Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women

被引:1314
作者
Salmeron, J
Manson, JE
Stampfer, MJ
Colditz, GA
Wing, AL
Willett, WC
机构
[1] BRIGHAM & WOMENS HOSP, CHANNING LAB, BOSTON, MA 02115 USA
[2] HARVARD UNIV, SCH MED, BOSTON, MA USA
[3] BRIGHAM & WOMENS HOSP, DEPT MED, BOSTON, MA 02115 USA
[4] HARVARD UNIV, SCH PUBL HLTH, DEPT NUTR, BOSTON, MA 02115 USA
[5] HARVARD UNIV, SCH PUBL HLTH, DEPT EPIDEMIOL, BOSTON, MA 02115 USA
[6] INST MEXICANO SEGURO SOCIAL, UNIDAD INVEST EPIDEMIOL, MEXICO CITY, DF, MEXICO
[7] INST MEXICANO SEGURO SOCIAL, SERV SALUD, MEXICO CITY, DF, MEXICO
来源
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 1997年 / 277卷 / 06期
关键词
D O I
10.1001/jama.277.6.472
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页码:472 / 477
页数:6
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