Dietary fibre and whole grains in diabetes management: Systematic review and meta-analyses
Fibre is promoted as part of a healthy dietary pattern and in diabetes management. We have considered the role of high-fibre diets on mortality and increasing fibre intake on glycaemic control and other cardiometabolic risk factors of adults with prediabetes or diabetes. We conducted a systematic re...
Gespeichert in:
| Veröffentlicht in: | PLoS medicine 2020-03, Vol.17 (3), p.e1003053 |
|---|---|
| Hauptverfasser: | , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 3 |
| container_start_page | e1003053 |
| container_title | PLoS medicine |
| container_volume | 17 |
| creator | Reynolds, Andrew N Akerman, Ashley P Mann, Jim |
| description | Fibre is promoted as part of a healthy dietary pattern and in diabetes management. We have considered the role of high-fibre diets on mortality and increasing fibre intake on glycaemic control and other cardiometabolic risk factors of adults with prediabetes or diabetes.
We conducted a systematic review of published literature to identify prospective studies or controlled trials that have examined the effects of a higher fibre intake without additional dietary or other lifestyle modification in adults with prediabetes, gestational diabetes, type 1 diabetes, and type 2 diabetes. Meta-analyses were undertaken to determine the effects of higher fibre intake on all-cause and cardiovascular mortality and increasing fibre intake on glycaemic control and a range of cardiometabolic risk factors. For trials, meta regression analyses identified further variables that influenced the pooled findings. Dose response testing was undertaken; Grading of Recommendations Assessment, Development and Evaluation (GRADE) protocols were followed to assess the quality of evidence. Two multicountry cohorts of 8,300 adults with type 1 or type 2 diabetes followed on average for 8.8 years and 42 trials including 1,789 adults with prediabetes, type 1, or type 2 diabetes were identified. Prospective cohort data indicate an absolute reduction of 14 fewer deaths (95% confidence interval (CI) 4-19) per 1,000 participants over the study duration, when comparing a daily dietary fibre intake of 35 g with the average intake of 19 g, with a clear dose response relationship apparent. Increased fibre intakes reduced glycated haemoglobin (HbA1c; mean difference [MD] -2.00 mmol/mol, 95% CI -3.30 to -0.71 from 33 trials), fasting plasma glucose (MD -0.56 mmol/L, 95% CI -0.73 to -0.38 from 34 trials), insulin (standardised mean difference [SMD] -2.03, 95% CI -2.92 to -1.13 from 19 trials), homeostatic model assessment of insulin resistance (HOMA IR; MD -1.24 mg/dL, 95% CI -1.72 to -0.76 from 9 trials), total cholesterol (MD -0.34 mmol/L, 95% CI -0.46 to -0.22 from 27 trials), low-density lipoprotein (LDL) cholesterol (MD -0.17 mmol/L, 95% CI -0.27 to -0.08 from 21 trials), triglycerides (MD -0.16 mmol/L, 95% CI -0.23 to -0.09 from 28 trials), body weight (MD -0.56 kg, 95% CI -0.98 to -0.13 from 18 trials), Body Mass Index (BMI; MD -0.36, 95% CI -0·55 to -0·16 from 14 trials), and C-reactive protein (SMD -2.80, 95% CI -4.52 to -1.09 from 7 trials) when compared with lower fibre diets. All trial analys |
| doi_str_mv | 10.1371/journal.pmed.1003053 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_plos_</sourceid><recordid>TN_cdi_plos_journals_2460794409</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_82529aa95a394b5da604ce288abe433b</doaj_id><sourcerecordid>2460794409</sourcerecordid><originalsourceid>FETCH-LOGICAL-c577t-41880b4d29d2dadc159a263ff5a4ec39f3f04cfe50e9d36635fea1452120ffcf3</originalsourceid><addsrcrecordid>eNptUk1v1DAUjBCIlsI_QBCJC5cs_kxiDkiofFWqxAG4cLFe7OetV0682NlW--9xu2nVIk627Jl5nvFU1UtKVpR39N0m7tIEYbUd0a4oIZxI_qg6plKohrZd-_je_qh6lvOGEKaIIk-rI86oYJKS4-r3J48zpH3t_JCwhsnWVxcxYL1O4Kdc-6m2HgacMdcjTLDGEaf5ff1jn2ccYfamTnjp8eqGOhatpqDCPmN-Xj1xEDK-WNaT6teXzz9PvzXn37-enX48b4zsurkRtO_JICxTllmwhkoFrOXOSRBouHLcEWEcSoLK8rbl0iFQIRllxDnj-En1-qC7DTHrJZasmWhJp4QgqiDODggbYaO3yY_FsY7g9c1BTGsNqVgJqHsmmQJQErgSg7TQluHI-r5kIDgfitaHZdpuKMmbkkaC8ED04c3kL_Q6XuqOSKVIVwTeLgIp_tlhnvXos8EQYMK4K-_mneDl56Qs0Df_QP_vThxQJsWcE7q7x1Cir6tyy9LXVdFLVQrt1X0jd6TbbvC_W2e9cA</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2460794409</pqid></control><display><type>article</type><title>Dietary