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Dietary fibre, lente carbohydrates and the insulin-resistant diseases

Published online by Cambridge University Press:  09 March 2007

David J. A. Jenkins ,
Mette Axelsen ,
Cyril W. C. Kendall ,
Livia S. A. Augustin ,
Vladimir Vuksan  and
Ulf Smith
David J. A. Jenkins*
Affiliation:
Department of Nutritional Sciences Faculty of Medicine, University of Toronto and the Clinical Nutrition and Risk Factor Modification Center, St Michael's Hospital, Toronto, Ontario, Canada
Mette Axelsen
Affiliation:
Lundberg Laboratory for Diabetes Research, Department of Internal Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
Cyril W. C. Kendall
Affiliation:
Department of Nutritional Sciences Faculty of Medicine, University of Toronto and the Clinical Nutrition and Risk Factor Modification Center, St Michael's Hospital, Toronto, Ontario, Canada
Livia S. A. Augustin
Affiliation:
Department of Nutritional Sciences Faculty of Medicine, University of Toronto and the Clinical Nutrition and Risk Factor Modification Center, St Michael's Hospital, Toronto, Ontario, Canada
Vladimir Vuksan
Affiliation:
Department of Nutritional Sciences Faculty of Medicine, University of Toronto and the Clinical Nutrition and Risk Factor Modification Center, St Michael's Hospital, Toronto, Ontario, Canada
Ulf Smith
Affiliation:
Lundberg Laboratory for Diabetes Research, Department of Internal Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
*
*Corresponding author: D. J. A. Jenkins, fax +1 416 978 5310, email [email protected]
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Abstract

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Several epidemiological studies link consumption of fibre-rich foods to a reduced risk of type 2 diabetes and CHD. The ‘fibre hypothesis’ suggested that this was a direct effect of fibre. However, fibre-rich foods contain different types of fibre as well as other potentially beneficial compounds, and many foods naturally high in fibre have low glycaemic and insulinaemic indices, possibly due to food form. The question therefore emerges as to the effect of isolated fibre per se on insulin sensitivity, lipids and other risk factors associated with the metabolic syndrome. Many beneficial effects are seen with pharmacological doses of isolated viscous soluble fibre, including improved insulin sensitivity, decreased LDL-cholesterol levels and decreased clotting factors. Similar effects are seen with low glycaemic-index foods. In contrast, insoluble non-viscous cereal fibre is not seen to act directly on risk factors when taken in refined foods such as in milled flour. Since cereal fibre, the major type of fibre in western diets, does not directly act on the risk factors for the metabolic syndrome, the question remains as to possible mechanisms. Until now, fibre and the nature and processing of the starch and particle size have been seen as the main determinants of the metabolic response to starchy foods. However, fibre-rich foods also have an increased protein-to-carbohydrate ratio. Hence we suggest that the protective effect of fibre may also be due to increased vegetable protein content, which may act directly to reduce clotting factors and oxidized LDL-cholesterol levels.

Keywords

Insulin resistanceDietary fibreLow glycaemic indexDiabetes mellitus type 2Cardiovascular diseases
Type
Research Article
Information
British Journal of Nutrition , Volume 83 , Issue S1 , June 2000 , pp. S157 - S163
Copyright
Copyright © The Nutrition Society 2000

