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The Reversibility of Obesity, Diabetes, Hyperlipidemia, and Coronary Heart Disease

  • James W. Anderson
  • Abayomi O. Akanji

Abstract

The most important cause of death in Western countries is cardiovascular disease. It accounts for about 36% of all deaths in the United States; in 1988, total health spending on prevention and treatment of heart disease was about $84 billion (1,2). The situation is likely similar in the other developed northern European countries. Coronary heart disease (CHD) is easily the most frequent and most important cardiovascular disease in these countries in the second half of the twentieth century, with the eradication of infectious disease and consequent reduction in the prevalence of rheumatic and syphilitic heart disease, and with improved technology for the earlier detection and management of congenital heart disease. This high prevalence of CHD is directly attributable to lifestyle and dietary factors, most of which are modifiable(3). The lifestyle-related risk factors are cigaret smoking, physical inactivity, and poor stress management; the diet-related factors are hyperlipidemia, hypertension, diabetes, and obesity (3). These factors have independent and additive effects not only in the genesis of CHD but also in the pathogenesis of the other factors. As an example, obesity can precipitate noninsulin-dependent diabetes mellitus (NIDDM) in the individual so predisposed; also the diabetic state can worsen atherogenic lipid profiles in individuals already genetically prone to hyperlipidemia.

Keywords

Coronary Heart Disease Glycemic Control Wheat Bran High Fiber High Carbohydrate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    US Department of Health and Human Services. The Surgeon General’s Report on Nutrition and Health. Washington, DC: US Government Printing Office, 1988; 1–12.Google Scholar
  2. 2.
    American Heart Association. Heart Facts. Dallas: American Heart Association, 1988; 1.Google Scholar
  3. 3.
    Atherosclerosis Study Group. Optimal resource; Is for primary prevention of atherosclerotic diseases. Circulation 1984; 70:155A.Google Scholar
  4. 4.
    Stamler J. The marked decline in coronary heart disease mortality rates in the United States, 1968–1981; summary of findings and possible explanations. Cardiology 1985; 72:11–22.Google Scholar
  5. 5.
    Burton BT, Foster WR. Health implications of obesity: NIH consensus development conference. J Am Diet Assoc 1985; 85:1117–1121.Google Scholar
  6. 6.
    National Diabetes Advisory Board Sixth Annual Report. Washington, DC: US Department of Health and Human Services. NIH Publication No. 84–1587, May 1984.Google Scholar
  7. 7.
    King H, Zimmet P. Trends in the prevalence and incidence of diabetes: non-insulin dependent diabetes mellitus. WldHlth Statist Quart 1988; 41:190–196.Google Scholar
  8. 8.
    Knowler WC, Bennett PH, Hamman RH, Miller M. Diabetes incidence and prevalence in Pima Indians: a 19-fold greater incidence than in Rochester, Minnesota. Am J Epidemiol 1978; 108:497–505.Google Scholar
  9. 9.
    Anderson JW, Tietyen-Clark J. Dietary fiber hyperlipidemia, hypertension and coronary heart disease. Am J Gastroenterol 1986; 81:907–919.Google Scholar
  10. 10.
    Kannel WB, Castelli WP, Gordon T. Cholesterol in the prediction of atherosclerotic disease. New perspectives based on the Framingham study. Ann Intern Med 1979; 90:85–91.Google Scholar
  11. 11.
    Burke GL, Sprafka JM, Folsom AR, Hahn LP, Luepker RV, Blackburn H. Trends in serum cholesterol levels from 1980- 1987. The Minnesota Heart Survey. N Engl J Med 1991; 324:941–946.Google Scholar
  12. 12.
    Newman WP, Freedman DS, Voors AW, Gard PD, Srinivasan SR, Creasanta JL, Williamson GD, Webber LS, Berenson GS. Relation of serum lipoprotein levels and systolic blood pressure to early atherosclerosis: the Bogalusa Heart Study. N Engl JMed 1986; 314:138–144.Google Scholar
  13. 13.
    Anderson JW, Deakins DA, Floore TL, Smith BM, Whitis SE. Dietary fiber and coronary heart disease. CRC Critical Rev Food Sci Nutr 1990; 29: 95–147.Google Scholar
  14. 14.
    Trowell HC. Dietary fiber hypothesis of the etiology of diabetes mellitus. Diabetes 1975; 24:762–765.Google Scholar
  15. 15.
