High Glycemic Index Carbohydrate Research Articles

Dumping Syndrome in Children: A Narrative Review.

Dumping syndrome (DS) is a typical side effect of stomach surgery, which includes cancer, non-cancer esophageal and gastric surgery, and bariatric surgery. It is marked by the fast evacuation of undigested food from the stomach into the small intestine, which causes a variety of symptoms. Early dumping symptoms include gastrointestinal symptoms such as stomach discomfort, diarrhea, and nausea, as well as vasomotor symptoms such as drowsiness and face flushing, and occur within the first hour following a meal. Late dumping symptoms appear one to three hours after a meal and are related to reactive hypoglycemia, resulting in hypoglycemia, sweating, palpitations, and confusion. Early dumping pathophysiology involves abnormalities in stomach structure and function, which result in rapid transit of stomach contents to the duodenum, insufficient digestion, and fluid transfers from the vascular compartment to the intestine. Late dumping occurs as a result of hyperinsulinemia caused by the fast passage of undigested foods to the gut. Symptom-based questionnaires and diagnostic testing such as plasma glucose measurement and stomach emptying studies can be used to confirm a diagnosis of DS. The primary approach to managing DS is dietary modifications, including eating smaller, more frequent meals and avoiding high glycemic index carbohydrates. Dietary supplements and medications may be used to slow down gastric emptying or control blood glucose levels. Pharmacological options include alpha-glycosidase inhibitors, somatostatin analogs, glucagon-like peptide-1 analogs, and sodium-glucose cotransporter inhibitors. In severe cases, refractory to conservative measures, surgical interventions may be considered. DS can arise in children following gastric surgery for obesity or corrective surgery for congenital abnormalities. It is frequently misdiagnosed and can have serious implications, such as hypoglycemia-related cognition deficits. Screening and early identification using glucose tolerance testing and continuous glucose monitoring (CGM) are critical in at-risk youngsters. Children's treatment techniques are similar to those used in adults, with dietary changes and medication therapies serving as the cornerstone of care. Overall, DS is a complex condition that requires a multidisciplinary approach to diagnosis and management. Further research is needed to improve understanding of its pathophysiology and optimize treatment strategies, particularly in children. This review aims to provide a well-rounded informative summary of the most recent literature on the under-recognized clinical and scientific aspects of DS among the children age group. It incorporates the quality of life, pathophysiology, diagnosis, prevalence, and treatment.

High–glycemic index carbohydrate increases nuclear factor-κB activation in mononuclear cells of young, lean healthy subjects

BackgroundHigh–glycemic index diets have been linked to greater risk of cardiovascular disease and type 2 diabetes. Postprandial glycemia within the normal range may promote oxidative stress and inflammatory processes underlying the development of disease. ObjectiveWe explored acute differences in the activation of the inflammatory marker nuclear factor-κB after consumption of 2 carbohydrate meals matched for macronutrient and micronutrient composition but differing in glycemic index. DesignAfter an overnight fast, 10 young, lean healthy subjects were fed in random order 3 meals providing 50 g of available carbohydrate as glucose, white bread, or pasta. Venous blood samples were collected at 0, 1, 2, and 3 h, and nuclear proteins were extracted from mononuclear cells. Changes in nuclear factor-κB–p65 proteins were detected by Western blotting. Acute changes in other markers of oxidative stress (nitrotyrosine and soluble intercellular adhesion molecule-1) were also assessed. ResultsThe maximum increase in nuclear factor-κB activation was similar after the bread meal [mean (±SEM) area under the curve: 69 ± 16% optical densityh] and the glucose challenge (75 ± 9% optical densityh), but was 3 times higher than after the pasta meal (23 ± 5% optical densityh) (P < 0.05). Similarly, changes in nitrotyrosine, but not soluble intercellular adhesion molecule-1, were higher after glucose and bread than after pasta (P = 0.01 at 2 h). ConclusionsThe findings suggest that high-normal physiologic increases in blood glucose after meals aggravate inflammatory processes in lean, young adults. This mechanism may help to explain relations between carbohydrates, glycemic index, and the risk of chronic disease.