fibre and whole grains in diabetes management: Systematic review and meta-analyses</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Public Library of Science (PLoS)</source><source>PubMed Central</source><creator>Reynolds, Andrew N ; Akerman, Ashley P ; Mann, Jim</creator><contributor>Ma, Ronald Ching Wan</contributor><creatorcontrib>Reynolds, Andrew N ; Akerman, Ashley P ; Mann, Jim ; Ma, Ronald Ching Wan</creatorcontrib><description>Fibre is promoted as part of a healthy dietary pattern and in diabetes management. We have considered the role of high-fibre diets on mortality and increasing fibre intake on glycaemic control and other cardiometabolic risk factors of adults with prediabetes or diabetes.
We conducted a systematic review of published literature to identify prospective studies or controlled trials that have examined the effects of a higher fibre intake without additional dietary or other lifestyle modification in adults with prediabetes, gestational diabetes, type 1 diabetes, and type 2 diabetes. Meta-analyses were undertaken to determine the effects of higher fibre intake on all-cause and cardiovascular mortality and increasing fibre intake on glycaemic control and a range of cardiometabolic risk factors. For trials, meta regression analyses identified further variables that influenced the pooled findings. Dose response testing was undertaken; Grading of Recommendations Assessment, Development and Evaluation (GRADE) protocols were followed to assess the quality of evidence. Two multicountry cohorts of 8,300 adults with type 1 or type 2 diabetes followed on average for 8.8 years and 42 trials including 1,789 adults with prediabetes, type 1, or type 2 diabetes were identified. Prospective cohort data indicate an absolute reduction of 14 fewer deaths (95% confidence interval (CI) 4-19) per 1,000 participants over the study duration, when comparing a daily dietary fibre intake of 35 g with the average intake of 19 g, with a clear dose response relationship apparent. Increased fibre intakes reduced glycated haemoglobin (HbA1c; mean difference [MD] -2.00 mmol/mol, 95% CI -3.30 to -0.71 from 33 trials), fasting plasma glucose (MD -0.56 mmol/L, 95% CI -0.73 to -0.38 from 34 trials), insulin (standardised mean difference [SMD] -2.03, 95% CI -2.92 to -1.13 from 19 trials), homeostatic model assessment of insulin resistance (HOMA IR; MD -1.24 mg/dL, 95% CI -1.72 to -0.76 from 9 trials), total cholesterol (MD -0.34 mmol/L, 95% CI -0.46 to -0.22 from 27 trials), low-density lipoprotein (LDL) cholesterol (MD -0.17 mmol/L, 95% CI -0.27 to -0.08 from 21 trials), triglycerides (MD -0.16 mmol/L, 95% CI -0.23 to -0.09 from 28 trials), body weight (MD -0.56 kg, 95% CI -0.98 to -0.13 from 18 trials), Body Mass Index (BMI; MD -0.36, 95% CI -0·55 to -0·16 from 14 trials), and C-reactive protein (SMD -2.80, 95% CI -4.52 to -1.09 from 7 trials) when compared with lower fibre diets. All trial analyses were subject to high heterogeneity. Key variables beyond increasing fibre intake were the fibre intake at baseline, the global region where the trials were conducted, and participant inclusion criteria other than diabetes type. Potential limitations were the lack of prospective cohort data in non-European countries and the lack of long-term (12 months or greater) controlled trials of increasing fibre intakes in adults with diabetes.