    American Diabetes Association. Policy Statement. Nutritional recommendations and principles for individuals with diabetes mellitus: 1986. Diab Care 1987; 10:126–132.Google Scholar
  16. 16.
    The Nutrition Sub-committee of the British Diabetic Association’s Medical Advisory Committee. Dietary recommendations for diabetics for the 1980s: a policy statement by the British Diabetic Association. Hum Nutr: Appl Nutr 1982; 36A:378–382.Google Scholar
  17. 17.
    Canadian Diabetes Association. Position Statement. Guidelines for the nutritional management of diabetes mellitus in the 1990’s. Beta Release 1989; 13:8,9.Google Scholar
  18. 18.
    Diabetes and Nutrition Study Group of the EASD. Nutritional recommendations for individuals with diabetes mellitus. Diab NutrMetab 1988; 1:145–149.Google Scholar
  19. 19.
    American Heart Association. Position Statement. Dietary guidelines for healthy American adults. Circulation 1988; 77:721A-724A.Google Scholar
  20. 20.
    Hubert HB, Feinleb M, Mcnamara P, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 1983; 67:968–977.Google Scholar
  21. 21.
    Kalkhoff RK, Hartz AH, Rulley D, Kissebah AH, Kelber S. Relationship of body fat distribution to blood pressure, carbohydrate intolerance and plasma lipids in healthy obese women. JLab Clin Med 1983; 102:621–627.Google Scholar
  22. 22.
    Larsson B, Svardsudd K, Welin L, Wilhemsen L, Bjorntorp P, Tibblin G. Abdominal adipose tissue distribution, obesity and risk of cardiovascular disease and death: 13-year follow- up of participants in a study of men born in 1913. Br Med J 1984; 288:1401–1404.Google Scholar
  23. 23.
    Gordon T, Castelli WP, Hjortland MC, Kannel WB, Dawber TR. Diabetes, blood lipids and the role of obesity in coronary heart disease risk for women: the Framingham study. Ann Intern Med 1977; 87:393–397.Google Scholar
  24. 24.
    Kannel WB, Gordon T. Physiological and medical concomitants of obesity: the Framingham Study. In: Bray GA, ed. Obesity in America. Washington, DC: US Department of Health, Education and Welfare, Public Health Service, National Institutes of Health, NIH Publication No. 79–359, 1979; 125–163.Google Scholar
  25. 25.
    Anderson JW. High fiber, hypocalorie vs. very-low-calorie diet effects on blood pressure of obese men. Diabetes 1986; 35(Suppl. 1):217A.Google Scholar
  26. 26.
    Anderson JW, Bryant CA. Dietary fiber: diabetes and obesity. Am J Gastroenterol 1986; 81:898.Google Scholar
  27. 27.
    Wood PD, Stefanick ML, Williams PT, Haskell WL. The effects on plasma lipoproteins of a prudent weight-reducing diet, with or without exercise, in overweight men and women. NEngl J Med 1991; 325:461–466.Google Scholar
  28. 28.
    Krotkiewski M. Use of fibres in different weight reduction programs. In: Bjorntorp P, Vahouny GV, Kritchevsky D, eds. Dietary Fiber and Obesity. New York: Alan R Liss, 1984; 85–109.Google Scholar
  29. 29.
    Anderson JW. The role of dietary carbohydrate and fiber in the control of diabetes. Adv Intern Med 1980; 26:67–95.Google Scholar
  30. 30.
    Jenkins MA, Goff DV, Leeds AR, Alberti KGMM, Wolever TMS, Gassull MA, Hockaday TDR. Unabsorbable carbohydrates and diabetes: decreased postprandial hyperglycaemia. Lancet 1976; ii:172–174.Google Scholar
  31. 31.
    Kiehm TG, Anderson JW, Ward K. Beneficial effects of a high carbohydrate, high fiber diet on hyperglycemic diabetic men. Am J Clin Nutr 1976; 29:895–899.Google Scholar
  32. 32.
    Wahlquist ML. Dietary fiber and carbohydrate metabolism. Am J Clin Nutr 1987; 45:1232–1236.Google Scholar
  33. 33.
    Vinik Al, Jenkins MA. Dietary fiber in management of diabetes. Diab Care 1988; 11:160–173.Google Scholar
  34. 34.
    Anderson JW, Geil PB. New perspectives in nutrition management of diabetes mellitus. Am J Med 1988; 85:159–165.Google Scholar
  35. 35.
