Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women
Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women
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DOI：
10.1001/jama.277.6.472
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发表时间：
1997-02-12
影响因子：
120.7
通讯作者：
Willett, WC
中科院分区：
文献类型：
--
作者：
Salmeron, J;Manson, JE;Willett, WC
客观。-前瞻性地研究血糖控制饮食、低纤维摄入和非胰岛素依赖型糖尿病风险之间的关系。队列研究。设置。-在1986年，共有65173名年龄在40到65岁之间的美国妇女，没有被诊断的心血管疾病、癌症和糖尿病，完成了一份详细的饮食调查表，我们从该调查表中计算了总的和特定来源的膳食纤维的通常摄入量、膳食血糖指数和血糖负荷。非胰岛素依赖型糖尿病在6年的随访中，记录了915例糖尿病事件。在调整年龄、体重指数、吸烟、体力活动、糖尿病家族史、酒精和谷物纤维摄入量以及总能量摄入量后，饮食血糖指数与糖尿病风险呈正相关。比较最高和最低五分位数，糖尿病的相对危险度（RR）为1.37（95%置信区间[CI]，1.09-1.71，Ptrend=.005）。血糖负荷（全球膳食胰岛素需求的指标）也与糖尿病呈正相关（RR=-1.47; 95%CI，1.16-1.86，Ptrend=.003）。当比较极端五分位数时，谷物纤维摄入量与糖尿病风险呈负相关（RR=0.72，95%CI，0.58-0.90，Ptrend= 0.001）。与低血糖负荷和高谷物纤维摄入相比，高血糖负荷和低谷物纤维摄入的组合进一步增加了糖尿病的风险（RR=2.50，95%CI，1.14 -5.51）。我们的研究结果支持了这一假设，即高血糖负荷和低谷物纤维含量的饮食会增加女性患糖尿病的风险。此外，他们建议谷物应该以最低限度的精制形式食用，以减少糖尿病的发病率。
Objective.-To examine prospectively the relationship between glycemic diets, low fiber intake, and risk of noninsulin-dependent diabetes mellitus.Design.-Cohort study.Setting.-in 1986, a total of 65173 US women 40 to 65 years of age and free from diagnosed cardiovascular disease, cancer, and diabetes completed a detailed dietary questionnaire from which we calculated usual intake of total and specific sources of dietary fiber, dietary glycemic index, and glycemic load.Main Outcome Measure.-Non-insulin-dependent diabetes mellitus.Results.-During 6 years of follow-up, 915 incident cases of diabetes were documented. The dietary glycemic index was positively associated with risk of diabetes after adjustment for age, body mass index, smoking, physical activity, family history of diabetes, alcohol and cereal fiber intake, and total energy intake. Comparing the highest with the lowest quintite, the relative risk (RR) of diabetes was 1.37 (95% confidence interval [CI], 1.09-1.71, Ptrend=.005). The glycemic load (an indicator of a global dietary insulin demand) was also positively associated with diabetes (RR=-1.47; 95% CI, 1.16-1.86, Ptrend=.003). Cereal fiber intake was inversely associated with risk of diabetes when comparing the extreme quintiles (RR=0.72, 95% CI, 0.58-0.90, Ptrend=.001). The combination of a high glycemic load and a low cereal fiber intake further increased the risk of diabetes (RR=2.50, 95% CI,1.14-5.51) when compared with a low glycemic load and high cereal fiber intake.Conclusions.-Our results support the hypothesis that diets with a high glycemic load and a low cereal fiber content increase risk of diabetes in women. Further, they suggest that grains should be consumed in a minimally refined form to reduce the incidence of diabetes.