Higher-fibre diets are an important component of diabetes management, resulting in improvements in measures of glycaemic control, blood lipids, body weight, and inflammation, as well as a reduction in premature mortality. These benefits were not confined to any fibre type or to any type of diabetes and were apparent across the range of intakes, although greater improvements in glycaemic control were observed for those moving from low to moderate or high intakes. Based on these findings, increasing daily fibre intake by 15 g or to 35 g might be a reasonable target that would be expected to reduce risk of premature mortality in adults with diabetes.</description><identifier>ISSN: 1549-1676</identifier><identifier>ISSN: 1549-1277</identifier><identifier>EISSN: 1549-1676</identifier><identifier>DOI: 10.1371/journal.pmed.1003053</identifier><identifier>PMID: 32142510</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Bias ; Biology and Life Sciences ; Blood pressure ; Body mass index ; Body weight ; C-reactive protein ; Carbohydrates ; Cardiovascular disease ; Cardiovascular diseases ; Cholesterol ; Cohort analysis ; Diabetes mellitus (insulin dependent) ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 1 - diagnosis ; Diabetes Mellitus, Type 1 - diet therapy ; Diabetes Mellitus, Type 1 - mortality ; Diabetes Mellitus, Type 2 - diagnosis ; Diabetes Mellitus, Type 2 - diet therapy ; Diabetes Mellitus, Type 2 - mortality ; Diet, Diabetic - adverse effects ; Diet, Diabetic - mortality ; Diet, Healthy - adverse effects ; Diet, Healthy - mortality ; Dietary fiber ; Dietary Fiber - administration & dosage ; Dietary Fiber - adverse effects ; Dietary intake ; Drug dosages ; Gestational diabetes ; Glucose ; Hemoglobin ; Humans ; Insulin ; Insulin resistance ; Lipids ; Low density lipoprotein ; Medicine and Health Sciences ; Mortality ; Nutrition research ; Nutritive Value ; Physical Sciences ; Protective Factors ; Recommended Dietary Allowances ; Regression analysis ; Research and Analysis Methods ; Risk Assessment ; Risk Factors ; Risk Reduction Behavior ; Systematic review ; Time Factors ; Treatment Outcome ; Triglycerides ; Whole Grains - adverse effects</subject><ispartof>PLoS medicine, 2020-03, Vol.17 (3), p.e1003053</ispartof><rights>2020 Reynolds et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Reynolds et al 2020 Reynolds et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c577t-41880b4d29d2dadc159a263ff5a4ec39f3f04cfe50e9d36635fea1452120ffcf3</citedby><cites>FETCH-LOGICAL-c577t-41880b4d29d2dadc159a263ff5a4ec39f3f04cfe50e9d36635fea1452120ffcf3</cites><orcidid>0000-0001-8952-3892</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7059907/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7059907/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32142510$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Ma, Ronald Ching Wan</contributor><creatorcontrib>Reynolds, Andrew N</creatorcontrib><creatorcontrib>Akerman, Ashley P</creatorcontrib><creatorcontrib>Mann, Jim</creatorcontrib><title>Dietary fibre and whole grains in diabetes management: Systematic review and meta-analyses</title><title>PLoS medicine</title><addtitle>PLoS Med</addtitle><description>Fibre is promoted as part of a healthy dietary pattern and in diabetes management. We have considered the role of high-fibre diets on mortality and increasing fibre intake on glycaemic control and other cardiometabolic risk factors of adults with prediabetes or diabetes.
