DF: Diabetes (2008)
Dietary Fiber and Diabetes
What is the evidence that dietary fiber from whole foods and dietary supplements is beneficial in diabetes?
Doses of 8-26 grams dietary fiber at a single meal or 30-50 grams of dietary fiber per day produced short and long term benefits on glycemic control. Sources of soluble fiber may be more effective in decreasing serum glucose than insoluble fiber.
These diets may also have beneficial effects on serum lipids, insulin sensitivity, and markers of inflammation in this population, however further study is required to identify specific recommendations for optimal dosage and types of fiber.
Doses of 6-19 grams of fiber supplements per meal or 10-29 grams of fiber supplements per day produced inconsistent short and long-term benefits on glycemic control. Soluble fiber supplements may be more effective in decreasing serum glucose than insoluble fiber. These studies are limited by the utilization of both soluble and insoluble fibers from several sources, some with combinations of sources within studies. Further study is required to identify specific recommendations for optimal dosage and types of fiber.
It is unclear at this time if fiber supplements have a beneficial effect on serum lipids in diabetes.
Based on the current data, it would appear that diets providing 30-50g fiber per day from whole food sources consistently produce lower serum glucose levels compared to a low fiber diet. Fiber supplements provided in doses of 10-29 grams per day may have some benefit in terms of glycemic control.
- Grade I means there is Good/Strong evidence supporting the statement;
- Grade II is Fair;
- Grade III is Limited/Weak;
- Grade IV is Expert Opinion Only;
- Grade V is Not Assignable.
Evidence Summary: Dietary fiber supplements and health benefits in diabetes
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- Alles MS, deRoos NM, Bakx JC, van de Lisdonk E, Zock PL, Hautvast GA. Consumption of fructooligosaccharides does not favorably affect blood glucose and serum lipid concentrations in patients with type 2 diabetes. Am J Clin Nutr. 1999 Jan; 69 (1): 64-69.
- Bruttomesso D, Briani G, Bilardo G, Vitale E, Lavagnini T, Marescotti C, Duner E, Giorato C, Tiengo A. The medium-term effect of natural or extractive dietary fibres on plasma amino acids and lipids in type 1 diabetics. Diabetes Res Clin Pract. 1989, Feb 15; 6 (2): 149-155. PMID: 2538300.
- Feldman N, Norenberg C, Voet H, Manor E, Berner Y, Madar Z. Enrichment of an Israeli ethnic food with fibres and their effects on the glycaemic and insulinaemic responses in subjects with non-insulin-dependent diabetes mellitus. Br J Nutr. 1995 Nov; 74 (5): 681-688. PMID: 8541274.
- Hanai H, Ikuma M, Sato Y, et al. Long-term effects of water-soluble corn bran hemicellulose on glucose tolerance in obese and non-obese patients: Improved insulin sensitivity and glucose metabolism in obese subjects. Biosci Biotechnol Biochem. 1997; 61: 1,358-1,361.
- Jenkins DJ, Wolever TM, Taylor RH, Barker HM, Fielden H, Jenkins AL. Effect of guar crispbread with cereal products and leguminous seeds on blood glucose concentrations of diabetics. Br Med J. 1980 Nov 8; 281 (6,250): 1,248-1,250. PMID: 6253021.
- Jenkins AL, Jenkins DJA, Zdravkovic U, Wursch P, Vuksan V. Depression of the glycemic index by high levels of beta-glucan fiber in two functional foods tested in type 2 diabetes. European Journal of Clinical Nutrition 2002; 56:622-628.
- Kirsten R, Heintz B, Nelson K, Oremek G, Speck U. Influence of two guar preparations on glycosylated hemoglobin, total cholesterol and triglycerides in patients with diabetes mellitus. Int J Clin Pharmacol Ther Toxicol. 1992 Dec; 30 (12): 582-586. PMID: 1335441.
- Lu ZX, Walker KZ, Muir JG, O'Dea K. Arabinoxylan fibre improves metabolic control in people with Type II diabetes. Eur J Clin Nutr. 2004 Apr; 58 (4): 621-628. PMID: 15042130.
- Schwab U, Louheranta A, Torronen A, Uusitupa M. Impact of sugar beet pectin and polydextrose on fasting and postprandial glycemia and fasting concentrations of serum total and lipoprotein lipids in middle-aged subjects with abnormal glucose metabolism. Eur J Clin Nutr. 2006 Sep; 60(9): 1,073-1,080. Epub 2006 Mar 8. PMID: 16523204.
- Tapola N, Karvonen H, Niskanen L, Mikola M, Sarkkinen E.Glycemic responses of oat bran products in type 2 diabetic patients. Nutr Metab Cardiovasc Dis. 2005 Aug; 15 (4): 255-261. PMID: 16054549.
