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AbstractContext: There is little data correlating dietary fibre (DF) intake and cardiovascular risk in Asian Indians with diabetes. IntroductionDiabetes is one of the leading causes of mortality worldwide, contributing directly or indirectly to more than 4.6 million deaths annually. 11.National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non communicable Diseases Prevention and Control, Chennai, Tamil Nadu, India2 Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation and Dr. Aim: To assess the DF intake and its association with lipid profile (total serum cholesterol and low density lipoprotein [LDL] - cholesterol levels) in urban Asian Indians with diabetes. Effect on blood lipids of very high intakes of fiber in diets low in saturated fat and cholesterol.
Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report.
Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge.
Glucose intolerance (diabetes and IGT) in a selected South Indian population with special reference to family history, obesity and lifestyle factors - the Chennai Urban Population Study (CUPS 14). Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III.
Reproducibility and validity of an interviewer-administered semi-quantitative food frequency questionnaire to assess dietary intake of urban adults in southern India.

Improved plasma glucose control, whole-body glucose utilization, and lipid profile on a low-glycemic index diet in type 2 diabetic men: A randomized controlled trial.
Adherence to dietary recommendations for saturated fat, fiber, and sodium is low in American Indians and other U.S. Association of fruit and vegetable intake with cardiovascular risk factors in urban south Indians.
Refined grain consumption and the metabolic syndrome in urban Asian Indians (Chennai Urban Rural Epidemiology Study 57). Dietary fiber does not displace energy but is associated with decreased serum cholesterol concentrations in healthy adults. Subjects and Methods: Dietary assessment using validated Food Frequency Questionnaire was conducted in 1191 free-living adults with known diabetes in the Chennai Urban Rural Epidemiology Study. Interventions targeted at reducing low density lipoprotein (LDL) cholesterol have shown benefit in reducing the risk of CVD in individuals with diabetes. Serum triglycerides and high density lipoprotein cholesterol were not associated with DF intake. Conclusion: In urban Asian Indians with diabetes, lower DF intake is positively related to total cholesterol and LDL cholesterol levels. An additional 53 subjects who were on lipid lowering drugs and those with a history of ischemic heart disease (n = 60), were also excluded. The association between total DF intake, total cholesterol and LDL cholesterol was determined using logistic regression and variables that showed significant association on univariate analysis were adjusted.

The physicochemical properties of DF alter metabolic pathways of hepatic cholesterol and lipoprotein metabolism, resulting in lowering of plasma LDL-cholesterol. This results to up-regulation of the LDL receptors and further increases clearance of LDL cholesterol from the blood circulation. The nature of fatty acids consumed independently plays a major role in altering lipid profile particularly total cholesterol and LDL.
The present study also indicates that subjects with high consumption of DF from vegetables and legumes have lower prevalence of hypercholesterolemia. It appears to be difficult for individuals in the lower income group to find inexpensive foods with higher levels of DF. Clinical trials in healthy adults have shown that higher intake of DF did not show any association with TG and HDL cholesterol.
The second limitation is that the study has not identified the type of DF consumed due to lack of information on insoluble and soluble fiber content for many Indian foods.ConclusionThe present study reports an inverse association between DF intake and hypercholesterolemia and high LDL cholesterol levels in subjects with type 2 diabetes in urban Chennai.

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