Abstract
Increasingly, evidence suggests a role for polyphenols in blood glucose control. The objective of this systematic review was to evaluate the effect of polyphenol-rich sources in combination with carbohydrate sources on resulting postprandial glycaemic and insulin responses. A literature search was conducted using Medline, CINHAL and Web of Science databases. Selected studies included randomised controlled trials in which the association of polyphenol-containing food or beverage consumption with a carbohydrate source and effect on acute postprandial glycaemia and/or insulin was reported. A total of thirteen full articles were included in the review. Polyphenol sources included coffee, black tea, fruit juice, plant extracts, berries and different rye breads, and carbohydrate sources included bread, pancakes and simple sugars such as sucrose, glucose and fructose. Although glycaemic and insulin responses differed depending on the polyphenol-carbohydrate combination, overall, polyphenol sources were shown to reduce the peak and early-phase glycaemic response and maintain the glycaemic response in the later stages of digestion. To a lesser extent, polyphenol sources were also shown to reduce peak insulin response and sustain the insulin response, especially when consumed with bread. This review supports epidemiological data suggesting that polyphenols in foods and beverages may have a beneficial effect on reducing the risk of type 2 diabetes. However, the extent of this effect is variable depending on the polyphenol and carbohydrate source.
Highlights
Evidence suggests a role for polyphenols in blood glucose control
Search criteria included all types of human adults; the final papers consisted of healthy adults without diabetes or glucose intolerance
Two studies in this review investigated the effects of coffee on glycaemic response (GR) and insulin response (IR), yet both studies found no effect of coffee and its polyphenols on either measure when consumed with glucose in solution(18,19)
Summary
Evidence suggests a role for polyphenols in blood glucose control. The objective of this systematic review was to evaluate the effect of polyphenol-rich sources in combination with carbohydrate sources on resulting postprandial glycaemic and insulin responses. Epidemiological studies are conflicting as to whether polyphenol-rich foods are associated with a reduced risk of type 2 diabetes(4–6); randomised controlled trials performed over weeks and months have shown beneficial effects of polyphenols on fasting blood glucose and longer-term markers of glycaemic control such as HbA1c(7–9). Considering the results from the variety of studies which have been performed to date, elucidation of the role of polyphenols in carbohydrate digestion is necessary in order to develop food products and/or meal combinations for improving the GP in both healthy subjects and for people with type 2 diabetes. The aim of this systematic review was to assess studies which determined the acute, postprandial GR and insulin response (IR) after the consumption of a polyphenol-rich source in combination with carbohydrate. Due to the heterogeneity in the reporting of GR results, the primary outcome measures were to determine the change in pGR and peak IR (pIR) and the GR/IR tAUC between control and the intervention foods and beverages
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