Dietary fiber, weight gain, and cardiovascular disease risk factors in young adults
Dietary fiber, weight gain, and cardiovascular disease risk factors in young adults
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DOI：
10.1001/jama.282.16.1539
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发表时间：
1999-10-27
影响因子：
120.7
通讯作者：
Jacobs, DR
中科院分区：
文献类型：
--
作者：
Ludwig, DS;Pereira, MA;Jacobs, DR
研究背景膳食结构可能影响胰岛素分泌，而高胰岛素水平反过来又可能增加心血管疾病（CVD）的风险。目的研究纤维摄入的作用及其与胰岛素水平、体重增加和其他CVD风险因素的关系，并与其他主要膳食成分进行比较。一项10年内CVD危险因素变化的多中心人群队列研究（1985-1986年至1995-1996年）在阿拉巴马州伯明翰;芝加哥，III;明尼阿波利斯，明尼苏达州;研究对象为2909名健康的黑人和白色人，年龄在18 - 30岁之间。胰岛素水平，和其他心血管疾病的危险因素，在第10年，调整基线value.Results调整后的潜在混杂因素，膳食纤维显示从最低到最高五分位数的摄入量与以下线性关联。体重（白人：174.8-166.7 lb [78.3-75.0 kg]，P <0.001;黑人：185.6-177.6 lb [83.5-79.9 kg]，P = 0.001），腰臀比（白人，0.813-0.801，P = 0.004;黑人：0.809-0.799，P = 0.05），根据体重指数调整的空腹胰岛素（白人：77.8-72.2 pmol/L [11.2-10.4 mu U/mL]，P = 0.007;黑人：92.4-82.6 pmol/L [13.3-11.9 mu U/mL]，P = 0.01）和2小时葡萄糖后胰岛素调整体重指数（白人：261.1-234.7 pmol/L [37.6-33.8 mu U/mL]，P = 0.03;黑人：370.2-259.7 pmol/L [53.3-37.4 mu U/mL]，P < .001）。纤维还与血压和甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和纤维蛋白原水平相关;通过调整空腹胰岛素水平，这些相关性大大减弱。与纤维相比，脂肪，碳水化合物和蛋白质的摄入量与所有CVD风险factors. Conclusions不一致或弱相关，纤维消费预测胰岛素水平，体重增加，和其他CVD风险因素更强烈比总或饱和脂肪消费。高纤维饮食可以通过降低胰岛素水平来预防肥胖和心血管疾病。
Context Dietary composition may affect insulin secretion, and high insulin levels, in turn, may increase the risk for cardiovascular disease (CVD).Objective To examine the role of fiber consumption and its association with insulin levels, weight gain, and other CVD risk factors compared with other major dietary components.Design and Setting The Coronary Artery Risk Development in Young Adults (CARDIA) Study, a multicenter population-based cohort study of the change in CVD risk factors over 10 years (1985-1986 to 1995-1996) in Birmingham, Ala; Chicago, III; Minneapolis, Minn; and Oakland, Calif.Participants A total of 2909 healthy black and white adults, 18 to 30 years of age at enrollment.Main Outcome Measures Body weight. insulin levels, and other CVD risk factors at year 10, adjusted for baseline values.Results After adjustment for potential confounding factors, dietary fiber showed linear associations from lowest to highest quintiles of intake with the following. body weight (whites: 174.8-166.7 lb [78.3-75.0 kg], P < .001; blacks: 185.6-177.6 lb [83.5-79.9 kg], P = .001), waist-to-hip ratio (whites, 0.813-0.801, P = .004; blacks: 0.809-0.799, P = .05), fasting insulin adjusted for body mass index (whites: 77.8-72.2 pmol/L [11.2-10.4 mu U/mL], P = .007; blacks: 92.4-82.6 pmol/L [13.3-11.9 mu U/mL], P = .01) and 2-hour postglucose insulin adjusted for body mass index (whites: 261.1-234.7 pmol/L [37.6-33.8 mu U/mL], P = .03; blacks: 370.2-259.7 pmol/L [53.3-37.4 mu U/m L], P < .001). Fiber was also associated with blood pressure and levels of triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and fibrinogen; these associations were substantially attenuated by adjustment for fasting insulin level. In comparison with fiber, intake of fat, carbohydrate, and protein had inconsistent or weak associations with all CVD risk factors.Conclusions Fiber consumption predicted insulin levels, weight gain, and other CVD risk factors more strongly than did total or saturated fat consumption. High-fiber diets may protect against obesity and CVD by lowering insulin levels.