High-fibre, low-fat diet predicts long-term weight loss and decreased type 2 diabetes risk: the Finnish Diabetes Prevention Study
Open accessAbstract
Aims/hypothesis The aim of this study was to investigate the association of dietary macronutrient composition and energy density with the change in body weight and waist circumference and diabetes incidence in the Finnish Diabetes Prevention Study.Subjects and methods Overweight, middle-aged men (n=172) and women (n=350) with impaired glucose tolerance were randomised to receive either 'standard care' (control) or intensive dietary and exercise counselling. Baseline and annual examinations included assessment of dietary intake with 3-day food records and diabetes status by repeated 75-g OGTTs. For these analyses the treatment groups were combined and only subjects with follow-up data (n=500) were included.Results Individuals with low fat (<median) and high fibre (>median) intakes lost more weight compared with those consuming a high-fat (>median), low-fibre (<median) diet (3.1 vs 0.7 kg after 3 years). In separate models, hazard ratios for diabetes incidence during a mean follow-up of 4.1 years were (highest compared with lowest quartile) 0.38 (95% CI 0.19-0.77) for fibre intake, 2.14 (95% CI 1.16-3.92) for fat intake, and 1.73 (95% CI 0.89-3.38) for saturated-fat intake, after adjustment for sex, intervention assignment, weight and weight change, physical activity, baseline 2-h plasma glucose and intake of the nutrient being investigated. Compared with the low-fat/high-fibre category, hazard ratios were 1.98 (95% CI 0.98-4.02), 2.68 (95% CI 1.40-5.10), and 1.89 (95% CI 1.09-3.30) for low-fat/low-fibre, high-fat/high-fibre, and high-fat/low-fibre, respectively.Conclusions/interpretation Dietary fat and fibre intake are significant predictors of sustained weight reduction and progression to type 2 diabetes in high-risk subjects, even after adjustment for other risk factors.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In large cohort studies, saturated fat is not associated with development of T2DM, after adjustment for BMI, total dietary fiber, or magnesium intake.
“in large cohort studies, saturated fat is not associated with development of T2DM, after adjustment for BMI, total dietary fiber, or magnesium intake (144–149).”
From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [144]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin
(2002) · New England Journal of Medicine · doi:10.1056/nejmoa012512 · Cited by 19,011 · see citing works
Tuomilehto, J., Lindström, J., Eriksson, J. G., Valle, T. T., Hämäläinen, H., Ilanne-Parikka, P., Keinänen-Kiukaanniemi, S., Laakso, M., Louheranta, A., Rastas, M., et al. (2001) · New England Journal of Medicine · doi:10.1056/nejm200105033441801 · Cited by 10,873 · cited 5× · see citing works
“The study design has been described in detail previously [1, 16, 17].”
BackgroundMethodInfluentialSelf-citationObesity and insulin resistance
Kahn, B. B., & Flier, J. S. (2000) · Journal of Clinical Investigation · doi:10.1172/jci10842 · Cited by 3,283 · see citing works
The Finnish Diabetes Prevention Study (DPS)
Lindström, J., Louheranta, A., Mannelin, M., Rastas, M., Salminen, V., Eriksson, J., Uusitupa, M., Tuomilehto, J., & for the Finnish Diabetes Prevention Study Group (2003) · Diabetes Care · doi:10.2337/diacare.26.12.3230 · Cited by 1,848 · see citing works
Self-citationDietary Fiber, Glycemic Load, and Risk of Non—insulin-dependent Diabetes Mellitus in Women
Salmerón, J. (1997) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1997.03540300040031 · Cited by 1,804 · see citing works
A Randomized Trial of a Low-Carbohydrate Diet for Obesity
Foster, G. D., Wyatt, H. R., Hill, J. O., McGuckin, B. G., Brill, C., Mohammed, B. S., Szapary, P. O., Rader, D. J., Edman, J. S., & Klein, S. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa022207 · Cited by 1,794 · see citing works
Dansinger, M. L., Gleason, J. A., Griffith, J. L., Selker, H. P., & Schaefer, E. J. (2005) · JAMA · doi:10.1001/jama.293.1.43 · Cited by 1,726 · see citing works
Carbohydrates, dietary fiber, and incident type 2 diabetes in older women
Meyer, K. A., Kushi, L. H., Jacobs, D. R., Slavin, J., Sellers, T. A., & Folsom, A. R. (2000) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/71.4.921 · Cited by 1,271 · see citing works
A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity
Samaha, F. F., Iqbal, N., Seshadri, P., Chicano, K. L., Daily, D. A., McGrory, J., Williams, T., Williams, M., Gracely, E. J., & Stern, L. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa022637 · Cited by 1,267 · see citing works
Dietary fat intake does affect obesity!