Sustained high glucose intake accelerates type 1 diabetes in NOD mice.

Epidemiological studies have suggested that dietary factors, especially high consumption of high glycaemic index carbohydrates and sugars, may trigger or exacerbate the progression of type 1 diabetes. We aimed to provide experimental evidence to confirm this relevance and to explore the underlying mechanisms. NOD mice were given sustained high-glucose drinking or glucose-free water and observed for the incidence of type 1 diabetes and islet inflammation. RNAseq was performed to detect the transcriptome changes of the NOD islet beta cell line NIT-1 after high glucose treatment, and mass spectrometry was performed to detect the proteome changes of NIT-1-cells-derived sEVs. Sustained high glucose drinking significantly aggravates islet inflammation and accelerates the onset of type 1 diabetes in NOD mice. Mechanistically, high glucose treatment induces aberrant ER stress and up-regulates the expression of autoantigens in islet beta cell. Moreover, high glucose treatment alters the proteome of beta-cells-derived sEVs, and significantly enhances the ability of sEVs to promote DC maturation and stimulate immune inflammatory response. This study provides evidence for negative effect of high glucose intake as a dietary factor on the pathogenesis of type 1 diabetes in genetically predisposed individuals. Therefore, avoiding high sugar intake may be an effective disease prevention strategy for children or adults susceptible to type 1 diabetes.

The Glycemic Index and Human Health with an Emphasis on Potatoes.

Diabetes and obesity are associated with the excessive intake of high-glycemic index (GI) carbohydrates, increased glycemic load (GL) foods, and inactive lifestyles. Carbohydrate-rich diets affect blood glucose levels. GI is an indicator of the impact of a specific food on blood glucose, while GL represents the quantity and quality of carbohydrates in the overall diet and their interactions. There are in vitro and in vivo methods for estimating GI and GL. These values are useful human health markers for conditions such as diabetes, obesity, and pregnancy. Potato is a major starchy vegetable, which is consumed widely and is the fourth most important crop globally. However, the GI of diets rich in starchy vegetables such as potatoes has not been studied in detail. The GI values in potatoes are affected by external and internal factors, such as methods of cooking, methods of processing, resistant starches, cultivation methods, mixed meals and food additions, and hormone levels. This review summarizes how these factors affect the GI and GL associated with diets containing potatoes. Understanding the impacts of these factors will contribute to the development of new and improved potato varieties with low GI values. The consumption of low-GI foods will help to combat obesity. The development of low-GI potatoes may contribute to the development of meal plans for individuals living with diabetes and obesity.

The Influence of Diet on Ovulation Disorders in Women-A Narrative Review.

Female infertility is commonly due to ovulation disorders. They are mostly related to polycystic ovary syndrome, which is currently viewed as one of the most common endocrine disorders in women of reproductive age. Ovulation-related female fertility is influenced by multiple factors which may include: age, smoking cigarettes, stress, use of psychoactive substances, and physical activity. Moreover, diet-related factors play an important role in the regulation of ovulation. Dietary components that exert a positive influence on ovulation include: carbohydrate products with low glycemic index, plant protein, monounsaturated and polyunsaturated fatty acids, folic acid, vitamin D, antioxidants, and iron. A diet based on the structure of the Mediterranean diet also seems beneficial. Components that have a negative influence mostly include high glycemic index carbohydrates, large amounts of animal protein, saturated fatty acids, and trans fatty acids, which are typically found in the Western model of nutrition. Due to the paucity of studies that presented a direct link between nutrition and the risk of anovulatory infertility, this study aimed to summarize the most recent research on the influence of dietary factors on ovulation disorders and indicate the possibilities of future research.

