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Open Access Research

Impact of dietary fiber intake on glycemic control, cardiovascular risk factors and chronic kidney disease in Japanese patients with type 2 diabetes mellitus: the Fukuoka Diabetes Registry

Hiroki Fujii1, Masanori Iwase12*, Toshiaki Ohkuma1, Shinako Ogata-Kaizu1, Hitoshi Ide1, Yohei Kikuchi1, Yasuhiro Idewaki1, Tamaki Joudai1, Yoichiro Hirakawa3, Kazuhiro Uchida4, Satoshi Sasaki5, Udai Nakamura1 and Takanari Kitazono1

Author Affiliations

1 Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan

2 Diabetes Centre, Hakujyuji Hospital, Fukuoka, Japan

3 Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

4 Department of Health Promotion, School of Health and Nutrition Science, Nakamura, Gakuen University, Fukuoka, Japan

5 Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo, Japan

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Nutrition Journal 2013, 12:159  doi:10.1186/1475-2891-12-159

Published: 11 December 2013

Abstract

Background

Dietary fiber is beneficial for the treatment of type 2 diabetes mellitus, although it is consumed differently in ethnic foods around the world. We investigated the association between dietary fiber intake and obesity, glycemic control, cardiovascular risk factors and chronic kidney disease in Japanese type 2 diabetic patients.

Methods

A total of 4,399 patients were assessed for dietary fiber intake using a brief self-administered diet history questionnaire. The associations between dietary fiber intake and various cardiovascular risk factors were investigated cross-sectionally.

Results

Body mass index, fasting plasma glucose, HbA1c, triglyceride and high-sensitivity C-reactive protein negatively associated with dietary fiber intake after adjusting for age, sex, duration of diabetes, current smoking, current drinking, total energy intake, fat intake, saturated fatty acid intake, leisure-time physical activity and use of oral hypoglycemic agents or insulin. The homeostasis model assessment insulin sensitivity and HDL cholesterol positively associated with dietary fiber intake. Dietary fiber intake was associated with reduced prevalence of abdominal obesity, hypertension and metabolic syndrome after multivariate adjustments including obesity. Furthermore, dietary fiber intake was associated with lower prevalence of albuminuria, low estimated glomerular filtration rate and chronic kidney disease after multivariate adjustments including protein intake. Additional adjustments for obesity, hypertension or metabolic syndrome did not change these associations.

Conclusion

We demonstrated that increased dietary fiber intake was associated with better glycemic control and more favorable cardiovascular disease risk factors including chronic kidney disease in Japanese type 2 diabetic patients. Diabetic patients should be encouraged to consume more dietary fiber in daily life.

Keywords:
Adiponectin; Albuminuria; Chronic kidney disease; Diabetes mellitus; Dietary fiber; Homeostasis model assessment; Hypertension; Inflammation; Insulin resistance; Metabolic syndrome