Bray, G. A., & Popkin, B. M. (1998) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/68.6.1157 · Cited by 1,123 · see citing works
Dietary Fiber and Weight Regulation
Howarth, N. C., Saltzman, E. J., & Roberts, S. B. (2009) · Nutrition Reviews · doi:10.1111/j.1753-4887.2001.tb07001.x · Cited by 1,053 · see citing works
Diabetes Mellitus: Report of a WHO Study Group.
(1986) · Annals of Internal Medicine · doi:10.7326/0003-4819-104-4-597_2 · Cited by 1,030 · see citing works
Stern, L., Iqbal, N., Seshadri, P., Chicano, K. L., Daily, D. A., McGrory, J., Williams, M., Gracely, E. J., & Samaha, F. F. (2004) · Annals of Internal Medicine · doi:10.7326/0003-4819-140-10-200405180-00007 · Cited by 831 · see citing works
Liu, S., Willett, W. C., Manson, J. E., Hu, F. B., Rosner, B., & Colditz, G. (2003) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/78.5.920 · Cited by 787 · see citing works
Diet and risk of type II diabetes: the role of types of fat and carbohydrate
Hu, F. B., Liu, S., & van Dam, R. M. (2001) · Diabetologia · doi:10.1007/s001250100547 · Cited by 758 · see citing works
Dietary Fiber, Weight Gain, and Cardiovascular Disease Risk Factors in Young Adults
Ludwig, D. S. (1999) · JAMA · doi:10.1001/jama.282.16.1539 · Cited by 717 · see citing works
Stem, L., Iqbal, N., Seshadri, P., & Chicano, K. L. (2004) · ACC Current Journal Review · doi:10.1016/j.accreview.2004.07.103 · Cited by 629 · see citing works
Whole-grain and fiber intake and the incidence of type 2 diabetes
Montonen, J., Knekt, P., Järvinen, R., Aromaa, A., & Reunanen, A. (2003) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/77.3.622 · Cited by 614 · see citing works
Physical Activity in the Prevention of Type 2 Diabetes
Laaksonen, D. E., Lindström, J., Lakka, T. A., Eriksson, J. G., Niskanen, L., Wikström, K., Aunola, S., Keinänen-Kiukaanniemi, S., Laakso, M., Valle, T. T., et al. (2005) · Diabetes · doi:10.2337/diabetes.54.1.158 · Cited by 614 · see citing works
Self-citationDietary Fat and Meat Intake in Relation to Risk of Type 2 Diabetes in Men
van Dam, R. M., Willett, W. C., Rimm, E. B., Stampfer, M. J., & Hu, F. B. (2002) · Diabetes Care · doi:10.2337/diacare.25.3.417 · Cited by 593 · see citing works
Koh-Banerjee, P., Chu, N.-F., Spiegelman, D., Rosner, B., Colditz, G., Willett, W., & Rimm, E. (2003) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/78.4.719 · Cited by 383 · see citing works
Dietary fat and incidence of type 2 diabetes in older Iowa women
Meyer, K. A., Kushi, L. H., Jacobs, D. R., & Folsom, A. R. (2001) · Diabetes Care · doi:10.2337/diacare.24.9.1528 · Cited by 382 · see citing works
Eriksson, J., Lindström, J., Valle, T., Aunola, S., Hämäläinen, H., Ilanne-Parikka, P., Keinänen-Kiukaanniemi, S., Laakso, M., Lauhkonen, M., Lehto, P., et al. (1999) · Diabetologia · doi:10.1007/s001250051229 · Cited by 368 · see citing works
Self-citationHigh protein intake sustains weight maintenance after body weight loss in humans
Westerterp-Plantenga, M. S., Lejeune, M. P. G. M., Nijs, I., van Ooijen, M., & Kovacs, E. M. R. (2004) · International Journal of Obesity · doi:10.1038/sj.ijo.0802461 · Cited by 326 · see citing works
Eisenstein, J., Roberts, S. B., Dallal, G. E., & Saltzman, E. J. (2002) · Nutrition Reviews · doi:10.1301/00296640260184264 · Cited by 295 · see citing works
