Fiber intake, serum cholesterol levels, and cardiovascular disease in European individuals with type 1 diabetes

OBJECTIVE - A cross-sectional analysis of dietary fiber intake was performe d in European type 1 diabetic patients enrolled in the EURODIAB IDDM Compli cations Study to explore its potential relationship to serum cholesterol le vels and the prevalence of cardiovascular disease (CVD). RESEARCH DESIGN AND METHODS - Dietary intake was assessed by a standardized 3-day dietary record. For analysis of fiber intake (total, soluble, and in soluble! and its associations with CVD (past history or electrocardiogram a bnormalities), complete data were available from 1,050 male and 1,012 femal e individuals. Relationships of fiber intakes to serum cholesterol levels ( total, HDL, and LDL cholesterol) were examined in 926 men and 881 women wit h type 1 diabetes. RESULTS - Higher intakes of total fiber (g/day) were independently associat ed with significantly higher levels of HDL cholesterol in male (P = 0.01) a nd female individuals (P = 0.03). Fiber intakes of men with type 1 diabetes were also inversely related to ratios of total cholesterol to HDL choleste rol (P = 0.0001) and levels of LDL cholesterol (P = 0.0002). A protective e ffect of total fiber intake against CVD was observed for female subjects, w here a significant trend was maintained after adjustment for potential conf ounders, including energy and saturated far (P = 0.03 vs. P = 0.2 in men). Results were similar in separate analyses of soluble and insoluble fiber. CONCLUSIONS - The present study demonstrates that higher fiber intakes are independently related to beneficial alterations of the serum cholesterol pa ttern in men and to a lower risk for CVD in European insulin-dependent wome n. Beneficial effects can already be observed for fiber amounts within the range commonly consumed by outpatients with type 1 diabetes.