    Council on Scientific Affairs, American Medical Association. Dietary fiber and health. JAMA 1989; 262:542–546.Google Scholar
  36. 36.
    Anderson JW. Treatment of Diabetes with High Fiber Diets. In: Spiller GA, ed. CRC Handbook of Dietary Fiber in Human Nutrition. Boca Raton, FL: CRC Press, 1984; 349–359.Google Scholar
  37. 37.
    Monnier LH, Colette C, Aquirre L, Orsetti A, Combeaue D. Restored synergistic entero-hormonal response after addition of dietary fiber to patients with impaired glucose tolerance and reactive hypoglycaemia. Diab Metab 1982; 8:217–227.Google Scholar
  38. 38.
    Simpson HC, Mann JI, Chakrabarti R, Imeson JD, Stirling Y, Tozer M, Woolf L, Meade TW. Effect of high fibre diet on haemostatic variables in diabetes. Br Med J1982; 284:1608.Google Scholar
  39. 39.
    Koepp P, Hegewisch S. Effect of guar on plasma viscosity and related parameters in diabetic children. Eur J Pediatr 1981; 137:31–33.Google Scholar
  40. 40.
    Rivellese A, Riccardi G, Giaceo A, Postiglione A, Mastranzo P, Mattioli PL. Reduction of risk factors for atherosclerosis in diabetic patients treated with a high-fiber diet. Prev Med 1983; 12:128–132.Google Scholar
  41. 41.
    Pacy PJ, Dodson PM, Taylor MP. The effect of a high fiber, low fat, low sodium diet on diabetics with intermittent claudication. Br J Clin Pract 1986; 46:313–317.Google Scholar
  42. 42.
    Swinburn BA, Boyce VL, Bergman RN, Howard BV, Bogardus C. Deterioration in carbohydrate metabolism and lipoprotein changes induced by modern, high fat diet in Pima Indians and Caucasians. J Clin Endocrinol Metab 1991; 73:156–165.Google Scholar
  43. 43.
    Helmrich SP, Ragland DR, Leung RW, Paffenberger RS. Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. NEngl JMed 1991; 325:147–152.Google Scholar
  44. 44.
    Anderson JW, Akanji AO. Treatment of diabetes with high fiber diets. In: Spiller GA, ed. CRC Handbook of Dietary Fiber. Boca Raton, FL: CRC Press, 1992; 443–470.Google Scholar
  45. 45.
    Anderson JW. Nutrition Management of Metabolic Conditions. Lexington, KY: HCF Diabetes Research Foundation, 1981.Google Scholar
  46. 46.
    Hockaday TDR. Controversies in therapeutics. I. Natural fiber useful as part of total dietary prescription. Br Med J 1990; 300:1334–1336.Google Scholar
  47. 47.
    Tattersall R, Mansell P. Controversies in therapeutics. 2. Benefits of fibre itself are uncertain. BrMed J1990; 300:1336,1337.Google Scholar
  48. 48.
    Uusitupa M, Siitonen O, Savolainen K, Silvasti M, Penttila I, Parvianen M. Metabolic and nutritional effects of long-term use of guar gum in the treatment of noninsulin-dependent diabetes of poor metabolic control. Am J Clin Nutr 1989; 49:345–351.Google Scholar
  49. 49.
    Vaaler S, Hanssen KF, Dahl-Jorgensen K, Frolic W, Aaseth J, Odegaard H, Aagenaes O. Diabetic control is improved by guar gum and wheat bran supplementation. Diab Med 1986; 3: 230–233.Google Scholar
  50. 50.
    Nygren C, Berglund O, Hallmans G, Lithner F, Taljehahl IB. The effect of a high bran diet on diabetes in mice and humans. Acta Endocrinol 1980; 94(Suppl. 237):66.Google Scholar
  51. 51.
    Anderson JW, Ward K. Long-term effects of high carbohydrate, high fiber diets on glucose and lipid metabolism: a preliminary report on patients with diabetes. Diab Care 1978; 1:77–82.Google Scholar
  52. 52.
    Anderson JW, Ward K. High carbohydrate, high fiber diets for insulin-treated men with diabetes mellitus. Am J Clin Nutr 1979; 32:2312–2321Google Scholar
  53. 53.
    Anderson JW, Sieling B. High fiber diets for obese diabetic patients. Obesity /Bariatric Med 1980; 9:109–113.Google Scholar
  54. 54.
