|BELALCAZAR, MARIA - University Of Texas Medical Branch|
|ANDERSON, ANDREA - University Of Texas Medical Branch|
|LANG, WEI - University Of Texas Medical Branch|
|SCHWENKE, DAWN - Arizona State University|
|HAFFNER, STEVEN - University Of Texas Health Science Center|
Submitted to: Journal of the Academy of Nutrition and Dietetics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/11/2014
Publication Date: 10/1/2014
Publication URL: http://handle.nal.usda.gov/10113/61327
Citation: Belalcazar, M.L., Anderson, A.M., Lang, W., Schwenke, D.C., Haffner, S.M., Raatz, S.K. 2014. Fiber intake and plasminogen activator inhibitor-1 in type 2 diabetes: Look AHEAD (Action for Health in Diabetes) Trial findings at baseline and 1 year. Journal of the Academy of Nutrition and Dietetics. 114(11):1800-1810.e2.
Interpretive Summary: We examined the associations of fiber intake and its changes I plasminogen activator inhibitor, a marker of metabolic disease risk. before and during an intensive lifestyle intervention (ILI) for weight loss in 1,701 participants. Higher baseline intake of fruit and high-fiber grain and cereal 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 that were not related to PAI-1 change.
Technical 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 (P¼0.008); this association persisted after weight and fitness adjustments (P¼0.03). Higher baseline intake of fruit (P¼0.019) 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 e2.35 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.