| Diabetes Care 1999 Mar;22 Suppl 2:B21-8
Fiber intake, serum cholesterol levels, and
cardiovascular disease in European individuals with type 1 diabetes.
EURODIAB IDDM Complications Study Group.
Toeller M, Buyken AE, Heitkamp G, de Pergola G, Giorgino
F, Fuller JH.
Clinical Department, Heinrich-Heine-University, Dusseldorf,
OBJECTIVE: A cross-sectional analysis of dietary fiber intake
was performed in European type 1 diabetic patients enrolled
in the EURODIAB IDDM Complications Study to explore its potential
relationship to serum cholesterol levels and the prevalence
of cardiovascular disease (CVD). RESEARCH DESIGN AND METHODS:
Dietary intake was assessed by a standardized 3-day dietary
record. For analysis of fiber intake (total, soluble, and insoluble)
and its associations with CVD (past history or electrocardiogram
abnormalities), complete data were available from 1,050 male
and 1,012 female individuals. Relationships of fiber intakes
to serum cholesterol levels (total, HDL, and LDL cholesterol)
were examined in 926 men and 881 women with type 1 diabetes.
RESULTS: Higher intakes of total fiber (g/day) were independently
associated with significantly higher levels of HDL cholesterol
in male (P = 0.01) and female individuals (P = 0.03). Fiber
intakes of men with type 1 diabetes were also inversely related
to ratios of total cholesterol to HDL cholesterol (P = 0.0001)
and levels of LDL cholesterol (P = 0.0002). A protective effect
of total fiber intake against CVD was observed for female subjects,
where a significant trend was maintained after adjustment for
potential confounders, including energy and saturated fat (P
= 0.03 vs. P = 0.2 in men). Results were similar in separate
analyses of soluble and insoluble fiber. CONCLUSIONS: The present
study demonstrates that higher fiber intakes are independently
related to beneficial alterations of the serum cholesterol pattern
in men and to a lower risk for CVD in European insulin-dependent
women. Beneficial effects can already be observed for fiber
amounts within the range commonly consumed by outpatients with
type 1 diabetes.