Fiber Intake and Plasminogen Activator Inhibitor-1 in Type 2 Diabetes: Look AHEAD (Action for Health in Diabetes) Trial Findings at Baseline and Year 1 - 25/10/14
Doi : 10.1016/j.jand.2014.06.357
L. Maria Belalcazar, MD ⁎ 
, Andrea M. Anderson, MS, Wei Lang, PhD, Dawn C. Schwenke, PhD, Steven M. Haffner, MD, Hiroshi Yatsuya, MD, PhD, Julia Rushing, MS, Mara Z. Vitolins, DrPH, RD, Rebecca Reeves, DrPH, RD, F. Xavier Pi-Sunyer, MD, Russell P. Tracy, PhD, Christie M. Ballantyne, MD
and the
, Andrea M. Anderson, MS, Wei Lang, PhD, Dawn C. Schwenke, PhD, Steven M. Haffner, MD, Hiroshi Yatsuya, MD, PhD, Julia Rushing, MS, Mara Z. Vitolins, DrPH, RD, Rebecca Reeves, DrPH, RD, F. Xavier Pi-Sunyer, MD, Russell P. Tracy, PhD, Christie M. Ballantyne, MDand the
Look AHEAD (Action for Health in Diabetes) Research Group
∗Address correspondence to: L. Maria Belalcazar, MD, Department of Medicine, Division of Endocrinology and Metabolism, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-1060.
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.
Le texte complet de cet article est disponible en PDF.Keywords : Lifestyle intervention, Weight loss, Cardiovascular disease risk, Fibrinolysis, Obesity
Plan
| Supplementary materials: The Figure and Table 2 are available at www.andjrnl.org |
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| STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors. |
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| FUNDING/SUPPORT This work was supported by the National Heart, Lung, and Blood Institute (grant no. HL090514 [C. M. Ballantyne and L. M. Belalcazar]). Look AHEAD is sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases and cosponsored by the 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, and the Centers for Disease Control and Prevention, as detailed below in the Acknowledgements section under the Look AHEAD (Action for Health in Diabetes) Research Group at Year 1. Additional sources of funding for Look AHEAD are also listed in the Acknowledgements section below. clinicaltrials.gov Identifier: NCT00017953. |
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| Clinical Sites |
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| The Johns Hopkins Medical Institutions Frederick L. Brancati, MD, MHS;a Jeff Honas, MS;b Lawrence Cheskin, MD;c Jeanne M. Clark, MD, MPH;c Kerry Stewart, EdD;c Richard Rubin, PhD;c Jeanne Charleston, RN; Kathy Horak, RD |
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| Pennington Biomedical Research Center George A. Bray, MD;a Kristi Rau;b Allison Strate, RN;b Brandi Armand, LPN;b Frank L. Greenway, MD;c Donna H. Ryan, MD;c Donald Williamson, PhD;c Amy Bachand; Michelle Begnaud; Betsy Berhard; Elizabeth Caderette; Barbara Cerniauskas; David Creel; Diane Crow; Helen Guay; Nancy Kora; Kelly LaFleur; Kim Landry; Missy Lingle; Jennifer Perault; Mandy Shipp, RD; Marisa Smith; Elizabeth Tucker |
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| The University of Alabama at Birmingham Cora E. Lewis, MD, MSPH;a Sheikilya Thomas MPH;b Monika Safford, MD;c Vicki DiLillo, PhD; Charlotte Bragg, MS, RD, LD; Amy Dobelstein; Stacey Gilbert, MPH; Stephen Glasser, MD; Sara Hannum, MA; Anne Hubbell, MS; Jennifer Jones, MA; DeLavallade Lee; Ruth Luketic, MA, MBA, MPH; Karen Marshall; L. Christie Oden; Janet Raines, MS; Cathy Roche, RN; Janet Truman; Nita Webb, MA; Audrey Wrenn, MAEd |
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| Harvard Center |
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| Massachusetts General Hospital: David M. Nathan, MD;a Heather Turgeon, RN, CDE;b Kristina Schumann;b Enrico Cagliero, MD;c Linda Delahanty, MS, RD;c Kathryn Hayward, MD;c Ellen Anderson, MS, RD;c Laurie Bissett, MS, RD; Richard Ginsburg, PhD; Valerie Goldman, MS, RD; Virginia Harlan, MSW; Charles McKitrick, RN, CDE; Alan McNamara; Theresa Michel, DPT, DSc, CCS; Alexi Poulos; Barbara Steiner, EdM; Joclyn Tosch |
