Effect of Wheat Bran on Glycemic Control and Risk Factors for Cardiovascular Disease in Type 2 Diabetes
TL;DR: High-fiber cereal foods did not improve conventional markers of glycemic control or risk factors for CHD in type 2 diabetes over 3 months, and may be a marker for another component of whole grains that imparts health advantages or a healthy lifestyle.
Abstract: OBJECTIVE —Cohort studies indicate that cereal fiber reduces the risk of diabetes and coronary heart disease (CHD). Therefore, we assessed the effect of wheat bran on glycemic control and CHD risk factors in type 2 diabetes.
RESEARCH DESIGN AND METHODS —A total of 23 subjects with type 2 diabetes (16 men and 7 postmenopausal women) completed two 3-month phases of a randomized crossover study. In the test phase, bread and breakfast cereals were provided as products high in cereal fiber (19 g/day additional cereal fiber). In the control phase, supplements were low in fiber (4 g/day additional cereal fiber).
RESULTS —Between the test and control treatments, no differences were seen in body weight, fasting blood glucose, HbA1c, serum lipids, apolipoproteins, blood pressure, serum uric acid, clotting factors, homocysteine, C-reactive protein, magnesium, calcium, iron, or ferritin. LDL oxidation in the test phase was higher than that seen in the control phase (12.1 ± 5.4%, P < 0.034). Of the subjects originally recruited, more dropped out of the study for health and food preference reasons from the control phase (16 subjects) than the test phase (11 subjects).
CONCLUSIONS —High-fiber cereal foods did not improve conventional markers of glycemic control or risk factors for CHD in type 2 diabetes over 3 months. Possibly longer studies are required to demonstrate the benefits of cereal fiber. Alternatively, cereal fiber in the diet may be a marker for another component of whole grains that imparts health advantages or a healthy lifestyle.
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TL;DR: A review of the most up to date data concerning dietary fiber and its effects on metabolic health is examined to give a better understanding of how and why dietary fiber may decrease the risk for certain diseases.
Abstract: Dietary fiber and whole grains contain a unique blend of bioactive components including resistant starches, vitamins, minerals, phytochemicals and antioxidants. As a result, research regarding their potential health benefits has received considerable attention in the last several decades. Epidemiological and clinical studies demonstrate that intake of dietary fiber and whole grain is inversely related to obesity, type two diabetes, cancer and cardiovascular disease (CVD). Defining dietary fiber is a divergent process and is dependent on both nutrition and analytical concepts. The most common and accepted definition is based on nutritional physiology. Generally speaking, dietary fiber is the edible parts of plants, or similar carbohydrates, that are resistant to digestion and absorption in the small intestine. Dietary fiber can be separated into many different fractions. Recent research has begun to isolate these components and determine if increasing their levels in a diet is beneficial to human health. These fractions include arabinoxylan, inulin, pectin, bran, cellulose, β-glucan and resistant starch. The study of these components may give us a better understanding of how and why dietary fiber may decrease the risk for certain diseases. The mechanisms behind the reported effects of dietary fiber on metabolic health are not well established. It is speculated to be a result of changes in intestinal viscosity, nutrient absorption, rate of passage, production of short chain fatty acids and production of gut hormones. Given the inconsistencies reported between studies this review will examine the most up to date data concerning dietary fiber and its effects on metabolic health.
954 citations
Cites background from "Effect of Wheat Bran on Glycemic Co..."
...[56] observed that wheat bran had no effect on glycemic control in subjects with type two diabetes....
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TL;DR: A diet high in rapidly absorbed carbohydrates and low in cereal fiber is associated with an increased risk of type 2 diabetes.
753 citations
Cites result from "Effect of Wheat Bran on Glycemic Co..."
...Because trials of the effects of high-fiber cereal foods and markers of blood glucose control have provided conflicting results (59, 60), it is possible that the consistent effects of cereal fiber observed in observational studies are due to residual confounding....
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TL;DR: A checklist of Recent and fossil catfishes (Order Siluriformes) is presented, summarizing taxonomic literature published through 2005, and one new name is proposed herein: Clariallabes teugelsi, as a replacement for Clarias (Allabenchelys) dumerili longibarbis David & Poll, 1937.
Abstract: A checklist of Recent and fossil catfishes (Order Siluriformes) is presented, summarizing taxonomic literature published through 2005. From 4624 nominal species group names and 810 genus group names, 3093 species are recognized as valid, and are distributed among 478 genera and 36 families. Distributional summaries are provided for each species, and nomenclatural synonymies, including relevant information on all name-bearing types, are included for all taxa. One new name is proposed herein: Clariallabes teugelsi, as a replacement for Clarias (Allabenchelys) dumerili longibarbis David & Poll, 1937, which is preoccupied by Clarias longibarbis Worthington, 1933, but has been treated as a valid species of Clariallabes by Teugels. Acrochordonichthys melanogaster Bleeker, 1854, is designated as type species of Acrochordonichthys Bleeker, 1857, inasmuch as no earlier valid designation has been found. A new genus Pseudobagarius , is proposed for the “ pseudobagarius group” of species formerly placed in Akysis . The status of 228 species group names remains unresolved and 31 names based on otoliths ascribed to catfishes are listed but not placed into the checklist. The current emphasis given to catfish taxonomy at present is likely to result in a dramatic increase in the total number of valid taxa as well as major changes in the membership of some of the higher level taxa recognized here.
719 citations
TL;DR: W whole grain intake is inversely associated with risk of type 2 diabetes, and this association is stronger for bran than for germ, while Findings from prospective cohort studies consistently support increasing whole grain consumption for the prevention oftype 2 diabetes.
