Bread Meal Research Articles

Muesli with 4 g oat β-glucans lowers glucose and insulin responses after a bread meal in healthy subjects

To evaluate the impact of an extruded muesli product based on beta-glucan-rich oat bran on postprandial glycaemia and insulinaemia. The study is divided in two series. Blood glucose and serum insulin responses were studied after subjects consuming test meals including a serving of muesli with 3 g (series 1) and 4 g (series 2) of beta-glucans, respectively. The muesli was a component in a single serving packet with muesli and yoghurt. This was served together with white wheat bread in the morning after an overnight fast. The compositions were standardized to contain 50 g available carbohydrates. As a reference meal a serving packet without beta-glucans was included. The study was performed at Applied Nutrition and Food Chemistry, Lund University, Sweden. Nineteen and thirteen healthy volunteers with normal body mass index were recruited for series 1 and 2, respectively. Muesli with 3 g of beta-glucans, included in a mixed bread meal, gave no significant differences in glycaemic response compared to a reference meal without muesli and beta-glucans. In contrast, muesli with 4 g of beta-glucans significantly (P<0.05) lowered the glucose and insulin responses compared to the reference meal. Muesli enriched with 4 g of beta-glucans reduces postprandial glucose and insulin levels to a breakfast based on high glycaemic index products. A total of 4 g of beta-glucans from oats seems to be a critical level for a significant decrease in glucose and insulin responses in healthy people.

Almonds and postprandial glycemia—a dose-response study

Almonds, together with other nuts, reduce serum cholesterol levels and may reduce the risk of coronary heart disease. There is much current interest in the relation of coronary heart disease to postprandial events. We have therefore assessed the effects of varying amounts of almonds on the postprandial blood glucose response to a carbohydrate meal. Our aim was to assess the effect of adding almonds to a bread meal. Nine healthy volunteers (2 women, 7 men; mean age, 27.8 years; mean body mass index, 22.9 kg/m 2) were randomly fed with 3 test meals and 2 white bread control meals on separate days. Subjects were fed the meals after a 10- to 12-hour overnight fast. Each meal contained 50 g of available carbohydrate from white bread eaten alone or with 30, 60, or 90 g (∼1, 2, or 3 oz) of almonds. Capillary finger-prick blood samples for glucose analysis were obtained at 0, 15, 30, 45, 60, 90, and 120 minutes. Glycemic responses were assessed by calculating the incremental area under the 2-hour blood glucose curve. The addition of almonds to white bread resulted in a progressive reduction in the glycemic index of the composite meal in a dose-dependent manner for the 30-g (105.8 ± 23.3), 60-g (63.0 ± 9.0), and 90-g (45.2 ± 5.8) doses of almonds ( r = −0.524, n = 36, P = .001). We conclude that, in addition to lowering serum cholesterol levels, almonds may also reduce the glycemic impact of carbohydrate foods with which they are eaten.

Thermic and Glycemic Responses to Bread and Pasta Meals with and Without Prior Low-Intensity Exercise

The purpose of the study was to investigate thermic and glycemic responses to conventional meals with and without prior low-intensity exercise. Fourteen healthy volunteers (7 men, 7 women) undertook 4 treatments, 2 bread and 2 pasta meals, either with (E) or without (NE) prior exercise (a 45-min treadmill walk). Meals provided 58 g carbohydrate and 2360 kJ. Energy expenditure and blood-glucose concentrations were measured before and for 3 h after the meals. The thermic effect of food (TEF) was lower after pasta (121 +/- 32 kJ/3 h) than after bread (154 +/- 62 kJ/3 h), P=0.009, but was not affected by exercise. Glycemic responses were lower after E (155 +/- 113 mmol x L(-1) x 3 h(-1)) than NE (199 +/- 97 mmol x L(-1) x 3 h(-1)) after pasta (P=0.020) but not after bread. TEF was lower after pasta than bread but was not affected by prior low-intensity exercise. The effects of exercise on glycemic responses to meals were inconsistent.

