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Diabetology & Metabolic Syndrome
Published in: Diabetology & Metabolic Syndrome 1/2014

Open Access 01-12-2014 | Research

Fiber intake and inflammation in type 1 diabetes

Authors: Fernanda S R Bernaud, Mileni Vanti Beretta, Cigléa do Nascimento, Fabrícia Escobar, Jorge L Gross, Mirela J Azevedo, Ticiana C Rodrigues

Published in: Diabetology & Metabolic Syndrome | Issue 1/2014

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Abstract

Background

Higher intake of dietary fiber is associated with lower risk of coronary heart disease, the leading cause of mortality among people with type 1 diabetes. The protective effect includes the anti-inflammatory properties of some foods. Population-based studies have shown an inverse association between some nutritional habits and high sensitive -C-reactive protein (hs-CRP). This study aimed to ascertain the association between fiber intake and hs-CPR levels in patients with type 1 diabetes.

Methods

This cross-sectional study was conducted with 106 outpatients with type 1 diabetes; age 40 ± 11 years; diabetes duration of 18 ± 8.8 years. Dietary intake was evaluated by 3-day weighed-diet records. Patients were categorized in 2 groups, according to fiber intake (>20 g/day and <20 g/day).

Results

The group with fiber intake > 20 g/day had lower hs-CRP levels [median (25th-75th) 0.7 mg/dl (0.4-2.4) vs. 1.9 mg/dl (1.0-4.4); P = 0.002], than the other group. Controlled for HbA1c and energy intake, an inverse relation was observed between hs-CRP levels and total fiber [ß = − 0.030 (SE: 0.0120), P = 0.02], soluble fiber [ß = − 0.078 (SE: 0.0421), P = 0.06] and insoluble fiber [ß = − 0.039 (SE: 0.01761), P = 0.026]. Even, after additional adjustment fibers remained associated with lower hs-CRP levels. Total fibers were stratified in 4 groups: < 10 g/day, from 10 to < 20 g/day, from 20 to 30 g/day and > 30 g/day. Compared to the group who ingested < 10 g/day of total fiber (referent group), the group who consumed > 30 g/d had significantly lower hs-CRP levels [−2.45 mg/L, P = 0.012] independent of the HbA1c values.

