4. Discussion
diabetes, satiety, cardiometabolic, gastrointestinal complaints
DIABETES
For quality of life, significantly higher values were reported in the intervention group than in the control group. However, this was already the case at the beginning of the study, so this effect cannot be attributed to the intervention. Looking at the occurrence of gastrointestinal complaints from the previous data analysis [Hettich et al. recently revalidated the questionnaire used and published updated reference values for the average German population [Results on the effect of the intervention on satiety were mixed. No differences were found between the groups. While the first model also found no difference during the intervention, the second model showed a highly significant positive association between baseline and 4 weeks and a significant positive association between baseline and 12 weeks. It is possible that the test sensitivity of the question used was insufficient to show clear results since satiety was not measured after each meal using visual analog scales, as is common [Ambiguous results also emerged for life satisfaction. While no differences were found in the first model, a closer look at the visits in the second model showed highly significant negative associations. Gazek and Wojtowicz reported that an increase in life satisfaction is associated with healthier food choices in women with diabetes [For the assessment of the subjective current health status, there were no differences between the intervention and control group. However, a significant negative correlation with BMI was found, consistent with the negative associations found between BMI and quality of life. Negative influences on self-rated health have been reported in the literature for both very low and extremely high BMI [There was also no effect on ratings of body sensation. However, similar to the subjective current health status, a highly significant negative association with BMI was measurable. The question used can be understood as a part of body image measurement [In order to clarify the influence of increased dietary fiber intake on well-being, further studies with more test-sensitive measuring instruments over a longer period of time are desirable. By capturing most parameters with one question, it was possible to capture more parameters of well-being than would have been the case with more comprehensive survey instruments, as the length might have led to incomplete answers. To determine differences between groups, groups of equal size might have been more appropriate. Regarding further subdivision into subjects with and without cardiometabolic risk, the resulting small number of cases might have been a limiting factor, especially in the control group. Overall, the feasibility of a study design for measuring satiety close to everyday life was piloted, some already known relationships between BMI and the measured parameters of well-being could be confirmed, and a promising indication of the influence of dietary fiber on body sensation was found. Whether dietary fiber contributes to improved satiety remains unclear. Further studies are needed to find out to what extent the effects differ between increasing fiber intake from natural sources and fiber-enriched foods.