Comparative analysis of the effects of rice and bread meals on bioavailability of itraconazole using NONMEM in healthy volunteers

The objectives of this retrospective study were to examine the relationship between the bioavailability of itraconazole and the type of food consumed and to determine the effects of food consumption on the pharmacokinetic parameters following a single oral dose of itraconazole in healthy volunteers. The plasma itraconazole concentration-time data were pooled from four pharmacokinetic studies in 144 healthy subjects. Individual pharmacokinetic values were estimated as model-independent (AUC, C (max), and T (max)) and model-dependent (T (lag), K (a), K (cp), K (pc), K (el), and V (d)/F; two-compartment open model with lag time) parameters using the WinNonlin software program. We estimated the population characteristics of the food effects using NONMEM. The consumption of a bread meal before the administration of itraconazole caused a significant increase in its bioavailability, as well as increases in the peak plasma concentration and lag time for itraconazole absorption. On the contrary, consumption of a rice meal before the administration of itraconazole caused a significant decrease in its bioavailability. Therefore, although a dose of itraconazole is normally administered immediately after a meal to increase its bioavailability, this is not an effective strategy after a rice meal.

Plasma ghrelin levels after two high-carbohydrate meals producing different insulin responses in patients with metabolic syndrome

Ghrelin is an orexigenic peptide produced in the stomach and its plasma levels are decreased acutely in response to ingested nutrients. To further clarify the role of insulin on ghrelin secretion, the present study was designed to investigate whether circulating ghrelin is affected differently by two mixtures of whole-grain breads known to produce low or high insulin responses in obese non-diabetic subjects with metabolic syndrome. After an overnight fast eight obese subjects with the metabolic syndrome (3 men and 5 women; BMI 33.7 ± 0.7 kg/m 2; age 55.6 ± 1.8 y) received two different meals consisting of whole-grain rye or wheat breads. The comparison group (3 men and 5 women; BMI 22.5 ± 0.5 kg/m 2; age 26.0 ± 0.9 y) received a wheat bread meal. Blood samples were collected postprandially at time intervals for 2 h. Feelings of hunger and satiety were analyzed using the visual analogue scales. Ghrelin concentrations decreased after bread meals in lean individuals, but not in obese individuals with the metabolic syndrome. Despite the difference in plasma insulin response, there was no difference in plasma ghrelin or feelings of hunger and satiety in patients with metabolic syndrome. After both rye and wheat bread meals, the decrease in ghrelin concentrations seen in normal-weight individuals after wheat bread meal was absent in subjects with metabolic syndrome. Despite the different plasma insulin response in obese patients, ghrelin levels did not change in response to either type of bread meals. In addition, ghrelin levels did not correlate with insulin, glucose, HOMA1-IR and satiety and hunger ratings in either study groups. This indicates that regulation of ghrelin might be altered in obese patients with metabolic syndrome independently of insulin.

Isolation and properties of Aspergillus niger IBT-90 xylanase for bakery

Xylanase of low molecular weight (K II) was isolated from the fungus Aspergillus niger IBT-90 cultivated in medium with wheat bran. K II was purified by precipitation with ammonium sulphate (20-80% saturation) and gel filtration on Biogel P-10. This enzyme is most active in hydrolysis of birchwood xylan at 50 degrees C and pH 5.5. Xylanase K II has an ability to degrade 1,4-beta-bonds and to debranch substrates. It degrades not only xylans but also cellulose, an important factor for its application in bakery. Ag+, Fe3+ and NBS are strong inhibitors of the enzyme. DTT and Na+ activate xylanase K II by 24 and 13%, respectively. Enzyme K II used as additive to flour improves dough properties, increases the volume of wheat-rye and whole meal bread, and increases the porosity of crumb and the moisture of the final product, consequently extending the shelf life of bread.