The Glycemic Index, Postprandial Hypotension and Cardiovascular Disease

High glycemic index diets have been associated with an increased risk of cardiovascular disease events and all-cause mortality. We suggest that part of the reason for this association is through the effect of the rapidly digested high glycemic index carbohydrate diets in promoting the effects of postprandial hypotension in vulnerable individuals. Postprandial hypotension has been recognized as a problem especially affecting the frail elderly. The phenomenon occurs earlier in the day and includes syncope and falls acutely and more serious cardiovascular events and increased all-cause mortality in the longer-term. The mechanism appears to relate to the rapid digestion of carbohydrates foods. Strategies that reduce the amount of meal carbohydrates and their rate of absorption by enzyme inhibition or by delaying gastric emptying and have proved helpful as has increased fluid intake, presumably due to dilution of small intestinal contents and a reduction in the tonicity, so reducing the need for intestinal fluid secretion to dilute osmotically active sugars and products of digestion. In this way the need for increased blood flow to the gut can be reduced, that would otherwise steal blood from the systemic circulation resulting in a drop in blood pressure and an increase in heart rate. Slowly absorbed or low glycemic index carbohydrates would therefore appear potentially useful as part of the dietary strategy for the treatment of postprandial hypotension and conversely postprandial hypotension could be one of the reasons why high glycemic index diets have been associated with increased CVD risk.

Low carbohydrate ketogenic therapy as a metabolic treatment for binge eating and ultraprocessed food addiction.

The aim of this study was to highlight the recent advancements and future directions for potential use of a low carbohydrate ketogenic dietary approach to treat binge eating and ultraprocessed food addiction. Herein, we explore proposed mechanisms of why a diet low in refined carbohydrates, processed sugar and higher fat content may be helpful in alleviating symptoms. Emerging evidence suggests there may be a metabolic role in development of maladaptive eating. These findings broaden our understanding of eating psychopathology causes. Ultraprocessed, refined or high glycemic index carbohydrates are a possible trigger mediating neurochemical responses similar to addiction. The carbohydrate-insulin model of obesity supports observations of these foods triggering abnormal blood sugar and insulin spikes subsequently leading to changes in metabolic and neurobiological signaling. This results in overeating symptoms and hunger exacerbation, which differs from observed effects of healthy fat consumption and lack of similar insulin spikes. As supported in recent case series, significantly reducing or abstaining from these addictive-like ultraprocessed foods and highly refined carbohydrates could be considered a treatment approach. The current review highlights recent and pertinent evidence with respect to theoretical and practical application of low carbohydrate ketogenic therapeutic approaches for ultraprocessed food addiction and binge eating symptoms. VIDEO ABSTRACT:.

Effects of carbohydrate quality and amount on plasma lactate: results from the OmniCarb trial

IntroductionPlasma lactate is a marker of non-oxidative glucose metabolism associated with progression to diabetes. We examined the effect of carbohydrate quality (glycemic index (GI)) and amount (%kcal) on plasma lactate....

Effects of Pre-Exercise High and Low Glycaemic Meal on Intermittent Sprint and Endurance Exercise Performance.

The purpose of this study is to investigate the effects of ingesting either a high glycaemic index (HGI) or low glycaemic index (LGI) carbohydrate meal (preceding a 12 h overnight fast and where the meal was ingested 45-min prior to activity) on intermittent sprint and endurance exercise performance. Ten male varsity athletes from intermittent sports (age 23.6 ± 1.7 years, VO2max 51.9 ± 4.7 mL·kg−1·min−1) underwent a peak velocity (Vpeak) test and familiarisation session, followed by two experimental sessions in random order. Experimental sessions involved the ingestion of either an HGI or LGI meal, followed by the completion of the modified Loughborough Intermittent Shuttle Test (mLIST). There was no significant difference between HGI or LGI meals on sprint times (p = 0.62) and distance to exhaustion (p = 0.54) in the mLIST. Exercise heart rate, blood lactate and ratings of perceived exertion were also similar between the two meal trials throughout the mLIST (all p > 0.05). Subjective ratings of hunger, fullness, satiety and satisfaction were also not significantly different between the two meals. In conclusion, consuming either an HGI or LGI meal after a prolonged 12 h fast and ingesting the meal 45 min prior to exercise did not differ in either physiological, subjective and intermittent sprint and endurance performance outcomes.

