It’s Diabetes Week, when people are encouraged to come together to share their stories and to raise awareness of diabetes. We’re doing our bit by sharing some science about gut health, fibre consumption and how this can impact on diabetes.
This 3 year study led by Jaana Lindström across 5 centres in Finland involved 522 middle-aged, overweight people suffering from impaired glucose tolerance. They were randomly allocated to either a ‘usual care control group’ or an’ intensive lifestyle intervention group’.
The control group received general dietary and exercise advice at baseline and had an annual physician’s examination. The intervention group each received additional individualised dietary counselings from a nutritionist with the goals of reducing body weight, reducing dietary and saturated fat, and increasing dietary fibre. They were also offered circuit-type resistance training sessions and advised to increase overall physical activity, in particularly in year 1.
The intervention group showed a significant improvement in every intervention goal. This was one of the first controlled, randomised studies to show that type 2 diabetes is preventable with lifestyle intervention.
The Finnish Diabetes Prevention Study also showed that people who ate more fibre had more of an anti-inflammatory chemical in their blood called indolepropionic acid, which is made by gut bacteria.
Following on from the Finnish study, Liping Zhao at Shanghai Jiao Tong University in China and his colleagues looked at the impact of a high fibre diet on people with type 2 diabetes. In the 16 week study, 16 people followed a standard low-fat, low-carb diet, while 27 people ate a lot of high-fibre foods, such as wholegrains, seeds and vegetables. The latter high-fibre group consumed a huge 37 grams of fibre a day; while the group of 16 on the average, healthy diet was eating about 16 grams of fibre a day – a similar amount to the current fibre average consumption in the UK.
Both groups also took a drug called acarbose, which makes people digest starch more slowly than usual. This allows starch to reach the large intestine, where microbes feed upon it. Before the study, all participants were gradually taken off any other medications to manage their blood sugar, with the exception of insulin which was adjusted as needed throughout the study.
By the end of the trial, 89% of those on the high-fibre diets showed signs that their bodies were regulating their blood sugar levels more effectively – compared to 50 per cent of the control group. Volunteers who ate more fibre also lost more weight, and had better blood lipid profiles. “Increasing dietary fibres can improve diabetes,” says Zhao.
In examining the gut bacteria in the people who responded to the diet best, the team found that 47 strains reduced in number during the diet, while 15 other strains became more abundant. The latter strains make butyric acid, which can boost the production of insulin, lowering blood sugar levels, claims Zhao.
The team aim to do more research to find other ways to boost the 15 seemingly beneficial strains of bacteria in people with diabetes, with the hope of developing probiotic treatments for diabetes.
However the results might not apply to everyone with diabetics, as most aren’t prescribed acarbose; but it is believed that we can all benefit from eating plenty of fibre.
Fibre in your daily diet
The key take out of this should be that the good bacteria in our guts, the ones that keep us healthy, need a lot more fibre than we’re now giving them to nourish then allowing them to thrive. In the UK, Public Health England believe most adults consume around 18g of fibre per day and most children and teenagers average15g, well short of the recommended target of 30G.
Kids and adults are so short on fibre in the U.S. that the expert panel that put together the most recent version of the dietary guidelines singled out fibre as one of four “nutrients of public health concern.”
The UK NHS give the following tips for increasing your fibre intake:
- Choose a higher-fibre breakfast cereal such porridge or like Troo Granola – Troo has more than 9G of fibre; almost 30% of your daily fibre requirement in one 45g bowl.
- Go for wholemeal or granary breads, or higher fibre white bread, and choose wholegrains like wholewheat pasta, bulgur wheat or brown rice. These carbs shouldn’t cover more than 25% of your plate.
- Go for potatoes with their skins on, such as a baked potato or boiled new potatoes.
- Add pulses like beans, lentils or chickpeas to stews, curries and salads.
- Include plenty of vegetables with meals, either as a side dish or added to sauces, stews or curries. Try to make veg fill at least half of your plate.
- Have some fresh fruit or fruit canned in natural juice for dessert.
- For snacks, try fresh fruit, vegetable sticks, rye crackers, oatcakes, houmous and unsalted nuts or seeds.
- Top up your fibre with Troo Spoonful of Fibre, you need to add this to your diet gradually but this delicious syrup is 65% fibre, with one table spoon adding 8g of fibre to your diet.