High-fibre, low fat diet pedicts long term weight loss and decreased type 2 diabetes risk: The Finnish Diabetes Prevention Study

Diabetes and Genetic Epidemiology Unit, Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland.
Diabetologia (Impact Factor: 6.67). 05/2006; 49(5):912-20. DOI: 10.1007/s00125-006-0198-3
Source: PubMed


The aim of this study was to investigate the association of dietary macronutrient composition and energy density with the change in body weight and waist circumference and diabetes incidence in the Finnish Diabetes Prevention Study.
Overweight, middle-aged men (n=172) and women (n=350) with impaired glucose tolerance were randomised to receive either 'standard care' (control) or intensive dietary and exercise counselling. Baseline and annual examinations included assessment of dietary intake with 3-day food records and diabetes status by repeated 75-g OGTTs. For these analyses the treatment groups were combined and only subjects with follow-up data (n=500) were included.
Individuals with low fat (<median) and high fibre (>median) intakes lost more weight compared with those consuming a high-fat (>median), low-fibre (<median) diet (3.1 vs 0.7 kg after 3 years). In separate models, hazard ratios for diabetes incidence during a mean follow-up of 4.1 years were (highest compared with lowest quartile) 0.38 (95% CI 0.19-0.77) for fibre intake, 2.14 (95% CI 1.16-3.92) for fat intake, and 1.73 (95% CI 0.89-3.38) for saturated-fat intake, after adjustment for sex, intervention assignment, weight and weight change, physical activity, baseline 2-h plasma glucose and intake of the nutrient being investigated. Compared with the low-fat/high-fibre category, hazard ratios were 1.98 (95% CI 0.98-4.02), 2.68 (95% CI 1.40-5.10), and 1.89 (95% CI 1.09-3.30) for low-fat/low-fibre, high-fat/high-fibre, and high-fat/low-fibre, respectively.
Dietary fat and fibre intake are significant predictors of sustained weight reduction and progression to type 2 diabetes in high-risk subjects, even after adjustment for other risk factors.