A Low Glycemic Index Diet Slows Prostate Cancer Growth (P05-018-19)

ObjectivesCarbohydrates are the main source of energy in older adults in the US. Moreover, they increase insulin and insulin-like growth factor-1 (IGF1), which are implicated in tumor growth by increasing cell survival. Previously, we found low carbohydrate (LC) diets slow prostate cancer (PC) growth and increase survival vs. a Western diet (WD) in mice. However, long-term adherence to a LC diet can be difficult for cancer patients. Thus, we aimed to determine whether modifying carbohydrate quality without changing quantity could result in the same outcome as when quantity is reduced. Carbohydrate quality was based on a glycemic index (GI), which indicates how carbohydrates affect blood glucose levels. Low GI carbohydrates are absorbed more slowly and result in a lower and slower increase in glucose levels and insulin demand than high GI carbohydrates. We hypothesized that high carbohydrate intake but with a low GI would slow PC growth, by reducing insulin levels. MethodsA xenograft mice study compared the effect on PC growth of 3 diets: HiGI WD (48% carbohydrate: sucrose), HiGI LC (20% carbohydrate: sucrose), and LoGI WD (48% carbohydrate: amylose, amylopectin, maltodextrin). Male SCID mice were fed an ad lib HiGI WD. At day 14, they were injected with 5 × 105 LAPC-4 cells. When tumors reached ∼200 mm3, mice were single-housed and randomized to their diets (n = 33/group). Mice were pair-fed to ensure all had the same weight throughout the study. Tumor volume and body weight were measured 2X per week. Body composition was determined by Echo-MRI. The outcomes of the study were tumor volume, survival, glucose, insulin, IGF-1 and IGFBP-3 levels, and tumor tissue analysis. ResultsLoGI WD mice had lower tumor volumes, insulin, IGF1, and IGF1: IGFBP3 ratio, and higher IGF-BP3 levels, than the other two groups. Blood glucose was similar across arms. Even though body weight was similar across arms, LoGI WD mice had lower body fat. In a meal tolerance test, glucose was higher in HiGI WD mice with comparable results between the other two diets. ConclusionsFeeding mice a low GI diet delayed PC growth and decreased serum insulin, IGF1 and IGF1: IGFBP3 ratios vs. a high GI diet. These data suggest carbohydrate quality is important for PC growth. Whether a low-carbohydrate and low GI diet would have additive benefits remains to be tested. Funding SourcesAmerican Institute for Cancer Research.

Effects of Ingesting a Food Bar Containing Whey Protein and Isomalto‐Oligosaccharides on Performance and Recovery from an Acute Bout of Resistance‐Exercise and Sprint‐Conditioning

