Effect of Dietary Fibre on Glucose Control and Serum Lipoproteins in Diabetic Patients

Rivellese, Angela Albarosa; Giacco, Antonia; Genovese, Salvatore; Riccardi, Gabriele; Pacioni, D.; Mattioli, P L; Mancini, Mario

doi:10.1016/s0140-6736(80)91886-3

Cited by 160 publications

(59 citation statements)

References 14 publications

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“…This was the major reason for using ileostomists. Two diets were used with respect to the content of the dietary fibre complex (with and without rye bran) since various fibre sources also are known to have different metabolic effects (Rivellese et al, 1980;Simpson et al, 1981;Berglund et al, 1982;Anderson et al, 1987;Salmeron et al, 1997).…”

Section: Discussionmentioning

confidence: 99%

“…In medium-to long-term studies (from 2 to 12 weeks), reviewed by Miller (1994) and a study by Fontvieille et al (1992), low glycemic-index diets appear to reduce urinary C-peptide excretion in diabetic subjects and normal volunteers and lower concentrations of fructosamine and/or glycosylated haemoglobin (HbA 1C ). A corresponding beneficial effect of high-fibre diets (HFDs) has been observed for prevention of diabetes or in non-insulin dependent diabetes mellitus patients (Rivellese et al, 1980;Simpson et al, 1981;Anderson et al, 1987;Salmeron et al, 1997) and animals (Berglund et al, 1982). In fact, until today, an HFD has been associated with a decreased risk of diabetes in seven prospective studies (Liu, 2003).…”

Section: Introductionmentioning

confidence: 99%

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Effects of meal frequency and high-fibre rye-bread diet on glucose and lipid metabolism and ileal excretion of energy and sterols in ileostomy subjects

et al. 2004

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Objective: To investigate the effect of a rye, high-fibre diet (HFD) vs a wheat, low-fibre diet (LFD), meal frequency, nibbling (Nib, seven times a day) or ordinary (Ord, three times a day), and their combined effects on blood glucose, insulin, lipids, urinary C-peptide and ileal excretion of energy, cholesterol and bile acids in humans. Design: LFD period with Nib or Ord meal frequency followed by an HFD diet with Nib or Ord meal frequency in randomized, crossover design. Setting: Outpatients of ileostomy volunteers were called for an investigation in research word. Subjects: A total of 10 subjects (two female subjects, age 34 and 51 y; eight males, mean age 54.4 y, range 43-65 y) participated in the experiment. All subjects were proctocolectomized for ulcerative colitis (mean 16.0 y, range 8-29 y before the study). Intervention: In total, 10 ileostomy subjects started with LFD for 2 weeks, the first week on either Nib (five subjects) or Ord (five subjects) and the second week on the other meal frequencies, in a crossover design, followed by a wash-out week, and continued with HFD period for 2 weeks in the same meal frequency manner. All foods consumed in both Nib or Ord regimens were identical and a high-fibre rye bread was used in the HFD period and a low-fibre wheat bread in the LFD period. Main outcome measures: Day-profiles of blood glucose, insulin and lipids, blood lipids before and after dietary intervention, and excretion of steroids in the effluents and C-peptide in the urine. Results: During the Nib regimen, plasma glucose and insulin peaks were lower at the end of the day with HFD compared with LFD. Urinary C-peptide excretion was significantly higher in the day-time on LFD compared with HFD (LFD-Ord vs HFD-Ord, Po0.01; LFD-Nib vs HFD-Nib, Po0.01). Plasma free-cholesterol, total cholesterol, triglycerides and phospholipids were significantly higher (Po0.05) after LFD than after HFD with the Nib regimen. A higher excretion of energy (Po0.05) and chenodeoxycholic acid (Po0.05) were observed with HFD compared with LFD regardless of meal frequency. A higher daily excretion of cholic acid, total bile acids, cholesterol, net cholesterol and net sterols (Po0.05) was observed on HFD compared with LFD with the Nib regimen. Conclusions: An HFD decreased insulin secretion measured as a decreased excretion of C-peptide in urine and as decreased plasma insulin peaks at the end of the day during a Nib regimen. The smoother glycaemic responses at the end of the day during a Nib regimen may be a consequence of a second meal phenomenon, possibly related to the nature of dietary fibre complex. Contributors: EAL and JXZ were responsible for the study design, conducting the dietary intervention, completing the statistical analysis and writing the paper. PT was responsible for the study design and conducting the dietary intervention of the study. DL was involved in the advisory of writing the paper and the analysis of the blood lipids. PÅ was involved in the concept and planning, and the analysis of the nutrients in the...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of meal frequency and high-fibre rye-bread diet on glucose and lipid metabolism and ileal excretion of energy and sterols in ileostomy subjects

et al. 2004

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“…The comparisons of beans with other foods indicate that the beneficial effects seen when leguminous seeds have been included in diets for diabetics [5,10,11] may be explained by the flatter blood glucose responses they produce. Much of the original interest in beans was stimulated by the use of the bean fibre, guar, in the treatment of diabetes [12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

