Abstract
It is well-appreciated that the diet is a crucial tool to counteract cardiometabolic disturbances due to its impact on blood glucose concentration and gut microbiome. This retrospective analysis aimed to examine whether the inclusion of isomaltulose and prebiotic inulin-type fructans (ITF) into the habitual diet has an impact on glycemic control and gut microbiota. Furthermore, we examined interindividual differences in glycemic response to sugar replacement with isomaltulose. We retrospectively analyzed data of 117 individuals who participated in a digital nutrition program including a 14-day continuous glucose measurement. Participants underwent six test days with sweetened drinks (isomaltulose vs. sucrose) consumed with their usual breakfasts and lunches. Dinner was supplemented with ITF for 11 days. Postprandial glycemia and 24 h-glycemic variability were determined following test meals and days, respectively. Fecal microbiota was analyzed by 16S rRNA sequencing before and after test phase. Meals with isomaltulose-sweetened drinks compared to meals with sucrose-sweetened drinks induced lower postprandial glycemia. Moreover, glucose oscillations over 24 h were lower on isomaltulose when compared to sucrose test days and improved further during ITF supplementation. Furthermore, ITF modulated gut microbiota composition beneficially. Responder analysis revealed that 72% of participants benefited from the sugar replacement with isomaltulose and that their gut microbiota differed from the low responders. Taken together, the incorporation of isomaltulose and ITF into the habitual diet was shown to be an effective strategy to improve glucose control and beneficially modulate gut microbiota, and thereby aid to maintain metabolic health. Data indicate interindividual differences in glycemic response to ingredients and suggest that gut microbiota might be somehow related to it.
Highlights
There is a high prevalence of impaired glucose tolerance and prediabetes in the general population [1, 2]
It has been shown previously that replacing rapidly digestible, high-glycemic index (GI) foods by slowly digestible, low-GI foods contributes to reduced postprandial glycemia and insulinemia and lowers glycemic variability [8–11]
We examined whether the intervention with two functional food ingredients with established health benefits, that are slowly digestible, lowGI ISO, and prebiotic Inulin-type fructans (ITF), is an effective strategy to improve blood glucose control and modify gut microbiota in a real-life setting
Summary
There is a high prevalence of impaired glucose tolerance and prediabetes in the general population [1, 2]. Hyperglycemia as well as a high glycemic variability are important risk factors for cardiometabolic diseases and type 2 diabetes (T2D) [3–5]. There is an urgent demand for effective strategies to prevent elevated blood glucose concentrations. A central element in those strategies are dietary modifications since individual diet represents a fundamental determinant of blood glucose regulation [6, 7]. A systematic reduction of the dietary glycemic index (GI) could be an important approach to improve postprandial glucose response. It has been shown previously that replacing rapidly digestible, high-GI foods by slowly digestible, low-GI foods contributes to reduced postprandial glycemia and insulinemia and lowers glycemic variability [8–11]. There is sufficient evidence that a frequent consumption of high-GI foods is associated with an increased risk of cardiometabolic diseases when compared to a diet rich in low-GI foods [12, 13]
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