McAuley, K. A., Hopkins, C. M., Smith, K. J., McLay, R. T., Williams, S. M., Taylor, R. W., & Mann, J. I. (2005) · Diabetologia · doi:10.1007/s00125-004-1603-4 · Cited by 275 · see citing works
Stevens, J., Ahn, K., Juhaeri, J., Houston, D. K., Steffan, L., & Couper, D. J. (2002) · Diabetes Care · doi:10.2337/diacare.25.10.1715 · Cited by 259 · see citing works
BLACK, A. E., & COLE, T. J. (2001) · Journal of the American Dietetic Association · doi:10.1016/s0002-8223(01)00018-9 · Cited by 249 · see citing works
Marshall, J. A., Bessesen, D. H., & Hamman, R. F. (1997) · Diabetologia · doi:10.1007/s001250050697 · Cited by 246 · see citing works
Meckling, K. A., O’Sullivan, C., & Saari, D. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-031606 · Cited by 233 · see citing works
Johnston, C. S., Tjonn, S. L., & Swan, P. D. (2004) · Journal of Nutrition · doi:10.1093/jn/134.3.586 · Cited by 211 · see citing works
Cigarette Smoking and Increased Central Adiposity
Barrett-Connor, E., & Khaw, K. (1989) · Annals of Internal Medicine · doi:10.7326/0003-4819-111-10-783 · Cited by 203 · see citing works
Marshall, J. A., Hamman, R. F., & Baxter, J. (1991) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a116132 · Cited by 203 · see citing works
Uusitupa, M., Lindi, V., Louheranta, A., Salopuro, T., Lindström, J., Tuomilehto, J., & for the Finnish Diabetes Prevention Study Group (2003) · Diabetes · doi:10.2337/diabetes.52.10.2532 · Cited by 196 · see citing works
Self-citationControl of Human Appetite: Implications for The Intake of Dietary Fat
Blundell, J. E., Lawton, C. L., Cotton, J. R., & Macdiarmid, J. I. (1996) · Annual Review of Nutrition · doi:10.1146/annurev.nu.16.070196.001441 · Cited by 192 · see citing works
Dietary fat plays a major role in obesity: no
Willett, W. C. (2002) · Obesity Reviews · doi:10.1046/j.1467-789x.2002.00060.x · Cited by 189 · see citing works
Dietary Glycemic Index, Glycemic Load, Fiber, Simple Sugars, and Insulin Resistance
Lau, C. J., Færch, K., Glümer, C., Tetens, I., Pedersen, O. B., Carstensen, B., Jørgensen, T., & Borch‐Johnsen, K. (2005) · Diabetes Care · doi:10.2337/diacare.28.6.1397 · Cited by 180 · see citing works
Lakka, T. A., & Salonen, J. T. (1992) · International Journal of Epidemiology · doi:10.1093/ije/21.3.467 · Cited by 155 · see citing works
Long-term effects of popular dietary approaches on weight loss and features of insulin resistance
McAuley, K. A., Smith, K. J., Taylor, R. W., McLay-Cooke, R. T., Williams, S., & Mann, J. I. (2005) · International Journal of Obesity · doi:10.1038/sj.ijo.0803075 · Cited by 154 · see citing works
Stubbs, R. J., Johnstone, A. M., O’Reilly, L., Barton, K., & Reid, C. (1998) · International Journal of Obesity · doi:10.1038/sj.ijo.0800715 · Cited by 150 · see citing works
Intake of fat and carbohydrate: role of energy density
Rolls, B., & Bell, E. (1999) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1600757 · Cited by 138 · see citing works
Luscombe, N. D., Clifton, P. M., Noakes, M., Farnsworth, E., & Wittert, G. (2003) · International Journal of Obesity · doi:10.1038/sj.ijo.0802270 · Cited by 124 · see citing works
Low-fat diets and energy balance: how does the evidence stand in 2002?
