Salmerón J, Manson J E, Stampfer M J, Colditz G A, Wing A L, Willett W C
Department of Nutrition, Harvard School of Public Health, Boston, Mass, USA.
JAMA. 1997 Feb 12;277(6):472-7. doi: 10.1001/jama.1997.03540300040031.
To examine prospectively the relationship between glycemic diets, low fiber intake, and risk of non-insulin-dependent diabetes mellitus.
Cohort study.
In 1986, a total of 65173 US women 40 to 65 years of age and free from diagnosed cardiovascular disease, cancer, and diabetes completed a detailed dietary questionnaire from which we calculated usual intake of total and specific sources of dietary fiber, dietary glycemic index, and glycemic load.
Non-insulin-dependent diabetes mellitus.
During 6 years of follow-up, 915 incident cases of diabetes were documented. The dietary glycemic index was positively associated with risk of diabetes after adjustment for age, body mass index, smoking, physical activity, family history of diabetes, alcohol and cereal fiber intake, and total energy intake. Comparing the highest with the lowest quintile, the relative risk (RR) of diabetes was 1.37 (95% confidence interval [CI], 1.09-1.71, P trend=.005). The glycemic load (an indicator of a global dietary insulin demand) was also positively associated with diabetes (RR= 1.47; 95% CI, 1.16-1.86, P trend=.003). Cereal fiber intake was inversely associated with risk of diabetes when comparing the extreme quintiles (RR=0.72, 95% CI, 0.58-0.90, P trend=.001). The combination of a high glycemic load and a low cereal fiber intake further increased the risk of diabetes (RR=2.50, 95% CI, 1.14-5.51) when compared with a low glycemic load and high cereal fiber intake.
Our results support the hypothesis that diets with a high glycemic load and a low cereal fiber content increase risk of diabetes in women. Further, they suggest that grains should be consumed in a minimally refined form to reduce the incidence of diabetes.
前瞻性研究血糖生成指数饮食、低纤维摄入量与非胰岛素依赖型糖尿病风险之间的关系。
队列研究。
1986年，共有65173名年龄在40至65岁之间、未患心血管疾病、癌症和糖尿病的美国女性完成了一份详细的饮食调查问卷，据此我们计算出膳食纤维总量及特定来源、饮食血糖生成指数和血糖负荷的通常摄入量。
非胰岛素依赖型糖尿病。
在6年的随访期间，记录到915例糖尿病新发病例。在对年龄、体重指数、吸烟、身体活动、糖尿病家族史、酒精和谷物纤维摄入量以及总能量摄入量进行调整后，饮食血糖生成指数与糖尿病风险呈正相关。将最高五分位数与最低五分位数进行比较，糖尿病的相对风险（RR）为1.37（95%置信区间[CI]，1.09 - 1.71，P趋势 = 0.005）。血糖负荷（全球饮食胰岛素需求指标）也与糖尿病呈正相关（RR = 1.47；95% CI，1.16 - 1.86，P趋势 = 0.003）。比较极端五分位数时，谷物纤维摄入量与糖尿病风险呈负相关（RR = 0.72，95% CI，0.58 - 0.90，P趋势 = 0.001）。与低血糖负荷和高谷物纤维摄入量相比，高血糖负荷和低谷物纤维摄入量相结合会进一步增加糖尿病风险（RR = 2.50，95% CI，1.14 - 5.51）。
我们的研究结果支持以下假设，即高血糖负荷和低谷物纤维含量的饮食会增加女性患糖尿病的风险。此外，研究结果表明应食用最少加工形式的谷物以降低糖尿病的发病率。
