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Diabetics
on High-Fiber Diets might need extra Calcium
Newswise — The amount of calcium your body
absorbs might depend, in part, on the amount
of dietary fiber you consume.
Researchers at UT Southwestern Medical
Center report that patients with
noninsulin-dependent diabetes (type 2)
excreted less calcium through their urine
when they consumed 50 grams of fiber a day
than when they ate 24 grams a day.
Excreting less calcium indicates that they
absorbed less of the mineral.
“We already know that fiber helps improve
your cholesterol and glucose control and
improves your bowel regularity. Our new
findings suggest that dietary fiber reduces
the body’s capacity to absorb calcium,” said
Dr. Abhimanyu Garg, professor of internal
medicine and an investigator in the Center
for Human Nutrition at UT Southwestern.
He is senior author of a study appearing
online in Diabetes Care.
“Because more calcium equals better bone
health, we recommend that people on
high-fiber diets talk to their physician
about increasing their dietary calcium as
well, in order to get the most benefit from
both.”
Dr. Garg said it’s important to speak with a
physician or a registered dietitian before
increasing your calcium intake because
excessive levels may cause kidney stones.
The American Diabetes Association (ADA)
recommends a daily intake of 24 grams of
dietary fiber, but the average American
consumes about 14 to 15 grams of fiber a
day.
Sometimes called “roughage,” dietary fiber
is the indigestible portion of plant foods
that pushes food through the digestive
system, absorbing water and easing
defecation.
Calcium is a nutrient found in food that is
absorbed by the body and then excreted in
urine, feces or sweat. It is the most
abundant mineral in the human body.
Prior research at UT Southwestern has shown
that a high intake of dietary fiber, mostly
from fruits and vegetables, lowers blood
glucose levels and leads to decreased
insulin levels in the blood, as well as
lowering blood lipid concentrations in
patients with type 2 diabetes, the most
prevalent type of diabetes.
For the current study, 13 patients with type
2 diabetes ate either a high-fiber diet (50
grams per day) or the moderate-fiber diet
(24 grams per day) recommended by the ADA
for six weeks, then switched to the other
diet for six weeks.
All participants stayed at UT Southwestern’s
Clinical and Translational Research Center (CTRC)
for the final week of each six-week period.
CTRC staff prepared both diets so that they
contained the same number and proportion of
calories from carbohydrates, fats and
proteins, as well as an equal amount of
minerals such as calcium, phosphorous,
magnesium, sodium and potassium.
The high-fiber diet included numerous
fiber-rich foods including cantaloupe,
grapefruit, papaya, okra, winter and
zucchini squash, granola and oatmeal. No
supplements were used.
“The reduction of urinary calcium excretion
on high-fiber diets tells us that the amount
of dietary fiber has a direct impact on
calcium absorption,” Dr. Garg said.
“In other words, the participants excreted
less calcium on the high-fiber diet because
the additional fiber caused their bodies to
absorb less calcium.”
Though most of the additional fiber in the
high-fiber diet was soluble fiber, Dr. Garg
said he cannot say for sure whether soluble
or insoluble fiber affects calcium
absorption.
“Generally, more fiber of either type is
beneficial,” he said.
“We should encourage people to try food
sources rich in fiber and calcium such as
spinach, broccoli, figs, papaya, artichoke,
okra, beans, mustard and turnip greens, and
cactus pads.”
Other UT Southwestern researchers involved
in the study were Dr. Meena Shah, lead
author and clinical associate professor of
clinical nutrition; Dr. Manisha Chandalia,
clinical associate professor of internal
medicine with the Center for Human
Nutrition; Beverley Adams-Huet, assistant
professor of clinical sciences; Linda
Brinkley, former research dietitian; Dr.
Khashayar Sakhaee, chief of mineral
metabolism; and Dr. Scott Grundy, director
of the Center for Human Nutrition.
The work was funded by the National
Institutes of Health and Southwestern
Medical Foundation.
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