References

Bosello, O, Ostuzzi, R, Armellini, F, Micciolo, R & Scuro, LA (1980) Glucose tolerance and blood lipids in bran-fed patients with impaired glucose tolerance. Diabetes Care 3, 46–49.CrossRefGoogle ScholarPubMed
Bosello, O, Cominacini, L, Zocca, I, Garbin, U, Ferrari, F & Davoli, A (1984) Effects of guar gum on plasma lipoproteins and apolipoproteins C-II and C-III in patients affected by familial combined hyperlipoproteinemia. American Journal of Clinical Nutrition 40, 1165–1174.CrossRefGoogle ScholarPubMed
Brown, L, Rosner, B, Willett, W & Sacks, F (1999) Cholesterol-lowering effects of dietary fiber: a meta-analysis. American Journal of Clinical Nutrition 69, 30–42.CrossRefGoogle ScholarPubMed
Bruttomesso, D, Biolo, G, Inchiostro, S, Fongher, C, Briani, G, Duner, E, Marescotti, M, Iori, E, Tiengo, A & Tessari, P (1991) No effects of high-fiber diets on metabolic control and insulin-sensitivity in type 1 diabetic subjects. Diabetes Research and Clinical Practice 13, 15–21.CrossRefGoogle ScholarPubMed
Burkitt, DP, Walker, AR & Painte, NS (1972) Effect of dietary fibre on stools and the transit-times, and its role in the causation of disease. Lancet 2, 1408–1412.CrossRefGoogle ScholarPubMed
Collings, P, Williams, C & Macdonald, I (1981) Effects of cooking on serum glucose and insulin responses to starch. British Medical Journal 282, 1032.CrossRefGoogle ScholarPubMed
Dorn, JP, Cerny, FJ, Epstein, LH, Naughton, J, Vena, JE, Winkelstein, WJ, Schisterman, E & Trevisan, M (1999) Work and leisure time physical activity and mortality in men and women from a general population sample. Annals of Epidemiology 9, 366–373.CrossRefGoogle ScholarPubMed
Ford, E & Liu, S (1999) Glycemic index, glycemic load, and serum high-density lipoprotein (HDL) cholesterol concentration among United States adults Circulation.Google Scholar
Frost, G, Leeds, A, Trew, G, Margara, R & Dornhorst, A (1998) Insulin sensitivity in women at risk of coronary heart disease and the effect of a low glycemic diet. Metabolism 47, 1245–1251.CrossRefGoogle ScholarPubMed
Frost, G, Leeds, A, Doré, C, Madeiros, S, Brading, S & Dornhorst, A (1999) Glycaemic index as a determinant of serum HDL-cholesterol concentration. Lancet 353, 1045–1048.CrossRefGoogle ScholarPubMed
Fukagawa, N, Anderson, J, Hageman, G, Young, V & Minaker, K (1990) High-carbohydrate, high-fiber diets increase peripheral insulin sensitivity in healthy young and old adults. American Journal of Clinical Nutrition 52, 524–528.CrossRefGoogle ScholarPubMed
Granfeldt, Y, Liljeberg, H, Drews, A, Newman, R & Björck, I (1994) Glucose and insulin responses to barley products: influence of food structure and amylose–amylopectin ratio. American Journal of Clinical Nutrition 59, 1075–1082.CrossRefGoogle ScholarPubMed
Granfeldt, Y, Drews, A & Björck, I (1995) Arepas made from high amylose corn flour produce favorably low glucose and insulin responses in healthy humans. Journal of Nutrition 125, 459–465.Google ScholarPubMed
Harold, M, Reeves, R, Bolze, M, Guthrie, R & Guthrie, D (1985) Effect of dietary fiber in insulin-dependent diabetics: insulin requirements and serum lipids. Journal of the American Dietetic Association 85, 1455–1461.CrossRefGoogle ScholarPubMed
Higgins, M, D'Agostino, R, Kannel, W, Cobb, J & Pinsky, J (1993) Benefits and adverse effects of weight loss. Observations from the Framingham Study. Annals of Internal Medicine 119, 758–763.CrossRefGoogle ScholarPubMed
Hu, FB, Stampfer, MJ, Manson, JE, Rimm, E, Colditz, GA, Rosner, BA, Hennekens, CH & Willett, WC (1997) Dietary fat intake and the risk of coronary heart disease in women. New England Journal of Medicine 337, 1491–1499.CrossRefGoogle ScholarPubMed
Hu, F, Stampfer, M, Manson, J, Rimm, E, Colditz, G, Speizer, F, Hennekens, C & Willett, W (1999) Dietary protein and risk of ischemic heart disease in women. American Journal of Clinical Nutrition 70, 221–227.CrossRefGoogle ScholarPubMed
