By William J. Cromie

Gazette Staff

Hold the white bread and potatoes; bring on cold breakfast cereal and broccoli.

That's the latest diet message from scientists at the School of Public Health to women whose genes, weight, or age put them at risk for diabetes.

Their study of more than 65,000 women, 40 to 65 years old, concludes that too much sugar and not enough fiber can double a female's risk of adult-onset diabetes.

The conclusions apparently apply to males as well.

"This work corroborates a previous study of Israeli men but involves a much larger study population," notes JoAnn Manson, associate professor of medicine. "Because these results are so strong and consistent with previous evidence about the protective benefits of a high-fiber diet, we suggest that grains be consumed in a minimally refined form."

Manson and her colleagues specifically recommend whole grain breads, high-fiber breakfast cereals (without sugar), beans, peanut butter, and yogurt. Cereal fiber was associated with a greater reduction in risk than fiber from vegetables and fruits. Colas, white rice, and french fries join white bread and other types of potatoes on the "go easy" list.

Better-known risk factors for adult onset diabetes include age, obesity, a family history of the disease, sedentary lifestyle, and smoking. Previous studies have concluded that maintaining a healthy weight and exercising regularly reduces risk of diabetes.

The adult-onset variety, which mainly strikes people over age 30, affects about 15 million people in the United States alone. Both adult-onset and juvenile diabetes, which emerges in childhood, increase the risk of heart disease and stroke significantly, six times for women and three-to-four times for men. The disease is also the leading cause of new cases of blindness in adults, kidney failure, and nerve damage to the feet and hands.

More than 160,000 Americans die each year from diabetes and its complications, according to the National Institutes of Health.

To ascertain the role of diet, Manson and her colleagues used information collected by the Nurses' Health Study, a long term Harvard and Brigham and Women's Hospital study of diet, lifestyle, and disease among 120,000 registered nurses. They selected 65,173 of them who were free of heart disease, cancer, and diabetes in 1986. During six years of follow-up, 915 cases of diabetes occurred among the women.

From the answers they gave to questions about their diet, the researchers conclude that high-sugar and low-fiber intake increase the chances that women will develop the disease.

Diets high in sugar and low in fiber can lead to a chronically high demand for insulin, which converts blood sugar into energy. As long as the pancreas turns out enough insulin to meet the extra demand, tolerance for blood sugar stays normal. But failure of the pancreas to respond properly can lead to adult-onset diabetes, also known as noninsulin-dependent diabetes mellitus, or type II diabetes.

In type I diabetes, which affects about 1 million Americans, the body fails to produce enough insulin to control blood sugar.

Others who took part in this research include Jorge Salmerón. Meir Stampfer, Graham Colditz, Alvin Wing, and Walter Willett. The researchers wrote a detailed report on the work that was published in yesterday's Journal of the American Medical Association.