Vinegar supplementation lowers glucose and insulin responses and increases satiety after a bread meal in healthy subjects

To investigate the potential of acetic acid supplementation as a means of lowering the glycaemic index (GI) of a bread meal, and to evaluate the possible dose-response effect on postprandial glycaemia, insulinaemia and satiety. In all, 12 healthy volunteers participated and the tests were performed at Applied Nutrition and Food Chemistry, Lund University, Sweden. Three levels of vinegar (18, 23 and 28 mmol acetic acid) were served with a portion of white wheat bread containing 50 g available carbohydrates as breakfast in randomized order after an overnight fast. Bread served without vinegar was used as a reference meal. Blood samples were taken during 120 min for analysis of glucose and insulin. Satiety was measured with a subjective rating scale. A significant dose-response relation was seen at 30 min for blood glucose and serum insulin responses; the higher the acetic acid level, the lower the metabolic responses. Furthermore, the rating of satiety was directly related to the acetic acid level. Compared with the reference meal, the highest level of vinegar significantly lowered the blood glucose response at 30 and 45 min, the insulin response at 15 and 30 min as well as increased the satiety score at 30, 90 and 120 min postprandially. The low and intermediate levels of vinegar also lowered the 30 min glucose and the 15 min insulin responses significantly compared with the reference meal. When GI and II (insulinaemic indices) were calculated using the 90 min incremental area, a significant lowering was found for the highest amount of acetic acid, although the corresponding values calculated at 120 min did not differ from the reference meal. Supplementation of a meal based on white wheat bread with vinegar reduced postprandial responses of blood glucose and insulin, and increased the subjective rating of satiety. There was an inverse dose-response relation between the level of acetic acid and glucose and insulin responses and a linear dose-response relation between acetic acid and satiety rating. The results indicate an interesting potential of fermented and pickled products containing acetic acid.

Food selection associated with sense of coherence in adults

BackgroundFavorable dietary habits promote health, whereas unfavorable habits link to various chronic diseases. An individual's "sense of coherence" (SOC) is reported to correlate with prevalence of some diseases to which dietary habits are linked. However, understanding what determines an individual's dietary preferences and how to change his/her behavior remains limited. The aim of the present study was to evaluate associations between dietary intake and SOC in adults.MethodsDiet intake was recorded by an 84-item semi-quantitative food frequency questionnaire and SOC was measured by the 13-item Antonovsky questionnaire in 2,446 men and 2,545 women (25–74 years old) from the population based northern Sweden MONICA screening in 1999.ResultsIntakes of energy, total and saturated fat, ascorbic acid, sucrose, and servings of fruits, vegetables, cereals, and sweets correlated with SOC among women, whereas intakes of total and saturated fat, ascorbic acid, fiber, and alcohol, and servings of fruits, vegetables, bread, bread and cereals, fish, and potatoes correlated with SOC among men. With a few exceptions, intakes of these nutrients/foods were significantly explained by SOC quartile scores in linear GLM models. Both women and men classified into the highest SOC quartile had significantly higher age-BMI-education standardized mean intakes of vegetables than those in the lowest quartiles. Women in the highest SOC quartile also had higher intake of fruits but lower intakes of energy, total and saturated fat, sucrose, and sweets.Projection to latent structures (PLS) multivariate modeling of intakes of the 84 food items and food aggregates simultaneously on SOC scores supported low SOC to coincide with a presumably less health promoting dietary preference, e.g. intake of pizza, soft drinks, candies, sausages for main course, hamburgers, mashed potato, chips and other snacks, potato salad, French fries, whereas men and women with high SOC scores were characterized by e.g. high intake of rye crisp whole meal bread, boiled potato, vegetables, berries, and fruits.ConclusionBoth men and women in the highest, as compared with the lowest, SOC score quartile reported more "healthy" food choices. Dietary habits for individuals in the lowest SOC quartile therefore may render a higher risk for various endemic diseases.

Fluoride tablet programs in healthy elderly subjects: distribution of fluoride in saliva and plaque with tablets in different sites

Based on root caries data and oral sugar clearance pattern, vestibular surfaces of upper incisors and lower molars may be regarded as risk areas along with the proximal surfaces. The aim of the present study was to use this information in improving fluoride tablet programs for the elderly. Six healthy elderly males with full dental arches took part. Flavored and unflavored tablets dissolved passively either under the tongue or in the vestibule close to the root caries risk areas. Salivary fluoride was determined at five to six intra-oral sites with a micro-sampling technique at intervals up to 10 min tablet use. Plaque samples were collected from single tooth surfaces before and after tablet use, and analyzed for total fluoride and total protein by micro-techniques. Salivary fluoride exposure to root caries risk areas was strongly increased when fluoride tablets were placed in the vestibule in these areas. The unflavored tablet gave higher fluoride retention in saliva than did the flavored brand. Plaque fluoride levels tended to be above baseline in the first couple of hours after tablet use, and then to decline. In the caries risk areas, at vestibular surfaces of lower posterior and upper incisor teeth, most of the fluoride taken up in plaque had been lost after 5 h and a bread meal, whereas in the non-risk areas it was largely retained. The study demonstrated that fluoride exposures to the vestibular caries risk areas can be strongly increased by placing fluoride tablets close to them. An unflavored tablet seemed to give higher exposures than a flavored one. The rapid loss of fluoride from plaque in slow clearance risk areas indicates that more than one daily treatment would be required for elderly caries risk subjects.