We conducted a systematic review of published literature to identify prospective studies or controlled trials that have examined the effects of a higher fibre intake without additional dietary or other lifestyle modification in adults with prediabetes, gestational diabetes, type 1 diabetes, and type 2 diabetes. Meta-analyses were undertaken to determine the effects of higher fibre intake on all-cause and cardiovascular mortality and increasing fibre intake on glycaemic control and a range of cardiometabolic risk factors. For trials, meta regression analyses identified further variables that influenced the pooled findings. Dose response testing was undertaken; Grading of Recommendations Assessment, Development and Evaluation (GRADE) protocols were followed to assess the quality of evidence. Two multicountry cohorts of 8,300 adults with type 1 or type 2 diabetes followed on average for 8.8 years and 42 trials including 1,789 adults with prediabetes, type 1, or type 2 diabetes were identified. Prospective cohort data indicate an absolute reduction of 14 fewer deaths (95% confidence interval (CI) 4-19) per 1,000 participants over the study duration, when comparing a daily dietary fibre intake of 35 g with the average intake of 19 g, with a clear dose response relationship apparent. Increased fibre intakes reduced glycated haemoglobin (HbA1c; mean difference [MD] -2.00 mmol/mol, 95% CI -3.30 to -0.71 from 33 trials), fasting plasma glucose (MD -0.56 mmol/L, 95% CI -0.73 to -0.38 from 34 trials), insulin (standardised mean difference [SMD] -2.03, 95% CI -2.92 to -1.13 from 19 trials), homeostatic model assessment of insulin resistance (HOMA IR; MD -1.24 mg/dL, 95% CI -1.72 to -0.76 from 9 trials), total cholesterol (MD -0.34 mmol/L, 95% CI -0.46 to -0.22 from 27 trials), low-density lipoprotein (LDL) cholesterol (MD -0.17 mmol/L, 95% CI -0.27 to -0.08 from 21 trials), triglycerides (MD -0.16 mmol/L, 95% CI -0.23 to -0.09 from 28 trials), body weight (MD -0.56 kg, 95% CI -0.98 to -0.13 from 18 trials), Body Mass Index (BMI; MD -0.36, 95% CI -0·55 to -0·16 from 14 trials), and C-reactive protein (SMD -2.80, 95% CI -4.52 to -1.09 from 7 trials) when compared with lower fibre diets. All trial analyses were subject to high heterogeneity. Key variables beyond increasing fibre intake were the fibre intake at baseline, the global region where the trials were conducted, and participant inclusion criteria other than diabetes type. Potential limitations were the lack of prospective cohort data in non-European countries and the lack of long-term (12 months or greater) controlled trials of increasing fibre intakes in adults with diabetes.
