Effect of test meals of varying dietary fiber

content on plasma insulin and glucose

response1
Joan
John

G. Potter,
Krall,

M.

Kathryn
P. Coffman,
B.A., Robert
and Margaret
J. Albrink,
M.D.

M.D.,

Ph.D.,

ABSTRACT

To
content

fiber

varying

men

aged

22 to 45.

rice,

pinto

beans,
the

in insulin

and

fiber

nearly

being
formula.
meal.
KEY

was

greatest
It was

assess
the effect
of dietary
fiber on glucose
but identical
protein
fat and carbohydrate
Each

or

meal

All

formula,

and

glucose

provided

Bran.

the

inverse
Bran

concluded

Am. J. Clin.

Nutr.

Dietary

75 g of carbohydrate

The

least

as did

in All

WORDS

Ph.D.,

mean

for All

plasma

Bran

and

the

formula.

The

of the

rank

by magnitude

(18

g) and

that

dietary

34:

fiber,

pinto

328-334,

glucose

rank

beans

fiber

as liquid

glucose
pinto

and

beans.

four different
meals
of
were fed to eight healthy
glucose

insulin

Rice

produced

meal

by content

of the

insulin

response

g), low
the

in rice

insulin

formula,

responses

of each
(16.2

dampened

tolerance
content

(2.8

response

as brown
were

nearly

of neutral
evoked,
g) and

highest

as great
fiber
absent

to a high

a rise

detergent
content
from

the

carbohydrate

1981.
tolerance,

plasma

insulin,

triglyerides.

test

meals,

plasma

lipids

Hyperinsulinemia
is associated
with hypertriglyceridemia
(1), obesity
(2), and atherosclerotic
heart disease
(3). Because
the hyperinsulinemia
might
play a role in the etiology
of these conditions
factors
regulating
plasma
insulin
concentrations
are of interest.
Although
between-individual
variation
in the
insulin
response
to a standard
glucose
challenge
reflects
endogenous
factors
governing
insulin
release,
different
sources
of dietary
carbohydrate
may evoke
widely
differing
insulin
response
in the same
individual
(4-6).
Certain
properties
of food thus influence
the
insulin
response
to a meal.
We recently
reported
that a high carbohydrate
diet in which
the carbohydrate
was given
as foods
rich in
fiber did not cause
carbohydrate-induced
11pemia
while
carbohydrate
given
in a liquid
formula
caused
the expected
increase
in triglycerides
(4). The insulin
response
to glucose
given as the liquid
formula
was much
greater
than
to a test
meal
containing
an equal
amount
of carbohydrate
as brown
rice and
cooked
dried
beans.
It was postulated
that
the high fiber content
of the meals,
by blunting the insulin
response
to the meals,
was
328

The American

Journal

of Clinical

responsible
for the lack
of rise of fasting
triglycerides
after one week on the diet.
The present
study was undertaken
to evaluate the response
of plasma
glucose
and insulin to the chief high fiber foods used in that
study:
wheat
bran
cereal,
pinto
beans,
and
brown
rice, compared
to a liquid
formula
meal.
The results
showed
marked
variation
in fiber content
and negative
correlation
between
dietary
fiber content
and both plasma
glucose
and insulin
response
to the meal.
Methods
The experiment
was approved
by the West
Virginia
University
Committee
on Protection
of Human
Subjects.
Informed
signed
consent
was obtained
from each subject.

From
the Department
of Medicine
and the Department
of Community
Medicine
and the College
of Agriculture
and Forestry.
West Virginia
University.
Morgantown,
West Virginia
26506.
2 Supported
in part by Institutional
Grants
2-210-1615
(75) and 5 K R01 AM09252
and
by Research
Career
Award
5K6HL00486.
NHLBI
(M.J.A.).
Address
reprint
requests
to: Margaret
J. Albrink.
M.D.,
Department
of Medicine.
West
Virginia
University Medical
Center.
Morgantown.
West Virginia
26506.

Nutrition

34:

MARCH
1981, pp. 328-334.
Printed
1981 American
Society
for Clinical

in U.S.A.
Nutrition

Downloaded from ajcn.nutrition.org by guest on March 25, 2015

following

Reid,

L.