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| Joslin Diabetes Center: Edward S. Horton, MD;a Sharon D. Jackson, MS, RD, CDE;b Osama Hamdy, MD, PhD;c A. Enrique Caballero, MD;c Sarah Bain; Elizabeth Bovaird, RN; Ann Goebel-Fabbri, PhD; Lori Lambert, MS, RD; Sarah Ledbury, MEd, RD; Maureen Malloy; Kerry Ovalle, MS, RCEP, CDE |
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| Beth Israel Deaconess Medical Center: George Blackburn, MD, PhD;a Christos Mantzoros, MD, DSc;c Kristinia Day, RD; Ann McNamara, RN |
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| University of Colorado Health Sciences Center James O. Hill, PhD;a Marsha Miller, MS, RD;b JoAnn Phillipp, MS;b Robert Schwartz, MD;c Brent Van Dorsten, PhD;c Judith Regensteiner, PhD;c Salma Benchekroun MS; Ligia Coelho; Paulette Cohrs, RN; Elizabeth Daeninck, MS, RD; Amy Fields, MPH; Susan Green; April Hamilton, CCRC; Jere Hamilton; Eugene Leshchinskiy; Michael McDermott, MD; Lindsey Munkwitz; Loretta Rome, TRS; Kristin Wallace, MPH; Terra Worley |
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| Baylor College of Medicine John P. Foreyt, PhD;a Rebecca S. Reeves, DrPH, RD;b Henry Pownall, PhD;c Ashok Balasubramanyam, MBBS;c Peter Jones, MD;c Michele Burrington, RD; Chu-Huang Chen, MD, PhD;c Allyson Clark, RD; Molly Gee, MEd, RD; Sharon Griggs; Michelle Hamilton; Veronica Holley; Jayne Joseph, RD; Patricia Pace, RD: Julieta Palencia, RN; Olga Satterwhite, RD; Jennifer Schmidt; Devin Volding, LMSW; Carolyn White |
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| University of California at Los Angeles School of Medicine Mohammed F. Saad, MD;a Siran Ghazarian Sengardi, MD;b Ken C. Chiu, MD;c Medhat Botrous; Michelle Chan; Kati Konersman, MA, RD, CDE; Magpuri Perpetua, RD |
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| The University of Tennessee Health Science Center |
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| University of Tennessee East. Karen C. Johnson, MD, MPH;a Carolyn Gresham, RN;b Stephanie Connelly, MD, MPH;c Amy Brewer, MS, RD; Mace Coday, PhD; Lisa Jones, RN; Lynne Lichtermann, RN; Shirley Vosburg, RD, MPH; J. Lee Taylor, MEd, MBA |
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| University of Tennessee Downtown. Abbas E. Kitabchi, PhD, MD;a Helen Lambeth, RN;b Debra Clark, LPN; Andrea Crisler, MT; Gracie Cunningham; Donna Green, RN; Debra Force, MS, RD, LDN; Robert Kores, PhD; Renate Rosenthal PhD; Elizabeth Smith, MS, RD, LDN; Maria Sun, MS, RD, LDN; Judith Soberman, MDc |
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| University of Minnesota Robert W. Jeffery, PhD;a Carolyn Thorson, CCRP;b John P. Bantle, MD;c J. Bruce Redmon, MD;c Richard S. Crow, MD;c Scott Crow, MD;c Susan K Raatz, PhD, RD;c Kerrin Brelje, MPH, RD; Carolyne Campbell; Jeanne Carls, MEd; Tara Carmean-Mihm; Emily Finch, MA; Anna Fox, MA; Elizabeth Hoelscher, MPH, RD, CHES; La Donna James; Vicki A. Maddy, RD; Therese Ockenden, RN; Birgitta I. Rice, MS, RPh, CHES; Ann D. Tucker, MA; Mary Susan Voeller, MA; Cara Walcheck, RD |
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| St Luke’s Roosevelt Hospital Center Xavier Pi-Sunyer, MD;a Jennifer Patricio, MS;b Stanley Heshka, PhD;c Carmen Pal, MD;c Lynn Allen, MD; Diane Hirsch, MS, RNC, CDE; Mary Anne Holowaty, MS, CN |
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| University of Pennsylvania Thomas A. Wadden, PhD;a Barbara J. Maschak-Carey, MSN, CDE;b Stanley Schwartz, MD;c Gary D. Foster, PhD;c Robert I. Berkowitz, MD;c Henry Glick, PhD;c Shiriki K. Kumanyika, PhD, RD, MPH;c Johanna Brock; Helen Chomentowski; Vicki Clark; Canice Crerand, PhD; Renee Davenport; Andrea Diamond, MS, RD; Anthony Fabricatore, PhD; Louise Hesson, MSN; Stephanie Krauthamer-Ewing, MPH; Robert Kuehnel, PhD; Patricia Lipschutz, MSN; Monica Mullen, MS, RD; Leslie Womble, PhD, MS; Nayyar Iqbal, MD |
