TY - JOUR
T1 - Fiber Intake and Plasminogen Activator Inhibitor-1 in Type 2 Diabetes
T2 - Look AHEAD (Action for Health in Diabetes) Trial Findings atBaseline and Year 1
AU - Belalcazar, L. Maria
AU - Anderson, Andrea M.
AU - Lang, Wei
AU - Schwenke, Dawn C.
AU - Haffner, Steven M.
AU - Yatsuya, Hiroshi
AU - Rushing, Julia
AU - Vitolins, Mara Z.
AU - Reeves, Rebecca
AU - Pi-Sunyer, F. Xavier
AU - Tracy, Russell P.
AU - Ballantyne, Christie M.
N1 - Funding Information:
This study is supported by the Department of Health and Human Services through the following cooperative agreements from the National Institutes of Health : DK57136, DK57149 , DK56990 , DK57177 , DK57171 , DK57151 , DK57182 , DK57131 , DK57002 , DK57078 , DK57154 , DK57178 , DK57219 , DK57008 , DK57135 , and DK56992 . The following federal agencies have contributed support: National Institute of Diabetes and Digestive and Kidney Diseases; National Heart, Lung, and Blood Institute; National Institute of Nursing Research; National Center on Minority Health and Health Disparities; National Institutes of Health Office of Research on Women’s Health; and the Centers for Disease Control and Prevention. This research was supported in part by the Intramural Research Program of the National Institute of Diabetes and Digestive and Kidney Diseases. The Indian Health Service provided personnel, medical oversight, and use of facilities. The opinions expressed in this paper are those of the authors and do not necessarily reflect the views of the Indian Health Service or other funding sources.
Funding Information:
Additional support was received from The Johns Hopkins Medical Institutions Bayview General Clinical Research Center ( M01RR02719 ); the Massachusetts General Hospital Mallinckrodt General Clinical Research Center ( M01RR01066 ); the University of Colorado Health Sciences Center General Clinical Research Center ( M01RR00051 ) and Clinical Nutrition Research Unit ( P30 DK48520 ); the University of Tennessee at Memphis General Clinical Research Center ( M01RR0021140 ); the University of Pittsburgh General Clinical Research Center ( M01RR000056 44 ) and NIH grant (DK 046204); the VA Puget Sound Health Care System Medical Research Service, Department of Veterans Affairs; and the Frederic C. Bartter General Clinical Research Center ( M01RR01346 ).
PY - 2014/11/1
Y1 - 2014/11/1
N2 - Plasminogen activator inhibitor 1 (PAI-1) is elevated in obese individuals with type 2 diabetes and may contribute, independently of traditional factors, to increased cardiovascular disease risk. Fiber intake may decrease PAI-1 levels. We examined the associations of fiber intake and its changes with PAI-1 before and during an intensive lifestyle intervention (ILI) for weight loss in 1,701 Look AHEAD (Action for Health in Diabetes) participants with dietary, fitness, and PAI-1 data at baseline and 1 year. Look AHEAD was a randomized cardiovascular disease trial in 5,145 overweight/obese patients with type 2 diabetes, comparing ILI (goal of ≥7% reduction in baseline weight) with a control arm of diabetes support and education. ILI participants were encouraged to consume vegetables, fruits, and grain products low in sugar and fat. At baseline, median fiber intake was 17.9 g/day. Each 8.3 g/day higher fiber intake was associated with a 9.2% lower PAI-1 level (. P=0.008); this association persisted after weight and fitness adjustments (. P=0.03). Higher baseline intake of fruit (. P=0.019) and high-fiber grain and cereal (. P=0.029) were related to lower PAI-1 levels. Although successful in improving weight and physical fitness at 1 year, the ILI in Look AHEAD resulted in small increases in fiber intake (4.1 g/day, compared with -2.35 g/day with diabetes support and education) that were not related to PAI-1 change (. P=0.34). Only 31.3% of ILI participants (39.8% of women, 19.1% of men) met daily fiber intake recommendations. Increasing fiber intake in overweight/obese individuals with diabetes interested in weight loss is challenging. Future studies evaluating changes in fiber consumption during weight loss interventions are warranted.
AB - Plasminogen activator inhibitor 1 (PAI-1) is elevated in obese individuals with type 2 diabetes and may contribute, independently of traditional factors, to increased cardiovascular disease risk. Fiber intake may decrease PAI-1 levels. We examined the associations of fiber intake and its changes with PAI-1 before and during an intensive lifestyle intervention (ILI) for weight loss in 1,701 Look AHEAD (Action for Health in Diabetes) participants with dietary, fitness, and PAI-1 data at baseline and 1 year. Look AHEAD was a randomized cardiovascular disease trial in 5,145 overweight/obese patients with type 2 diabetes, comparing ILI (goal of ≥7% reduction in baseline weight) with a control arm of diabetes support and education. ILI participants were encouraged to consume vegetables, fruits, and grain products low in sugar and fat. At baseline, median fiber intake was 17.9 g/day. Each 8.3 g/day higher fiber intake was associated with a 9.2% lower PAI-1 level (. P=0.008); this association persisted after weight and fitness adjustments (. P=0.03). Higher baseline intake of fruit (. P=0.019) and high-fiber grain and cereal (. P=0.029) were related to lower PAI-1 levels. Although successful in improving weight and physical fitness at 1 year, the ILI in Look AHEAD resulted in small increases in fiber intake (4.1 g/day, compared with -2.35 g/day with diabetes support and education) that were not related to PAI-1 change (. P=0.34). Only 31.3% of ILI participants (39.8% of women, 19.1% of men) met daily fiber intake recommendations. Increasing fiber intake in overweight/obese individuals with diabetes interested in weight loss is challenging. Future studies evaluating changes in fiber consumption during weight loss interventions are warranted.
KW - Cardiovascular disease risk
KW - Fibrinolysis
KW - Lifestyle intervention
KW - Obesity
KW - Weight loss
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U2 - 10.1016/j.jand.2014.06.357
DO - 10.1016/j.jand.2014.06.357
M3 - Article
C2 - 25131348
AN - SCOPUS:84908470231
SN - 2212-2672
VL - 114
SP - 1800-1810.e2
JO - Journal of the Academy of Nutrition and Dietetics
JF - Journal of the Academy of Nutrition and Dietetics
IS - 11
ER -