Conclusions

The present study suggests that an increased consumption of dietary fiber > 30 g/day may play a role in reducing inflammation in individuals with type 1 diabetes.
Appendix
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Literature
1.
Hu FB, Willett WC: Optimal diets for prevention of coronary heart disease. JAMA. 2002, 288: 2569-2578. 10.1001/jama.288.20.2569.CrossRefPubMed
2.
Jensen MK, Koh-Banerjee P, Hu FB, Franz M, Sampson L, Gronbaek M, Rimm EB: Intakes of whole grains, bran, and germ and the risk of coronary heart disease in men. Am J Clin Nutr. 2004, 80: 1492-1499.PubMed
3.
Krolewski AS, Kosinski EJ, Warram JH, Leland OS, Busick EJ, Asmal AC, Rand LI, Christlieb AR, Bradley RF, Kahn CR: Magnitude and determinants of coronary artery disease in juvenile-onset, insulin-dependent diabetes mellitus. Am J Cardiol. 1987, 59: 750-755. 10.1016/0002-9149(87)91086-1.CrossRefPubMed
4.
Dauchet L, Amouyel P, Hercberg S, Dallongeville J: Fruit and vegetable consumption and risk of coronary heart disease: a meta-analysis of cohort studies. J Nutr. 2006, 136: 2588-2593.PubMed
5.
Dauchet L, Amouyel P, Dallongeville J: Fruit and vegetable consumption and risk of stroke: a meta-analysis of cohort studies. Neurology. 2005, 65: 1193-1197. 10.1212/01.wnl.0000180600.09719.53.CrossRefPubMed
6.
He FJ, Nowson CA, MacGregor GA: Fruit and vegetable consumption and stroke: meta-analysis of cohort studies. Lancet. 2006, 367: 320-326. 10.1016/S0140-6736(06)68069-0.CrossRefPubMed
7.
He FJ, Nowson CA, Lucas M, MacGregor GA: Increased consumption of fruit and vegetables is related to a reduced risk of coronary heart disease: meta-analysis of cohort studies. J Hum Hypertens. 2007, 21: 717-728. 10.1038/sj.jhh.1002212.CrossRefPubMed
8.
Bellavia A, Larsson SC, Bottai M, Wolk A, Orsini N: Fruit and vegetable consumption and all-cause mortality: a dose–response analysis. Am J Clin Nutr. 2013, 98 (2): 454-459. 10.3945/ajcn.112.056119.CrossRefPubMed
9.
Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L, Hu FB, Willett WC: Fruit and vegetable intakes, C-reactive protein, and the metabolic syndrome. Am J Clin Nutr. 2006, 84: 1489-1497.PubMed
10.
Oliveira A, Rodriguez-Artalejo F, Lopes C: The association of fruits, vegetables, antioxidant vitamins and fibre intake with high-sensitivity C-reactive protein: sex and body mass index interactions. Eur J Clin Nutr. 2009, 63: 1345-1352. 10.1038/ejcn.2009.61.CrossRefPubMed
11.
Gao X, Bermudez OI, Tucker KL: Plasma C-reactive protein and homocysteine concentrations are related to frequent fruit and vegetable intake in Hispanic and non-Hispanic white elders. J Nutr. 2004, 134: 913-918.PubMed
12.
Macready AL, George TW, Chong MF, Alimbetov DS, Jin Y, Vidal A, Spencer JP, Kennedy OB, Tuohy KM, Minihane AM, Gordon MH, Lovegrove JA: Flavonoid-rich fruit and vegetables improve microvascular reactivity and inflammatory status in men at risk of cardiovascular disease–FLAVURS: a randomized controlled trial. Am J Clin Nutr. 2014, 99 (3): 479-489. 10.3945/ajcn.113.074237.CrossRefPubMed
13.
Lopez-Garcia E, Schulze MB, Fung TT, Melgs JB, Rifai N, Mansono JE, Hu FB: Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr. 2004, 80: 1029-1035.PubMed
14.
Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L, Hu FB, Willett WC: Dietary patterns and markers of systemic inflammation among Iranian women. J Nutr. 2007, 137: 992-998.PubMed
15.
Steemburgo T, Dall'Alba V, Almeida JC, Zelmanovitz T, Gross JL, de Azevedo MJ: Intake of soluble fibers has a protective role for the presence of metabolic syndrome in patients with type 2 diabetes. Eur J Clin Nutr. 2009, 63 (1): 127-133. 10.1038/sj.ejcn.1602902.CrossRefPubMed