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| University of Pittsburgh David E. Kelley, MD;a Jacqueline Wesche-Thobaben, RN, CDE;b Lewis Kuller, MD, DrPH;c Andrea Kriska, PhD;c Janet Bonk, RN, MPH; Rebecca Danchenko; Daniel Edmundowicz, MD;c Mary L. Klem, PhD, MLIS;c Monica E. Yamamoto, DrPH, RD, FADA;c Barb Elnyczky, MA; George A. Grove, MS; Pat Harper, MS, RD, LDN; Janet Krulia, RN, CDE; Juliet Mancino, MS, RD, CDE, LDN; Anne Mathews, MS, RD, LDN; Tracey Y. Murray; Joan R. Ritchea; Jennifer Rush, MPH; Karen Vujevich, RN-BC, MSN, CRNP; Donna Wolf, MS |
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| The Miriam Hospital/Brown Medical School Rena R. Wing, PhD;a Renee Bright, MS;b Vincent Pera, MD;c John Jakicic, PhD;c Deborah Tate, PhD;c Amy Gorin, PhD;c Kara Gallagher, PhD;c Amy Bach, PhD; Barbara Bancroft, MS, RN; Anna Bertorelli, MBA, RD; Richard Carey; Tatum Charron; Heather Chenot, MS; Kimberley Chula-Maguire, MS; Pamela Coward, MS, RD; Lisa Cronkite; Julie Currin, MD; Maureen Daly, RN; Caitlin Egan, MS; Erica Ferguson, RD; Linda Foss, MPH; Jennifer Gauvin; Don Kieffer, PhD; Lauren Lessard; Deborah Maier, MS; JP Massaro; Tammy Monk, MS; Rob Nicholson, PhD; Erin Patterson; Suzanne Phelan, PhD; Hollie Raynor, PhD, RD; Douglas Raynor, PhD; Natalie Robinson, MS, RD; Deborah Robles; Jane Tavares |
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| The University of Texas Health Science Center at San Antonio Steven M. Haffner, MD;a Maria G. Montez, RN, MSHP, CDE;b Carlos Lorenzo, MDc |
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| University of Washington / VA Puget Sound Health Care System Steven E. Kahn, MB, ChB;a Brenda Montgomery, RN, MS, CDE;b Robert Knopp, MD;c Edward Lipkin, MD;c Matthew L. Maciejewski, PhD;c Dace Trence, MD;c Terry Barrett; Joli Bartell; Diane Greenberg, PhD; Anne Murillo; Betty Ann Richmond, MEd; April Thomas, MPH, RD |
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| Southwestern American Indian Center, Phoenix, Arizona and Shiprock, NM William C. Knowler, MD, DrPH;a Paula Bolin, RN, MC;b Tina Killean;b Cathy Manus, LPN;c Jonathan Krakoff, MD;c Jeffrey M. Curtis, MD, MPH;c Justin Glass, MD;c Sara Michaels, MD;c Peter H. Bennett, MB, FRCP;c Tina Morgan;c Shandiin Begay, MPH; Bernadita Fallis, RN, RHIT, CCS; Jeanette Hermes, MS, RD; Diane F. Hollowbreast; Ruby Johnson; Maria Meacham, RN, CDE; Julie Nelson, RD; Carol Percy, RN; Patricia Poorthunder; Sandra Sangster; Nancy Scurlock, MSN, ANP-C, CDE; Leigh A. Shovestull, RD, CDE; Janelia Smiley; Katie Toledo, MS, LPC; Christina Tomchee; Darryl Tonemah, PhD |
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| University of Southern California Anne Peters, MD;a Valerie Ruelas, MSW, LCSW;b Siran Ghazarian Sengardi, MD;b Kathryn Graves, MPH, RD, CDE; Kati Konersman, MA, RD, CDE; Sara Serafin-Dokhan |
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| Coordinating Center |
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| Wake Forest University Mark A. Espeland, PhD;a Judy L. Bahnson;b Lynne Wagenknecht, DrPH;c David Reboussin, PhD;c W. Jack Rejeski, PhD;c Alain Bertoni, MD, MPH;c Wei Lang, PhD;c Gary Miller, PhD;c David Lefkowitz, MD;c Patrick S. Reynolds, MD;c Paul Ribisl, PhD;c Mara Vitolins, DrPH;c Michael Booth, MBA;b Kathy M. Dotson;b Amelia Hodges;b Carrie C. Williams, MA;b Jerry M. Barnes, MA; Patricia A. Feeney, MS; Jason Griffin; Lea Harvin; William Herman, MD, MPH; Patricia Hogan, MS; Sarah Jaramillo, MS; Mark King; Kathy Lane; Rebecca Neiberg, MS; Andrea Ruggiero, MS; Christian Speas; Michael P. Walkup, MS; Karen Wall; Michelle Ward; Delia S. West, PhD; Terri Windham |
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| Central Resources Centers |
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| DXA Reading Center, University of California at San Francisco Michael Nevitt, PhD;a Susan Ewing, MS; Cynthia Hayashi; Jason Maeda, MPH; Lisa Palermo, MS, MA; Michaela Rahorst; Ann Schwartz, PhD; John Shepherd, PhD |
