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Fiber Intake and Risk of Developing Non—insulin-dependent Diabetes Mellitus-Reply

Jorge Salmerón, MD
JAMA. 1997;277(22):1762. doi:10.1001/jama.1997.03540460028024.
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In Reply.  —As Dr Maki and colleagues point out, experimental and metabolic studies offer strong evidence supporting a beneficial short-term effect of high-fiber diets on glucose metabolism. In patients with NIDDM, this effect appears to be greater for purified viscous soluble fiber than for less viscous fibers.1 However, among healthy subjects, short-term supplementation of nonviscous fibers seems to have a greater beneficial effect on glucose tolerance than do viscous fibers.2In our study population, the main source of dietary fiber is cereals, and more than 75% of this fiber is insoluble. However, the main sources of insoluble fibers are also the important sources of soluble fiber; thus the intakes of these components are highly correlated (r=0.89). When we compared the lowest and highest quintiles of energy-adjusted intakes, insoluble fiber was inversely associated with risk of diabetes (RR, 0.76; 95% CI, 0.61-0.95) after controlling for other important factors—whereas soluble fiber


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