16.
Qi L, van Dam RM, Liu S, Franz M, Mantzoros C, Hu FB: Whole-grain, bran, and cereal fiber intakes and markers of systemic inflammation in diabetic women. Diabetes Care. 2006, 29 (2): 207-211. 10.2337/diacare.29.02.06.dc05-1903.CrossRefPubMed
17.
Kolb H, Mandrup-Poulsen T: The global diabetes epidemic as a consequence of lifestyle-induced low-grade inflammation. Diabetologia. 2010, 53 (1): 10-20. 10.1007/s00125-009-1573-7.CrossRefPubMed
18.
Fernandez-Real JM, Ricart W: Insulin resistance and chronic cardiovascular inflammatory syndrome. Endocr Rev. 2003, 24: 278-301. 10.1210/er.2002-0010.CrossRefPubMed
19.
Schram MT, Chaturvedi N, Schalkwijk CG, Fuller JH, Stehouwer CD: Markers of inflammation are cross-sectionally associated with microvascular complications and cardiovascular disease in type 1 diabetes-the EURODIAB Prospective Complications Study. Diabetologia. 2005, 48: 370-378. 10.1007/s00125-004-1628-8.CrossRefPubMed
20.
Zoppini G, Faccini G, Muggeo M, Zenari L, Falezza G, Targher G: Elevated plasma levels of soluble receptors of TNF-a and their association with smoking and microvascular complications in young adults with type 1 diabetes. J Clin Endocrinol Metabol. 2001, 86: 3805-3808.
21.
Orchard TJ, Olson JC, Erbey JR, Williams K, Forrest KY, Smithline Kinder L, Ellis D, Becker DJ: Insulin resistance-related factors, but not glycemia, predict coronary artery disease in type 1 diabetes: 10-year follow-up data from the Pittsburgh epidemiology of diabetes complications study. Diabetes Care. 2003, 26: 1374-1379. 10.2337/diacare.26.5.1374.CrossRefPubMed
22.
Toeller M, Buyken AE, Heitkamp G, Cathelineau G, Ferriss B, Michel G, EURODIAB IDDM Complications Study Group: Nutrient intakes as predictors of body weight in European people with type 1 diabetes. Int J Obes Relat Metab Disord. 2001, 25 (12): 1815-1822. 10.1038/sj.ijo.0801816.CrossRefPubMed
23.
Snell-Bergeon JK, Chartier-Logan C, Maahs DM, Ogden LG, Hokanson JE, Kinney GL, Eckel RH, Ehrlich J, Rewers M: Adults with type 1 diabetes eat a high-fat atherogenic diet that is associated with coronary artery calcium. Diabetologia. 2009, 52 (5): 801-809. 10.1007/s00125-009-1280-4.PubMedCentralCrossRefPubMed
24.
Giacco R, Parillo M, Rivellese AA, Lasorella G, Giacco A, D'Episcopo L, Riccardi G: Long-term dietary treatment with increased amounts of fiber-rich low-glycemic index natural foods improves blood glucose control and reduces the number of hypoglycemic events in type 1 diabetic patients. Diabetes Care. 2000, 23 (10): 1461-1466. 10.2337/diacare.23.10.1461.CrossRefPubMed
25.
Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Partikka P, Keinänen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M: Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Eng J Med. 2001, 344: 1343-1350. 10.1056/NEJM200105033441801.CrossRef
26.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Masterson BJ, Oparil S, Wright JT, Roccella EJ: The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003, 289: 2560-2572. 10.1001/jama.289.19.2560.CrossRefPubMed
27.
Gross JL, Azevedo MJ, Silveiro SP, Canani LH, Caramori ML, Zelmanovitz T: Diabetic nephropathy: diagnosis, prevention and treatment. Diabetes Care. 2005, 28: 164-176. 10.2337/diacare.28.1.164.CrossRefPubMed
28.
Wilkinson CP, Ferris FL, Klein RE, Lee PP, Agardh CD, Davis M, Dills D, Kampik A, Pararajasegaram R, Verdaguer JT: Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology. 2003, 110: 1677-1682. 10.1016/S0161-6420(03)00475-5.CrossRefPubMed
29.
