Journal
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
Volume 114, Issue 11, Pages 1800-+Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jand.2014.06.357
Keywords
Lifestyle intervention; Weight loss; Cardiovascular disease risk; Fibrinolysis; Obesity
Categories
Funding
- National Heart, Lung, and Blood Institute [HL090514]
- National Institute of Diabetes and Digestive and Kidney Diseases
- National, Heart, Lung, and Blood Institute
- National Institute of Nursing Research
- Office of Research on Women's Health
- National Center on Minority Health and Health Disparities
- Centers for Disease Control and Prevention
- ARS [813640, ARS-0427566] Funding Source: Federal RePORTER
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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.
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