FIBER,

PLASMA

INSULIN,

Subjects
The subjects
were 8 healthy
men aged 22 to 45. None
was obese.
Mean
relative
weight
was 100. range
9 1 to
I 10. Each
received
four test meals,
about
a week
apart.
in latin square
design.
Thus the order
in which
the meals
were consumed
was evenly
distributed
amongst
the subjects.
Meals
Composition
of the four test meals
is shown
in Table
1. The amount
of food in the test meal was designed
to
provide
75 g of carbohydrate
(7). Casein
(Casec.
Mead
Johnson)
or corn oil (Mazola)
were added
as necessary
to equalize
the protein
and fat content
of all meals.
The
ingredients
of the formula
meal were mixed
in a blender.
Each subject
was required
to ingest his meal continuously
over 20 mm and to add enough
water
to each
meal
so
that the total
volume
of water.
400 ml including
food
water,
was the same
in each
meal.
The
meals
were

Laboratory

procedures

Blood
was drawn
fasting.
at 30. 60. 120, and 180 mm
after the beginning
of ingestion
of the test meals.
Each
sample
was analyzed
for insulin
(8) and glucose
(Beckman glucose
analyzer).
Cholesterol
(9) and triglycerides
(10) were measured
on the fasting
and 3-h samples.
Aliquots
of uncooked
pinto
beans,
brown
rice, and
All Bran were analyzed
for dietary
fiber by a modification of the method
of Van Soest (II.
12). Total
cell wall
fiber
was analyzed
directly
as neutral
detergent
fiber
(NDF)
which
includes
lignin.
cellulose,
and hemicellulose. Acid detergent
fiber (lignin + cellulose)
and lignin

were also analyzed

directly while cellulose
lulose were calculated
by difference.

and hemicel-

Statistical analysis was carried out by analysis of

variance,
the order
of the meal
and type of meal
being
included
as factors
which
were tested.
Tukeys
multiple
comparison
procedure
was used to locate
the significant
differences
for each
diet
for each
time
interval
after
ingestion
of the test meal (13). In certain
instances
paired
test was used.

Results
There
was no effect of order
of meal but a
large
effect
of type
of meal.
The
plasma
glucose
and insulin
responses
to the test meals
are shown
in Figure
1. The chief differences
were
in the /2 and
1 h values,
where
the
formula
produced
the greatest
rise in plasma
glucose,
rice being
next,
All Bran and pinto
beans
causing
the least rise. The significant
differences
using
Tukeys
test are shown
in
the legend.
Of interest
also was the three hour
glucose
value which
for the formula
diet was

GLUCOSE

329

less than
for the other
three
meals
and the
difference
was
significant
when
tested
by
paired
I test.
A specific
t test was calculated
at 3 h because
the standard
errors
were considerably
smaller
at that time than those at 0,
/2,
1, and 2 h.
The mean
insulin
response
to the formula
was nearly
twice that to the beans
and the All
Bran. The rank of insulin
response
to the four
meals was the same as that of plasma
glucose,
the formula
causing
the greatest
rise in insulin, rice causing
a slightly
lesser response,
All
Bran
and beans
causing
the least response.
The peak insulin
response
to pinto beans
was
later than for the other
three
meals.
The
difference
in insulin
response
was
much
greater
than
the difference
in glucose
response,
a nearly
2-fold
greater
peak insulin
occurring
after
the formula
meal
than
after
the pinto beans
and All Bran meals.
The peak
glucose
response
to formula
was only
27%
greater
than
the response
to All Bran
and
pinto
beans.
The mean
plasma
triglyceride
concentration at 3 h was lower than the fasting
concentration
after all four meals,
significant
for two
of the four meals.
The decrease
was greatest
after
the formula
and
least
after
the pinto
beans
(Fig. 2). The triglyceride
decrease
was
roughly
correlated
with the insulin
and glucose rise stimulated
by the meal (Fig.
1). The
/2 h insulin
bore a low grade
correlation
with
the percent
decrease
in triglyceride
(r = 0.331,
p < 0.05). The mean
and SD of fasting
cholesterol
before
and after all four tests together
was 184 37 and 186 35 mg/dl
and it did
not change
significantly
after any meal.
The
type
and
amount
of fiber
varied
greatly
among
the three types of food. Tables
I and 2 show the amount
and composition
of
the meals,
each designed
to supply
75 g of
carbohydrate.
All Bran
and
pinto
beans,
which
were
similar
in evoking
the least
response
of glucose
and insulin,
also had the
greatest
amount
of NDF
(Table
2). Brown
rice by comparison
had only a small amount
of NDF.
All Bran
and
pinto
beans
were
similar
in lignin
content
but All Bran
had
more hemicellulose
than cellulose
while pinto
beans
had more cellulose
than hemicellulose.
The ranking
by insulin
response
was the inverse to ranking
by NDF,
cellulose,
or lignin.
The ranking
by book value for crude
fiber (7)

