Below are some abstracts and links to full text articles on the research into diabetes and high fiber diet spanning about thirty years. The search was for “Anderson JW and diabetes” (without the quotes) at PubMed.
High-fibre diets for diabetic and hypertriglyceridemic patients.
J W Anderson
Can Med Assoc J. 1980 November 22; 123(10): 975–979. PMCID: PMC1704970
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1704970/pdf/canmedaj014…
Diets high in complex carbohydrate result in lower insulin requirements than the high-fat diets conventionally used to treat diabetes. Accompanying unacceptable increases in fasting triglyceride levels can be overcome by increasing the fibre content of the diet. In diabetics a diet providing 70% of energy from carbohydrate and containing 35 to 40 g of fibre per 1000 Cal will rapidly reduce the plasma glucose level and the requirement for insulin or sulfonylurea. It will also lower the serum cholesterol and triglyceride levels in individuals with hypertriglyceridemia. These improvements are maintained in patients following a modified high-carbohydrate, high-fibre diet providing 55% to 60% of energy by carbohydrate (75% of which is complex), 15% to 20% by protein and 20% to 30% by fat, with 25 g of plant fibre per 1000 Cal. With long-term use (for up to 48 months) of the maintenance diets patients maintained or corrected their body weight, and no nutritional deficiencies were observed.
Long-term effects of high-carbohydrate, high-fiber diets on glucose and lipid metabolism: a preliminary report on patients with diabetes.
Diabetes Care. 1978 Mar-Apr; 1(2):77-82.
Anderson JW, Ward K.
High-carbohydrate, high-fiber (HCF) diets have beneficial therapeutic effects for selected patients with diabetes mellitus. We have treated 10 patients with HCF diets on a metabolic ward and followed them for an average of 15 months while they were on maintenance diets at home. The HCF diets containing 70 per cent of calories as carbohydrate were accompanied by significant reductions in requirements for insulin or sulfonylureas. Fasting plasma glucose, serum cholesterol, and triglyceride values were significantly lower on the HCF diet than on a 43 per cent carbohydrate diet. On the HCF diet, insulin therapy was discontinued for five patients and sulfonylurea therapy for three. After an average of 15 months on the maintenance diet containing 55 per cent to 60 per cent carbohydrate, seven patients were still managed without insulin or sulfonylureas. Average fasting plasma glucose values during maintenance diets at home were identical to values on the HCF diets in the hospital. On the maintenance diet, serum cholesterol values were similar to initial values but serum triglyceride values were significantly lower than values on the 43 per cent carbohydrate diet. These studies indicate that moderately high-carbohydrate, high-fiber diets can be successfully followed at home and that improvements in glucose metabolism achieved in the hospital can be sustained outside the hospital.
PMID: 729433 [PubMed - indexed for MEDLINE]
Adherence to high-carbohydrate, high-fiber diets: long-term studies of non-obese diabetic men.
J Am Diet Assoc. 1985 Sep; 85(9):1105-10.
[J Am Diet Assoc. 1985]
Story L, Anderson JW, Chen WJ, Karounos D, Jefferson B.
High-carbohydrate, high-fiber (HCF) diets provide short-term benefits for selected individuals with diabetes. Long-term effects of HCF diets, however, have not previously been documented. The effectiveness and acceptability of HCF diets for 14 men with diabetes followed for 4 years as outpatients were assessed. Hospital HCF diets with 70% of energy as carbohydrate and 65 gm plant fiber daily lowered insulin doses, serum cholesterol, and triglycerides. Home HCF diets with 55% to 60% carbohydrate and 50 gm plant fiber daily sustained improvements throughout the observed period of up to 86 months. Of the 11 patients for whom diet adherence was evaluated, 9 had good to excellent adherence, 1 had fair adherence, and 1 had poor adherence.
PMID: 2993398 [PubMed - indexed for MEDLINE]
Effects of dietary fiber and carbohydrate on glucose and lipoprotein metabolism in diabetic patients.
Diabetes Care. 1991 Dec; 14(12):1115-25
Riccardi G, Rivellese AA.
Institute of Internal Medicine and Metabolic Diseases, Second Medical School, University of Naples, Italy.