Astrup, A. V., Buemann, B., Flint, A., & Raben, A. (2002) · Proceedings of The Nutrition Society · doi:10.1079/pns2002149 · Cited by 107 · see citing works
Ylönen, K., Saloranta, C., Kronberg‐Kippilä, C., Groop, L., Aro, A., & Virtanen, S. M. (2003) · Diabetes Care · doi:10.2337/diacare.26.7.1979 · Cited by 106 · see citing works
Energy density of diets and obesity.
Poppitt, S. (1995) · PubMed · Cited by 89 · see citing works
Safety of low‐carbohydrate diets
Crowe, T. C. (2005) · Obesity Reviews · doi:10.1111/j.1467-789x.2005.00196.x · Cited by 82 · see citing works
Effects of food unit size and energy density on intake in humans
Devitt, A. A., & Mattes, R. D. (2004) · Appetite · doi:10.1016/j.appet.2003.10.003 · Cited by 74 · see citing works
Borg, P. T., Fogelholm, M., & Kukkonen-Harjula, K. (2004) · International Journal of Obesity · doi:10.1038/sj.ijo.0802790 · Cited by 58 · see citing works
Self-citationLifestyle strategies for weight control: experience from the Finnish Diabetes Prevention Study
Lindström, J., Peltonen, M., Tuomilehto, J. O., & for the Finnish Diabetes Prevention Study Group (2005) · Proceedings of The Nutrition Society · doi:10.1079/pns2004412 · Cited by 57 · see citing works
Self-citationThe compilation of food analysis values as a database for dietary studies—the finnish experience
Ovaskainen, M.-L., Valsta, L. M., & Lauronen, J. (1996) · Food Chemistry · doi:10.1016/0308-8146(96)00113-6 · Cited by 53 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Health benefits of dietary fiber
Anderson, J. W., Baird, P., Davis Jr, R. H., Ferreri, S., Knudtson, M., Koraym, A., Waters, V., & Williams, C. L. (2009) · Nutrition Reviews · doi:10.1111/j.1753-4887.2009.00189.x · Cited by 2,239 · see citing works
de Souza, R. J., Mente, A., Maroleanu, A., Cozma, A. I., Ha, V., Kishibe, T., Uleryk, E., Budylowski, P., Schünemann, H., Beyene, J., et al. (2015) · BMJ · doi:10.1136/bmj.h3978 · Cited by 1,424 · see citing works
Stephen, A. M., Champ, M. M.-J., Cloran, S. J., Fleith, M., van Lieshout, L., Mejborn, H., & Burley, V. J. (2017) · Nutrition Research Reviews · doi:10.1017/s095442241700004x · Cited by 798 · see citing works
(DPS), F. T. F. D. P. S., Lindström, J., Peltonen, M., Eriksson, J. G., Ilanne-Parikka, P., Aunola, S., Keinänen-Kiukaanniemi, S., Uusitupa, M., & Tuomilehto, J. (2013) · Diabetologia · doi:10.1007/s00125-012-2752-5 · Cited by 551 · see citing works
Self-citationFiber and Magnesium Intake and Incidence of Type 2 Diabetes: A Prospective Study and Meta-analysis
Schulze, M. B. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.9.956 · Cited by 537 · see citing works
Anand, S. S., Hawkes, C., de Souza, R. J., Mente, A., Dehghan, M., Nugent, R., Zulyniak, M. A., Weis, T., Bernstein, A. M., Krauss, R. M., et al. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.07.050 · Cited by 507 · see citing works
Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain.
