Dietary fiber, weight gain, and cardiovascular disease risk factors in young adults.
BACKGROUND
Dietary composition may affect insulin secretion, and high insulin levels, in turn, may increase the risk for cardiovascular disease (CVD).


OBJECTIVE
To examine the role of fiber consumption and its association with insulin levels, weight gain, and other CVD risk factors compared with other major dietary components.


METHODS
The Coronary Artery Risk Development in Young Adults (CARDIA) Study, a multicenter population-based cohort study of the change in CVD risk factors over 10 years (1985-1986 to 1995-1996) in Birmingham, Ala; Chicago, III; Minneapolis, Minn; and Oakland, Calif.


METHODS
A total of 2909 healthy black and white adults, 18 to 30 years of age at enrollment.


METHODS
Body weight, insulin levels, and other CVD risk factors at year 10, adjusted for baseline values.


RESULTS
After adjustment for potential confounding factors, dietary fiber showed linear associations from lowest to highest quintiles of intake with the following: body weight (whites: 174.8-166.7 lb [78.3-75.0 kg], P<.001; blacks: 185.6-177.6 lb [83.5-79.9 kg], P = .001), waist-to-hip ratio (whites: 0.813-0.801, P = .004; blacks: 0.809-0.799, P = .05), fasting insulin adjusted for body mass index (whites: 77.8-72.2 pmol/L [11.2-10.4 microU/mL], P = .007; blacks: 92.4-82.6 pmol/L [13.3-11.9 microU/mL], P = .01) and 2-hour postglucose insulin adjusted for body mass index (whites: 261.1-234.7 pmol/L [37.6-33.8 microU/mL], P = .03; blacks: 370.2-259.7 pmol/L [53.3-37.4 microU/mL], P<.001). Fiber was also associated with blood pressure and levels of triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and fibrinogen; these associations were substantially attenuated by adjustment for fasting insulin level. In comparison with fiber, intake of fat, carbohydrate, and protein had inconsistent or weak associations with all CVD risk factors.


CONCLUSIONS
Fiber consumption predicted insulin levels, weight gain, and other CVD risk factors more strongly than did total or saturated fat consumption. High-fiber diets may protect against obesity and CVD by lowering insulin levels.
Ludwig
D S
DS
Department of Medicine, Children's Hospital, Boston, Mass 02115, USA.
Pereira
M A
MA
Kroenke
C H
CH
Hilner
J E
JE
Van Horn
L
L
Slattery
M L
ML
Jacobs
D R
DR
D000328:Adult; D001741:Black or African American; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D003625:Data Collection; D004041:Dietary Fats; D004043:Dietary Fiber; D005260:Female; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D008055:Lipids / Q000097:blood; D008297:Male; D015233:Models, Statistical; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D015430:Weight Gain; D044465:White People
D004041:Dietary Fats; D004043:Dietary Fiber; D007328:Insulin; D008055:Lipids