Effects of isolated single fibers, fiber mixtures, and fiber-rich whole foods on glucose homeostasis in individuals with overweight and obesity: A systematic review and meta-analysis.

BACKGROUND & AIMS: Increasing evidence from epidemiological studies indicates that dietary fibers are protective against the development of type 2 diabetes mellitus. Supplementation of dietary fiber may therefore be a strategy to improve metabolic health in individuals with overweight and obesity at high risk to develop type 2 diabetes mellitus (T2DM). However, results from intervention studies are inconsistent, which may be related to the form of supplementation. In this systematic review and meta-analysis, we evaluated randomized controlled trials (RCTs) investigating the effects of dietary fiber administered as single isolated fibers, mixtures of isolated fibers, or fiber-rich whole foods on markers of insulin resistance and glucose homeostasis in individuals with overweight or obesity without T2DM.

METHODS

PubMed, Scopus, Web of Science and Embase databases were searched for RCTs comparing the effects of fiber supplementation with placebo treatments on glucose homeostasis. Changes in outcome parameters were analyzed using random effects meta-analyses to estimate effect size and 95 % confidence intervals (CI).

RESULTS

A total of 51 eligible papers (n = 3420 participants) with a study duration between one and twelve months were included in the meta-analysis. Dietary fiber supplementation improved fasting glucose concentrations -0.07 mmol/L (95 % CI: -0.12, -0.02; P = 0.0005; I2 = 54 %), reduced fasting insulin levels -5.89 pmol/L (95 % CI -9.18, -2.60, P = 0.0004; I2 = 89 %), and decreased HOMA-IR -0.38 (95 % CI: -0.68, -0.08; P < 0.00001; I2 = 94 %). In addition, subgroup analysis revealed that supplementation of single fibers improved fasting insulin, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), hemoglobin A1c (HbA1c) and insulin area under the curve (AUC). Isolated fiber mixtures in addition reduced fasting glucose but not insulin AUC. Supplementation of whole foods only improved HbA1c.

CONCLUSION

Dietary fiber supplementation improved glucose homeostasis and insulin sensitivity in individuals with overweight and obesity without T2DM. Although differential effects were observed based on the form of fiber supplementation, no form of fiber supplementation could be considered superior. The study was registered in PROSPERO as CRD42023427415.