Downloaded from ajcn.nutrition.org by guest on March 25, 2015

prepared
in batch
and frozen
until
needed.
The beans
and rice were cooked
by steaming.
An aliquot
of each
meal was saved
for fiber analysis.
The subjects
consumed
their
usual
diets
before
and
between
the test meals.
They
pursued
their
usual
semisedentary
lives during
the tolerance
tests.

AND

POTTER

330
160

ET

AL.

#{149}-#{149}Formula
#{149}---.#{149}
Rice

E
0
0

140

)t--

A1)Bran

h--A

Beans

E
(I)

120

0
C-)
-J

00

4
(I)

4
-J

80

60

160
E

120

-J
(I)

80

4
(I)

4
-J
0.

40

HOURS

FIG.
1. Response
of plasma
glucose
SEM.
Significant
differences
by Tukeys

and
test

AFTER

75gm

insulin
to various
as follows:

CHO

meals

MEAL

containing

Probability

75 g of carbohydrate.

p
p

Not

to

Insulin

Ih
<0.01
<0.05

3h
<0.01*
<0.01

p<O.IO

significant by Tukeys

was similar
NDF.

/.h
0.01
< 0.01
<

the

ranking

test

but

by

significant

content

and

values

Glucose

Formula
versus
bran
Formula
versus
beans
Rice versus
bran
Rice versus
beans

means

by paired

of

Discussion
The
four
types
of meals,
containing
the
same
amount
of protein,
fat, and carbohydrate,
but varying
in fiber
content,
evoked
very
different
responses
of plasma
glucose
and insulin.
The liquid
formula
caused
the
greatest
response
of both insulin
and glucose,

/ih
<0.01
<0.01
<0.05
<0.01

Ih
<0.01
<0.10

2h
<0.10

test.

and All Bran and pinto beans caused

the least
response.
Rice caused
almost
as great
a rise
as the liquid
formula.
The differences
were
greater
for insulin
than
for glucose.
Factors
that might
influence
insulin
response
such as
the time required
for ingestion
of the meal,
amount
of fluid,
and amount
of protein
and
fat were strictly
controlled
and were identical
in all meals.
The monosaccharide,
either
as
fed or as the product
of digestion,
was glucose
in all four meals.
The peculiar
property
of

Downloaded from ajcn.nutrition.org by guest on March 25, 2015

FIBER,

PLASMA

INSULIN,

AND

331

GLUCOSE

a,
E
00

w
0
w
0
(9
1-

(I)

Beans

Bran
HOURS

Rice
AFTER

Formula

MEAL

FIG. 2. Plasma triglyceride concentration

fasting and
men. SEM
is indicated by bars. Significant
difference
from

3 h after each test meal. Columns

show
fasting
value
for a given
meal is indicated

TABLE
1
Composition

each*

of test meals

meal

In food

tAs

106
97
118

11.2
7.8
27

was consumed

Casec,

Mead

per

in 20 mm

of each

composition

TABLE
2
Fiber
content

Protein

Carbohydrate

Fat
(.iseint

In food

Corn

15.8
19.7

meal:

calculated

with 400

3.8
1.8
1.4

ml water, including

Protein
Fat
Carbohydrate
from

book

water

oil

In food

Glucose

75
75
75

2
2
4

27

Final composition

*Food

75 g of carbohydrate

Amount
of
uncooked
food

All Bran
Brown
rice
Pinto beans
Formula
Each

supplying

means
for eight
by * (p <0.01).

75

in food.

27 g (24% of cal)
4 g (8% of cal)
75 g (68% cal)

values (7).