    Anderson JW, Chen WL, Sieling B. Hypolipidemic effects of high-carbohydrate, high fiber diets. Metabolism 1980; 29: 551–558.Google Scholar
  55. 55.
    Anderson JW, Zeigler JA, Deakins DA, Floore TL, Dillon DW, Wood CL, Oeltgen PR, Whitley RJ. Metabolic effects of high carbohydrate, high fiber diets for insulin-dependent diabetic individuals. Am J Clin Nutr 1991; 54:936–943.Google Scholar
  56. 56.
    O’Dea K, Traianedes K, Ireland P, Niall M, Sadler J, Hopper J, De Luise M. The effects of diet differing in fat, carbohydrate, and fiber on carbohydrate and lipid metabolism in type II diabetes. JAm DietAssoc 1989; 89:1076–1086.Google Scholar
  57. 57.
    Coulston AM, Hollenbeck CB, Swislocki ALM, Chen Y-D, Reaven GM. Deleterious metabolic effects of high carbohydrate, sucrose containing diets in patients with non-insulin dependent diabetes mellitus. AmJMed 1987; 82:213–220.Google Scholar
  58. 58.
    Coulston AM, Hollenbeck CB, Swislocki ALM, Reaven GM. Persistence of hypertriglyceridemic effect of low-fat high-carbohy- drate diets in NIDDM patients. Diab Care 1989; 12:94–101.Google Scholar
  59. 59.
    Garg A, Bonanome A, Grundy SM, Zhang Z-J, Unger RH. Comparison of a high-carbohydrate diet with a high monoun- saturated fat diet in patients with noninsulin-dependent diabetes mellitus. N Engl J Med 1988; 319:829–834.Google Scholar
  60. 60.
    Riccardi G, Rivellese AA. Dietary fiber and carbohydrate: effects on glucose and Upoprotein metabolism in diabetic patients. Diab Care 1991; 14:115–125.Google Scholar
  61. 61.
    Anderson JW, Akanji AO. Dietary fiber—an overview. Diab Care 1991; 14:1126–1131.Google Scholar
  62. 62.
    Kinmonth AL, Angus RM, Jenkins A, Smith MA, Baum JD. Whole foods and increased dietary fiber improve blood glucose control in diabetic children. Arch Dis Child 1982; 57:187–194.Google Scholar
  63. 63.
    Lindsay AN, Hardy A, Jarrett L, Rallison ML. High carbohydrate, high fiber diet in children with type I diabetes. Diab Care 1984; 7: 63–67.Google Scholar
  64. 64.
    Kuhl C, Molsted-Pederson L, Hornnes PJ. Guar gum and glycemic control of pregnant insulin-dependent diabetic patients. Diab Care 1983;6:152–154.Google Scholar
  65. 65.
    Ney D, Hollingsworth DR, Cousins L. Decreased insulin requirement and improved control of diabetes in pregnant women given a high carbohydrate, high fiber, low fat diet. Diab Care 1982; 5: 529–533.Google Scholar
  66. 66.
    Kyllastinen M, Lahikainen T. Long-term dietary supplementation with a fiber product (guar gum) in elderly diabetics. Curr TherRes 1982; 30:872–879.Google Scholar
  67. 67.
    Sels JP, Flendrig JA, Postmes Th J. The influence of guar gum bread on the regulation of diabetes mellitus type II in elderly patients. Br JNutr 1987; 57:177–183.Google Scholar
  68. 68.
    Dodson PM, Pacy PJ, Beevers M, Bal P, Fletcher RF, Taylor KG. The effects of a high fiber, low fat and low sodium dietary regime on diabetic hypertensive patients of different ethnic groups. Postgrad Med J 1983; 59:641–644.Google Scholar
  69. 69.
    Pacy PJ, Dodson PM, Kubicki AJ, Fletcher RF, Taylor KG. Comparison of the hypotensive and metabolic effects of bendrofluazide therapy and a high fiber, low fat, low sodium diet in diabetic subjects with mild hypertension. JHypertension 1984; 2:215–220.Google Scholar
  70. 70.
    Dodson PM, Pacy PJ, Bal P, Kubicki AJ, Fletcher RF, Taylor KG. A controlled trial of a high fiber, low fat and low sodium diet for mild hypertension in type 2 (non-insulin-dependent) diabetic patients. Diabetologia 1984; 27:522–526.Google Scholar
  71. 71.