“…Each individual used in the gtycaemic index study (except patient 8) took the standard bread and cottage cheese meal on more than one occasion, the mean being once for every six other foods tested (range 4-9). The data on the three individuals (subjects [10][11][12] who were studied at a later date but were not able to be included in the glycaemic index comparison, were used in the subsequent comparison of legumes with the other starchy foods.…”

Section: Methodsmentioning

confidence: 99%

“…However, in the context of high fibre diets this does not appear to be the case [5]. Indeed studies using purified fibre and high-fibre, high-carbohydrate diets have been associated with improved diabetic control [9][10][11][12][13][14][15]. Nevertheless, the carbohydrate foods of greatest potential use to the diabetic have not as yet been defined and it has now been acknowledged that information on the glycaemic effect of individual foods and meals is urgently needed [3].…”

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confidence: 99%

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The glycaemic index of foods tested in diabetic patients: A new basis for carbohydrate exchange favouring the use of legumes

et al. 1983

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Summary. Recently diabetic patients have been encouraged to increase their carbohydrate intake, but exact details of which foods to use are lacking. To determine whether sufficiently large differences existed to justify more specific dietary advice, we compared the glycaemic responses to 50 g carbohydrate portions of different foods, taken as breakfast test meals by groups of five to seven diabetic patients. Two-to threefold differences were seen amongst the 15 foods tested. The glycaemic responses for spaghetti, 'All-bran', rice and beans were significantly below those for bread, while 'Cornflakes' were above. Factors predicted to influence this were without effect, including: substituting wholemeal for white bread, increasing substantially the simple sugars (using 'All-bran' or bananas instead of wholemeal bread) and doubling meal protein by adding cottage cheese to bread. Paired comparisons of the glycaemic response to the five legumes with those of the seven other starchy foods (breads, spaghetti, rice, Cornflakes, oatmeal porridge and potatoes) showed that the mean peak rise in blood glucose concentration and mean area under the glucose curve after beans were 23 and 28% lower, respectively, than the mean for the other foods (p < 0.001). Such results suggest a potentially valuable role for dried leguminous seeds in carbohydrate exchanges for individuals with impaired carbohydrate tolerance. These large differences in the blood glucose response to different food cannot at present be predicted directly from tables of chemical composition. Nevertheless, physiological testing may both aid in understanding the factors responsible and help selection of the appropriate carbohydrate foods for the diabetic diet.Key words: Glycaemic index, leguminous seeds, low blood glucose rise, diabetes, diabetic diet, fat, sugars, protein.To lessen the risk to the diabetic of carciovascular disease, current dietary guidelines of the American [1] and Canadian [2] Diabetes Associations and the British Diabetic Association [3] have recommended increasing complex carbohydrate and fibre intakes, while reducing fat consumption. Exactly how this should be achieved is not known and there are fears that increased intake of specific foods, or carbohydrates in general, may worsen diabetic control [4]. However, in the context of high fibre diets this does not appear to be the case [5]. Indeed studies using purified fibre and high-fibre, high-carbohydrate diets have been associated with improved diabetic control [9][10][11][12][13][14][15]. Nevertheless, the carbohydrate foods of greatest potential use to the diabetic have not as yet been defined and it has now been acknowledged that information on the glycaemic effect of individual foods and meals is urgently needed [3].We have therefore compared the effect of taking 50 g carbohydrate portions of 15 different foods on the blood glucose responses of diabetic patients. We wished to determine whether large differences existed which favoured the use of particular foods. It was also important to s...

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Diet and Diabetes

Gaby¹

1981

JAMA

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Effect of Dietary Fibre on Glucose Control and Serum Lipoproteins in Diabetic Patients

Cited by 160 publications

References 14 publications

Effects of meal frequency and high-fibre rye-bread diet on glucose and lipid metabolism and ileal excretion of energy and sterols in ileostomy subjects

Effects of meal frequency and high-fibre rye-bread diet on glucose and lipid metabolism and ileal excretion of energy and sterols in ileostomy subjects

The glycaemic index of foods tested in diabetic patients: A new basis for carbohydrate exchange favouring the use of legumes

Diet and Diabetes

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