum lipid responses in men with type 2 diabetes and hypercholesterolemia. , 1999, The American journal of clinical nutrition.

[4]  R. Holman,et al.  Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study , 2000, BMJ : British Medical Journal.

[5]  S M Grundy,et al.  Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus. , 2000, The New England journal of medicine.

[6]  Kaye Foster-Powell,et al.  International table of glycemic index and glycemic load values: 2002. , 2002, The American journal of clinical nutrition.

[7]  F. Pi‐Sunyer Glycemic index and disease. , 2002, The American journal of clinical nutrition.

[8]  C. Kendall,et al.  High-complex carbohydrate or lente carbohydrate foods? , 2002, The American journal of medicine.

[9]  P. Wuersch,et al.  Depression of the glycemic index by high levels of β-glucan fiber in two functional foods tested in type 2 diabetes , 2002, European Journal of Clinical Nutrition.

[10]  P. Elliott,et al.  Nutrient intakes of middle-aged men and women in China, Japan, United Kingdom, and United States in the late 1990s: The INTERMAP Study , 2003, Journal of Human Hypertension.

[11]  X. Shu,et al.  Validity and reproducibility of the food frequency questionnaire used in the Shanghai Women's Health Study , 2004, European Journal of Clinical Nutrition.

[12]  Walter C Willett,et al.  Dietary patterns, meat intake, and the risk of type 2 diabetes in women. , 2004, Archives of internal medicine.

[13]  Hongying Zhong,et al.  [Investigation of dietary fiber intakes and varies in 53 patients with diabetes]. , 2005, Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine].

[14]  F. Marangoni,et al.  The glycemic index of bread and biscuits is markedly reduced by the addition of a proprietary fiber mixture to the ingredients. , 2008, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[15]  F. Ovalle Effect of a Low–Glycemic Index or a High–Cereal Fiber Diet on Type 2 Diabetes: A Randomized Trial , 2009 .

[16]  N. Sattar,et al.  Effect of intensive control of glucose on cardiovascular outcomes and death in patients with diabetes mellitus: a meta-analysis of randomised controlled trials , 2009, The Lancet.

[17]  E. J. Elliott,et al.  The use of low-glycaemic index diets in diabetes control , 2010, British Journal of Nutrition.

[18]  Rodica Pop-Busui,et al.  Effect of intensive treatment of hyperglycaemia on microvascular outcomes in type 2 diabetes: an analysis of the ACCORD randomised trial , 2010, The Lancet.

[19]  X. Shu,et al.  Dietary patterns are associated with lower incidence of type 2 diabetes in middle-aged women: the Shanghai Women's Health Study. , 2010, International journal of epidemiology.

[20]  D. Giugliano,et al.  Dietary glycemic index and glycemic load are associated with metabolic control in type 2 diabetes: The CAPRI experience. , 2010, Metabolic syndrome and related disorders.

[21]  Diederick E. Grobbee,et al.  The global burden of diabetes and its complications: an emerging pandemic , 2010, European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology.

[22]  Biao Xu,et al.  Prevalence of chronic complications of type 2 diabetes mellitus in outpatients - a cross-sectional hospital based survey in urban China , 2010, Health and Quality of Life Outcomes.

[23]  E. Rimm,et al.  Whole-Grain, Cereal Fiber, Bran, and Germ Intake and the Risks of All-Cause and Cardiovascular Disease–Specific Mortality Among Women With Type 2 Diabetes Mellitus , 2010, Circulation.

[24]  V. Basevi,et al.  Standards of Medical Care in Diabetes—2012 , 2011, Diabetes Care.

[25]  Hongyan Wu,et al.  Dietary Fiber Intake Is Associated with HbA1c Level among Prevalent Patients with Type 2 Diabetes in Pudong New Area of Shanghai, China , 2012, PloS one.

[26]  A. Mainous,et al.  Dietary Fiber for the Treatment of Type 2 Diabetes Mellitus: A Meta-Analysis , 2012, The Journal of the American Board of Family Medicine.

[27]  Paul Zimmet,et al.  Type 2 Diabetes: An Epidemic Requiring Global Attention and Urgent Action , 2012, Diabetes Care.

[28]  Bing Zhang,et al.  [Status and trend of fat and cholesterol intake among Chinese middle and old aged residents in 9 provinces from 1991 to 2009]. , 2013, Wei sheng yan jiu = Journal of hygiene research.