    Rivellese A, Parillo M, Giaeeo A, Marco FD, Riccardi G. A fiber-rich diet for the treatment of diabetic patients with chronic renal failure. Diab Care 1984; 8:620,621.Google Scholar
  72. 72.
    Parillo M, Riccardi G, Pacioni D, Iovine C, Contaldo F, Carmela I, De Marco F, Perrotti N, Rivellese A. Metabolic consequences of feeding a high-carbohydrate, high-fiber diet to diabetic patients with chronic kidney failure. Am J Clin Nutr 1988; 48:255–259.Google Scholar
  73. 73.
    Uribe M, Dibildox M, Malpica S, Guillermo E, Villallobos A, Nieto L, Vargas F, Ramos G. Beneficial effect of vegetable protein diet supplemented with psyllium plantago in patients with hepatic encephalopathy and diabetes mellitus. Gastroenterology 1985; 88:901–907.Google Scholar
  74. 74.
    The Lipid Research Clinic Program. The Lipid Research Clinic Coronary Primary Prevention Trial results: reduction in incidence of coronary heart disease. JAMA 1984; 251:351–364.Google Scholar
  75. 75.
    Castelli WP, Doyle JT, Gordon T, Hames CG, Hjortland MC, Hulley SB, Kagan A, Zukel WJ. HDL cholesterol and other lipids in coronary heart disease: the Cooperative Lipoprotein Phenotyping Study. Circulation 1977; 55:767–772.Google Scholar
  76. 76.
    Hulley SB, Rosenman RH, Bawol RD, Brand RJ. Epidemiology as a guide to clinical decisions: the association between triglyceride and coronary heart disease. N Engl J Med 1980; 302:1383–1389.Google Scholar
  77. 77.
    WiIhemsen L, Wedel H, Tibblin G. Multivariate analysis of risk factors for coronary heart disease. Circulation 1973; 48:950–998.Google Scholar
  78. 78.
    Gordon T, Castelli WP, Hjortland MC, Kannel WB, Dawber TR. High density lipoprotein as a protective factor against coronary heart disease: the Framingham study. Am J Med 1977; 62:707–714.Google Scholar
  79. 79.
    Aberg H, Lithell H, Selinius I, Hedstrand H. Serum triglycerides are a risk factor for myocardial infarction but not for angina pectoris. Atherosclerosis 1985; 54:89–97.Google Scholar
  80. 80.
    West KM, Ahuja MMS, Bennett PH, Czyzyk A, De Acosta OM, Fuller JH, Grab B, Grabauskas V, Jarrett RJ, Kosaka K, Keen H, Krolewski AS, Miki E, Schliack V, Teuseher A, Watkins PJ, Stober JA. The role of circulating glucose and triglyceride concentrations and their interactions with other ‘risk factors’ as determinants of arterial disease in nine diabetic population samples from the WHO multinational study. Diab Care 1983; 6:361–369.Google Scholar
  81. 81.
    Mahley RW. Apolipoprotein E: cholesterol transport protein with expanding role in cell biology. Science 1988; 240:622–630.Google Scholar
  82. 82.
    Anderson JW, Story L, Sieling B, Chen WL, Petro MS, Story J. Hypocholesterolemic effects of high fiber diets rich in watersoluble plant fibers: long term studies with oat bran and bean- supplemented diets for hypercholesterolemic men. J Can Diet Assoc 1984; 45:140–149.Google Scholar
  83. 83.
    McIvor ME, Cummings CC, Van Duyn MA, Leo TA, Margolis S, Behall KM, Michnowski JE, Mendeloff Al. Long-term effects of guar gum on blood lipids. Atherosclerosis 1986; 60:7–13.Google Scholar
  84. 84.
    Anderson JW, Chen W-JL. Plant fiber. Carbohydrate and lipid metabolism. Am J Clin Nutr 1979; 32:346–363.Google Scholar
  85. 85.
    Hagander B, Asp N-G, Efendic S, Nilsson-Ehle P, Seherstein B. Dietary fiber decreases fasting blood glucose levels and plasma LDL concentration in noninsulin-dependent diabetes mellitus patients. Am J Clin Nutr 1988; 47:852–858.Google Scholar
  86. 86.
    Hollenbeck CB, Coulston AM, Reaven GM. To what extent does increased dietary fiber improve glucose and lipid metabolism in patients with noninsulin-dependent diabetes mellitus (NIDDM). Am J Clin Nutr 1986; 43:16–24.Google Scholar
  87. 87.
