Whole grain foods for the prevention of type 2 diabetes mellitus
ABSTRACT Diet as one aspect of lifestyle is thought to be one of the modifiable risk factors for the development of type 2 diabetes mellitus (T2DM). Information is needed as to which components of the diet could be protective for this disease.
To asses the effects of whole-grain foods for the prevention of T2DM.
We searched CENTRAL, MEDLINE, EMBASE, CINAHL and AMED.
We selected cohort studies with a minimum duration of five years that assessed the association between intake of whole-grain foods or cereal fibre and incidence of T2DM. Randomised controlled trials lasting at least six weeks were selected that assessed the effect of a diet rich in whole-grain foods compared to a diet rich in refined grain foods on T2DM and its major risk factors.
Two authors independently selected the studies, assessed study quality and extracted data. Data of studies were not pooled because of methodological diversity.
One randomised controlled trial and eleven prospective cohort studies were identified. The randomised controlled trial, which was of low methodological quality, reported the change in insulin sensitivity in 12 obese hyperinsulinemic participants after six-week long interventions. Intake of whole grain foods resulted in a slight improvement of insulin sensitivity and no adverse effects. Patient satisfaction, health related quality of life, total mortality and morbidity was not reported. Four of the eleven cohort studies measured cereal fibre intake, three studies whole grain intake and two studies both. Two studies measured the change in whole grain food intake and one of them also change in cereal fibre intake. The incidence of T2DM was assessed in nine studies and changes in weight gain in two studies. The prospective studies consistently showed a reduced risk for high intake of whole grain foods (27% to 30%) or cereal fibre (28% to 37%) on the development of T2DM.
The evidence from only prospective cohort trials is considered to be too weak to be able to draw a definite conclusion about the preventive effect of whole grain foods on the development of T2DM. Properly designed long-term randomised controlled trials are needed. To facilitate this, further mechanistic research should focus on finding a set of relevant intermediate endpoints for T2DM and on identifying genetic subgroups of the population at risk that are most susceptible to dietary intervention.
- SourceAvailable from: Aurelie Chanson-Rolle[Show abstract] [Hide abstract]
ABSTRACT: Due to the increasing evidence of their health benefits, whole grains are recommended for consumption worldwide. Such recommendations are, however, rarely quantitative. Our aim was to perform a quantitative evaluation of the relationship between whole grain consumption and the occurrence of type 2 diabetes (T2D) to support a recommendation on the daily consumption of whole grains. We conducted a systematic review by searching three bibliographic databases. We included human studies addressing the relationship between whole grain consumption and T2D occurrence, and providing quantitative information on daily intake of whole grains. A dose-response meta-regression analysis between whole grain intake and T2D occurrence was performed, using a hierarchical mixed least square linear regression model. Eight observational studies were included (all but one prospective), with a total of 15,573 cases of T2D among 316,051 participants. Quantitative meta-regression demonstrated a significant linear inverse relationship between whole grain intake and T2D occurrence (P<0.0001), with an overall absolute reduction of 0.3% in the T2D rate for each additional 10 g of whole grain ingredient consumed daily. The association persisted when adjusted on sex, age, country, study design, follow up duration, and mode of report of whole grain intakes (as foods or ingredients). The meta-regression model made it possible to estimate the decrease in T2D risk corresponding to various changes in whole grain intakes, and the results contribute to setting up quantitative recommendations. For instance, consuming three servings of whole grain foods (45 g of whole grain ingredients) daily would induce a 20% relative reduction in the T2D risk as compared to consuming a half serving (7.5 g of whole grain ingredients). These results should be considered for future recommendations, by considering the actual whole grain intake of the concerned populations. The systematic review protocol was published on the PROSPERO register (CRD42013006925).PLoS ONE 06/2015; 10(6):e0131377. DOI:10.1371/journal.pone.0131377 · 3.53 Impact Factor
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ABSTRACT: The promise of nutrigenomics is of personalized nutrition that will lead to optimization or maintenance of good health and/or prevention of the development of chronic diseases. Type 2 diabetes mellitus (T2DM) is a leading health problem throughout the world. Adherence to a Mediterranean-style diet, regulation of carbohydrate intake, and regular exercise may be desirable. Four key genes were originally identified: KCNJ11, potassium inwardly rectifying channel, subfamily J, member 11 gene; PPAR-gamma, peroxisome proliferator activated receptor-gamma; TCF2, transcription factor 2, hepatic; WFS1, Wolfram syndrome 1. However, genome-wide association studies are accelerating our knowledge of the genetics of complex diseases, and have identified seven other key genes in T2DM: CDKAL1, CDK5 regulatory subunit associated protein-like 1; CDKN2, cyclin-dependent kinase inhibitor 2A; FTO, fat mass and obesity associated; HHEX, haematopoietically expressed homeobox; IDE, insulin-degrading enzyme; IGF2BP2, insulin-like growth factor 2 mRNA-binding protein 2; SLC30A8, solute carrier family 30 (zinc transporter), member 8; TCF7L2, transcription factor 7-like 2 (T-cell specific, HMG-box). Gene-nutrient or gene-environment interactions may be important. For example, the PPAR-gamma variant genotype is responsive to different types and levels of lipids, while the effect of the FTO variant can be partly overcome by exercise. Several of these genes act through their effect on the gastrointestinal tract. There are analytical challenges in analyzing the high-dimensional datasets relating genes, nutrients, and other variables to their influence on health and disease processes. An even greater challenge may be in implementing population level changes in diet and behavior to fully exploit the potential of this field.Omics: a journal of integrative biology 09/2008; 12(4):237-44. DOI:10.1089/omi.2008.0044 · 2.73 Impact Factor
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ABSTRACT: Students majoring in hospitality, family consumer science, and dietetics in undergraduate institutions could influence how often whole grains are used by both consumers and individually. Presently, some individuals are unfamiliar with a variety of whole grains and most do not consume the recommended number of servings per day. Students, working in groups, may learn more if allowed to self-direct their learning. The whole grains lesson offered during fall semester 2007 in one section of a university food principles and preparation class featured 10 different whole grains, prepared and rated by 46 students. Students rated some of the unfamiliar whole grains and the self-directed learning style favorably.Journal of Culinary Science & Technology 04/2009; 7(1):65-72. DOI:10.1080/15428050902788360