Williams KV, Erbey JR, Becker D, Arslanian S, Orchard TJ: Can clinical factors estimate insulin resistance in type 1 diabetes?. Diabetes Care. 2000, 49: 626-632. 10.2337/diabetes.49.4.626.CrossRef
30.
Moulin CC, Tiskievicz F, Zelmanovitz T, de Oliveira J, Azevedo MJ, Gross JL: Use of weighed diet records in the evaluation of diets with different protein contents in patients with type 2 diabetes. Am J ClinNutr. 1998, 67: 853-857.
31.
Vaz JS, Bittencourt M, Almeida JC, Gross JL, de Azevedo MJ, Zelmanovitz T: Protein intake estimated by weighed diet records in patients with type 2 diabetes: misreporting and intra-individual variability using 24-hour nitrogen output as criterion standard. J Am Diet Assoc. 2008, 108: 867-872. 10.1016/j.jada.2008.03.022.CrossRefPubMed
32.
USDA SR 17 Research Quality Nutrient Data: The Agricultural Research Service: Composition of Foods. 2007, Washington, DC: U.S. Department of Agriculture, 8
33.
Schakel S, Sievert YA, Buzzard IM: Dietary Fiber Values for Common Foods. “CRC Handbook of Dietary Fiber in Human Nutrition. Edited by: Spiller GA. 2001, Boca Raton, FL: CRC Press, 615-648.
34.
Liu S, Manson JE, Stampfer MJ, Rexrode KM, Hu FB, Rimm EB, Willett WC: Whole grain consumption and risk of ischemic stroke in women: a prospective study. JAMA. 2000, 284: 1534-1540. 10.1001/jama.284.12.1534.CrossRefPubMed
35.
Friedewald WT, Levy RL, Fredrickson DS: Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without Use of the prepartive ultracentrifuge. Clin Chem. 1972, 18: 499-502.PubMed
36.
Institute of Medicine: Dietary Reference Intakes: Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. 2002, Washington, DC: National Academies Press
37.
Cooper AJ, Sharp SJ, Lentjes MAH, Luben RN, Khaw KT, Wareham NJ, Forouhi NG: A prospective study of the association between quantity and variety of fruit and vegetable intake and incident type 2 diabetes. Diabetes Care. 2012, 35 (6): 1293-1300. 10.2337/dc11-2388.PubMedCentralCrossRefPubMed
38.
Crowe FL, Roddam AW, Key TJ, Appleby PN, Overvad K, Jakobsen MU, Tjønneland A, Hansen L, Boeing H, Weikert C, Linseisen J, Kaaks R, Trichopoulou A, Misirli G, Lagiou P, Sacerdote C, Pala V, Palli D, Tumino R, Panico S, Bueno-de-Mesquita HB, Boer J, van Gils CH, Beulens JW, Barricarte A, Rodríguez L, Larrañaga N, Sánchez MJ, Tormo MJ, Buckland G: European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart Study Collaborators. Fruit and vegetable intake and mortality from ischaemic heart disease: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study. Eur Heart J. 2011, 32 (10): 1235-1243. 10.1093/eurheartj/ehq465.PubMedCentralCrossRefPubMed
39.
Rutter MK, Meigs JB, Sullivan LM, D’Agostino RB, Wilson PWF: C-reactive protein, the metabolic syndrome, and prediction of cardiovascular events in the Framingham Offspring Study. Circulation. 2004, 110 (4): 380-385. 10.1161/01.CIR.0000136581.59584.0E.CrossRefPubMed
40.
Sattar N1, Gaw A, Scherbakova O, Ford I, O'Reilly DS, Haffner SM, Isles C, Macfarlane PW, Packard CJ, Cobbe SM, Shepherd J: Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation. 2003, 108 (4): 414-419. 10.1161/01.CIR.0000080897.52664.94. See commentCrossRefPubMed
41.
Balkwill F, Mantovani A: Inflammation and cancer: backto Virchow?. Lancet. 2001, 357 (9255): 539-545. 10.1016/S0140-6736(00)04046-0. See commentCrossRefPubMed
42.
Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO, Criqui M, Fadl YY, Fortmann SP, Hong Y, Myers GL, Rifai N, Smith SC, Taubert K, Tracy RP, Vinicor F: Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003, 107 (3): 499-511. 10.1161/01.CIR.0000052939.59093.45. See commentCrossRefPubMed
43.