    Hall Y, Stamler J, Cohen DB, Mojonnier L, Epstein MB, Berkson DM, Whipple IT, Cathcings S. Effectiveness of a low saturated fat, low cholesterol, weight reducing diet for the control of hypertriglyceridemia. Atherosclerosis 1972; 16:389–403.Google Scholar
  88. 88.
    Sommariva D, Scotti L, Fasoli A. Low fat diet versus low carbohydrate diet in the treatment of type IV hyperproteinemia. Atherosclerosis 1978; 29:43–51.Google Scholar
  89. 89.
    Kinsella JE. Effects of polyunsaturated fatty acids on factors related to cardiovascular disease. Am J Cardiol 1987; 60: 23G-32G.Google Scholar
  90. 90.
    Harris WS. Fish oils and plasma lipid and lipoprotein metabolism in humans: a critical review. J Lipid Res 1989; 30: 785–807.Google Scholar
  91. 91.
    National Center for Health Statistics—National Heart, Lung and Blood Institute Collaborative Lipid Group: Trends in serum cholesterol levels among US adults aged 20–74 years— Data from the National Health and Nutrition Examination Surveys, 1960–1980. JAMA 1987; 257:937–942.Google Scholar
  92. 92.
    McGee DL, Reed DM, Yano K, Kagan A, Tillotson J. Ten year incidence of coronary heart disease in the Honolulu Heart Program. Am J Epidemiol 1984; 119:667–676.Google Scholar
  93. 93.
    Hegsted DM, Ausman LM. Diet, alcohol and coronary heart disease. JNutr 1988; 118:1184–1189.Google Scholar
  94. 94.
    Kushi LH, Lew RA, Stare FJ, Ellison CR, Lozy ME, Bourke G, Daly L, Graham I, Hickey N, Mulcahy R, Kevaney J. Diet and 20-year mortality from coronary heart disease. The Ireland- Boston Diet-Heart Study. NEngl JMed 1985; 312:811–818.Google Scholar
  95. 95.
    Stampfer MJ, Sacks FM, Salvini S, Willett WC, Hennekens CH. A prospective study of cholesterol, apolipoproteins and the risk of myocardial infarction. NEngl JMed 1991; 325:373–381.Google Scholar
  96. 96.
    Chen Z, Peto R, Collins R, MacMahon S, Lu J, Li W. Serum cholesterol concentration and coronary heart disease in population with low cholesterol concentrations. Br Med J 1991; 303:276–282.Google Scholar
  97. 97.
    Stamler JS, Shekelle R. Dietary cholesterol and human coronary heart disease. Arch Pathol LabMed 1988; 112:1032–1040.Google Scholar
  98. 98.
    Liu K, Stamler J, Trevisan M, Moss D. Dietary lipids, sugar, fiber, and mortality from coronary heart disease. Arteriosclerosis 1982; 2:221–227.Google Scholar
  99. 99.
    IChaw KT, Barrett-Connor E. Dietary fiber and reduced ischemic heart disease mortality rates in men and women: a 12 year prospective study. Am JEpidemiol 1987; 126:1093–1102.Google Scholar
  100. 100.
    Arntzenius AC, Kromhout D, Barth JD, Reiber JHC, Bruschke AVG, Buis B, vanGent CM, Kempen-Voogd N, Strikwerda S, van der Velde EA. Diet, lipoproteins and the progression of coronary atherosclerosis. The Leiden Intervention Trial. N Engl JMed 1985; 312:805–811.Google Scholar
  101. 101.
    Hallfrisch J, Tobin JD, Muller DC, Andres R. Fiber intake, age and other coronary risk factors in men of the Baltimore Longitudinal Study (1959–1975). J Gerontol Med Sci 1988; 43M:64–68.Google Scholar
  102. 102.
    Morris JN, Marr JW, Clayton DG. Diet and heart: a postscript. Br Med J 1977; 2:1307–1314.Google Scholar
  103. 103.
    Kromhout D, Bosschieter EB, Coulender CDL. Dietary fiber and 10-year mortality for coronary heart disease, cancer and all other causes. Lancet 1982; ii:518–522.Google Scholar
  104. 104.
    Hjermann I. Dietary prevention of coronary heart disease. Biblthca Nutr Dieta 1987; 40:28–32.Google Scholar
  105. 105.
