Looking for an Indulgent Carbohydrate? It is Dietary Fiber
Did you eat enough dietary fiber today? Hoping so. In the effort to maintain a healthy weight, conversations involving energy balance swirl around physical activity and sources of calories. Alcohol provides empty calories. Too much protein challenges kidneys and grain proteins contain gluten. Fats are so calorie dense (>2x proteins and carbs). Last but not least, carbohydrates, too often consumed as sugar. We forget that dietary fibers are a form of carbohydrate. High fructose corn syrup and added sugars are often vilified as the evil causes of obesity and diabetes.
In fact, between 1980 and 2013, the proportion of men and women who are obese or overweight has increased from 28.8% to 36.9% and from 29.8% to 38%, respectively. Approximately 23% of children and adolescents are now overweight and during this period, the prevalence has increased from 8% to 13% in developing countries.
Obesity is driving the diabetes epidemic. There will be a 69% increase in numbers of adults with diabetes in developing countries and 20% increase in developed countries between 2010 and 2030. In total, 439 million people may have diabetes in 2030. Most of these people will have type 2 diabetes. To slow this trend, one proposal to change energy balance is to decrease energy intake. The second is to increase physical activity.
Diabetes can also occur because of pancreatic insufficiency. In this form, the immune system destroys insulin-producing beta-cells. Although the cause of type 1 diabetes is different from the more common form (type 2), one can study factors contributing to insulin resistance and poor glycemic control.
Using data from a 7 year prospective cohort analysis of 1,659 individuals with type 1 diabetes, Balk and colleagues studied the impact of dietary and lifestyle choices on blood glucose control (assessed by glycosylated hemoglobin, HbA1c). They discovered carbohydrate intake, total animal or vegetable protein, fat, physical activity, smoking status, and alcohol intake were not associated with HbA1c concentrations at follow-up. Eating less than 18g of dietary fiber intake per day was statistically significant. During the follow up period, glycemic control was statistically influenced by the intake of total dietary fiber and vegetable protein.
In short, dietary fiber intake was the single consistent variable associated with HbA1c concentrations. Eating more fiber is beneficial.
Most people do not consume recommended amounts of fiber. As countries develop and socioeconomic status increases, we eat more animal protein and less fiber-rich foods. It is unfortunate, because there are so many options to obtain dietary fiber.
If you are trying to manage your weight, or your diabetes, by being miserly about the quantity of food you eat, make certain to eat more dietary fiber.
Balk SN, Schoenaker DAJM, Mishra GD, Toeller M, Chaturvedi N, Fuller JH, Soedamah-Muthu SS, EURODIAB Prospective Complications Study Group. 2016 Eur J Clin Nutr doi: 10.1038/ejcn.2015.110
Ng M et al. Globa, regional, and national prevalence of overweight and obesity among children and adults during 1980-2013: A systematic analysis for the Global Burden of Disease Study 2013. 2014 Lancet doi: 10.1016/S0140-6736(14)60460-8
Shaw JE, Sicree RA, Zimmel PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. 2010 Diab Res Clin Pract doi: 10.1016/j.diabres.2009.10.007
McKeeLH, Latner TA. Underutilized sources of dietary fiber: A review. 2000 Plant Foods Human Nutr doi: 10.1023/A:1008144310986