We previously reported that consuming a food bar (FB)containing whey protein and the plant fiber isomalto‐oligosaccharides [IMO] hada lower glycemic but similar insulinemic response as a high glycemic indexcarbohydrate. Therefore, we hypothesized that ingestion of this FB prior to, during, and following intense exercise would better maintain glucosehomeostasis and exercise capacity during exercise as well as hasten recovery incomparison to a carbohydrate matched placebo (PLA). Twelve resistance‐trainedmales participated in an open label, randomized, counterbalanced, cross‐overtrial with a 7‐d washout period. Participants consumed a carbohydrate matcheddextrose PLA or a FB containing 20 g of whey, 25 g of IMO, and 7 g of fat 30‐min prior to, mid‐way, and following intense exercise. Participantsperformed 11 resistance‐exercises (3 sets of 10 repetitions at 70% of onerepetition maximum) followed by performing agility and sprint conditioningdrills for time. Participants donated blood samples, performed isokineticstrength tests, and rated perceptions of muscle soreness and hypoglycemia priorto and following exercise and after 48 hours of recovery. Data were analyzed bygeneral linear model repeated measures and are reported as mean change frombaseline with 95% confidence intervals. Results revealed that blood glucose wassignificantly higher 30‐min post‐ingestion with PLA (PLA 3.1 [2.0, 4.3], FB 0.8[0.2, 1.5] mmol/L, p=0.001) while post‐exercise ratio of insulin to glucose wasgreater with FB (PLA 0.04 [0.00, 0.08], FB 0.11 [0.07, 0.15], p=0.013, η2=0.25). Total lifting volume was maintained toa greater degree from Set 1 to Set 3 with FB than PLA (PLA −198.26 [−320.1, −76.4], FB −81.7 [−203.6, 40.1] kg, p=0.175, η2=0.08). Ratings of muscle soreness of thedistal vastus medialis to a standard amount of pressure were lower with FB (PLA1.88 [0.60, 3.17]; FB 0.29 [−0.99, 1.57] cm, p=0.083, η2=0.13). However, no significant differences were observed between treatments in sprintperformance, isokinetic strength, markers of catabolism, stress and sexhormones, or inflammatory markers. Results indicate that ingestion ofthis FB can positively affect glucose homeostasis, sustain exerciseperformance, and lessen perceptions of muscle soreness after intense training.Support or Funding InformationThis study was supported internally by Dr. Richard B. Kreider and the Exercise and Sport Nutrition Laboratory at Texas A&amp;M University as part of a student dissertation. Dr. Conrad Earnest served as a Director of Clinical Sciences for Nutrabolt. Dr. Kreider served as a university approved scientific advisor for Nutrabolt. Dr. Peter Murano serves as Texas A&amp;M University approved quality assurance supervisor.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Could the high consumption of high glycaemic index carbohydrates and sugars, associated with the nutritional transition to the Western type of diet, be the common cause of the obesity epidemic and the worldwide increasing incidences of Type 1 and Type 2 diabetes?

The globally increasing incidences of Type 1 diabetes (T1DM) and Type 2 diabetes (T2DM) can have a common background. If challenged by the contemporary high level of nutritional glucose stimulation, the β-cells in genetically predisposed individuals are at risk for damage which can lead to the diseases. The fat to carbohydrate dietary shift can also contribute to the associated obesity epidemic.

APOE4 Genotype Exerts Greater Benefit in Lowering Plasma Cholesterol and Apolipoprotein B than Wild Type (E3/E3), after Replacement of Dietary Saturated Fats with Low Glycaemic Index Carbohydrates.

We examined the impact of APOE genotype on plasma lipids and glucose in a secondary analysis of data from a five-arm, randomised controlled, parallel dietary intervention trial (‘RISCK’ study), to investigate the impact of replacing saturated fatty acids (SFA) with either monounsaturated fat (MUFA) or carbohydrate of high or low glycaemic index (GI) on CVD risk factors and insulin sensitivity. We tested the impact of APOE genotype (carriage of E2 and E4 alleles versus E3/E3), determined retrospectively, on plasma lipids, lipoproteins and glucose homeostasis at baseline (n = 469), and on the change in these variables after 24 weeks of dietary intervention (n = 389). At baseline, carriers of E2 (n = 70), E4 (n = 125) and E3/E3 (n = 274) expressed marked differences in total plasma cholesterol (TC, p = 0.001), low density lipoprotein cholesterol (LDL-C, p < 0.0001), apolipoprotein B (apo B, p < 0.0001) and total to high density lipoprotein cholesterol ratio (TC:HDL-C, p = 0.002), with plasma concentrations decreasing in the order E4 > E3/E3 > E2. Following intervention, there was evidence of a significant diet x genotype interaction with significantly greater decreases in TC (p = 0.02) and apo B (p = 0.006) among carriers of E4 when SFA was replaced with low GI carbohydrate on a lower fat diet (TC −0.28 mmol/L p = 0.03; apo B −0.1 g/L p = 0.02), and a relative increase in TC (in comparison to E3/E3) when SFA was replaced with MUFA and high GI carbohydrates (TC 0.3 mmol/L, p = 0.03). Among carriers of E2 (compared with E3/E3) there was an increase in triacylglycerol (TAG) when SFA was replaced with MUFA and low GI carbohydrates 0.46 mmol/L p = 0.001). There were no significant interactions between APOE genotype and diet for changes in indices of glucose homeostasis. In conclusion, variations in APOE genotype led to differential effects on the lipid response to the replacement of SFA with MUFA and low GI carbohydrates.