Johnson.

meal

(g)*
Crude
fiber

Neutral
detergent

Acid
detergent

Lignin

Cellulose

All Bran
Brown
rice

8.2
0.9

18.0
2.8

8.7
3.2

2.3
1.5

6.4
1.7

10.2
8

Pinto beans
Formula

5.1

16.2
0

12.1
0

2.2
0

9.9
0

5
0

*NDF

is comprised

of hemicellulose,

cellulose, and

lignin. Acid

cellulose. NDF,
acid detergent
fiber,
and lignin
were determined
determined
by difference. Crude fiber was calculated from book

detergent

directly,
while
values (7).

Hemicellulose

fiber is comprised
of lignin
cellu lose and hemicellulose

and
were

Downloaded from ajcn.nutrition.org by guest on March 25, 2015

LU

332

POTTER

AL.

insulinogenic
than
the vegetable
protein
it
replaced.
The fact that the insulin
response
to the bran and bean meals
was similar
(Fig.
1) while the casein
content
was very dissimilar
(Table
1) makes
it unlikely
that casein
was
responsible
for the difference.
Degree
of cooking
and physical
state could
account
for some
of the differences
in the
effect of the meals.
Cooked
starch
meals raise
plasma
glucose
and insulin
while raw soluble
starch
does not (6) although
it supports
caloric
balance
(19). A meal
of whole
apples
caused
a lesser
increase
in plasma
glucose
and
insulin
than
an equivalent
amount
of
apple
puree
although
both forms
were isofibrous
(20). Apple
puree
caused
less rise than
apple juice
suggesting
that sugar
in solution
is particularly
insulinogenic
(20). The foods
in the present
study
were cooked
to a palatable
state,
but by their
nature
differed
in
texture.
The
effect
of degree
and
type
of
cooking
on insulin
response
to meals
remains
largely
unexplored.
While
the difference
between
liquids
and solid food could
have accounted
for some
of the difference
between
our
formula
and
solid
foods
it could
not
account
for the differences
between
rice and
the other
solid foods.
Of all the variables
discussed,
dietary
fiber
seems
most likely
to account
for the greatly
different
responses,
the rank
of insulin
and
glucose
response
being the inverse
of the rank
with
regard
to NDF
content.
All Bran
and
pinto
beans
were
nearly
indistinguishable
with respect
to NDF
and the plasma
glucose
and insulin
response
evoked.
The ranking
by
magnitude
of insulin
response
correlated
best
with ranking
by cellulose
and/or
lignin
content.
The range
in insulin
response
between
the
mean
peak for the rice meal and that for the
bean and bran meals,
about
2-fold,
was much
smaller
than
the 10-fold
difference
between
the NDF
content
of rice (2.8 g) and All Bran
(20 g). If fiber is responsible
for any of the
difference,
the amount
of fiber in the beans
and All Bran
may be far in excess
of that
needed
to reduce
insulin
output.
Crapo
et a!. (5) also reported
differing
glucose and insulin
response
to various
meals
containing
equal
equivalents
of glucose
and
in their
study
as in ours
insulin
response
differed
more
than did glucose
response.
In-