Dietary recommendations for the treatment of diabetic patients issued by national and international diabetes associations consistently emphasize the need to increase carbohydrate consumption. However, these recommendations have been questioned on the basis of growing evidence that, in both insulin-dependent and non-insulin-dependent diabetic patients, a high-carbohydrate diet does not offer any advantage in terms of blood glucose and plasma lipid concentrations compared with a high-fat (mainly unsaturated) diet. It has been shown repeatedly that a high-carbohydrate diet increases plasma insulin and triglyceride levels and can deteriorate blood glucose control in the postprandial period. However, much of the controversy between advocates and detractors of dietary carbohydrate can be settled by taking into account dietary fiber. Several studies have shown that the adverse metabolic effects of high-carbohydrate diets are neutralized when fiber and carbohydrate are increased simultaneously in the diet for diabetic patients. In particular, these studies demonstrated that a high-carbohydrate/high-fiber diet significantly improves blood glucose control and reduces plasma cholesterol levels in diabetic patients compared with a low-carbohydrate/low-fiber diet. In addition, a high-carbohydrate/high-fiber diet does not increase plasma insulin and triglyceride concentrations, despite the higher consumption of carbohydrates. Unfortunately, dietary fiber represents a heterogenous category, and there is still much to understand as to which foods should be preferred to maximize the metabolic effects of fiber. There are indications that only water-soluble fiber is active on plasma glucose and lipoprotein metabolism in humans. Therefore, in practice, the consumption of legumes, vegetables, and fruits–rich in water-soluble fiber–should be particularly encouraged. The mechanisms by which dietary fiber exerts its hypoglycemic and hypolipidemic activities are unknown. However, the ability of dietary fiber to retard food digestion and nutrient absorption certainly has an important influence on lipid and carbohydrate metabolism. The beneficial effects of high-fiber foods are also exerted by some foods not particularly rich in fiber. The fiber content and physical form of the food can influence the accessibility of nutrients by digestive enzymes, thus delaying digestion and absorption. The identification of these foods with a low-glycemic response would help enlarge the list of foods particularly suitable for diabetic patients. In conclusion, a diet low in cholesterol and saturated fat should be recommended to all diabetic patients to prevent cardiovascular disease. A balanced increase in consumption of fiber-rich foods and unsaturated fat is the most rational way to replace foods rich in saturated fat and cholesterol in the diabetic diet.
PMID: 1663443 [PubMed - indexed for MEDLINE]
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Carbohydrate and fiber recommendations for individuals with diabetes: a quantitative assessment and meta-analysis of the evidence.
Anderson JW, Randles KM, Kendall CW, Jenkins DJ.
J Am Coll Nutr. 2004 Feb; 23(1):5-17.
Department of Internal Medicine, College of Medicine, and the Graduate Center for Nutritional Sciences, University of Kentucky, Lexington, Kentucky, USA. jwandersmd@aol.com
To review international nutrition recommendations with a special emphasis on carbohydrate and fiber, analyze clinical trial information, and provide an evidence-based recommendation for medical nutrition therapy for individuals with diabetes. Relevant articles were identified by a thorough review of the literature and the data tabulated. Fixed-effects meta-analyses techniques were used to obtain mean estimates of changes in outcome measures in response to diet interventions. Most international organizations recommend that diabetic individuals achieve and maintain a desirable body weight with a body mass index of </=25 kg/m(2). For diabetic subjects moderate carbohydrate, high fiber diets compared to moderate carbohydrate, low fiber diets are associated with significantly lower values for: postprandial plasma glucose, total and low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides. High carbohydrate, high fiber diets compared to moderate carbohydrate, low fiber diets are associated with lower values for: fasting, postprandial and average plasma glucose; hemoglobin A(1c); total, LDL-cholesterol, HDL-cholesterol and triglycerides. Low glycemic index diets compared to high glycemic index diets are associated with lower fasting plasma glucose values and lower glycated protein values. Based on these analyses we recommend that the diabetic individual should be encouraged to achieve and maintain a desirable body weight and that the diet should provide these percentages of nutrients: carbohydrate, >/=55%; protein, 12-16%; fat, <30%; and monounsaturated fat, 12-15%. The diet should provide 25-50 g/day of dietary fiber (15-25 g/1000 kcal). Glycemic index information should be incorporated into exchanges and teaching material.
PMID: 14963049 [PubMed - indexed for MEDLINE]
LINK to Full Article:
http://www.jacn.org/cgi/content/full/23/1/5
This link is to further studies in journals at NIH PubMed. In the right column are links to 40 reviews and 48 free full text related articles online.
http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=link&…$=relatedarticles&logdbfrom=pmc
