Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Diabetes Obes Metab. 2023 Jul;25(7):1911-1921. doi: 10.1111/dom.15054. Epub 2023 Apr 3.
To assess the associations of total dietary fibre and fibre from different food sources (ie, cereal, fruit and vegetables) with the risk of diabetes.
The Melbourne Collaborative Cohort Study enrolled 41 513 participants aged 40 to 69 years from 1990 to 1994. The first and second follow-ups were conducted in 1994 to 1998 and 2003 to 2007, respectively. Self-reported diabetes incidence was recorded at both follow-ups. We analysed data from 39 185 participants, with a mean follow-up of 13.8 years. The relationships between dietary fibre intake (total, fruit, vegetable and cereal fibre) and the incidence of diabetes were assessed using modified Poisson regression, adjusted for dietary, lifestyle, obesity, socioeconomic and other possible confounders. Fibre intake was categorized into quintiles.
At total of 1989 incident cases were identified over both follow-up surveys. Total fibre intake was not associated with diabetes risk. Higher intake of cereal fibre (P for trend = 0.003), but not fruit (P for trend = 0.3) and vegetable fibre (P for trend = 0.5), was protective against diabetes. For cereal fibre, quintile 5 versus quintile 1 showed a 25% reduction in diabetes risk (incidence risk ratio [IRR] 0.75, 95% confidence interval [CI] 0.63-0.88). For fruit fibre, only quintile 2 versus quintile 1 showed a 16% risk reduction (IRR 0.84, 95% CI 0.73-0.96). Adjustment for body mass index (BMI) and waist-to-hip ratio eliminated the association and mediation analysis showed that BMI mediated 36% of the relationship between fibre and diabetes.
Intake of cereal fibre and, to a lesser extent, fruit fibre, may reduce the risk of diabetes, while total fibre showed no association. Our data suggest that specific recommendations regarding dietary fibre intake may be needed to prevent diabetes.
评估总膳食纤维和不同食物来源（即谷物、水果和蔬菜）膳食纤维与糖尿病风险的关联。
墨尔本合作队列研究于 1990 年至 1994 年招募了 41513 名年龄在 40 至 69 岁的参与者。第一次和第二次随访分别于 1994 年至 1998 年和 2003 年至 2007 年进行。在两次随访中都记录了糖尿病的发病情况。我们对 39185 名参与者进行了数据分析，平均随访时间为 13.8 年。使用修正泊松回归分析膳食纤维摄入量（总膳食纤维、水果膳食纤维、蔬菜膳食纤维和谷物膳食纤维）与糖尿病发病之间的关系，调整了饮食、生活方式、肥胖、社会经济和其他可能的混杂因素。膳食纤维摄入量分为五分位数。
在两次随访中，共发现 1989 例新发病例。总膳食纤维摄入量与糖尿病风险无关。较高的谷物纤维摄入量（趋势 P 值=0.003），而不是水果纤维（趋势 P 值=0.3）和蔬菜纤维（趋势 P 值=0.5），与糖尿病的发生呈负相关。对于谷物纤维，第 5 五分位数与第 1 五分位数相比，糖尿病风险降低了 25%（发病率风险比[IRR]0.75，95%置信区间[CI]0.63-0.88）。对于水果纤维，只有第 2 五分位数与第 1 五分位数相比，糖尿病风险降低了 16%（IRR 0.84，95%CI 0.73-0.96）。调整体重指数（BMI）和腰臀比后，这种关联消失，中介分析表明，BMI 介导了纤维与糖尿病之间 36%的关系。
摄入谷物纤维和在较小程度上摄入水果纤维可能会降低糖尿病的风险，而总膳食纤维则与糖尿病无关。我们的数据表明，可能需要针对膳食纤维摄入提出具体建议，以预防糖尿病。