Metabolic Responses to Venezuelan Corn Meal and Rice Bran Supplemented Arepas (Breads)

ABSTRACTThe metabolic responses to South American foods remain to be determined. Using glycemic index (GI) and insulinemic index (II) values as references for therapeutic potential of foods, this study investigated the glucose responses to a typical Venezuelan corn bread (arepa) and to an arepa supplemented with rice bran. Adding rice bran to the bread increased the content of resistant starch and dietary fiber measured as total, soluble, and insoluble dietary fiber. It also increased the protein content of the arepa. Three meals, white wheat bread, 100% corn meal arepa, and an arepa supplemented with 20% rice bran, were administered within a one‐week period. Available starch in the foods was determined to provide 50 g of available carbohydrate per meal. To calculate the indices, bread was used as the reference. The GI and II of the two arepa meals were significantly smaller than the GI and II of white wheat bread, although the differences between the two types of arepas were not significant. It is concluded that Venezuelan arepas (corn meal bread) may have potential health benefits and that the presence of 20% rice bran in the arepa meal did not produce a significant improvement in the glucose response. Due to the presence of antioxidant elements in the supplemented arepa and its higher protein, dietary fiber, and resistant starch content, it may have a potential preventive effect against the development of other pathologies.

Effects of Acute Chromium Supplementation on Postprandial Metabolism in Healthy Young Men

Background: Chromium (Cr) potentiates the action of insulin in the cell and improves glucose tolerance after long-term supplementation.Objective: We hypothesized that Cr may also have acute effects and might be beneficial in lowering the glycemic index of a meal.Methods: We studied the effects of short-term Cr supplementation using a randomized crossover design. Thirteen apparently healthy, non-smoking young men of normal body mass index performed three trials each separated by one week. Test meals, providing 75 g of available carbohydrates, consisted of white bread with added Cr (400 or 800 μg as Cr picolinate) or placebo.Results: After addition of 400 and 800 μg Cr incremental area under the curve (AUC) for capillary glucose was 23% (p = 0.053) and 20% (p = 0.054), respectively, lower than after the white bread meal. These differences reached significance if the subjects were divided into responders (n = 10) and non-responders (n = 3). For the responders AUC after 400 and 800 μg Cr was reduced by 36% and 30%, respectively (Placebo 175 ± 22, Cr400 111 ± 14 (p < 0.01), Cr800 122 ± 15 mmol · min/L (p < 0.01)). Glycemia was unchanged after addition of Cr in the non-responders. Responders and non-responders differed significantly in their nutrient intake and eating pattern, and total serum iron concentration tended to be lower in the responder group (p = 0.07).Conclusions: Acute chromium supplementation showed an effect on postprandial glucose metabolism in most but not all subjects. The response to Cr may be influenced by dietary patterns.

Sensory qualities of whole wheat pan bread—influence of farming system, milling and baking technique

