EPIC-InterAct Study

The EPIC-InterAct study looked at the impact of fibre on type 2 diabetes(InterActConsortium, Dietary fibre and incidence of type 2 diabetes in eight European countries: the EPIC-InterAct Study and a meta-analysis of prospective studies. , 2015).

“During 10.8 years of follow-up, 11,559 participants with type 2 diabetes were identified and a sub cohort of 15,258 participants was selected for the case-cohort study.

Country-specific HRs were estimated using Prentice-weighted Cox proportional hazards models and were pooled using a random effects meta-analysis. Eighteen other cohort studies were identified for the meta-analysis.”

“Dietary fibre intake was associated with a lower risk of diabetes (HRQ4 vs Q1 0.82; 95% CI 0.69, 0.97) after adjustment for lifestyle and dietary factors.

Similar inverse associations were observed for the intake of cereal fibre and vegetable fibre, but not fruit fibre.

The associations were attenuated and no longer statistically significant after adjustment for BMI. In the meta-analysis (19 cohorts), the summary RRs per 10 g/day increase in intake were 0.91 (95% CI 0.87, 0.96) for total fibre, 0.75 (95% CI 0.65, 0.86) for cereal fibre, 0.95 (95% CI 0.87, 1.03) for fruit fibre and 0.93 (95% CI 0.82, 1.05) for vegetable fibre.”

“The overall evidence indicates that the intake of total and cereal fibre is inversely related to the risk of type 2 diabetes. The results of the EPIC-InterAct Study suggest that the association may be partially explained by body weight”.

Systematic Review & Meta Analysis of Fibre and Diabetes

A comprehensive review encompassing 185 prospective studies and 58 clinical trials aimed to elucidate the impact of carbohydrate quality on health outcomes, particularly focusing on dietary fibre.

Results indicated a significant reduction in all-cause mortality, cardiovascular-related mortality, coronary heart disease, stroke incidence and mortality, type 2 diabetes, and colorectal cancer among individuals with higher dietary fibre intake.

Clinical trials corroborated these findings, showing lower body weight, systolic blood pressure, and total cholesterol with increased dietary fibre consumption.

Optimal benefits were observed at daily fiber intakes between 25g and 29g, with potential for further risk reduction at higher levels. Similar trends were noted for whole grain intake.

However, lower certainty of evidence was found for dietary glycemic index and load.

Recommendations to enhance dietary fibre and whole grain intake were supported by the evidence, suggesting potential causal relationships between these dietary components and disease prevention in the general population.