    Gordon T, Kagan A, Garcia-Palmieri M, Kannel WB, Zukel WJ, Tillotson J, Sorlie P, Hjortland M. Diet and its relation to coronary heart disease and death in three populations. Circulation 1981; 63:500–515.Google Scholar
  106. 106.
    Garcia-Palmieri MR, Sorlie P, Tillotson J, Costas R, Rodriguez M. Relationship of dietary intake to subsequent coronary heart disease incidence: the Puerto Rico Heart Health Program. Am J Clin Nutr 1980; 33:1818–1827.Google Scholar
  107. 107.
    Ray TK, Mansell KM, Knight LC, Malmud LS, Owen OE, Boden G. Long-term effects of dietary fiber on glucose tolerance and gastric emptying in noninsulin-dependent diabetic patients. Am J Clin Nutr 1983; 37:376–381.Google Scholar
  108. 108.
    Van Duyn MAS, Leo TA, McIvor ME, Behall KM, Michnowski JE, Mendeloff Al. Nutritional risk of high-carbohydrate, guar gum dietary supplementation in non-insulin-dependent diabetes mellitus. Diab Care 1986; 9:497–503.Google Scholar
  109. 109.
    Behall KM, Scholfield W, McIvor ME, Van Duyn MS, Leo TA, Michnowski JE, Cummings CC, Mendeloff Al. Effect of guar gum on mineral balances in NIDDM adults. Diab Care 1989; 12:357–364.Google Scholar
  110. 110.
    Garg A, Bonanome A, Grundy SM, Unger RH, Breslau NA, Pak CYC. Effects of dietary carbohydrates on metabolism of calcium and other minerals in normal subjects and patients with non-insulin-dependent diabetes mellitus. J Clin Endocrinol Metab 1990; 70:1007–1013.Google Scholar
  111. 111.
    Huupponen R, Karhuvaara S, Seppala P. Effect of guar gum on glipizide absorption in man. Eur J Clin Pharmacol 1985; 28:717–719.Google Scholar
  112. 112.
    Huupponen R. The effect of guar gum on the acute metabolic response to glyburide. Res Commun Chem Path Pharmacol 1986; 54:137–140.Google Scholar
  113. 113.
    Jones DB, Slaughter P, Jelfs R, Lousley S, Carter RD, Mann JI. Low dose guar improves diabetic control. J R Soc Med 1985; 78:546–548.Google Scholar
  114. 114.
    Peterson DB, Ellis PR, Baylis JM, et al. Low dose guar in a novel food product: improved metabolic control in non-insu- lin-dependent diabetes. Diab Med 1987; 4:111–115.Google Scholar
  115. 115.
    Paganus A, Maenpaa J, Akerblom HK, Stenman U-H, Knip M, Simell O. Beneficial effects of palatable guar and guar plus fructose diets in diabetic children. Acta Paediatr Scand 1987; 76:76–81.Google Scholar
  116. 116.
    Miller DL, Miller PF, Dekker JJ. Small bowel obstruction from bran cereal. JAMA 1990; 263:813–814.Google Scholar
  117. 117.
    Ebeling P, Yki-Jarvinen H, Aro A, Helve E, Sinisalo M, Koivisto VA. Glucose and lipid metabolism and insulin sensitivity in type I diabetes: the effect of guar gum. Am J Clin Nutr 1988; 48:98–103.Google Scholar
  118. 118.
    Nestel PJ, Nolan C, Bazelmans J, Cook E. Effects of a high- starch diet with low or high fiber content on postabsorptive glucose utilization and glucose production in normal subjects. Diab Care 1984; 7:207–210.Google Scholar
  119. 119.
    Fukagawa NK, Anderson JW, Hageman G, Young VR, Minaker KL. High carbohydrate, high fiber diets increase peripheral insulin sensitivity in healthy young and old adults. Am J Clin Nutr 1990; 52:524–528.Google Scholar
  120. 120.
    Pedersen O, Hjollund E, Lindkov HO, Helms P, Sorensen NS, Ditzel J. Increased insulin receptor binding to monocytes from insulin dependent diabetic patients after a low fat, high starch, high fiber diet. Diab Care 1982; 5:284–291.Google Scholar
  121. 121.
    Ward GM, Simpson RW, Simpson HCR, Naylor BA, Mann JI, Turner RC. Insulin receptor binding increased by high carbohydrate low fat diet in non-insulin-dependent diabetics. Eur J Clin Invest 1982; 12:93–96.Google Scholar
  122. 122.
