Evidence mapPaperPMID 42499112Full record

ArticleMedicine2026

Association of dietary fiber with all-cause mortality in U.S. adults with diabetes: Mediating role of the systemic immune-inflammation index.

Chaoban Wang, Shiwen Yu, Ting Chen

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In one paragraph

Article in Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

3 authors.

Chaoban WangDepartment of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Shiwen YuDepartment of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.ORCID 0009-0003-6714-9408
Ting ChenDepartment of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.ORCID 0009-0006-8048-5539

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Dietary fiber is recommended in diabetes management for its potential anti-inflammatory effects, but currently, the association between fiber intake, systemic inflammation, and long-term survival in adults with diabetes remains uncertain. This cohort study analyzed data from 3894 U.S. adults with diabetes across 10 National Health and Nutrition Examination Survey cycles (1999-2020). Fiber intake levels (grams of fiber per kilogram of body weight, g/kg) was assessed via dietary interviews, and mortality outcomes were linked to National Death Index records through 2019. The systemic immune-inflammation index (SII) was calculated using platelet, neutrophil, and lymphocyte counts. Cox proportional hazards models evaluated associations between fiber intake and all-cause mortality, adjusted for demographics, lifestyle factors, and comorbidities. Mediation analysis quantified SII's role in mortality risk reduction. Higher fiber intake levels demonstrated a dose-dependent inverse relationship with all-cause mortality (P < .001). In fully adjusted models, the 3rd quartile (Q3) of fiber intake levels showed the lowest mortality risk (hazard ratio = 0.47, 95% confidence interval = 0.37-0.68). The association attenuated slightly in Q4, possibly indicating a threshold effect. Mediation analysis revealed that 13.07% (95% confidence interval = 6.85%-18%) of the mortality reduction was attributable to SII downregulation. Increased dietary fiber intake levels are associated with reduced all-cause mortality in diabetic populations, with a possible mediating factor being the reduction in systemic inflammation levels among U.S. adults with diabetes. These findings support integrating fiber-rich diets into diabetes management protocols.

Indexed as

Diabetes MellitusDietary FiberInflammationAdultAgedCohort StudiesFemaleHumansMaleMiddle AgedNutrition SurveysProportional Hazards ModelsUnited StatesDietary Fiberdiabetesdietaryimmune-inflammation indexmortalityNHANES

Identifiers

PMID42499112
PMCPMC13406171

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.