Downloaded from ajcn.nutrition.org by guest on March 25, 2015

fructose
of causing
little
increase
in plasma
glucose
or insulin
was thus avoided
(14).
The fiber
content,
as NDF,
of the meals
varied
inversely
with the insulin
and glucose
response,
being
absent
from
the liquid
formula
and highest
in the pinto
beans
and All
Bran.
We
earlier
reported
that
refined
wheat
starch
as bread
evoked
a slightly
lower insulin
and
glucose
response
than
an equivalent
amount
of ingested
glucose
(14). Some of the
differences
in the insulin
effect
of the meals
in the present
study
could
be accounted
for
by the difference
between
glucose
in solution
and cooked
starch.
However,
the large difference between
the rice, which
evoked
a high
insulin
response,
and
All Bran
and
pinto
beans,
which
evoked
a low response,
must be
due to other
factors.
Another
possibility
is that the solid meals
contained
less than
the intended
75 g of
carbohydrate.
The amount
of carbohydrate
was calculated
from
the book
values
(7) in
which
carbohydrate
is calculated
by subtracting water,
protein,
fat, and ash from
total
weight.
The NDF
would
thus be included
in
the designation
carbohydrate
and
would
displace
nearly
20 g of the calculated
75 g of
starch
in the All Bran
and bean
meals,
but
only 2 to 3 g in the rice meal.
While
most of
the fiber components
would
be converted
to
a digestible
form by the action
of bacteria
in
the colon
and would
thus
provide
calories
(15) they would
not provide
a plasma
glucose
or insulin
raising
stimulus.
Peterson
and
Reaven
(16) showed
double
or more
the insulin response
to 80 grams
compared
to 40 g
of glucose.
The 2-fold
difference
between
the
two glucose
doses was much
greater
than the
postulated
difference
in starch
between
pinto
beans
and formula
created
by displacement
by fiber
in the present
study.
Thompson
et
a!. (17)
found
no difference
in integrated
glucose
or insulin
response
whether
meals
contained
65 or 45% of calories
from carbohydrate
as corn
syrup.
However,
a small
amount
of the difference
in response
to our
various
meals
could
be due to differences
in
amounts
of starch.
Protein
also stimulates
insulin
release
(18).
Care was taken
to equalize
protein
content
of
all meals
by adding
casein
where
needed
(Table
1). The casein
could
have been more

ET

FIBER,

PLASMA

INSULIN,

GLUCOSE

333

stimulated
only a slight
rise in insulin.
and a
carbohydrate-induced
rise in fasting
triglycerides,
while it occurred
following
a low fiber
diet, did not take place (4).
When
hypertriglyceridemia
is induced
by
a high carbohydrate
diet the hypertriglyceridemia
is most
marked
in the fasting
state,
decreasing
after
the first high carbohydrate
diet of the day, and remaining
low throughout the day (26).
The
magnitude
of acute
decrease
in triglycerides
with
feeding
was
found
by Barter
et al. (26) to be related
to the
magnitude
of insulin
response
to the meal.
The authors
postulated
that fasting
hypertriglyceridemia
induced
by prior
high
carbohydrate
diet represented
impaired
triglyceride removal
at an insulin
sensitive
site, probably
adipose
tissue.
In the subjects
of the
present
study
a similar
reduction
of triglyceride
concentration
below
fasting
levels
occurred
3 h after ingestion
of the meals.
The
reduction
was greatest
after the glucose
formula meal, and least after the bean meal. The
reduction
of triglyceride
levels
with
carbohydrate
feeding
thus occurs
not only in subjects with carbohydrate-induced
lipemia
but
also in persons
with normal
triglycerides
who
have
previously
been
consuming
ordinary
diets.
The acute
triglyceride-lowering
effect
of glucose
or insulin
administration
and its
probable
dependence
on insulin-stimulated
triglyceride
removal
has been
reviewed
by
Macdonald
(27).
The
greater
postprandial
decrease
in triglycerides
after
the high carbohydrate
low fiber meals,
about
30%, than
after the high fiber meal,
about
10%, might
be expected
to result
in lower
day-long
triglyceride
levels with low than high fiber diets
were it not for the fact that after a few days
of high carbohydrate
low fiber diet a rise in
fasting
triglycerides
of at least 30% would
be
expected
to occur
(4). We found
that postprandial
triglycerides
as well as fasting
triglycerides
were higher
during
a low fiber than
high fiber diet (4), although
in that study
the
greater
fat content
(15% of calories)
than
in
the present
study
(8% of calories)
obliterated
the postprandial
fall in triglycerides.
The acute decline
in triglyceride
concentration after
glucose
or insulin
administration
may
represent
a normal
shift
from
the fat
economy
of fasting,
in which
adipose
tissue
is relatively
inactive
in removing
circulating