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| Central Laboratory, Northwest Lipid Research Laboratories Santica M. Marcovina, PhD, ScD;a Greg Strylewicz, MS |
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| ECG Reading Center, EPICARE, Wake Forest University School of Medicine Ronald J. Prineas, MD, PhD1; Teresa Alexander; Lisa Billings; Charles Campbell; Sharon Hall; Susan Hensley; Yabing Li, MD; Zhu-Ming Zhang, MD |
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| Diet Assessment Center, University of South Carolina, Arnold School of Public Health, Center for Research in Nutrition and Health Disparities Elizabeth J Mayer-Davis, PhD1; Robert Moran, PhD |
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| Hall-Foushee Communications, Inc. |
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| Richard Foushee, PhD; Nancy J. Hall, MA |
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| Federal Sponsors |
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| National Institute of Diabetes and Digestive and Kidney Diseases: Barbara Harrison, MS; Van S. Hubbard, MD, PhD; Susan Z.Yanovski, MD |
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| National Heart, Lung, and Blood Institute: Lawton S. Cooper, MD, MPH; Jeffrey Cutler, MD, MPH; Eva Obarzanek, PhD, MPH, RD |
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| Centers for Disease Control and Prevention: Edward W. Gregg, PhD; David F. Williamson, PhD; Ping Zhang, PhD |
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| Funding and Support |
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| This study is supported by the Department of Health and Human Services through the following cooperative agreements from the National Institutes of Health: DK57136, DK57149, DK56990, DK57177, DK57171, DK57151, DK57182, DK57131, DK57002, DK57078, DK57154, DK57178, DK57219, DK57008, DK57135, and DK56992. The following federal agencies have contributed support: National Institute of Diabetes and Digestive and Kidney Diseases; National Heart, Lung, and Blood Institute; National Institute of Nursing Research; National Center on Minority Health and Health Disparities; National Institutes of Health Office of Research on Women’s Health; and the Centers for Disease Control and Prevention. This research was supported in part by the Intramural Research Program of the National Institute of Diabetes and Digestive and Kidney Diseases. The Indian Health Service provided personnel, medical oversight, and use of facilities. The opinions expressed in this paper are those of the authors and do not necessarily reflect the views of the Indian Health Service or other funding sources. |
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| Additional support was received from The Johns Hopkins Medical Institutions Bayview General Clinical Research Center (M01RR02719); the Massachusetts General Hospital Mallinckrodt General Clinical Research Center (M01RR01066); the University of Colorado Health Sciences Center General Clinical Research Center (M01RR00051) and Clinical Nutrition Research Unit (P30 DK48520); the University of Tennessee at Memphis General Clinical Research Center (M01RR0021140); the University of Pittsburgh General Clinical Research Center (M01RR000056 44) and NIH grant (DK 046204); the VA Puget Sound Health Care System Medical Research Service, Department of Veterans Affairs; and the Frederic C. Bartter General Clinical Research Center (M01RR01346). |
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| The following organizations have committed to make major contributions to Look AHEAD: Federal Express; Health Management Resources; Johnson & Johnson, LifeScan Inc; Optifast-Novartis Nutrition; Roche Pharmaceuticals; Ross Product Division of Abbott Laboratories; Slim-Fast Foods Company; and Unilever. |
© 2014
Academy of Nutrition and Dietetics. Publié par Elsevier Masson SAS. Tous droits réservés.
Vol 114 - N° 11
P. 1800 - novembre 2014 Retour au numéro
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