Higher-fibre diets are an important component of diabetes management, resulting in improvements in measures of glycaemic control, blood lipids, body weight, and inflammation, as well as a reduction in premature mortality. These benefits were not confined to any fibre type or to any type of diabetes and were apparent across the range of intakes, although greater improvements in glycaemic control were observed for those moving from low to moderate or high intakes. Based on these findings, increasing daily fibre intake by 15 g or to 35 g might be a reasonable target that would be expected to reduce risk of premature mortality in adults with diabetes.</description><subject>Bias</subject><subject>Biology and Life Sciences</subject><subject>Blood pressure</subject><subject>Body mass index</subject><subject>Body weight</subject><subject>C-reactive protein</subject><subject>Carbohydrates</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Cholesterol</subject><subject>Cohort analysis</subject><subject>Diabetes mellitus (insulin dependent)</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 1 - diagnosis</subject><subject>Diabetes Mellitus, Type 1 - diet therapy</subject><subject>Diabetes Mellitus, Type 1 - mortality</subject><subject>Diabetes Mellitus, Type 2 - diagnosis</subject><subject>Diabetes Mellitus, Type 2 - diet therapy</subject><subject>Diabetes Mellitus, Type 2 - mortality</subject><subject>Diet, Diabetic - adverse effects</subject><subject>Diet, Diabetic - mortality</subject><subject>Diet, Healthy - adverse effects</subject><subject>Diet, Healthy - mortality</subject><subject>Dietary fiber</subject><subject>Dietary Fiber - administration & dosage</subject><subject>Dietary Fiber - adverse effects</subject><subject>Dietary intake</subject><subject>Drug dosages</subject><subject>Gestational diabetes</subject><subject>Glucose</subject><subject>Hemoglobin</subject><subject>Humans</subject><subject>Insulin</subject><subject>Insulin resistance</subject><subject>Lipids</subject><subject>Low density lipoprotein</subject><subject>Medicine and Health Sciences</subject><subject>Mortality</subject><subject>Nutrition research</subject><subject>Nutritive Value</subject><subject>Physical Sciences</subject><subject>Protective Factors</subject><subject>Recommended Dietary Allowances</subject><subject>Regression analysis</subject><subject>Research and Analysis Methods</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Risk Reduction Behavior</subject><subject>Systematic review</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Triglycerides</subject><subject>Whole Grains - adverse effects</subject><issn>1549-1676</issn><issn>1549-1277</issn><issn>1549-1676</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNptUk1v1DAUjBCIlsI_QBCJC5cs_kxiDkiofFWqxAG4cLFe7OetV0682NlW--9xu2nVIk627Jl5nvFU1UtKVpR39N0m7tIEYbUd0a4oIZxI_qg6plKohrZd-_je_qh6lvOGEKaIIk-rI86oYJKS4-r3J48zpH3t_JCwhsnWVxcxYL1O4Kdc-6m2HgacMdcjTLDGEaf5ff1jn2ccYfamTnjp8eqGOhatpqDCPmN-Xj1xEDK-WNaT6teXzz9PvzXn37-enX48b4zsurkRtO_JICxTllmwhkoFrOXOSRBouHLcEWEcSoLK8rbl0iFQIRllxDnj-En1-qC7DTHrJZasmWhJp4QgqiDODggbYaO3yY_FsY7g9c1BTGsNqVgJqHsmmQJQErgSg7TQluHI-r5kIDgfitaHZdpuKMmbkkaC8ED04c3kL_Q6XuqOSKVIVwTeLgIp_tlhnvXos8EQYMK4K-_mneDl56Qs0Df_QP_vThxQJsWcE7q7x1Cir6tyy9LXVdFLVQrt1X0jd6TbbvC_W2e9cA</recordid><startdate>20200301</startdate><enddate>20200301</enddate><creator>Reynolds, Andrew N</creator><creator>Akerman, Ashley P</creator><creator>Mann, Jim</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><scope>CZK</scope><orcidid>https://orcid.org/0000-0001-8952-3892</orcidid></search><sort><creationdate>20200301</creationdate><title>Dietary fibre and whole grains in diabetes management: Systematic review and meta-analyses</title><author>Reynolds, Andrew N ; Akerman, Ashley P ; Mann, Jim</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c577t-41880b4d29d2dadc159a263ff5a4ec39f3f04cfe50e9d36635fea1452120ffcf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Bias</topic><topic>Biology and Life Sciences</topic><topic>Blood pressure</topic><topic>Body mass index</topic><topic>Body weight</topic><topic>C-reactive protein</topic><topic>Carbohydrates</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Cholesterol</topic><topic>Cohort analysis</topic><topic>Diabetes mellitus (insulin dependent)</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 1 - diagnosis</topic><topic>Diabetes Mellitus, Type 1 - diet therapy</topic><topic>Diabetes Mellitus, Type 1 - mortality</topic><topic>Diabetes Mellitus, Type 2 - diagnosis</topic><topic>Diabetes Mellitus, Type 2 - diet therapy</topic><topic>Diabetes Mellitus, Type 2 - mortality</topic><topic>Diet, Diabetic - adverse effects</topic><topic>Diet, Diabetic - mortality</topic><topic>Diet, Healthy - adverse effects</topic><topic>Diet, Healthy - mortality</topic><topic>Dietary fiber</topic><topic>Dietary Fiber - administration & dosage</topic><topic>Dietary Fiber - adverse effects</topic><topic>Dietary intake</topic><topic>Drug dosages</topic><topic>Gestational diabetes</topic><topic>Glucose</topic><topic>Hemoglobin</topic><topic>Humans</topic><topic>Insulin</topic><topic>Insulin resistance</topic><topic>Lipids</topic><topic>Low density lipoprotein</topic><topic>Medicine and Health Sciences</topic><topic>Mortality</topic><topic>Nutrition research</topic><topic>Nutritive Value</topic><topic>Physical Sciences</topic><topic>Protective Factors</topic><topic>Recommended Dietary Allowances</topic><topic>Regression analysis</topic><topic>Research and Analysis Methods</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Risk Reduction Behavior</topic><topic>Systematic review</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Triglycerides</topic><topic>Whole Grains - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Reynolds, Andrew N</creatorcontrib><creatorcontrib>Akerman, Ashley P</creatorcontrib><creatorcontrib>Mann, Jim</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><collection>PLoS Medicine</collection><jtitle>PLoS medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Reynolds, Andrew N</au><au>Akerman, Ashley P</au><au>Mann, Jim</au><au>Ma, Ronald Ching Wan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dietary fibre and whole grains in diabetes management: Systematic review and meta-analyses</atitle><jtitle>PLoS medicine</jtitle><addtitle>PLoS Med</addtitle><date>2020-03-01</date><risdate>2020</risdate><volume>17</volume><issue>3</issue><spage>e1003053</spage><pages>e1003053-</pages><issn>1549-1676</issn><issn>1549-1277</issn><eissn>1549-1676</eissn><abstract>Fibre is promoted as part of a healthy dietary pattern and in diabetes management. We have considered the role of high-fibre diets on mortality and increasing fibre intake on glycaemic control and other cardiometabolic risk factors of adults with prediabetes or diabetes.
We conducted a systematic review of published literature to identify prospective studies or controlled trials that have examined the effects of a higher fibre intake without additional dietary or other lifestyle modification in adults with prediabetes, gestational diabetes, type 1 diabetes, and type 2 diabetes. Meta-analyses were undertaken to determine the effects of higher fibre intake on all-cause and cardiovascular mortality and increasing fibre intake on glycaemic control and a range of cardiometabolic risk factors. For trials, meta regression analyses identified further variables that influenced the pooled findings. Dose response testing was undertaken; Grading of Recommendations Assessment, Development and Evaluation (GRADE) protocols were followed to assess the quality of evidence. Two multicountry cohorts of 8,300 adults with type 1 or type 2 diabetes followed on average for 8.8 years and 42 trials including 1,789 adults with prediabetes, type 1, or type 2 diabetes were identified. Prospective cohort data indicate an absolute reduction of 14 fewer deaths (95% confidence interval (CI) 4-19) per 1,000 participants over the study duration, when comparing a daily dietary fibre intake of 35 g with the average intake of 19 g, with a clear dose response relationship apparent. Increased fibre intakes reduced glycated haemoglobin (HbA1c; mean difference [MD] -2.00 mmol/mol, 95% CI -3.30 to -0.71 from 33 trials), fasting plasma glucose (MD -0.56 mmol/L, 95% CI -0.73 to -0.38 from 34 trials), insulin (standardised mean difference [SMD] -2.03, 95% CI -2.92 to -1.13 from 19 trials), homeostatic model assessment of insulin resistance (HOMA IR; MD -1.24 mg/dL, 95% CI -1.72 to -0.76 from 9 trials), total cholesterol (MD -0.34 mmol/L, 95% CI -0.46 to -0.22 from 27 trials), low-density lipoprotein (LDL) cholesterol (MD -0.17 mmol/L, 95% CI -0.27 to -0.08 from 21 trials), triglycerides (MD -0.16 mmol/L, 95% CI -0.23 to -0.09 from 28 trials), body weight (MD -0.56 kg, 95% CI -0.98 to -0.13 from 18 trials), Body Mass Index (BMI; MD -0.36, 95% CI -0·55 to -0·16 from 14 trials), and C-reactive protein (SMD -2.80, 95% CI -4.52 to -1.09 from 7 trials) when compared with lower fibre diets. All trial analyses were subject to high heterogeneity. Key variables beyond increasing fibre intake were the fibre intake at baseline, the global region where the trials were conducted, and participant inclusion criteria other than diabetes type. Potential limitations were the lack of prospective cohort data in non-European countries and the lack of long-term (12 months or greater) controlled trials of increasing fibre intakes in adults with diabetes.
