The glycemic load of meals, cognition and mood in middle and older aged adults with differences in glucose tolerance: A randomized trial

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Summary Background & aims In younger individuals a lower rather than a higher glycemic load (GL) meal has been shown to benefit cognition and mood; however the data in older and middle aged adults is limited and conflicting. One explanation is that the GL of a meal may interact with pre-existing glucose tolerance (GT) or the tendency for blood glucose to drop to low levels. The present study therefore considered the interaction between the GL of a meal, individual differences in glucose tolerance and the tendency to develop low blood glucose. Methods 155 healthy older and middle aged adults, aged 45–80 years, were randomly assigned to receive either a glucose, sucrose or isomaltulose (Palatinose™) based breakfast. The meals were of identical macronutrient composition and differed only in GL. Mood and cognitive performance was assessed 30, 105 and 195 min after breakfast. Results Those with better but not poorer GT had better mood, episodic and working memory after a lower rather than a higher GL meal. The tendency to develop low blood glucose had little effect on adults' response to meals differing in GL. Conclusions Although it has been assumed previously that those with poor glucose tolerance would benefit from a low GL meal, it was in fact those with better tolerance who responded positively. (Clinical Trials Identifier: Clinicaltrials.gov NCT01842022 ).