The short-term effect of high fiber intake on fish-oil treatment in 15 free-living, non-insulin-dependent diabetic patients was evaluated by using a controlled, sequential study design. During an 8-wk fish-oil-treatment period when patients received 20 g fish oil/d, the usual daily fiber intake was increased with a 15-g pectin supplement at midpoint. Fish oil alone lowered triacylglycerol and very-low-density-lipoprotein-cholesterol concentrations by 41% and 36%, respectively (both P < 0.01 by the end of the treatment period) with unchanged mean total, low-density-, and high-density-lipoprotein-cholesterol concentrations. When the fiber intake was increased, however, total and low-density-lipoprotein-cholesterol concentrations decreased significantly (P < 0.001 and < 0.05, respectively) with fish-oil treatment. The cholesterol ester fraction of plasma lipids was reduced by 34% when compared with fish oil alone (P < 0.05). The plasma triacylglycerol fraction decreased further by 44% (P < 0.001). Other beneficial effects observed included a 30% decline in the fatty acid fraction (P < 0.002) by end of the treatment period. Diabetic control was maintained during the 12-wk study. In conclusion, a high fiber intake may be beneficial in fish oil-treated diabetic patients.