    Hjollund E, Pedersen O, Richelsen B, Beck-Nielsen H, Sorensen NS. Increased insulin binding to adipocytes and monocytes and increased insulin sensitivity of glucose transport and metabolism in adipocytes from non-insulin-depen- dent diabetics after a low-fat/high starch/high fiber diet. Metabolism 1983; 32:1067–1075.Google Scholar
  123. 123.
    Nestler JE, Barlascini CO, Clore JN, Blackard WG. Absorption characteristic of breakfast determines insulin sensitivity and carbohydrate tolerance for lunch. Diab Care 1988; 11:755–760.Google Scholar
  124. 124.
    Trinick TR, Laker MF, Johnston DG, Keir M, Buchanan KD, Alberti KGMM. Effect of guar on second-meal glucose tolerance in normal man. Clin Sci 1986; 71:49–55.Google Scholar
  125. 125.
    Sundell IB, Hallmans G, Nilsson TK, Nygren C. Plasma glucose and insulin, urinary catecholamine and Cortisol responses to test breakfasts with high or low fiber content: the importance of the previous diet. Ann Nutr Metab 1989; 33: 333–340.Google Scholar
  126. 126.
    Morgan LM, Goulder TJ, Tsiolakis D, Marks V, Alberti KGMM. The effect of unabsorbable carbohydrate on gut hormones. Diabetologia 1979; 17:85–89.Google Scholar
  127. 127.
    Groop P-H, Groop L, Totterman KJ, Fyhrquist F. Relationship between changes in GIP concentrations and changes in insulin and C-peptide concentration after guar gum therapy. Scand J Clin Lab Invest 1986; 46:505–510.Google Scholar
  128. 128.
    Sestoft L, Krarup T, Palmvig B, Meinertz H, Faergeman 0. High carbohydrate, low fat diet: effect on lipid and carbohydrate metabolism, GIP and insulin secretion in diabetics. Danish Med Bull 1985; 32: 64–69.Google Scholar
  129. 129.
    Anderson JW, Bridges SR. Short-chain fatty acid fermentation products of plant fiber affect glucose metabolism of isolated rat hepatocytes. Proc Soc Exp Biol Med 1984; 177:372–376.Google Scholar
  130. 130.
    Akanji AO, Peterson DB, Humphreys S, Hockaday TDR. Change in plasma acetate levels in diabetic subjects on mixed high fiber diets. Am J Gastroenterol 1989; 84:1365–1370.Google Scholar
  131. 131.
    Ciavarella A, Gianfranco DM, Stefoni S, Borgnino LC, Vannini P. Reduced albuminuria after dietary protein restriction in insulin-dependent diabetic patients with clinical nephropathy. Diab Care 1987; 10:407–413.Google Scholar
  132. 132.
    Ornish D, Brown SE, Scherwitz LW, Billings JH, Armstrong WT, Ports TA, McLanahan SM, Kirkeeide RL, Brand RJ, Gould KL. Can lifestyle changes reverse coronary heart disease? Lancet 1990; 336:129–133.Google Scholar
  133. 133.
    Watts GF, Lewis B, Brunt JNH, Lewis ES, Coltart DJ, Smith LDR, Mann JI, Swan AV. Effects on coronary artery disease of lipid-lowering diet, or diet plus cholestyramine, in The St. Thomas’ Atherosclerosis Regression Study (STARS). Lancet 1992; 339:563–569.Google Scholar
  134. 134.
    McMurry MP, Cerqueira MT, Connor SL, Connor WE. Changes in lipid and lipoprotein levels and body weight it Tarahumara Indians after consumption of an affluent diet. NEnglJMed 1991; 325:1704–1708.Google Scholar
  135. 135.
    Shintani TT, Hughes CK, Beckham S, O’Connor HK. Obesity and cardiovascular risk intervention through the ad libitum feeding of traditional Hawaiian diet. Am J Clin Nutr 1991; 53:1647S-1651S.Google Scholar
  136. 136.
    Marshall JA, Hamman RF, Baxter J. High-fat, low-carbohy- drate diet and the etiology of non-insulin-dependent diabetes mellitus: The San Luis Valley diabetes study. Am J Epidemiol 1991; 134:590–603.Google Scholar

Copyright information

© Humana Press, Totowa, NJ 1994

Authors and Affiliations

  • James W. Anderson
  • Abayomi O. Akanji

There are no affiliations available

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