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Fiber intake and plasminogen activator inhibitor-1 in type 2 diabetes: Look AHEAD (Action for Health in Diabetes) trial findings at baseline and year 1.

Abstract
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.
AuthorsL Maria Belalcazar, Andrea M Anderson, Wei Lang, Dawn C Schwenke, Steven M Haffner, Hiroshi Yatsuya, Julia Rushing, Mara Z Vitolins, Rebecca Reeves, F Xavier Pi-Sunyer, Russell P Tracy, Christie M Ballantyne, Look AHEAD (Action for Health in Diabetes) Research Group
JournalJournal of the Academy of Nutrition and Dietetics (J Acad Nutr Diet) Vol. 114 Issue 11 Pg. 1800-10.e2 (Nov 2014) ISSN: 2212-2672 [Print] United States
PMID25131348 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
CopyrightCopyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Chemical References
  • Dietary Fiber
  • Plasminogen Activator Inhibitor 1
  • SERPINE1 protein, human
Topics
  • Behavior Therapy
  • Body Mass Index
  • Cardiovascular Diseases (complications, epidemiology, etiology, prevention & control)
  • Cohort Studies
  • Combined Modality Therapy
  • Diabetes Mellitus, Type 2 (blood, complications, diet therapy, therapy)
  • Diabetic Angiopathies (complications, epidemiology, prevention & control)
  • Diabetic Cardiomyopathies (complications, epidemiology, prevention & control)
  • Diet, Reducing
  • Dietary Fiber (therapeutic use)
  • Exercise
  • Female
  • Follow-Up Studies
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Overweight (blood, complications, diet therapy, therapy)
  • Patient Compliance
  • Physical Fitness
  • Plasminogen Activator Inhibitor 1 (blood)
  • Risk
  • Texas (epidemiology)
  • Weight Loss

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