Higher-fibre diets are an important component of diabetes management, resulting in improvements in measures of glycaemic control, blood lipids, body weight, and inflammation, as well as a reduction in premature mortality. These benefits were not confined to any fibre type or to any type of diabetes and were apparent across the range of intakes, although greater improvements in glycaemic control were observed for those moving from low to moderate or high intakes. Based on these findings, increasing daily fibre intake by 15 g or to 35 g might be a reasonable target that would be expected to reduce risk of premature mortality in adults with diabetes.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>32142510</pmid><doi>10.1371/journal.pmed.1003053</doi><orcidid>https://orcid.org/0000-0001-8952-3892</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1549-1676 |
| ispartof | PLoS medicine, 2020-03, Vol.17 (3), p.e1003053 |
| issn | 1549-1676 1549-1277 1549-1676 |
| language | eng |
| recordid | cdi_plos_journals_2460794409 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central |
| subjects | Bias Biology and Life Sciences Blood pressure Body mass index Body weight C-reactive protein Carbohydrates Cardiovascular disease Cardiovascular diseases Cholesterol Cohort analysis Diabetes mellitus (insulin dependent) Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 1 - diagnosis Diabetes Mellitus, Type 1 - diet therapy Diabetes Mellitus, Type 1 - mortality Diabetes Mellitus, Type 2 - diagnosis Diabetes Mellitus, Type 2 - diet therapy Diabetes Mellitus, Type 2 - mortality Diet, Diabetic - adverse effects Diet, Diabetic - mortality Diet, Healthy - adverse effects Diet, Healthy - mortality Dietary fiber Dietary Fiber - administration & dosage Dietary Fiber - adverse effects Dietary intake Drug dosages Gestational diabetes Glucose Hemoglobin Humans Insulin Insulin resistance Lipids Low density lipoprotein Medicine and Health Sciences Mortality Nutrition research Nutritive Value Physical Sciences Protective Factors Recommended Dietary Allowances Regression analysis Research and Analysis Methods Risk Assessment Risk Factors Risk Reduction Behavior Systematic review Time Factors Treatment Outcome Triglycerides Whole Grains - adverse effects |
| title | Dietary fibre and whole grains in diabetes management: Systematic review and meta-analyses |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-24T15%3A17%3A13IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Dietary%20fibre%20and%20whole%20grains%20in%20diabetes%20management:%20Systematic%20review%20and%20meta-analyses&rft.jtitle=PLoS%20medicine&rft.au=Reynolds,%20Andrew%20N&rft.date=2020-03-01&rft.volume=17&rft.issue=3&rft.spage=e1003053&rft.pages=e1003053-&rft.issn=1549-1676&rft.eissn=1549-1676&rft_id=info:doi/10.1371/journal.pmed.1003053&rft_dat=%3Cproquest_plos_%3E2460794409%3C/proquest_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2460794409&rft_id=info:pmid/32142510&rft_doaj_id=oai_doaj_org_article_82529aa95a394b5da604ce288abe433b&rfr_iscdi=true |