Dietary associations with prediabetic states--the DR's EXTRA Study (ISRCTN45977199)

Eur J Clin Nutr. 2012 Jul;66(7):819-24. doi: 10.1038/ejcn.2012.23. Epub 2012 Mar 14.


Background/objectives: Impaired fasting plasma glucose (IFG) and impaired glucose tolerance (IGT) predict development of type 2 diabetes (T2D), but display different pathophysiology for T2D. We studied the association of selected food items and nutrients with IFG, IGT and combined IFG and IGT (IFG+IGT), independent of cardiorespiratory fitness (VO(2max)).

Subjects/methods: In a population-based sample of 1261 individuals, aged 58-78 years, we identified 126 subjects with IFG, 97 with IGT and 49 with simultaneous IFG and IGT by an oral glucose tolerance test. Dietary intake was assessed by 4-day food records. Cardiorespiratory fitness was assessed by defining maximal oxygen uptake (VO(2max)) from respiratory gas analysis during a maximal symptom-limited exercise stress test on a bicycle ergometer.

Results: Increased intake of saturated fat was associated with higher odds for IFG (OR 1.07; 1.01-1.14) after adjustment for age, gender, VO(2max) and energy misreporting variable. Consumption of additional whole-grain bread (50 g/1000 kcal) and intake of dietary fiber (g/1000 kcal) were inversely associated with IGT (OR 0.61; 0.41-0.92, OR 0.91; CI 0.85-0.97, respectively).

Conclusion: Dietary fiber and sources of cereal fiber are negatively associated with IGT, and saturated fat intake is positively associated with IFG, but not with IGT. The present data give practical dietary means at the population level for the elimination of prediabetic conditions.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Bicycling / physiology
  • Blood Glucose / metabolism
  • Bread
  • Cardiovascular System
  • Diet / adverse effects*
  • Diet Records
  • Dietary Fats / adverse effects*
  • Dietary Fiber / pharmacology
  • Dietary Fiber / therapeutic use
  • Edible Grain
  • Energy Intake*
  • Exercise Test
  • Fasting
  • Fatty Acids / adverse effects*
  • Female
  • Glucose Intolerance / blood
  • Glucose Intolerance / etiology
  • Glucose Intolerance / prevention & control*
  • Glucose Tolerance Test
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / etiology
  • Hyperglycemia / prevention & control*
  • Male
  • Middle Aged
  • Odds Ratio
  • Oxygen Consumption
  • Prediabetic State / blood
  • Prediabetic State / diet therapy*
  • Respiration
  • Respiratory System


  • Blood Glucose
  • Dietary Fats
  • Dietary Fiber
  • Fatty Acids

Associated data

  • ISRCTN/ISRCTN45977199