Organic wheat production has increased in Sweden, and there is a need to describe the quality of the final product. To optimize utilization of alternatively grown wheat for human consumption, it is necessary to understand the effects of crop and processing variation on the sensory qualities of the final product. The aim of this study was to investigate the effect of farming systems, milling technique, and variation in formulation on the sensory attributes of whole wheat pan bread. Six samples of wheat (Triticum aestivum, variety Kosack) from field trials, three grown in conventional farming systems and three in organic farming systems (biodynamic and ecological), were roller- and stone-milled, respectively. Breads were baked according to an experimental design in which two levels of flour and two levels of kneading were also included. Sensory analysis, achieved through a descriptive profiling test, was conducted with eight trained assessors using 19 sensory attributes for 48 different bread types in two replicates. Image analysis was used to establish the slice area of the breads. Milling technique had a greater impact on the sensory qualities of bread and on the slice area than did farming system and baking technique. Conventional wheat had lower protein and ash contents, but higher volume weight than did the organic wheat. Damaged starch, extensographic values (Rm,E) and farinographic values for water absorption, dough development time and dough stability were higher for roller-milled samples than for the stone-milled. Whole meal breads of roller-milled wheat were dominated by sweetness, juiciness and compactness attributes, whereas those from stone-milled wheat were characterized by saltiness, deformity and roasted cereal attributes. The six wheat samples revealed that variation in breads' sensory qualities was larger for the three organic samples than for the three conventional samples.

Prolonged transit time through the stomach and small intestine improves iron dialyzability and uptake in vitro.

The iron dialyzability and uptake in relation to transit time through the stomach and small intestine was investigated using a dynamic in vitro gastrointestinal model in combination with Caco-2 cells. Three test meals were evaluated, consisting of lactic fermented vegetables with white (I) or whole meal bread (II) and of sourdough-fermented rye bread (III). Three transit times were tested (fast, medium, and slow transport). Iron dialyzability and absorption differed significantly between medium and slow transit time for meal I and between fast and medium transit time for meal III. For meal II, high in phytate, the iron dialyzability and absorption were low irrespective of transit time. The meals could be ranked with respect to iron dialyzability and uptake in the order I > III > II. Although the in vitro models used have limitations compared to in vivo experiments, the results suggest that an increased transit time may improve iron availability.

Milk as a supplement to mixed meals may elevate postprandial insulinaemia.

The objective was to evaluate the impact of milk added to a high-glycaemic index (GI) white bread meal vs a low-GI spaghetti meal, respectively, on postprandial glucose and insulin responses in healthy subjects. The volunteers were served the bread or spaghetti meals with either milk (200 or 400 ml, respectively) or water (400 ml) following an overnight fast. Capillary blood samples were collected before and during 3 h after the meals. The study was performed at the Department of Applied Nutrition and Food Chemistry, Lund University, Sweden. Ten healthy volunteers, seven men and three women, aged 22-30 y, with normal body mass indices, were recruited. There was no difference in postprandial glucose area under curve (AUC) with and without added milk in the case of the high-GI bread meals. As could be expected, glucose AUC after the bread meal+water was higher than after the spaghetti meal+water. Milk added at 200 or 400 ml to the spaghetti meal did not affect glucose AUC. However, a significantly higher insulin AUC was seen with the bread meal with 400 ml milk (+65%) and the spaghetti meal with 200 ml or 400 ml milk (+300%), respectively, compared with corresponding test meal with water The addition of milk to a low-GI spaghetti meal may significantly increase the postprandial insulinaemia. Even an ordinary amount of milk (200 ml) increased the insulin AUC to a low-GI spaghetti meal to the same level as seen with white bread. The mechanism for the insulinotrophic effect of milk is not known, and the potential long-term metabolic consequences need to be elucidated. Swedish Dairy Association.

Eating patterns--temporal distribution, converging and diverging foods, meals eaten inside and outside of the home--implications for developing FBDG.

A consideration of eating patterns in the general population is necessary when deriving food-based dietary guidelines (FBDG) as promoting the intake of one food may indirectly result in the increased consumption of another, which may not always be desirable. A number of issues that influence meal patterns such as temporal distribution of food intake (using data from the Netherlands), converging and diverging foods (using data from Ireland) and meals eaten inside and outside of the home (using data from the UK) are examined and discussed in the context of developing FBDG. Food intake databases from three EU countries: The Netherlands, Ireland and the UK. The hot meal (dinner) was found to be the main contributor to the intake of energy and macro-nutrients in the Dutch population. It was also the main contributor to the intake of all micro-nutrients with the exception of calcium where the bread meal contributed a similar proportion as the hot meal to the intake of this micronutrient. Furthermore, fruit intake showed a very different temporal distribution to vegetable intake. Exploring the convergence of certain foods in the Irish population also revealed differences between fruit and vegetables. A low correlation was shown for consumers of fruit and vegetables indicating that being a high fruit consumer did not suggest being also a high vegetable consumer. An examination of where meals were consumed among British adults showed that 71% of all meals were consumed inside the home while 29% were consumed outside. 27% of food energy and 45% of alcohol energy was consumed out of home by the total population. In addition, those eating less of their foods out of home obtained a lower proportion of their food energy from fat and protein and a higher proportion from carbohydrate. A different demographic profile was associated with eating out compared to eating in, comprising more males and younger individuals. Information on patterns of food intake and food habits, specifically temporal distribution, the convergence and divergence of foods and foods consumed inside and outside of the home, give a culturally specific picture of food consumption practices within a population. This should enable the development of more culturally acceptable and realistic FBDG.

