Carbohydrates for glycemic control: functional and microbiome aspects.

Abstract

Glycemia goals are used as indicators of control and progression in prediabetes and diabetes. Adopting healthy eating habits is essential. It is worth considering the quality of carbohydrates to help with dietary glycemic control. The present article aims to review recent meta-analyses published in the years 2021-2022 on the effects of dietary fiber and low glycemic index/load (LGI/LGL) foods on glycemic control and how gut microbiome modulation contributes to glycemic control. Data involving more than 320 studies were reviewed. The evidence allows us to infer that LGI/LGL foods, including dietary fiber intake, are associated with reduced fasting glycemia and insulinemia, postprandial glycemic response, HOMA-IR, and glycated hemoglobin, which are more evident in soluble dietary fiber. These results can be correlated with changes in the gut microbiome. However, the mechanistic roles of microbes or metabolites implicated in these observations continue to be explored. Some controversial data highlight the need for more homogeneity between studies. The properties of dietary fiber are reasonably well established for their glycemic homeostasis effects, including the fermentation aspects. Findings of gut microbiome correlations with glucose homeostasis can be incorporated into clinical nutrition practice. Target dietary fiber interventions on microbiome modulation can offer options to improve glucose control and contribute to personalized nutritional practices.