Fowler, S. P., Williams, K., Resendez, R. G., Hunt, K. J., Hazuda, H. P., & Stern, M. P. (2008) · Obesity · doi:10.1038/oby.2008.284 · Cited by 464 · see citing works
Hemmingsen, B., Gimenez-Perez, G., Mauricio, D., Roqué i Figuls, M., Metzendorf, M.-I., & Richter, B. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003054.pub4 · Cited by 316 · see citing works
Dietary fiber intake and risk of type 2 diabetes: a dose–response analysis of prospective studies
Yao, B., Fang, H., Xu, W., Yan, Y., Xu, H., Liu, Y., Mo, M., Zhang, H., & Zhao, Y. (2014) · European Journal of Epidemiology · doi:10.1007/s10654-013-9876-x · Cited by 281 · see citing works
Randomized Clinical Trials of Weight Loss Maintenance: A Review
Turk, M. W., Yang, K., Hravnak, M., Sereika, S. M., Ewing, L. J., & Burke, L. E. (2009) · Journal of Cardiovascular Nursing · doi:10.1097/01.jcn.0000317471.58048.32 · Cited by 258 · see citing works
Tinker, L. F. (2008) · Archives of Internal Medicine · doi:10.1001/archinte.168.14.1500 · Cited by 165 · see citing works
Sattar, N., McConnachie, A., Ford, I., Gaw, A., Cleland, S. J., Forouhi, N. G., McFarlane, P., Shepherd, J., Cobbe, S., & Packard, C. (2007) · Diabetes · doi:10.2337/db06-1256 · Cited by 127 · see citing works
Liu, L., Wang, S., & Liu, J. (2015) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.201400449 · Cited by 97 · see citing works
Wolfram, G., Bechthold, A., Boeing, H., Ellinger, S., Hauner, H., Kroke, A., Leschik-Bonnet, E., Linseisen, J., Lorkowski, S., Schulze, M., et al. (2015) · Annals of Nutrition and Metabolism · doi:10.1159/000437243 · Cited by 94 · see citing works
Honsek, C., Kabisch, S., Kemper, M., Gerbracht, C., Arafat, A. M., Birkenfeld, A. L., Dambeck, U., Osterhoff, M. A., Weickert, M. O., & Pfeiffer, A. F. H. (2018) · Diabetologia · doi:10.1007/s00125-018-4582-6 · Cited by 63 · see citing works
Regulation of energy expenditure and substrate oxidation by short-chain fatty acids
Sukkar, A. H., Lett, A. M., Frost, G., & Chambers, E. S. (2019) · Journal of Endocrinology · doi:10.1530/joe-19-0098 · Cited by 54 · see citing works
Development of various diabetes prediction models using machine learning techniques
Shin, J., Kim, J., Lee, C., Yoon, J. Y., Kim, S., Song, S., & Kim, H.-S. (2022) · Diabetes & Metabolism Journal · doi:10.4093/dmj.2021.0115 · Cited by 29 · see citing works
“gestational diabetes, and insulin resistance, emphasizing the need for early diagnosis and treatment [2-4].”
Background
- Authors
- Lindström, J., Peltonen, M., Eriksson, J. G., Louheranta, A., Fogelholm, M., Uusitupa, M., & Tuomilehto, J.
- Affiliations
- Kuopio University Hospital (FI)
- Urho Kaleva Kekkonen Institute (FI)
- University of Eastern Finland (FI)
- University of Helsinki (FI)
- Corresponding author
- Lindström, J.
- Venue
- Diabetologia
- Published
- 2006-03-16
- Volume
- 49
- Issue
- 5
- Pages
- 912-920
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W2016616366
- Cited by
- 293
- References
- 50
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 4 · 2023: 11 · 2022: 9 · 2021: 10 · 2020: 14 · 2019: 11 · 2018: 23 · 2017: 19 · 2016: 15 · 2015: 19 · 2014: 16 · 2013: 14 · 2012: 21
- FWCI
- 21.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Yrjö Jahnssonin Säätiö
- Juho Vainion Säätiö
- Novo Nordisk
- Diabetestutkimussäätiö
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
- Keywords
- high-fiber diet, low-fat diet, macronutrient composition, energy density, weight loss, waist circumference, type 2 diabetes prevention, impaired glucose tolerance, nutrition counseling, physical activity counseling, Finnish Diabetes Prevention Study
- MeSH terms
- Counseling, Diabetes Mellitus, Type 2, Dietary Fiber, Female, Finland, Humans, Male, Risk Factors, Weight Loss, Exercise, Glucose Intolerance, Diet, Fat-Restricted
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
