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Fiber is an important part of everyone's diet so here is some information on fiber supplementation...


The Clinical Impact of Fiber Supplementation
for the Reduction of Postprandial Blood Glucose
and Risk Reduction of Complications from Diabetes
Author: Freed, SH, diabetesincontrol@home.com; Joffe, DJ, djoffe@tampabay.rr.com
Source: Diabetes In Control Newsletter, Issue 15 (1) : 12-18 2000 Aug

Abstract:

OBJECTIVE: The prevalence of diabetes has increased dramatically in recent years1. However, the role of dietary fiber in blood glucose regulation remains unclear. The purpose of this work was to investigate the acute effects of supplementing the diet with soluble fiber in regards to it’s glucose and cholesterol lowering thereby reducing the HbA1c and therefore the complications from diabetes.

By reducing the HbA1c (Average Blood Glucose) 1%, the DCCT2 study showed Type 1 diabetics could reduce the complications of Retinopathy by 38%, Nephropathy by 28% Neuropathy by 35%. The UKPDS3 showed that by reducing the HbA1c in Type 2 diabetics by 0.9% you could reduce any diabetic end point by 12%, reduce any Microvascular end point by 25%, reduce MI by 16%, reduce Retinopathy by 21% and reduce microalbuminurea at 12 years by 34%.

The UKPDS also showed that Postprandial (blood glucose 1-2 hours after eating) glucose is a better indicator of glycemic control than fasting glucose levels4. Treatment of postprandial hyperglycemia is critical to achieving optimal outcomes in type 2 diabetes5.

The New England JM6 5/2000 showed that a high intake of dietary fiber 50 gms particularly of the soluble type, improves glycemic control, decreases hyperinsulinemia, and lowers plasma lipid concentrations in patients with type 2 diabetes.

METHODS:

After 30 days of monitoring fasting and postprandial blood glucose, a base HbA1c (9.2%), cholesterol screen-total cholesterol (210), Triglycerides (299), HDL (35), weight (208lbs.)and blood pressure(145/82), Average Postprandial blood glucose(250mg/dl.), average fasting blood glucose (150mg/dl.) were taken. Fifteen patients (7male/8 female), average age 65, were given 10grams of soluble fiber to be added to their diet of 15-20 grams. Fiber (Bios Life 2) consisted of Guar Gum, Gum Arabic, Locust Bean Gum, Pectin, Oat Fiber (Source of Beta Glucans), and Stevia dispersed in Calcium Carbonate. Five grams were taken twice daily 5-10 minutes prior to eating for 90 days. They continued to monitor fasting and postprandial blood glucose through the study period. At the conclusion of the 90 day period, their levels were measured.

RESULTS:

Compliance with the fiber diet and supplementation was excellent. During the 12 weeks of the high-fiber diet and supplementation, mean daily preprandial plasma glucose concentrations were 17 percent lower (95 percent confidence interval). The high-fiber diet and supplementation also lowered the area under the curve for 2-hour plasma glucose concentrations, by 36 percent. The high-fiber diet and supplementation reduced plasma total cholesterol concentrations by 12 percent, triglyceride concentrations by 42 percent, raised high-density lipoprotein cholesterol concentrations by 6 percent, reduced body weight by an average of 6 pounds, lowered blood pressure from 145/82 to 131/77 and lowered HbA1c from 9.2% to 7.8%(1.4 decrease).

CONCLUSIONS:

A high intake of dietary fiber, particularly of the soluble type, above the level recommended by the ADA (25-30grm.), improves glycemic control, decreases hyperinsulinemia, and lowers plasma lipid concentrations in patients with type 2 diabetes. Reducing postprandial blood glucose significantly caused a decrease of HbA1c by 1.4%, therefore reducing the complications from diabetes. 2-5-6


1-Beckles GLA et al. Diabetes Care. 1998;21:1432-1438.American Diabetes Association. Diabetes Care. 1998;21(Suppl 1).Colwell JA. Ann Intern Med. 1996;124(1pt2):131-135.Abraira C et al. Diabetes Care. 1992;15:1560-1571.Klein R et al. Am J Epidemiol. 1987;126:415-428.Cowie CC et al. Diabetes in America. 2nd ed.vol. 44, November ol. 44, November, 1995. 2- The New England Journal of Medicine -- September 30, 1993 -- Vol. 329, No. 14-DCCT research group, Diabetes 95;44:969-983; 3- Hawaii Med J 2000 Jul;59(7):295-8, 313; BMJ. 2000 Aug 12;321(7258):405-12. 4. Harris et al. Diabetes Care. 1994. 5- De Veciana et al. N Engl J Med. 1995;333:1239

