High-fibre, low-fat diet predicts long-term weight loss and decreased type 2 diabetes risk:: the Finnish Diabetes Prevention Study
High-fibre, low-fat diet predicts long-term weight loss and decreased type 2 diabetes risk:: the Finnish Diabetes Prevention Study
复制标题
DOI：
10.1007/s00125-006-0198-3
复制
发表时间：
2006-05-01
期刊：
影响因子：
8.2
通讯作者：
Tuomilehto, J
中科院分区：
文献类型：
--
作者：
Lindström, J;Peltonen, M;Tuomilehto, J
本研究的目的是调查芬兰糖尿病预防研究中膳食常量营养素组成和能量密度与体重、腰围和糖尿病发病率变化的关系。超重的中年男性（n=172）和女性（n=350）葡萄糖耐量受损患者被随机分为标准治疗组（对照组）和强化饮食和运动咨询组。基线和年度检查包括通过3天食物记录评估饮食摄入量和通过重复75 g OGTT评估糖尿病状态。在这些分析中，将治疗组合并，仅纳入有随访数据的受试者（n=500）。与高脂肪（>中位数）、低纤维（<中位数）饮食的受试者相比，低脂肪（<中位数）和高纤维（>中位数）饮食的受试者体重减轻更多（3年后分别为3.1和0.7 kg）。在单独的模型中，平均随访4.1年期间糖尿病发病率的风险比为（最高与最低四分位数相比）0.38（95% CI 0.19-0.77）纤维摄入量，2.14（95% CI 1.16-3.92），脂肪摄入量为1.73（95% CI 0.89-3.38），在调整性别、干预分配、体重和体重变化、体力活动后，基线2小时血糖和所研究的营养素的摄入。与低脂肪/高纤维类别相比，风险比为1.98（95% CI 0.98-4.02），2.68（95% CI 1.40-5.10）和1.89（95% CI 1.09-3.30）低脂/低纤维、高脂/高纤维和高脂/低纤维，膳食脂肪和纤维摄入量是高风险受试者持续体重减轻和进展为2型糖尿病的重要预测因子，即使在调整其他风险因素后也是如此。
The aim of this study was to investigate the association of dietary macronutrient composition and energy density with the change in body weight and waist circumference and diabetes incidence in the Finnish Diabetes Prevention Study.Overweight, middle-aged men (n=172) and women (n=350) with impaired glucose tolerance were randomised to receive either 'standard care' (control) or intensive dietary and exercise counselling. Baseline and annual examinations included assessment of dietary intake with 3-day food records and diabetes status by repeated 75-g OGTTs. For these analyses the treatment groups were combined and only subjects with follow-up data (n=500) were included.Individuals with low fat (< median) and high fibre (> median) intakes lost more weight compared with those consuming a high-fat (> median), low-fibre (< median) diet (3.1 vs 0.7 kg after 3 years). In separate models, hazard ratios for diabetes incidence during a mean follow-up of 4.1 years were (highest compared with lowest quartile) 0.38 (95% CI 0.19-0.77) for fibre intake, 2.14 (95% CI 1.16-3.92) for fat intake, and 1.73 (95% CI 0.89-3.38) for saturated-fat intake, after adjustment for sex, intervention assignment, weight and weight change, physical activity, baseline 2-h plasma glucose and intake of the nutrient being investigated. Compared with the low-fat/high-fibre category, hazard ratios were 1.98 (95% CI 0.98-4.02), 2.68 (95% CI 1.40-5.10), and 1.89 (95% CI 1.09-3.30) for low-fat/low-fibre, high-fat/high-fibre, and high-fat/low-fibre, respectively.Dietary fat and fibre intake are significant predictors of sustained weight reduction and progression to type 2 diabetes in high-risk subjects, even after adjustment for other risk factors.