Downloaded from ajcn.nutrition.org by guest on March 25, 2015

sulin
response
to rice and corn
was lower
than
to glucose
solution
while
potatoes
evoked
almost
as great an insulin
response
as
did glucose,
and white
bread
was intermediate. A discrepancy
between
their
study
and
the present
study
is that insulin
response
to
brown
rice in our study
was greater
than
to
white
rice in their study.
Differences
in fiber
between
their brand
(Uncle
Bens Converted
Rice)
and our brand
(River
Brand
Brown
Rice)
or in cooking
could
account
for the
discrepancy.
Rank
of insulin
response
in their
study
was nearly
the inverse
of rank of published
values
of cell wall fiber determined
by
Van
Soest
(21) with
the exception
of rice
which
was not included
in that list. If rice is
assumed
to be low in fiber,
as our Table
2,
then the low insulin
response
to rice in their
study would
not be explained
by the low fiber
content.
Although
few other studies
have correlated
insulin
response
with fiber content
of
meals,
Jenkins
et al. (22) reported
that addition of guar
and
pectin,
only
variably
detected
by the methods
of the present
study,
blunted
the insulin
response
to glucose
challenge (22). By creating
less demand
for insuun, or by other
unknown
mechanisms,
high
fiber diets have been beneficial
in the treatment of diabetes
(23, 24).
The mechanisms
by which
high fiber diets
lower
insulin
response
is not known.
The
importance
of viscosity
in causing
delayed
gastric
emptying
time and slowing
of carbohydrate
absorption
has been suggested
(25),
although
viscosity
of bran could
not be measured.
The fact that the difference
in insulin
response
was much
greater
than
the difference in glucose
response
could
be an indication of enhanced
insulin
sensitivity
following
the high fiber meal, through
unknown
mechanisms.
Perhaps
hyperinsulinemia
begets
instant insulin
resistance.
A role for excess
insulin
response
in the
genesis
of hypertriglyceridemia
has been postulated
(1). The rise in fasting
plasma
triglycerides
in normal
persons
after several
days of
very high
carbohydrate
diet (carbohydrateinduced
lipemia)
has also been attributed
to
the excess
insulin
secretion
stimulated
by
such
diets
(I).
The
role
of
insulin
is
strengthened
by our earlier
finding
that when
the high carbohydrate
diet was administered
as foods
high in fiber,
a representative
meal

AND

POTTER

334

ET

9.

10.

II.

12.
13.

14.

15.

16.

17.

18.

19.

The
gratefully

skillful laboratory
acknowledged.

assistance

of

Ruth

Deal

is

References
I. Olefsky
JM,
Farquhar
JW.
Reaven
GM.
Reappraisal
of the role of insulin
in hypertriglyceridemia.
Ami
Med
1974:57:551-60.
2. Assimacopoulos-Jeannet
F. Jeanrenaud
B. The hormonal
and metabolic
basis of experimental
obesity.
Clin Endocrinol
Metab
1976:5:337-65.
3. Stout
RW. Diabetes
and atherosclerosis-the
role of
insulin.
Diabetologia
1978:16:141-50.
4. Albrink
Mi,
Newman
T, Davidson
PC. Effect
of
high-and
low-fiber
diets on plasma
lipids
and insulin. Am J Clin Nutr
1979:32:1486-91.
5. Crapo
PA,
Reaven
0.
Olefsky
J. Postprandial
plasma-glucose
and
insulin
response
to different
complex
carbohydrates.
Diabetes 1977:26:1178-83.
6. Crapo
PA, Reaven
0, Olefsky
J. Plasma
glucose
and
insulin
responses
to orally
administered
simple
and
complex
carbohydrates.
Diabetes
1976:25:741-47.
7. Composition
of Foods.
Agriculture
Handbook
no. 8.
Superintendent
of Documents.
Washington.
D.C.:
United
States
Government
Printing
Office,
1963.
8. Morgan
OR,
Lazarow
A. Immunoassay
of insulin:

20.

21.
22.

23.

24.

25.

26.

27.