Quantitation of the Lignan Secoisolariciresinol Diglucoside in Baked Goods Containing Flax Seed or Flax Meal

Samples of commercially prepared white, whole wheat, flax, and multigrain breads were analyzed by a rapid RP-HPLC method for the presence of the lignan secoisolariciresinol diglucoside (SDG). SDG was detected only in products containing flax, with concentrations ranging from 0.06 to 1.98 microM/g of DW (19-602 microM/loaf). Full-fat flax meal, powdered aqueous alcohol extracts of flax seed, and SDG were added to a white bread mix and baked into loaves in a domestic bread maker. Quantitative recovery of SDG from the test breads was observed when SDG was added; however, when flax meal or aqueous alcohol extracts were added, only 73-75% of the theoretical yield of SDG was recovered. SDG was also detected in commercially prepared flax cookies, bagels, and muffins with concentrations ranging from 0.26 to 2.93 microM/g of DW. The extent of grinding of the flax seed was also shown to have a significant effect on the recovery of SDG from both flax meal breads and baked goods, with extraction of SDG from finely ground samples greater than that from course material.

Effects of encapsulated magnesium on growth and bone mineral concentrations in weanling rats

The effect of magnesium oxide (MgO) encapsulated (E) with a modified cellulose (Ethocel) on growth and bone minerals was assessed in weanling rats. Ethocel encapsulated Mg was added to bread flour at 10 or 30% of RDA/serving (80 mg/100g or 240 mg/100g dry bread). Bread meal, previously supplemented with Mg, was the sole source of Mg in the diet based on AIN93G. Male Sprague-Dawley rats, 26 d old, 8/group, were given either control diet: AIN93G or bread based diets: Mg10E, Mg30E and Mg30N (nonencapsulated) for 4 weeks. Food intake and weight gain of rats fed Mg10E and 30E diets declined 22 and 45%, respectively (P≤0.05). The decline in liver, femur and tibia weights was consistent with decreased food intake and weight gain. Plasma Mg remained unaltered, while plasma Ca concentrations were 14 and 26% lower than the control in the Mg30E and Mg30N groups (P≤0.05). Femur Mg levels were similar to control, but tibia Mg concentrations were reduced by an average of 24% in Mg10E and Mg30E groups and significantly (43%) in the Mg30N group. There was a significant reduction in tibia Ca in the Mg30N group of about 43%; the decline in femur and tibia calcium in the other two bread groups was less significant. The data suggest that encapsulation of MgO did not alter the bioavailability of Mg; it minimized the adverse effects of supplemental Mg on calcium homeostasis.

Inhibition of non-haem iron absorption in man by polyphenolic-containing beverages

The effects of different polyphenol-containing beverages on Fe absorption from a bread meal were estimated in adult human subjects from the erythrocyte incorporation of radio-Fe. The test beverages contained different polyphenol structures and were rich in either phenolic acids (chlorogenic acid in coffee), monomeric flavonoids (herb teas, camomile (Matricaria recutita L.), vervain (Verbena officinalis L.), lime flower (Tilia cordata Mill.), pennyroyal (Mentha pulegium L.) and peppermint (Mentha piperita L.), or complex polyphenol polymerization products (black tea and cocoa). All beverages were potent inhibitors of Fe absorption and reduced absorption in a dose-dependent fashion depending on the content of total polyphenols. Compared with a water control meal, beverages containing 20-50 mg total polyphenols/serving reduced Fe absorption from the bread meal by 50-70%, whereas beverages containing 100-400 mg total polyphenols/serving reduced Fe absorption by 60-90%. Inhibition by black tea was 79-94%, peppermint tea 84%, pennyroyal 73%, cocoa 71%, vervain 59%, lime flower 52% and camomile 47%. At an identical concentration of total polyphenols, black tea was more inhibitory than cocoa, and more inhibitory than herb teas camomile, vervain, lime flower and pennyroyal, but was of equal inhibition to peppermint tea. Adding milk to coffee and tea had little or no influence on their inhibitory nature. Our findings demonstrate that herb teas, as well as black tea, coffee and coca can be potent inhibitors of Fe absorption. This property should be considered when giving dietary advice in relation to Fe nutrition.