Meals based on cod or veal in combination with high or low glycemic index carbohydrates did not affect diet-induced thermogenesis, appetite sensations, or subsequent energy intake differently

The objective of this study was to investigate the acute effects of meals containing protein from either cod or veal in combination with high or low glycemic index (GI) carbohydrates, on diet-induced thermogenesis (DIT) (primary endpoint), appetite, energy intake (EI), as well as postpranidal ghrelin, glucose, and insulin responses. Twenty-three overweight men and women (mean ± SD age: 30.0 ± 7.6 y, BMI: 27.2 ± 1.4 kg/m2) consumed 4 test meals: cod with mashed potatoes (high GI carbohydrate), cod with wholegrain pasta (low GI carbohydrate), veal with mashed potatoes, and veal with wholegrain pasta (∼2010 kJ, ∼25.5 E% protein, ∼41.0 E% carbohydrate, ∼33.5 E% fat). Energy expenditure was measured at baseline and six times postprandially, each lasting 25 min. Additionally, appetite sensations were measured every half hour. Arterialized venous blood samples were drawn every 20 min until an ad libitum buffet-style lunch was served 3.5 h later. DIT did not differ between test meals (P > 0.05), and there were no differences in appetite sensations or ad libitum EI (all, P > 0.05). Meal-time interactions were found for glucose and insulin (P = 0.04 and P < 0.001). Pairwise comparisons revealed that glucose and insulin peaks were higher after the meals with high GI carbohydrates. No differences were found between meals with cod or veal in combination with carbohydrates with low or high GI on DIT, appetite sensations, or EI in overweight men and women. However, as expected meals with high GI carbohydrates resulted in higher glucose and insulin responses compared to meals with low GI carbohydrates regardless of protein source.

Ejercicio moderado y consumo de alimentos de alto y bajo índice glucémico en mujeres sedentarias

ObjectiveTo analyze changes in blood glucose, insulin and triglyceride concentrations in relation to a moderate aerobic exercise in sedentary women of different body weight, exposed to either a high or low glycemic index carbohydrates diet. DiseñoCross-over type. SiteResearch was performed in the Exercise Physiology Laboratory at Facultad de Ciencias de la Cultura Física, Universidad Autónoma de Chihuahua, México. ParticipantsTwenty-six young sedentary women who did not exercise in the last year participated in the study. Four of adequate weight (AW) and 2 with obesity (OB) were excluded for not consuming the suggested carbohydrates (1gr/kg of weight) nor completed the programed exercise. There were n=10 in each group (AW/OB). InterventionTwo treatments of 55minutes of aerobic exercise each were applied one day after consuming either high or low glycemic index carbohydrates. Main measurementsPlasmatic glucose, insulin, and triglycerides were determined before and after the scheduled exercise. ResultsGlucose, insulin, and triglycerides were higher in OB than in AW at baseline. Glucose was normalized in OB from 5.8±0.35 to 5.3±0.23 mmol/L (P=.001), only by eating foods with low glycemic index; triglycerides increased from 139.5±66.0 to 150.8±67.2mg/dl (P=.004) at the end of the exercise, after consumption of low glycemic index carbohydrates. ConclusionElevation of triglycerides secondary to exercise after consumption of low glycemic index seems to indicate an increase of lipid oxidation in OB.

High Dietary Glycemic Load is Associated with Poor Functional Outcome in Patients with Acute Cerebral Infarction.