Jacobs DR, Jr, Meyer, KA, Kushi, LH & Folsom, AR (1998) Whole-grain intake may reduce the risk of ischemic heart disease death in postmenopausal women: the Iowa Women's Health Study. American Journal of Clinical Nutrition 68, 248–257.CrossRefGoogle ScholarPubMed
Järvi, A, Karlström, B, Granfeldt, Y, Björck, I, Vessby, B & Asp, N-G (1995) The influence of food structure on postprandial metabolism in patients with non-insulin-dependent diabetes mellitus. American Journal of Clinical Nutrition 61, 837–842.CrossRefGoogle ScholarPubMed
Järvi, A, Karlström, B, Granfeldt, Y, Björk, I, Asp, N-G & Vessby, B (1999) Improved glycemic control and lipid profile and normalized fibrinolytic activity on a low-glycemic index diet in type 2 diabetic patients. Diabetes Care 22, 10–18.CrossRefGoogle ScholarPubMed
Jenkins, DJA, Reynolds, D, Leeds, AR, Waller, AL & Cummings, JH (1979) Hypocholesterolemic action of dietary fiber unrelated to fecal bulking effect. American Journal of Clinical Nutrition 32, 2430–2435.CrossRefGoogle ScholarPubMed
Jenkins, DJ, Wolever, TM, Taylor, R, Barker, H, Fielden, H, Baldwin, JM, Bowling, AC, Newman, HC, Jenkins, AL & Goff, DV (1981) Glycemic index of foods: a physiological basis for carbohydrate exchange. American Journal of Clinical Nutrition 34, 362–366.CrossRefGoogle Scholar
Jenkins, DJ, Wesson, V, Wolever, TM, Jenkins, AL, Kalmusky, J, Guidici, S, Csima, A, Josse, RG & Wong, GS (1988) Wholemeal versus wholegrain breads: proportion of whole or cracked grain and the glycaemic response. British Medical Journal 297, 958–960.CrossRefGoogle ScholarPubMed
Jenkins, DJ, Wolever, TM, Vuksan, V, Brighenti, F, Cunnane, SC, Rao, AV, Jenkins, AL, Buckley, G, Patten, R, Singer, W, Corey, P & Josse, RG (1989) Nibbling versus gorging: metabolic advantages of increased meal frequency. New England Journal of Medicine 321, 929–934.CrossRefGoogle ScholarPubMed
Jenkins, D, Wolever, T, Rao, A, Hegele, R, Mitchell, S, Ransom, T, Boctor, D, Spadafora, P, Jenkins, A, Mehling, C, Katzman-Relle, L, Connelly, P, Story, J, Furumoto, E, Corey, P & Würsch, P (1993) Effect on blood lipids of very high intakes of fiber in diets low in saturated fat and cholesterol. New England Journal of Medicine 329, 21–26.Google ScholarPubMed
Jenkins, D, Kendall, C, Vuksan, V, Augustin, L, Mehling, C, Parker, T, Vidgen, E, Lee, B, Faulkner, D, Seyler, H, Josse, R, Leiter, L, Connelly, P & Fulgoni, III V (1999) Effect of wheat bran on serum lipids: influence of particle size and wheat protein. Journal of the American College of Nutrition 18, 159–165.CrossRefGoogle ScholarPubMed
Karlström, B, Vessby, B, Asp, N, Boberg, M, Gustafsson, I, Lithell, H & Werner, I (1984) Effects of an increased content of cereal fiber in the diet of type 2 (non-insulin-dependent) diabetic patients. Diabetologia 26, 272–277.CrossRefGoogle ScholarPubMed
Landin, K, Holm, G, Tengborn, L & Smith, U (1992) Guar gum improves insulin sensitivity, blood lipids, blood pressure, and fibrinolysis in healthy men. American Journal of Clinical Nutrition 56, 1061–1065.CrossRefGoogle ScholarPubMed
Levi, F, Pasche, C, LaVecchia, C, Lucchini, F & Franceschi, S (1999) Food groups and colorectal cancer risk. British Journal of Cancer 79, 1283–1287.CrossRefGoogle ScholarPubMed
Lichtenstein, A (1998) Soy protein, isoflavones and cardiovascular disease risk. Journal of Nutrition 128, 1589–1592.CrossRefGoogle ScholarPubMed
Liljeberg, H, Granfeldt, Y & Björck, I (1992) Metabolic responses to starch in bread containing intact kernels versus milled flour. European Journal of Clinical Nutrition 46, 561–575.Google ScholarPubMed
