Therese Hjorth, Alena Schadow, Ingrid Revheim, Ulrike Spielau, Klara Meyer, Anne Rieder, Paula Varela, Simon Ballance, Antje Koerner, Rikard Landberg, Anette E Buyken, Jutta Dierkes, Hanne Rosendahl-Riise
{"title":"与全麦面包相比，普通燕麦β-葡聚糖面包对2型糖尿病高危成人长期血糖控制的有效性：一项随机对照试验","authors":"Therese Hjorth, Alena Schadow, Ingrid Revheim, Ulrike Spielau, Klara Meyer, Anne Rieder, Paula Varela, Simon Ballance, Antje Koerner, Rikard Landberg, Anette E Buyken, Jutta Dierkes, Hanne Rosendahl-Riise","doi":"10.1016/j.ajcnut.2025.06.018","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>A high intake of whole grains is associated with reduced risk of type 2 diabetes and cardiovascular disease, and soluble fiber from oats and barley, that is, β-glucans, has been shown to lower blood cholesterol and postprandial glycaemia. Despite such data and the European Food Safety Authority health claims supporting β-glucan-induced reductions in glucose and cholesterol, effectiveness in real-life settings among individuals at elevated risk of developing type 2 diabetes remains unclear.</p><p><strong>Objectives: </strong>This study aims to assess the long-term effectiveness of daily consumption of β-glucan-enriched bread, compared with whole-grain wheat bread, on glycated hemoglobin (HbA1c) and glycemic control in adults at risk of type 2 diabetes.</p><p><strong>Methods: </strong>A 16-wk randomized, double-blind dietary intervention was conducted in 194 adults [58 ± 8 y; BMI: 32 ± 5 kg/m<sup>2</sup>; HbA1c 5.6% ± 0.3% (38 ± 3 mmol/mol); LDL cholesterol 3.6 ± 1.0 mmol/L] across sites in Germany, Norway, and Sweden. Participants consumed ≥3 slices/d of either β-glucan-enriched bread (6 g β-glucan/d) or control bread, 6 d/wk.</p><p><strong>Results: </strong>After 16 wk, there was no significant between-group difference in HbA1c [Δ = -0.01%, 95% confidence interval (CI): -0.03, 0.06; P = 0.49]. Similarly, no differences were observed in fasting glucose (Δ = -0.02 mmol/L; 95% CI: -0.11, 0.14), insulin (Δ = -0.76 pmol/L; 95% CI: -0.99, 2.5), or LDL cholesterol (Δ = -0.11 mmol/L; 95% CI: -0.27, 0.05) (all P > 0.05).</p><p><strong>Conclusions: </strong>Contrary to expectations from efficacy studies, this effectiveness trial does not support the metabolic benefits of oat-derived β-glucan-enriched bread under real-life conditions. A simple bread replacement may not be sufficient to improve glucose homeostasis in individuals at risk of type 2 diabetes. This trial was registered with clinicaltrials.gov as NCT04994327.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5000,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of regular oat β-glucan-enriched bread compared with whole-grain wheat bread on long-term glycemic control in adults at risk of type 2 diabetes: a randomized controlled trial.\",\"authors\":\"Therese Hjorth, Alena Schadow, Ingrid Revheim, Ulrike Spielau, Klara Meyer, Anne Rieder, Paula Varela, Simon Ballance, Antje Koerner, Rikard Landberg, Anette E Buyken, Jutta Dierkes, Hanne Rosendahl-Riise\",\"doi\":\"10.1016/j.ajcnut.2025.06.018\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>A high intake of whole grains is associated with reduced risk of type 2 diabetes and cardiovascular disease, and soluble fiber from oats and barley, that is, β-glucans, has been shown to lower blood cholesterol and postprandial glycaemia. Despite such data and the European Food Safety Authority health claims supporting β-glucan-induced reductions in glucose and cholesterol, effectiveness in real-life settings among individuals at elevated risk of developing type 2 diabetes remains unclear.</p><p><strong>Objectives: </strong>This study aims to assess the long-term effectiveness of daily consumption of β-glucan-enriched bread, compared with whole-grain wheat bread, on glycated hemoglobin (HbA1c) and glycemic control in adults at risk of type 2 diabetes.</p><p><strong>Methods: </strong>A 16-wk randomized, double-blind dietary intervention was conducted in 194 adults [58 ± 8 y; BMI: 32 ± 5 kg/m<sup>2</sup>; HbA1c 5.6% ± 0.3% (38 ± 3 mmol/mol); LDL cholesterol 3.6 ± 1.0 mmol/L] across sites in Germany, Norway, and Sweden. Participants consumed ≥3 slices/d of either β-glucan-enriched bread (6 g β-glucan/d) or control bread, 6 d/wk.