two antibody
system.
Diabetes
1963:12:115-126.
Abell
LL,
Levy
BB,
Brody
BB.
Kendall
FE.
A
simplified
method
for the estimation
of total cholesterol in serum
and demonstration
of its specificity.
J
Biol Chem
1952:195:357-66.
Lofland
HB Jr. A semiautomated
procedure
for the
determination
of triglycerides
in serum.
Anal
Biochem
1964:9:393-400.
Goering
HK, Van Soest
PJ. Forage
fiber analyses.
Agricultural
Handbook
no. 379. Washington.
D.C.:
ARA,
USDA,
1970.
Fonnesbeck
PV. Partitioning
of the nutrients
of forage for horses.
J Anim
Sci 1969:28:624-33.
Winer
Bi. Statistical
principals
in experimental
design.
2nd ed. New
York:
McGraw-Hill
Book
Co..
1971:196-201.
Swan
DC,
Davidson
PC, Albrink
Mi.
Effects
of
simple
and complex
carbohydrates
on plasma
nonesterified fatty acids, plasma
sugar
and plasma
insulin
during
oral carbohydrate
tolerance
tests.
Lancet 1966:1:60-3.
Bond
JH, Levitt
MD.
Fate of soluble
carbohydrate
in the colon
of rats and man. I Clin Invest
1976:57:
1158-64.
Peterson
DT,
Reaven
CM.
Evidence
that
glucose
load is an important
determinant
of plasma
insulin
response
in normal
subjects.
Diabetes
1971:20:72933.
Thompson
RG. Hayford
IT. Danney
MM.
Glucose
and insulin
response
to diet.
Effect
of variations
in
source
and
amount
of
carbohydrate.
Diabetes
1978:27:1020-26.
Floyd
JE. Fajans
SS. Conn
JW. Knopf
RF. Rull I.
Stimulation
of insulin
secretion
by amino
acids.
I
Clin Invest
1966 5: 1487-1502.
Macdonald
1, Braithwaite
DM.
The
influence
of
dietary
carbohydrates
on the lipid pattern
in serum
and in adipose
tissue.
Clin Sci 1964:27:23-30.
Haber
GB. Heaton
KW.
Murphy
D. Burroughs
L.
Depletion
and disruption
of dietary
fiber.
Effects
on
satiety, plasma-glucose
and serum-insulin.
Lancet
1977:2:679-82.
Fiber
Analysis
Tables.
J Clin Nutr
1978:31
(suppl):
5281. 1978.
Jenkins
DJA.
Leeds
AR.
Gassull
MA.
Cochet
B.
Alberti
KGMM.
Decrease
in post-prandial
insulin
and glucose
concentration
by guar and pectin.
Ann
Intern
Med
1977:86:20-23.
Keihm
TG,
Anderson
1W, Ward
K. Beneficial
effects
of a high
carbohydrate.
high
fiber
diet
on
hyperglycemic
diabetic
men.
Am
I Clin
Nutr
1976:30:895-99.
Miranda
PM,
Horwitz
DL. High
fiber diets
in the
treatment
of diabete
mellitus.
Ann
Intern
Med
1978:88:482-486.
Jenkins
DJA.
Dietary
fiber,
diabetes,
and hyperlipidemia.
Progress
and prospects.
Lancet
1979:2:128790.
Barter
P1, Carroll
KF,
Nestel
P1. Diurnal
fluctuations
in triglyceride,
free
fatty
acids
and
insulin
during sucrose consumption
and insulin infusion in
man.
I Clin Invest
197 1:50:583-91.
Macdonald
I. Effects
of dietary
carbohydrates
on
serum
lipids.
Prog Biochem
Pharmacol
1973:8:2
1641.

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triglycerides,
to the carbohydrate
economy
of
the fed state with its increased
insulin-stimulated
triglyceride
removal
by adipose
tissue.
The fact that the magnitude
of triglyceride
reduction
was related
to the magnitude
of
insulin
response,
in our study
as in that of
Barter
et al. (26), offers
an explanation
for
the trend
for less triglyceride
reduction
after
the high fiber
meals
than
after
the formula
meal.
Dietary
fiber
may
thus
dampen
the
shift to carbohydrate
metabolism
with feeding, a possibility
strengthened
by the occurrence
of reactive
hypoglycemia
after
the fiber-free
formula
meal (Fig.
1).
To the extent
that dietary
fiber dampens
insulin
response,
a high fiber-diet
would
result in lower
ambient
insulin
concentrations
during
the day, a more
gradual
and perhaps
diminished
shift
from
the fat economy
of
fasting
to the carbohydrate
economy
of the
fed state,
a more
even
24-h metabolic
state,
a lack of reactive
hypoglycemia,
and a stable
triglyceride
concentration
during
the day. If
the suggestive
evidence
of the present
study
that insulin
response
could
be predicted
from
fiber content
is borne
out, diets could
better
be designed
for the treatment
and prevention
of diseases
in which
excessive
insulin
response
might
have an etiologic
role, such as
obesity
(2), hypertriglyceridemia
(1), and atherosclerosis
(3).

AL.