Effect of Sanhuang Jiangtang recipe on insulin peripheral resistance in Type II diabetes mellitus) recipe on insulin peripheral resistance in Type II diabetes mellitus

Objective: To observe the effect of Sanhuang Jiangtang recipe ( , SHJT) on insulin peripheral resistance in Type II diabetes mellitus (DM).Methods: Ninety-five patients with type II DM were randomly divided into two groups. Fifty-three cases of SHJT group were given decoction and tablets of SHJT orally for 4–6 months. The efficacy was compared with that of 42 cases treated with Glipizide as the control. Before and after treatment standard steamed bread meal test was performed to measure the insulin peripheral sensitivity, insulin release to glucose and insulin sensitivity index.Results: (1) The total effective rates of improving insulin peripheral resistance and reducing blood sugar in SHJT group were 79. 2% and 80.1 %, which was equivalent to levels in the control group, but SHJT recipe was more effective in relieving symptoms of Qi deficiency and signs of blood stasis. (2) In SHJT group, the insulin peripheral sensitivity and insulin sensitivity index were significantly increased (P < 0.05 and 0.01), meanwhile the fasting blood sugar and blood sugar area were reduced (P < 0.05), but the change of insulin release to glucose was blunted. (3)The lowering of blood sugar in SHJT group was significantly negative correlated with the changing of degree of insulin peripheral sensitivity and index of insulin sensitivity (P < 0.01 and 0.05), but not with that of insulin area.Conclusion: It suggested that the treatment of SHJT recipe might decrease insulin peripheral resistance (partial reversal) by means of reducing hyperinsulinemia and improving insulin sensitivity.

Importance of colonic bacterial fermentation in short bowel patients: small intestinal malabsorption of easily digestible carbohydrate.

The small intestine's large capacity for glucose absorption and for adaptation seems to contradict the reported importance of carbohydrate malabsorption in short bowel (SB) patients. The aim of the present study was to investigate the occurrence of malabsorption in these patients ingesting realistic amounts of carbohydrates. We performed a dose-response study [ingestion of increasing amounts of glucose and complex carbohydrates (boiled rice and wheat bread), and the nonabsorbable disaccharide lactulose] in SB patients with an intact colon. The hydrogen (H2) -breath test and changes in serum acetate were used to evaluate colonic fermentation and, thus, indirectly, the lack of small intestinal carbohydrate assimilation. Blood glucose and plasma insulin were measured to evaluate absorption. Plasma concentrations of the ileal brake hormones--glucagon-like peptide-1 (GLP-1) and peptide tyrosine tyrosine (PYY)--were measured to test whether release of these hormones was related to colonic fermentation. Significant amounts of 25 g and 50 g glucose, and of the bread and rice meals were fermented rather than absorbed, as judged by the increases in end-expiratory H2. Serum acetate concentrations were significantly higher in SB patients than in healthy controls. The orocecal transit times of all test meals ranged from 15 to 120 min. GLP-1 and PYY releases in SB patients were significantly higher than in healthy volunteers. They were mutually parallel and paralleled the increase in insulin. They were not related to ongoing fermentation or to intraluminal carbohydrate content per se, but most probably to absorption of glucose in the distal bowel. In conclusion, well-adapted SB patients had pronounced small intestinal malabsorption of carbohydrate, even after ingestion of small amounts of easily absorbable carbohydrates. A fast small intestinal spreading of carbohydrates, once in the small intestine, and a spill-over to the colon seem to explain the data best.