Fiber Intake and Plasminogen Activator Inhibitor-1 in Type 2 Diabetes: Look AHEAD (Action for Health in Diabetes) Trial Findings atBaseline and Year 1

L. Maria Belalcazar, Andrea M. Anderson, Wei Lang, Dawn C. Schwenke, Steven M. Haffner, Hiroshi Yatsuya, Julia Rushing, Mara Z. Vitolins, Rebecca Reeves, F. Xavier Pi-Sunyer, Russell P. Tracy, Christie M. Ballantyne

Research output: Contribution to journalArticle

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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 (. 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.

Original languageEnglish
Pages (from-to)1800-1810.e2
JournalJournal of the Academy of Nutrition and Dietetics
Volume114
Issue number11
DOIs
Publication statusPublished - 01-11-2014

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Plasminogen Activator Inhibitor 1
noninsulin-dependent diabetes mellitus
Type 2 Diabetes Mellitus
diabetes
dietary fiber
Life Style
Health
lifestyle
Weight Loss
Weights and Measures
weight loss
Fruit
Cardiovascular Diseases
cardiovascular diseases
education
Education
Social Adjustment
Physical Fitness
physical fitness
plasminogen activator inhibitors

All Science Journal Classification (ASJC) codes

  • Food Science
  • Nutrition and Dietetics

Cite this

Belalcazar, L. Maria ; Anderson, Andrea M. ; Lang, Wei ; Schwenke, Dawn C. ; Haffner, Steven M. ; Yatsuya, Hiroshi ; Rushing, Julia ; Vitolins, Mara Z. ; Reeves, Rebecca ; Pi-Sunyer, F. Xavier ; Tracy, Russell P. ; Ballantyne, Christie M. / Fiber Intake and Plasminogen Activator Inhibitor-1 in Type 2 Diabetes : Look AHEAD (Action for Health in Diabetes) Trial Findings atBaseline and Year 1. In: Journal of the Academy of Nutrition and Dietetics. 2014 ; Vol. 114, No. 11. pp. 1800-1810.e2.
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title = "Fiber Intake and Plasminogen Activator Inhibitor-1 in Type 2 Diabetes: Look AHEAD (Action for Health in Diabetes) Trial Findings atBaseline and Year 1",
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 (. 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.",
author = "Belalcazar, {L. Maria} and Anderson, {Andrea M.} and Wei Lang and Schwenke, {Dawn C.} and Haffner, {Steven M.} and Hiroshi Yatsuya and Julia Rushing and Vitolins, {Mara Z.} and Rebecca Reeves and Pi-Sunyer, {F. Xavier} and Tracy, {Russell P.} and Ballantyne, {Christie M.}",
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Belalcazar, LM, Anderson, AM, Lang, W, Schwenke, DC, Haffner, SM, Yatsuya, H, Rushing, J, Vitolins, MZ, Reeves, R, Pi-Sunyer, FX, Tracy, RP & Ballantyne, CM 2014, 'Fiber Intake and Plasminogen Activator Inhibitor-1 in Type 2 Diabetes: Look AHEAD (Action for Health in Diabetes) Trial Findings atBaseline and Year 1', Journal of the Academy of Nutrition and Dietetics, vol. 114, no. 11, pp. 1800-1810.e2. https://doi.org/10.1016/j.jand.2014.06.357

Fiber Intake and Plasminogen Activator Inhibitor-1 in Type 2 Diabetes : Look AHEAD (Action for Health in Diabetes) Trial Findings atBaseline and Year 1. / Belalcazar, L. Maria; Anderson, Andrea M.; Lang, Wei; Schwenke, Dawn C.; Haffner, Steven M.; Yatsuya, Hiroshi; Rushing, Julia; Vitolins, Mara Z.; Reeves, Rebecca; Pi-Sunyer, F. Xavier; Tracy, Russell P.; Ballantyne, Christie M.

In: Journal of the Academy of Nutrition and Dietetics, Vol. 114, No. 11, 01.11.2014, p. 1800-1810.e2.

Research output: Contribution to journalArticle

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