title: High dietary glycemic index and low fiber content are associated with metabolic syndrome in patients with type 2 diabetes.
abstract: OBJECTIVE
  To investigate possible associations of dietary glycemic index (GI) and fiber content with metabolic syndrome (MetS) in patients with type 2 diabetes.
  
  
  METHODS
  In this cross-sectional study, 175 outpatients with type 2 diabetes (aged 61.1 ± 9.7 years; HbA(1c) 7.3% ± 1.4%; diabetes duration of 11 years [range, 5-17]) had food intake assessed by 3-day weighed-diet records. Dietary GI (according to FAO/WHO) and fiber content were categorized as high or low based on median values. MetS was defined according to the 2009 Joint Interim Statement.
  
  
  RESULTS
  Patients with MetS (n = 109) had higher 24-hour GI (60.0% ± 6.3% vs 57.5% ± 6.4%), higher breakfast GI (59.8% ± 8.0% vs 55.0% ± 9.9%), and lower fiber intake at 24 hours (17.0 ± 6.6 g vs 21.2 ± 8.0 g), breakfast (1.9 [1.2-3.2] vs 3.1 [1.8-4.9] g), lunch (6.2 [3.9-8.0] vs 7.5 [4.7-9.4] g), and dinner (3.3 [2.1-5.2] vs 4.9 [3.1-6.4] g; p < 0.05 for all comparisons) than patients without MetS. In multivariate analyses, high GI (~60%) of 24 hours (odds ratio [OR], 2.12; 95% confidence interval [CI], 1.10-4.11; p = 0.025), breakfast (OR, 2.20; 95% CI, 1.15-4.21; p = 0.017), and lunch (OR, 2.46; 95% CI, 1.28-4.74; p = 0.007) was associated with MetS. Breakfast (OR, 2.14; 95% CI, 1.04-4.41; p = 0.039) and dinner (OR, 2.27; 95% CI, 1.15-4.49; p = 0.019) with low fiber content were also associated with MetS. When high GI and low fiber intake were combined into the same variable, associations with MetS were maintained.
  
  
  CONCLUSIONS
  Increased dietary GI and reduced fiber content were positively associated with MetS, mainly due to breakfast intake, in patients with type 2 diabetes.
authors: Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors: Flávia M
authors: FM
authors: Silva
authors: Thais
authors: T
authors: Steemburgo
authors: Vanessa D F
authors: VD
authors: de Mello
authors: Simone F
authors: SF
authors: Tonding
authors: Jorge L
authors: JL
authors: Gross
authors: Mirela J
authors: MJ
authors: Azevedo
mesh_terms: D000368:Aged; D001786:Blood Glucose; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism*; D004032:Diet; D015930:Diet Records; D004040:Dietary Carbohydrates; D004043:Dietary Fiber / Q000008:administration & dosage*; D005260:Female; D038321:Glycemic Index; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000378:metabolism*; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004043:Dietary Fiber