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Intakes of dietary fiber, vegetables, and fruits and incidence of cardiovascular disease in Japanese patients with type 2 diabetes.
Diabetes Care 2013; 36(12):3916-22DC

Abstract

OBJECTIVE

Foods rich in fiber, such as vegetables and fruits, prevent cardiovascular disease (CVD) among healthy adults, but such data in patients with diabetes are sparse. We investigated this association in a cohort with type 2 diabetes aged 40-70 years whose HbA1c values were ≥ 6.5% in Japan Diabetes Society values.

RESEARCH DESIGN AND METHODS

In this cohort study, 1,414 patients were analyzed after exclusion of patients with history of CVDs and nonresponders to a dietary survey. Primary outcomes were times to stroke and coronary heart disease (CHD). Hazard ratios (HRs) of dietary intake were estimated by Cox regression adjusted for systolic blood pressure, lipids, energy intake, and other confounders.

RESULTS

Mean daily dietary fiber in quartiles ranged from 8.7 to 21.8 g, and mean energy intake ranged from 1,442.3 to 2,058.9 kcal. Mean daily intake of vegetables and fruits in quartiles ranged from 228.7 to 721.4 g. During the follow-up of a median of 8.1 years, 68 strokes and 96 CHDs were observed. HRs for stroke in the fourth quartile vs. the first quartile were 0.39 (95% CI 0.12-1.29, P = 0.12) for dietary fiber and 0.35 (0.13-0.96, P = 0.04) for vegetables and fruits. There were no significant associations with CHD. The HR per 1-g increase was smaller for soluble dietary fiber (0.48 [95% CI 0.30-0.79], P < 0.01) than for total (0.82 [0.73-0.93], P < 0.01) and insoluble (0.79 [0.68-0.93], P < 0.01) dietary fiber.

CONCLUSIONS

Increased dietary fiber, particularly soluble fiber, and vegetables and fruits were associated with lower incident stroke but not CHD in patients with type 2 diabetes.

Authors+Show Affiliations

Corresponding author: Hirohito Sone, sone@med.niigata-u.ac.jp.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 available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24170762

Citation

Tanaka, Shiro, et al. "Intakes of Dietary Fiber, Vegetables, and Fruits and Incidence of Cardiovascular Disease in Japanese Patients With Type 2 Diabetes." Diabetes Care, vol. 36, no. 12, 2013, pp. 3916-22.
Tanaka S, Yoshimura Y, Kamada C, et al. Intakes of dietary fiber, vegetables, and fruits and incidence of cardiovascular disease in Japanese patients with type 2 diabetes. Diabetes Care. 2013;36(12):3916-22.
Tanaka, S., Yoshimura, Y., Kamada, C., Tanaka, S., Horikawa, C., Okumura, R., ... Sone, H. (2013). Intakes of dietary fiber, vegetables, and fruits and incidence of cardiovascular disease in Japanese patients with type 2 diabetes. Diabetes Care, 36(12), pp. 3916-22. doi:10.2337/dc13-0654.
Tanaka S, et al. Intakes of Dietary Fiber, Vegetables, and Fruits and Incidence of Cardiovascular Disease in Japanese Patients With Type 2 Diabetes. Diabetes Care. 2013;36(12):3916-22. PubMed PMID: 24170762.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intakes of dietary fiber, vegetables, and fruits and incidence of cardiovascular disease in Japanese patients with type 2 diabetes. AU - Tanaka,Shiro, AU - Yoshimura,Yukio, AU - Kamada,Chiemi, AU - Tanaka,Sachiko, AU - Horikawa,Chika, AU - Okumura,Ryota, AU - Ito,Hideki, AU - Ohashi,Yasuo, AU - Akanuma,Yasuo, AU - Yamada,Nobuhiro, AU - Sone,Hirohito, AU - ,, Y1 - 2013/10/29/ PY - 2013/10/31/entrez PY - 2013/10/31/pubmed PY - 2014/12/17/medline SP - 3916 EP - 22 JF - Diabetes care JO - Diabetes Care VL - 36 IS - 12 N2 - OBJECTIVE: Foods rich in fiber, such as vegetables and fruits, prevent cardiovascular disease (CVD) among healthy adults, but such data in patients with diabetes are sparse. We investigated this association in a cohort with type 2 diabetes aged 40-70 years whose HbA1c values were ≥ 6.5% in Japan Diabetes Society values. RESEARCH DESIGN AND METHODS: In this cohort study, 1,414 patients were analyzed after exclusion of patients with history of CVDs and nonresponders to a dietary survey. Primary outcomes were times to stroke and coronary heart disease (CHD). Hazard ratios (HRs) of dietary intake were estimated by Cox regression adjusted for systolic blood pressure, lipids, energy intake, and other confounders. RESULTS: Mean daily dietary fiber in quartiles ranged from 8.7 to 21.8 g, and mean energy intake ranged from 1,442.3 to 2,058.9 kcal. Mean daily intake of vegetables and fruits in quartiles ranged from 228.7 to 721.4 g. During the follow-up of a median of 8.1 years, 68 strokes and 96 CHDs were observed. HRs for stroke in the fourth quartile vs. the first quartile were 0.39 (95% CI 0.12-1.29, P = 0.12) for dietary fiber and 0.35 (0.13-0.96, P = 0.04) for vegetables and fruits. There were no significant associations with CHD. The HR per 1-g increase was smaller for soluble dietary fiber (0.48 [95% CI 0.30-0.79], P < 0.01) than for total (0.82 [0.73-0.93], P < 0.01) and insoluble (0.79 [0.68-0.93], P < 0.01) dietary fiber. CONCLUSIONS: Increased dietary fiber, particularly soluble fiber, and vegetables and fruits were associated with lower incident stroke but not CHD in patients with type 2 diabetes. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/24170762/Intakes_of_dietary_fiber_vegetables_and_fruits_and_incidence_of_cardiovascular_disease_in_Japanese_patients_with_type_2_diabetes_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=24170762 DB - PRIME DP - Unbound Medicine ER -