- Vaaler S, Hanssen KF, Dahl-Jorgensen K, Frolich W, Aaseth J, Odegaard B, Aagenaes O. Diabetic control is improved by guar gum and wheat bran supplementation. Diabet Med. 1986 May; 3 (3): 230-233. PMID: 3030619.
- Vuksan V, Jenkins DJ, Spadafora P, Sievenpiper JL, Owen R, Vidgen E, Brighenti F, Josse R, Leiter LA, Bruce-Thompson C. Konjac-mannan (glucomannan) improves glycemia and other associated risk factors for coronary heart disease in type 2 diabetes. A randomized controlled metabolic trial. Diabetes Care. 1999 Jun; 22 (6): 913-919. PMID: 10372241.
Evidence Summary: What is the evidence that dietary fiber from whole foods is beneficial in diabetes?
- Quality Rating Summary
For a summary of the Quality Rating results, click here.
- Asp NG, Agardh CD, Ahren B, Dencker I, Johansson CG, Lundquist I, Nyman M, Sartor G, Schersten B. Dietary fibre in type II diabetes. Acta Med Scand Suppl. 1981; 656: 47-50.
- Chandalia M, Garg A, Lutjohann D, von Bergmann K, Grundy SM, Brinkley LJ. Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus. N Engl J Med. 2000:342:1392-1398.
- Del Toma E, Lintas C, Clementi A, Marcelli M. Soluble and insoluble dietary fiber in diabetic diets. Eur J Clin Nutr. 1988;42: 313-319.
- Jacobs DR Jr., Pereira MA, Stumpf K, Pins JJ, Adlercreutz H. Whole grain food intake elevates serum enterolactone. Br J Nutr. 2002 Aug; 88 (2): 111-116. PMID: 12144714.
- Jenkins DJ, Goff DV, Leeds AR, Alberti KG, Wolever TM, Gassull MA, Hockaday TD. Unabsorbable carbohydrates and diabetes: Decreased post-prandial hyperglycaemia. Lancet. 1976 Jul 24; 2 (7978): 172-174. PMID: 73796.
- Juntunen, KS, Laaksonen DE, Poutanen KS, Niskanen LK, Mykkanen HM. High-fiber rye bread and insulin secretion and sensitivity in healthy postmenopausal women. Am J Clin Nutr. 2003; 77: 385-391.
- Karlstrom B, Vessby B, Asp NG, Ytterfors A. Effects of four meals with different kinds of dietary fibre on glucose metabolism in healthy subjects and non-insulin-dependent diabetic patients. Eur J Clin Nutr. 1988 Jun; 42 (6): 519-526.
- Lintas C, Cappelloni M, Bonmassar L, Clementi A, Del Toma E, Ceccarelli G. Dietary fibre, resistant starch and in vitro starch digestibility of cereal meals. Glycaemic and insulinaemic responses in NIDDM patients. Eur J Clin Nutr. 1995 Oct; 49 Suppl 3: S264-S267. No abstract available. PMID: 8549543.
- Mahalko JR, Sandstead HH, Johnson LK, Inman LF, Milne DB, Warner RC, Haunz EA. Effect of consuming fiber from corn bran, soy hulls, or apple powder on glucose tolerance and plasma lipids in type II diabetes. Am J Clin Nutr. 1984 Jan; 39 (1): 25-34.
- McKeown NC, Meigs JB, Liu S, et al. Carbohydrate nutrition, insulin resistance, and the prevalance of the metabolic syndrome in the Framingham offspring cohort, Diabetes Care. 2004; 27: 538-546.
- Parsons SR. Effects of high fiber breakfasts on glucose metabolism in noninsulin-dependent diabetics. Am J Clin Nutr. 1984 Jul; 40 (1): 66-71.
- Qi L, Meigs JB, Liu S, Manson JE, Mantzoros C, Hu FB. Dietary fibers and glycemic load, obesity, and plasma adiponectin levels in women with type 2 diabetes. Diabetes Care. 2006 July; 29 (7): 1,501-1,505.
- Qi L, Rimm E, Liu S, Rifai N, Hu FB. Dietary glycemic index, glycemic load, cereal fiber, and plasma adiponectin concentration in diabetic men. Diabetes Care. 2005 May; 28 (5): 1,022-1,028. PMID: 15855561.
- Qi L, Vam Dam RM, Liu S, Franz M, Mantzoros C, Hu FB. Whole-grain, bran, and cereal fiber intakes and markers of systemic inflammation in diabetic women. Diabetics Care. 29: 207-211, 2006.
Search Plan and Results: Dietary Fiber vs. Fiber Supplement: DM