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Available from: Matti I J Uusitupa, Oct 06, 2015
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    • "Reducing the amount of daily kilocalories and fat grams con - sumed is essential for healthy weight loss ( Lindström et al . , 2006 ; Sacks et al . , 2009 ) , though decreasing dietary intake is known to be a substantial challenge ( Fan & Jin , 2013 ; Glanz et al . , 2005 ; Lillis , Hayes , Bunting , & Masuda , 2009 ; Tapper et al . , 2009 ) . In order to help people lose and maintain weight loss , effective interventions must address both psychological processes an"
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    ABSTRACT: The objective of this study was to evaluate an intervention that combined mindful eating and online pre-ordering to promote healthier lunch purchases at work. The study took place at an urban hospital with 26 employees who were overweight or obese. The design included a contemporaneous comparison with delayed-treatment control and a three-phase prospective study. A minimum 4-week baseline period preceded a 4-week full-intervention, in which participants received mindful eating training, pre-ordered their lunches, and received price discounts toward lunch purchases. In a 4-week reduced intervention phase, participants pre-ordered lunches without price discounts. Participant lunch purchases were tracked electronically at the point of purchase. The primary outcome measures were the amounts of kilocalories and fat grams in purchased lunches. In contemporaneous comparisons, the treatment group purchased lunches with an average of 144.6 fewer kilocalories (p=0.01) and 8.9 fewer grams of fat (p=0.005) compared to controls. In multivariable longitudinal analyses, participants decreased the average number of calories in their meals by 114.6 kcal per lunch and the average grams of fat by 5.4 per lunch during the partial-intervention compared to the baseline (p<0.001). At the end of the study, a moderate increase was observed in participants' overall mindful eating behaviors as compared to the beginning of the study (p<0.001). The majority of participants (92%) said they would use the pre-ordering system if offered in the future. Combined mindful eating training and online pre-ordering appears a feasible and useful worksite intervention to improve food choices by employees.
    Appetite 10/2014; 84. DOI:10.1016/j.appet.2014.10.005 · 2.69 Impact Factor
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    • "Overall obesity, central obesity and the decline in physical activity have been shown to be associated with elevated risk of incident type 2 diabetes, independent of one another16, and therefore, it is reasonable to suppose that the increase in overall and central obesity, and decreased frequency of physical activity contributed to the steep increment in the prevalence of type 2 diabetes among the elderly in the present study. Another possible explanation is that higher intake of animal fat is related to the rise in the prevalence of type 2 diabetes1. Our previous study reported that the percentage of energy intake from fat among Hisayama residents was unchanged at approximately 25% between 1985 and 2004, but the proportion of animal fat to total fat intake tended to increase from 42.3 to 47.5% during this period30. "
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    ABSTRACT: Aims/IntroductionWe examined secular trends in the prevalence of type 2 diabetes and prediabetes in community-dwelling Japanese subjects.Materials and MethodsA total of 2,490 subjects in 1988 and 2,852 subjects in 2002 aged 40–79 years underwent a 75-g oral glucose tolerance test, and their glucose tolerance status was defined by the 1998 World Health Organization criteria.ResultsThe age-adjusted prevalence of type 2 diabetes increased significantly from 1988 to 2002 in men (14.6% in 1988 to 20.8% in 2002, P < 0.001) and women (9.1% in 1988 to 11.2% in 2002, P = 0.002). A significant rise in the age-adjusted prevalence of prediabetes was also observed in both sexes (26.2% in 1988 to 35.3% in 2002, P < 0.001 for men; 22.5% in 1988 to 25.1% in 2002, P = 0.04 for women). In age-stratified analysis, the prevalence of type 2 diabetes increased markedly over time in men aged 60–69 and 70–79 years (both P < 0.001) and women aged 70–79 years (P = 0.02). The prevalence of overall and central obesity increased significantly in men aged 60–69 and 70–79 years, and women aged 70–79 years from 1988 to 2002, whereas the frequency of regular exercise decreased significantly in men aged 70–79 years between the surveys.Conclusions Our findings suggest that the prevalence of type 2 diabetes and prediabetes increased significantly in both sexes from the 1980s to the 2000s in a general Japanese population, and that the increasing prevalence of obesity and the decline in physical activity exerted an influence on this rising trend.
    03/2014; 5(2). DOI:10.1111/jdi.12136
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    • "Diabetes and its co-morbidities are costly diseases [17]. The most important risk factors for T2D are obesity , sedentary lifestyle and unhealthy diet [18] [19] [20]. Smoking is also associated with increased T2D risk [21]. "
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    ABSTRACT: To assess the risk for type 2 diabetes (T2D) and cardiovascular disease (CVD) among employees of a Finnish airline; to study the association of shift work with T2D and CVD risk; and to test the feasibility of risk screening in occupational health care setting. Altogether 4169 employees were invited for a health check-up and 2312 participated in this study. The check-up included physical examinations, questionnaires on working hours, sleep, and lifestyle, diabetes risk score FINDRISC, and blood tests. Lifestyle counselling was offered for those with increased T2D risk. Altogether 15% of participants had a high T2D risk (FINDRISC≥15 and/or elevated, but non-diabetic blood glucose), and a further 15% had a moderate T2D risk (FINDRISC 10-14 and normal blood glucose). Of those 60% agreed to attend lifestyle counselling. Metabolic syndrome was more common, lipid profile more unfavorable and hsCRP higher by increasing FINDRISC score category. Risk factor profiles linked to shift work status were not self-evident. The renewed health check-up process effectively identified those employees with increased T2D and CVD risk who would benefit from lifestyle intervention. The use of FINDRISC questionnaire was a feasible first-step screening method in occupational health care setting.
    02/2012; 6(2):95-102. DOI:10.1016/j.pcd.2012.01.003
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