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Fiber intake and plasminogen activator inhibitor-1 in type 2 diabetes: Look AHEAD (Action for Health in Diabetes) trial findings at baseline and year 1.

Abstract

Plasminogen activator inhibitor 1 (PAI-1) is elevated in obese individuals with type 2 diabetes and may contribute, independently of traditional factors, to increased cardiovascular disease risk. Fiber intake may decrease PAI-1 levels. We examined the associations of fiber intake and its changes with PAI-1 before and during an intensive lifestyle intervention (ILI) for weight loss in 1,701 Look AHEAD (Action for Health in Diabetes) participants with dietary, fitness, and PAI-1 data at baseline and 1 year. Look AHEAD was a randomized cardiovascular disease trial in 5,145 overweight/obese patients with type 2 diabetes, comparing ILI (goal of ≥7% reduction in baseline weight) with a control arm of diabetes support and education. ILI participants were encouraged to consume vegetables, fruits, and grain products low in sugar and fat. At baseline, median fiber intake was 17.9 g/day. Each 8.3 g/day higher fiber intake was associated with a 9.2% lower PAI-1 level (P=0.008); this association persisted after weight and fitness adjustments (P=0.03). Higher baseline intake of fruit (P=0.019) and high-fiber grain and cereal (P=0.029) were related to lower PAI-1 levels. Although successful in improving weight and physical fitness at 1 year, the ILI in Look AHEAD resulted in small increases in fiber intake (4.1 g/day, compared with -2.35 g/day with diabetes support and education) that were not related to PAI-1 change (P=0.34). Only 31.3% of ILI participants (39.8% of women, 19.1% of men) met daily fiber intake recommendations. Increasing fiber intake in overweight/obese individuals with diabetes interested in weight loss is challenging. Future studies evaluating changes in fiber consumption during weight loss interventions are warranted.

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    MeSH

    Behavior Therapy
    Body Mass Index
    Cardiovascular Diseases
    Cohort Studies
    Combined Modality Therapy
    Diabetes Mellitus, Type 2
    Diabetic Angiopathies
    Diabetic Cardiomyopathies
    Diet, Reducing
    Dietary Fiber
    Exercise
    Female
    Follow-Up Studies
    Humans
    Life Style
    Male
    Middle Aged
    Overweight
    Patient Compliance
    Physical Fitness
    Plasminogen Activator Inhibitor 1
    Risk
    Texas
    Weight Loss

    Pub Type(s)

    Journal Article
    Multicenter Study
    Randomized Controlled Trial
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    25131348

    Citation

    Belalcazar, L Maria, et al. "Fiber Intake and Plasminogen Activator Inhibitor-1 in Type 2 Diabetes: Look AHEAD (Action for Health in Diabetes) Trial Findings at Baseline and Year 1." Journal of the Academy of Nutrition and Dietetics, vol. 114, no. 11, 2014, pp. 1800-10.e2.
    Belalcazar LM, Anderson AM, Lang W, et al. Fiber intake and plasminogen activator inhibitor-1 in type 2 diabetes: Look AHEAD (Action for Health in Diabetes) trial findings at baseline and year 1. J Acad Nutr Diet. 2014;114(11):1800-10.e2.
    Belalcazar, L. M., Anderson, A. M., Lang, W., Schwenke, D. C., Haffner, S. M., Yatsuya, H., ... Ballantyne, C. M. (2014). Fiber intake and plasminogen activator inhibitor-1 in type 2 diabetes: Look AHEAD (Action for Health in Diabetes) trial findings at baseline and year 1. Journal of the Academy of Nutrition and Dietetics, 114(11), pp. 1800-10.e2. doi:10.1016/j.jand.2014.06.357.
    Belalcazar LM, et al. Fiber Intake and Plasminogen Activator Inhibitor-1 in Type 2 Diabetes: Look AHEAD (Action for Health in Diabetes) Trial Findings at Baseline and Year 1. J Acad Nutr Diet. 2014;114(11):1800-10.e2. PubMed PMID: 25131348.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Fiber intake and plasminogen activator inhibitor-1 in type 2 diabetes: Look AHEAD (Action for Health in Diabetes) trial findings at baseline and year 1. AU - Belalcazar,L Maria, AU - Anderson,Andrea M, AU - Lang,Wei, AU - Schwenke,Dawn C, AU - Haffner,Steven M, AU - Yatsuya,Hiroshi, AU - Rushing,Julia, AU - Vitolins,Mara Z, AU - Reeves,Rebecca, AU - Pi-Sunyer,F Xavier, AU - Tracy,Russell P, AU - Ballantyne,Christie M, AU - ,, Y1 - 2014/08/15/ PY - 2013/09/24/received PY - 2014/06/11/accepted PY - 2014/8/19/entrez PY - 2014/8/19/pubmed PY - 2015/1/27/medline KW - Cardiovascular disease risk KW - Fibrinolysis KW - Lifestyle intervention KW - Obesity KW - Weight loss SP - 1800 EP - 10.e2 JF - Journal of the Academy of Nutrition and Dietetics JO - J Acad Nutr Diet VL - 114 IS - 11 N2 - Plasminogen activator inhibitor 1 (PAI-1) is elevated in obese individuals with type 2 diabetes and may contribute, independently of traditional factors, to increased cardiovascular disease risk. Fiber intake may decrease PAI-1 levels. We examined the associations of fiber intake and its changes with PAI-1 before and during an intensive lifestyle intervention (ILI) for weight loss in 1,701 Look AHEAD (Action for Health in Diabetes) participants with dietary, fitness, and PAI-1 data at baseline and 1 year. Look AHEAD was a randomized cardiovascular disease trial in 5,145 overweight/obese patients with type 2 diabetes, comparing ILI (goal of ≥7% reduction in baseline weight) with a control arm of diabetes support and education. ILI participants were encouraged to consume vegetables, fruits, and grain products low in sugar and fat. At baseline, median fiber intake was 17.9 g/day. Each 8.3 g/day higher fiber intake was associated with a 9.2% lower PAI-1 level (P=0.008); this association persisted after weight and fitness adjustments (P=0.03). Higher baseline intake of fruit (P=0.019) and high-fiber grain and cereal (P=0.029) were related to lower PAI-1 levels. Although successful in improving weight and physical fitness at 1 year, the ILI in Look AHEAD resulted in small increases in fiber intake (4.1 g/day, compared with -2.35 g/day with diabetes support and education) that were not related to PAI-1 change (P=0.34). Only 31.3% of ILI participants (39.8% of women, 19.1% of men) met daily fiber intake recommendations. Increasing fiber intake in overweight/obese individuals with diabetes interested in weight loss is challenging. Future studies evaluating changes in fiber consumption during weight loss interventions are warranted. SN - 2212-2672 UR - https://www.unboundmedicine.com/medline/citation/25131348/Fiber_intake_and_plasminogen_activator_inhibitor_1_in_type_2_diabetes:_Look_AHEAD__Action_for_Health_in_Diabetes__trial_findings_at_baseline_and_year_1_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2212-2672(14)01046-6 DB - PRIME DP - Unbound Medicine ER -