Abstract: Funding: This study was funded by research grants CA50385 and DK58845 from the National Institutes of Health. The study sponsors did not have any role in the study design; collection, analysis, and interpretation of data; writing of the paper; and decision to submit it for publication. ABSTRACT Background Control of body weight by balancing energy intake and energy expenditure is of major importance for the prevention of type 2 diabetes, but the role of specific dietary factors in the etiology of type 2 diabetes is less well established. We evaluated intakes of whole grain, bran, and germ in relation to risk of type 2 diabetes in prospective cohort studies. Methods and Findings We followed 161,737 US women of the Nurses' Health Studies (NHSs) I and II, without history of diabetes, cardiovascular disease, or cancer at baseline. The age at baseline was 37-65 y for NHSI and 26-46 y for NHSII. Dietary intakes and potential confounders were assessed with regularly administered questionnaires. We documented 6,486 cases of type 2 diabetes during 12-18 y of follow-up. Other prospective cohort studies on whole grain intake and risk of type 2 diabetes were identified in searches of MEDLINE and EMBASE up to January 2007, and data were independently extracted by two reviewers. The median whole grain intake in the lowest and highest quintile of intake was, respectively, 3.7 and 31.2 g/d for NHSI and 6.2 and 39.9 g/d for NHSII. After adjustment for potential confounders, the relative risks (RRs) for the highest as compared with the lowest quintile of whole grain intake was 0.63 (95% confidence interval (CI) 0.57-0.69) for NHSI and 0.68 (95% CI 0.57-0.81) for NHSII (both: p-value, test for trend ,0.001). After further adjustment for body mass index (BMI), these RRs were 0.75 (95% CI 0.68-0.83; p- value, test for trend ,0.001) and 0.86 (95% CI 0.72-1.02; p-value, test for trend 0.03) respectively. Associations for bran intake were similar to those for total whole grain intake, whereas no significant association was observed for germ intake after adjustment for bran. Based on pooled data for six cohort studies including 286,125 participants and 10,944 cases of type 2 diabetes, a two-serving-per-day increment in whole grain consumption was associated with a 21% (95% CI 13%-28%) decrease in risk of type 2 diabetes after adjustment for potential confounders and BMI.
709 citations
Cites background from "Effect of Wheat Bran on Glycemic Co..."
...Results of intervention studies of wheat bran have been mixed, with beneficial effects on glucose tolerance in studies in persons with [42] and without glucose intolerance [43], but no improvement in glycemic control in individuals with established type 2 diabetes [44]....
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TL;DR: DF consumption contributes to a number of unexpected metabolic effects independent from changes in body weight, which include improvement of insulin sensitivity, modulation of the secretion of certain gut hormones, and effects on various metabolic and inflammatory markers that are associated with the metabolic syndrome.
Abstract: A high dietary fiber (DF) intake is emphasized in the recommendations of most diabetes and nutritional associations. It is accepted that viscous and gel-forming properties of soluble DF inhibit macronutrient absorption, reduce postprandial glucose response, and beneficially influence certain blood lipids. Colonic fermentation of naturally available high fiber foods can also be mainly attributed to soluble DF, whereas no difference between soluble and insoluble DF consumption on the regulation of body weight has been observed. However, in prospective cohort studies, it is primarily insoluble cereal DF and whole grains, and not soluble DF, that is consistently associated with reduced diabetes risk, suggesting that further, unknown mechanisms are likely to be involved. Recent research indicates that DF consumption contributes to a number of unexpected metabolic effects independent from changes in body weight, which include improvement of insulin sensitivity, modulation of the secretion of certain gut hormones, and effects on various metabolic and inflammatory markers that are associated with the metabolic syndrome. In this review, we briefly summarize novel findings from recent interventions and prospective cohort studies. We discuss concepts and potential mechanisms that might contribute to the further understanding of the involved processes.
612 citations
Cites background from "Effect of Wheat Bran on Glycemic Co..."
...Consumption of wheat bran for 3 mo did not change fasting glucose and glycated hemoglobin (HbA1c) levels in diabetic subjects (27)....
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References
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TL;DR: Dairy therapy remains the first line of treatment of high blood cholesterol, and drug therapy is reserved for patients who are considered to be at high risk for CHD, and the fundamental approach to treatment is comparable.
Abstract: THE SECOND report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II, or ATP II) presents the National Cholesterol Education Program's updated recommendations for cholesterol management. It is similar to the first in general outline, and the fundamental approach to treatment of high blood cholesterol is comparable. This report continues to identify low-density lipoproteins (LDL) as the primary target of cholesterol-lowering therapy. As in the first report, the second report emphasizes the role of the clinical approach in primary prevention of coronary heart disease (CHD). Dietary therapy remains the first line of treatment of high blood cholesterol, and drug therapy is reserved for patients who are considered to be at high risk for CHD. However, the second report contains new features that distinguish it from the first. These include the following: Increased emphasis on See also pp 3002 and 3009.
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TL;DR: A modest intake of fatty fish (two or three portions per week) may reduce mortality in men who have recovered from MI.
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"Effect of Wheat Bran on Glycemic Co..." refers background in this paper
...To date, the only large-scale (secondary prevention) prospective study, the Diet and Reinfarction Trial (DART), which increased cereal fiber by 10–12 g/day in the diet, failed to detect a cardiovascular benefit (30)....
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TL;DR: Using a simple worksheet, a patient's 5- and 10-year CHD risks can be estimated using components of the profile selected because they are objective and strongly and independently related to CHD.
Abstract: Using a simple worksheet, a patient's 5- and 10-year CHD risks can be estimated. The components of the profile were selected because they are objective and strongly and independently related to CHD and because they can be measured through simple office procedures and laboratory results
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