6- NEJM May 11, 2000 - Vol. 342, No. 19; Klein, R, Diabetes Care. 1996:18:258-268

Source Information. Can J Physiol Pharmacol June 1988; J Am Coll Nutr Aug 1996; Jama 1999;282; Am J Clin Nut 1993;58:513-8; Ann Intern Med April 1978; Va Med Nov 1979; Vopr Pitan 1994; Am Fam Physician Apr. 1989; Am J Clin Nutr Nov 1991; Can J Physiol Pharmacol June 1988 (For complete Study – www.diabetesincontrol.com )

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The Clinical Impact of Fiber Supplementation on Cardio-Vascular Risk Parameters in Type 2 Diabetes:
http://www.makelifebetter.com/global...ife_Study.html

Diverticular Disease and Fiber...
http://www.vitacost.com/science/hn/C...ar_Disease.htm
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Long-term effects of fiber on cholesterol levels - adapted from the American Journal of Medicine, December 1994
Nutrition Research Newsletter, Feb, 1995

The cholesterol-lowering efficacy of dietary fiber has been a subject of controversy. Some scientists have argued that the reduction in serum cholesterol associated with high fiber diets is a direct result of increased fiber intake while others believe that it may be an indirect effect of an accompanying reduction in the consumption of saturated fat and cholesterol. It has also been unclear whether the effectiveness of fiber varies depending on the fat content of the diet and whether all types of water-soluble fiber are equally effective in lowering serum cholesterol.

To evaluate the effects of fiber supplementation in combination with a low-fat diet, researchers from several US institutions conducted a multicenter 15-week, placebo-controlled study in which hypercholesterolemic subjects following a Step One diet received 20 g or 10 g of a fiber supplement or a placebo daily. The supplement consisted of a mixture of guar gum, pectin, soy fiber, pea fiber, and corn bran. As previously reported, the fiber supplement lowered total cholesterol by 5 to 6%, low-density lipoprotein (LDL) cholesterol by 7 to 8%, and the ratio of LDL to high-density lipoprotein (HDL) cholesterol by 6 to 9%.

This report describes an unblinded follow-up study in which 59 subjects who had completed the double-blind study were asked to take 20 g of the fiber supplement for an additional 36 weeks in order to determine the effect of long-term fiber supplementation on lipoprotein levels. Because some subjects had received the active agent during the double-blind phase of the study while others had received an inactive placebo, the total length of fiber supplementation ranged from 36 to 51 weeks for various subjects.

Long-term fiber supplementation significantly reduced total cholesterol, LDL cholesterol, and the LDL/HDL ratio, by 5, 9, and 11%, respectively. Changes were apparent after three weeks of treatment, with the maximum effect occurring by the 15th week. The benefits of fiber persisted throughout the 36- to 51-week treatment period.

These results support the hypothesis that long-term fiber supplementation can have moderate cholesterol-lowering effects for patients who are following a Step One diet. An accompanying editorial cautions, however, that many gaps in the knowledge of the fiber/ cholesterol relationship remain to be filled. More needs to be learned about the precise mechanisms of the cholesterol-lowering action of dietary fiber, the differences in effects of different types of fiber, and the amount of fiber that needs to be consumed in order to reduce cholesterol levels significantly.

Donald B Hunninghake, Valery T Miller, John C Larosa et al, Long-Term Treatment of Hypercholesterolemia with Dietary Fiber, American J Medicine 97(6):504-508 Dec 1994) [Reprints: Robert R O'Connor, Sandoz Pharmaceuticals Corporation, 59 Route 10, East Hanover NJ 07936]

Abhimanyu Garg, Efficacy of Dietary Fiber in Lowering Serum Cholesterol [Editorial], American J Medicine 97(6)-501-503 (Dec 1994) [Reprints: Abhimanyu Garg,

MBBS, MD, Center for Human Nutrition, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas TX 75235-9052]
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http://www.vitacost.com/science/hn/Supp/Fiber.htm

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