Liljeberg, H, Granfeldt, Y & Björck, I (1996) Products based on a high fiber barley genotype, but not on common barley or oats, lower postprandial glucose and insulin responses in healthy humans. Journal of Nutrition 126, 458–466.CrossRefGoogle ScholarPubMed
Liu, S, Willett, W & Stampfer, M et al. (1998) A prospective study of dietary glycemic load, carbohydrate and risk of coronary heart disease in US women. Federation of American Societies for Experimental Biology 12, A260.Google Scholar
Liu, S, Stampfer, M, Hu, F, Giovannucci, E, Rimm, E, Manson, J, Hennekens, C & Willett, W (1999) Whole-grain consumption and risk of coronary heart disease: results from the Nurses' Health Study. American Journal of Clinical Nutrition 70, 412–419.CrossRefGoogle ScholarPubMed
Ludwig, D, Majzoub, J, Al-Zahrani, A, Dallal, G, Blanco, I & Roberts, S (1999) High glycemic index foods, overeating, and obesity. Pediatrics 103, E26.CrossRefGoogle ScholarPubMed
Luscombe, N, Noakes, M & Clifton, P (1999) Diets high and low in glycemic index versus high monounsaturated fat diets: effects on glucose and lipid metabolism in NIDDM. European Journal of Clinical Nutrition 53, 473–478.CrossRefGoogle ScholarPubMed
Manson, JE, Hu, FB, Rich-Edwards, JW, Colditz, GA, Stampfer, MJ, Willett, WC, Speizer, FE & Hennekens, CH (1999) A prospective study of walking as compared with vigorous exercise in the prevention of coronary heart disease in women. New England Journal of Medicine 341, 650–658.CrossRefGoogle ScholarPubMed
Powell, JT, Franks, PJ & Poulter, NR (1999) Does nibbling or grazing protect the peripheral arteries from atherosclerosis? Journal of Cardiovascular Risk 6, 19–22.CrossRefGoogle ScholarPubMed
Rimm, E, Aschemrio, A, Giovannucci, E, Spiegelman, D, Stampfer, M & Willet, W (1994) Vegetable, fruit, and cereal fiber intake and risk of coronary heart disease among men. Journal of the American Medical Association 275, 447–451.CrossRefGoogle Scholar
Ross, SW, Brand, JC, Thorburn, AW & Truswell, AS (1987) Glycemic index of processed wheat products. American Journal of Clinical Nutrition 46, 631–635.CrossRefGoogle ScholarPubMed
Salmeron, J, Ascherio, A, Rimm, EB, Colditz, GA, Spiegelman, D, Stampfer, MJ, Wing, AL & Willett, WC (1997 a) Dietary fiber, glycemic load, and risk of NIDDM in men. Diabetes Care 20, 545–550.CrossRefGoogle ScholarPubMed
Salmeron, J, Manson, JE, Stampfer, MJ, Colditz, GA, Wing, AL & Willett, WC (1997 b) Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. Journal of the American Medical Association 277, 472–477.CrossRefGoogle ScholarPubMed
Stilling, B, Mehlsen, J, Hamberg, O, Larsen, JJ, Gram, NC & Madsbad, S (1999) Effect of a new starch-free bread on metabolic control in NIDDM patients. Nutrition, Metabolism and Cardiovascular Diseases 9, 98–101.Google ScholarPubMed
Tagliaferro, V, Cassader, M, Bozzo, C, Pisu, E, Bruno, A, Marena, S, Cavallo-Perin, P, Cravero, L & Pagano, G (1985) Moderate guar-gum addition to usual diet improves peripheral sensitivity to insulin and lipaemic profile in NIDDM. Diabetes Metabolism 11, 380–385.Google ScholarPubMed
Torsdottir, I, Alpsten, M, Andersson, H & Einarsson, S (1989) Dietary guar gum effects on postprandial blood glucose, insulin and hydroxyproline in humans. Journal of Nutrition 119, 1925–1931.CrossRefGoogle ScholarPubMed
Trowell, H (1978) Diabetes mellitus and dietary fiber of starchy foods. American Journal of Clinical Nutrition 31, S53-S57.CrossRefGoogle ScholarPubMed
Virkamäki, A, Ueki, K & Kahn, C (1999) Protein–protein interaction in insulin signaling and the molecular mechanisms of insulin resistance. Journal of Clinical Investigation 103, 931–943.CrossRefGoogle ScholarPubMed
Wolk, A, Manson, J, Stampfer, M, Colditz, G, Hu, F, Speizer, F, Hennekens, C & Willett, WC (1999) Long-term intake of dietary fiber and decreased risk of coronary heart disease among women. Journal of the American Medical Association 281, 1998–2004.CrossRefGoogle ScholarPubMed