Hara M, Matsuzaki Y, Shimuzu T, Tomita M, Ayabe T, Enomoto Y, Onitsuka T: Preoperative serum C-reactive protein level in non-small cell lung cancer. Anticancer Res. 2007, 27 (4C): 3001-3004.PubMed
44.
King DE, Mainous AG, Egan BM, Woolson RF, Geesey ME: Fiber and C-reactive protein in diabetes, hypertension, and obesity. Diabetes Care. 2005, 28 (6): 1487-1489. 10.2337/diacare.28.6.1487.CrossRefPubMed
45.
Koenig W, Sund M, Fröhlich M, Fischer HG, Löwel H, Döring A, Pepys MB: C-Reactive protein, a sensitive marker of inflammation, predicts future risk of coronary heart disease in initially healthy middle-aged men: results from the MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) Augsburg Cohort Study 1984 to 1992. Circulation. 1999, 99 (2): 237-242. 10.1161/01.CIR.99.2.237.CrossRefPubMed
46.
Ajani UA, Ford ES, Mokdad AH: Dietary fiber and C-Reactive protein: findings from National Health and Nutrition Examination Survey Data. J Nutr. 2004, 134 (5): 1181-1185.PubMed
47.
Villaseñor A, Ambs A, Ballard-Barbash R, Baumgartner KB, McTiernan A, Ulrich CM, Neuhouser ML: Dietary fiber is associated with circulating concentrations of C-reactive protein in breast cancer survivors: the HEAL study. Breast Cancer Res Treat. 2011, 129 (2): 485-494. 10.1007/s10549-011-1474-6.PubMedCentralCrossRefPubMed
48.
King DE, Egan BM, Woolson RF, Mainous AG, Al-Solaiman Y, Jesri A: Effect of a high-fiber diet vs a fiber-supplemented diet on C-reactive protein level. Arch Intern Med. 2007, 167: 502-506. 10.1001/archinte.167.5.502.CrossRefPubMed
49.
Ma Y, Griffith JA, Chasan-Taber L, Olendzki BC, Jackson E, Stanek EJ, Li W, Pagoto SL, Hafner AR, Ockene IS: Association between dietary fiber and serum C-reactive protein. Am J Clin Nutr. 2006, 83: 760-766.PubMedCentralPubMed
50.
de Mello VDF, Schwab U, Kolehmainen M, Koenig W, Siloaho M, Poutanen K, Mykkänen H, Uusitupa M: A diet high in fatty fish, bilberries and wholegrain products improves markers of endothelial function and inflammation in individuals with impaired glucose metabolism in a randomized controlled trial: The Sysdimet study. Diabetologia. 2011, 54: 2755-2767. 10.1007/s00125-011-2285-3.CrossRefPubMed
51.
Howard BV, Van Horn L, Hsia J, Manson JE, Stefanick ML, Wassertheil-Smoller S, Kuller LH, LaCroix AZ, Langer RD, Lasser NL: Low-fat dietary pattern and risk of cardiovascular disease: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. JAMA. 2006, 295 (6): 655-666. 10.1001/jama.295.6.655.CrossRefPubMed
52.
Lefevre M, Jonnalagadda S: Effect of whole grains on markers of subclinical inflammation. Nutr Rev. 2012, 70 (7): 387-396. 10.1111/j.1753-4887.2012.00487.x.CrossRefPubMed
53.
Gomes MB, Cobas RA, Matheus AS, Tannus LR, Negrato CA, Rodacki M, Braga N, Cordeiro MM, Luescher JL, Berardo RS, Nery M, Arruda-Marques MC, Calliari LE, Noronha RM, Manna TD, Zajdenverg L, Salvodelli R, Penha FG, Foss MC, Foss-Freitas MC, Pires AC, Robles FC, Guedes M, Dib SA, Dualib P, Silva SC, Sepulvida J, Almeida HG, Sampaio E, Rea R: Regional differences in clinical care among patients with type 1 diabetes in Brazil: brazilian type 1 diabetes study group. Diabetol Metab Syndr. 2012, 4: 44-10.1186/1758-5996-4-44.PubMedCentralCrossRefPubMed
Metadata
Title
Fiber intake and inflammation in type 1 diabetes
Authors
Fernanda S R Bernaud
Mileni Vanti Beretta
Cigléa do Nascimento
Fabrícia Escobar
Jorge L Gross
Mirela J Azevedo
Ticiana C Rodrigues
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Diabetology & Metabolic Syndrome / Issue 1/2014
Electronic ISSN: 1758-5996
DOI
https://doi.org/10.1186/1758-5996-6-66

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