</p><p><strong>Results: </strong>After 16 wk, there was no significant between-group difference in HbA1c [Δ = -0.01%, 95% confidence interval (CI): -0.03, 0.06; P = 0.49]. Similarly, no differences were observed in fasting glucose (Δ = -0.02 mmol/L; 95% CI: -0.11, 0.14), insulin (Δ = -0.76 pmol/L; 95% CI: -0.99, 2.5), or LDL cholesterol (Δ = -0.11 mmol/L; 95% CI: -0.27, 0.05) (all P > 0.05).</p><p><strong>Conclusions: </strong>Contrary to expectations from efficacy studies, this effectiveness trial does not support the metabolic benefits of oat-derived β-glucan-enriched bread under real-life conditions. A simple bread replacement may not be sufficient to improve glucose homeostasis in individuals at risk of type 2 diabetes. This trial was registered with clinicaltrials.gov as NCT04994327.</p>\",\"PeriodicalId\":50813,\"journal\":{\"name\":\"American Journal of Clinical Nutrition\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":6.5000,\"publicationDate\":\"2025-06-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Clinical Nutrition\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.ajcnut.2025.06.018\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Clinical Nutrition","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ajcnut.2025.06.018","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
Effectiveness of regular oat β-glucan-enriched bread compared with whole-grain wheat bread on long-term glycemic control in adults at risk of type 2 diabetes: a randomized controlled trial.
Background: A high intake of whole grains is associated with reduced risk of type 2 diabetes and cardiovascular disease, and soluble fiber from oats and barley, that is, β-glucans, has been shown to lower blood cholesterol and postprandial glycaemia. Despite such data and the European Food Safety Authority health claims supporting β-glucan-induced reductions in glucose and cholesterol, effectiveness in real-life settings among individuals at elevated risk of developing type 2 diabetes remains unclear.
Objectives: This study aims to assess the long-term effectiveness of daily consumption of β-glucan-enriched bread, compared with whole-grain wheat bread, on glycated hemoglobin (HbA1c) and glycemic control in adults at risk of type 2 diabetes.
Methods: A 16-wk randomized, double-blind dietary intervention was conducted in 194 adults [58 ± 8 y; BMI: 32 ± 5 kg/m2; HbA1c 5.6% ± 0.3% (38 ± 3 mmol/mol); LDL cholesterol 3.6 ± 1.0 mmol/L] across sites in Germany, Norway, and Sweden. Participants consumed ≥3 slices/d of either β-glucan-enriched bread (6 g β-glucan/d) or control bread, 6 d/wk.
Results: After 16 wk, there was no significant between-group difference in HbA1c [Δ = -0.01%, 95% confidence interval (CI): -0.03, 0.06; P = 0.49]. Similarly, no differences were observed in fasting glucose (Δ = -0.02 mmol/L; 95% CI: -0.11, 0.14), insulin (Δ = -0.76 pmol/L; 95% CI: -0.99, 2.5), or LDL cholesterol (Δ = -0.11 mmol/L; 95% CI: -0.27, 0.05) (all P > 0.05).
Conclusions: Contrary to expectations from efficacy studies, this effectiveness trial does not support the metabolic benefits of oat-derived β-glucan-enriched bread under real-life conditions. A simple bread replacement may not be sufficient to improve glucose homeostasis in individuals at risk of type 2 diabetes. This trial was registered with clinicaltrials.gov as NCT04994327.
期刊介绍：
American Journal of Clinical Nutrition is recognized as the most highly rated peer-reviewed, primary research journal in nutrition and dietetics.It focuses on publishing the latest research on various topics in nutrition, including but not limited to obesity, vitamins and minerals, nutrition and disease, and energy metabolism.
Purpose:
The purpose of AJCN is to:
Publish original research studies relevant to human and clinical nutrition.
Consider well-controlled clinical studies describing scientific mechanisms, efficacy, and safety of dietary interventions in the context of disease prevention or health benefits.
Encourage public health and epidemiologic studies relevant to human nutrition.
Promote innovative investigations of nutritional questions employing epigenetic, genomic, proteomic, and metabolomic approaches.
Include solicited editorials, book reviews, solicited or unsolicited review articles, invited controversy position papers, and letters to the Editor related to prior AJCN articles.
Peer Review Process:
All submitted material with scientific content undergoes peer review by the Editors or their designees before acceptance for publication.
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