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Dietary fiber, carbohydrate quality and quantity, and mortality risk of individuals with diabetes mellitus.
PLoS One 2012; 7(8):e43127Plos

Abstract

BACKGROUND

Dietary fiber, carbohydrate quality and quantity are associated with mortality risk in the general population. Whether this is also the case among diabetes patients is unknown.

OBJECTIVE

To assess the associations of dietary fiber, glycemic load, glycemic index, carbohydrate, sugar, and starch intake with mortality risk in individuals with diabetes.

METHODS

This study was a prospective cohort study among 6,192 individuals with confirmed diabetes mellitus (mean age of 57.4 years, and median diabetes duration of 4.4 years at baseline) from the European Prospective Investigation into Cancer and Nutrition (EPIC). Dietary intake was assessed at baseline (1992-2000) with validated dietary questionnaires. Cox proportional hazards analysis was performed to estimate hazard ratios (HRs) for all-cause and cardiovascular mortality, while adjusting for CVD-related, diabetes-related, and nutritional factors.

RESULTS

During a median follow-up of 9.2 y, 791 deaths were recorded, 306 due to CVD. Dietary fiber was inversely associated with all-cause mortality risk (adjusted HR per SD increase, 0.83 [95% CI, 0.75-0.91]) and CVD mortality risk (0.76[0.64-0.89]). No significant associations were observed for glycemic load, glycemic index, carbohydrate, sugar, or starch. Glycemic load (1.42[1.07-1.88]), carbohydrate (1.67[1.18-2.37]) and sugar intake (1.53[1.12-2.09]) were associated with an increased total mortality risk among normal weight individuals (BMI≤25 kg/m(2); 22% of study population) but not among overweight individuals (P interaction≤0.04). These associations became stronger after exclusion of energy misreporters.

CONCLUSIONS

High fiber intake was associated with a decreased mortality risk. High glycemic load, carbohydrate and sugar intake were associated with an increased mortality risk in normal weight individuals with diabetes.

Authors+Show Affiliations

University Medical Center, Utrecht, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22927948

Citation

Burger, Koert N J., et al. "Dietary Fiber, Carbohydrate Quality and Quantity, and Mortality Risk of Individuals With Diabetes Mellitus." PloS One, vol. 7, no. 8, 2012, pp. e43127.
Burger KN, Beulens JW, van der Schouw YT, et al. Dietary fiber, carbohydrate quality and quantity, and mortality risk of individuals with diabetes mellitus. PLoS ONE. 2012;7(8):e43127.
Burger, K. N., Beulens, J. W., van der Schouw, Y. T., Sluijs, I., Spijkerman, A. M., Sluik, D., ... Nöthlings, U. (2012). Dietary fiber, carbohydrate quality and quantity, and mortality risk of individuals with diabetes mellitus. PloS One, 7(8), pp. e43127. doi:10.1371/journal.pone.0043127.
Burger KN, et al. Dietary Fiber, Carbohydrate Quality and Quantity, and Mortality Risk of Individuals With Diabetes Mellitus. PLoS ONE. 2012;7(8):e43127. PubMed PMID: 22927948.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary fiber, carbohydrate quality and quantity, and mortality risk of individuals with diabetes mellitus. AU - Burger,Koert N J, AU - Beulens,Joline W J, AU - van der Schouw,Yvonne T, AU - Sluijs,Ivonne, AU - Spijkerman,Annemieke M W, AU - Sluik,Diewertje, AU - Boeing,Heiner, AU - Kaaks,Rudolf, AU - Teucher,Birgit, AU - Dethlefsen,Claus, AU - Overvad,Kim, AU - Tjønneland,Anne, AU - Kyrø,Cecilie, AU - Barricarte,Aurelio, AU - Bendinelli,Benedetta, AU - Krogh,Vittorio, AU - Tumino,Rosario, AU - Sacerdote,Carlotta, AU - Mattiello,Amalia, AU - Nilsson,Peter M, AU - Orho-Melander,Marju, AU - Rolandsson,Olov, AU - Huerta,José María, AU - Crowe,Francesca, AU - Allen,Naomi, AU - Nöthlings,Ute, Y1 - 2012/08/23/ PY - 2012/01/11/received PY - 2012/07/16/accepted PY - 2012/8/29/entrez PY - 2012/8/29/pubmed PY - 2013/1/30/medline SP - e43127 EP - e43127 JF - PloS one JO - PLoS ONE VL - 7 IS - 8 N2 - BACKGROUND: Dietary fiber, carbohydrate quality and quantity are associated with mortality risk in the general population. Whether this is also the case among diabetes patients is unknown. OBJECTIVE: To assess the associations of dietary fiber, glycemic load, glycemic index, carbohydrate, sugar, and starch intake with mortality risk in individuals with diabetes. METHODS: This study was a prospective cohort study among 6,192 individuals with confirmed diabetes mellitus (mean age of 57.4 years, and median diabetes duration of 4.4 years at baseline) from the European Prospective Investigation into Cancer and Nutrition (EPIC). Dietary intake was assessed at baseline (1992-2000) with validated dietary questionnaires. Cox proportional hazards analysis was performed to estimate hazard ratios (HRs) for all-cause and cardiovascular mortality, while adjusting for CVD-related, diabetes-related, and nutritional factors. RESULTS: During a median follow-up of 9.2 y, 791 deaths were recorded, 306 due to CVD. Dietary fiber was inversely associated with all-cause mortality risk (adjusted HR per SD increase, 0.83 [95% CI, 0.75-0.91]) and CVD mortality risk (0.76[0.64-0.89]). No significant associations were observed for glycemic load, glycemic index, carbohydrate, sugar, or starch. Glycemic load (1.42[1.07-1.88]), carbohydrate (1.67[1.18-2.37]) and sugar intake (1.53[1.12-2.09]) were associated with an increased total mortality risk among normal weight individuals (BMI≤25 kg/m(2); 22% of study population) but not among overweight individuals (P interaction≤0.04). These associations became stronger after exclusion of energy misreporters. CONCLUSIONS: High fiber intake was associated with a decreased mortality risk. High glycemic load, carbohydrate and sugar intake were associated with an increased mortality risk in normal weight individuals with diabetes. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/22927948/Dietary_fiber_carbohydrate_quality_and_quantity_and_mortality_risk_of_individuals_with_diabetes_mellitus_ L2 - http://dx.plos.org/10.1371/journal.pone.0043127 DB - PRIME DP - Unbound Medicine ER -