Background and PurposeElevated postprandial blood glucose is a critical risk factor for stroke. The dietary glycemic load (GL) and glycemic index (GI) are frequently used as markers of the postprandial blood glucose response to estimate the overall glycemic effect of diets. We hypothesized that high dietary GL, GI, or total carbohydrate intake is associated with a poor functional outcome in patients with acute ischemic stroke.MethodsWe prospectively included 263 first-ever ischemic stroke patients who completed a semiquantitative food-frequency questionnaire. The dietary GL, GI, and total carbohydrate intake were investigated by examining the average frequency of intake during the previous year based on reference amounts for various food items. Poor functional outcome was defined as a score on the modified Rankin Scale (mRS) of ≥3 at 3 months after stroke.ResultsThe patients were aged 65.4±11.7 years (mean±standard deviation), and 58.2% of them were male. A multivariate analysis adjusted for age, sex, marital status, prestroke mRS score, diabetes mellitus, hyperlipidemia, body mass index, triglycerides, low-density lipoprotein, hemoglobin A1c, stroke classification, and National Institutes of Health Stroke Scale score, early neurological deterioration, and high-grade white-matter hyperintensities revealed that the dietary GL and total carbohydrate intake were associated with a poor functional outcome, with odds ratios for the top quartile relative to the bottom quartile of 28.93 (95% confidence interval=2.82–296.04) and 36.84 (95% confidence interval=2.99–453.42), respectively (p for trend=0.002 and 0.002, respectively). In contrast, high dietary GI was not associated with a poor functional outcome (p for trend=0.481).ConclusionsIncreased dietary GL and carbohydrate intake were associated with a poor short-term functional outcome after an acute ischemic stroke.

Low Glycemic Index Prototype Isomaltulose-Update of Clinical Trials.

Low glycemic index diets are supposed to achieve a more beneficial effect on blood glucose control in people with diabetes mellitus and may also provide metabolic benefits for the general population. A prototype of a low-glycemic index carbohydrate is the natural occurring disaccharide isomaltulose that can be commercially produced from sucrose (beet sugar) to industrial scale. It is currently used in various food and drink applications as well as special and clinical nutrition feeds and formula diet as a food ingredient and alternative sugar. Here we provide an overview on clinical trials with isomaltulose including an analysis of its effects on glycemia and fat oxidation as compared to high glycemic index sugars and carbohydrates. In addition, we discuss recent reports on beneficial effects in weight-loss maintenance and pregnancy.

The effect of consuming low- versus high-glycemic index meals after exercise on postprandial blood lipid response following a next-day high-fat meal

Background/Objectives:Exercise performed shortly before (that is, within half a day of) a high-fat meal is beneficial for stimulating fat oxidation after the meal and reducing postprandial triglycerides (TG). This benefit of exercise is unfortunately negated if the after-exercise food choice to replace the calories expended during exercise is one containing high-glycemic index (HGI) carbohydrates. We determined the effect of consuming low-glycemic index (LGI) carbohydrates after an exercise session on fat oxidation and TG after a subsequent high-fat meal.Subjects/Methods:Using a randomized, counterbalanced crossover design, 23 overweight or obese individuals (body mass index ⩾25 kg m−2) performed: walking exercise (90 min) at 1800 h followed by no meal (EX); exercise followed by a meal with LGI carbohydrates (that is, lentils, EX-LGI); exercise followed by a meal with HGI carbohydrates (that is, instant potatoes, white bread, EX-HGI); and a control condition with no exercise or meal. After a 10-h overnight fast, participants were given a standardized high-fat meal. Fat oxidation was estimated before and for 6 h after this meal from respiratory gas measures and TG determined from blood samples.Results:Fat oxidation (mean±s.d.) was higher with EX (6.9±1.7 g h−1) than EX-HGI (6.3±1.6 g h−1; P=0.007) and Control (5.9±1.7 g h−1; P=0.00002), and EX-LGI (6.6±1.7 g h−1) was higher than Control (P=0.002). TG total area under the curve was 18–32% lower with EX and EX-LGI compared with control (P=0.0005 and P=0.0001, respectively) and EX-HGI (P=0.05 and P=0.021, respectively).Conclusions:A meal containing HGI carbohydrates consumed after an evening exercise session cancels the beneficial effect of exercise for stimulating fat oxidation and lowering TG after a subsequent high-fat meal, whereas consuming a post-exercise meal with LGI carbohydrates retains the positive effect of exercise.

Current Controversies around Carbohydrate Restriction and the Risk of High-Protein Diets

Recently, a Low carbohydrate (LCH) diet has been recommended by many doctors to control hyperglycemia and overweight. Unlike a traditional calorie-restricted diet, a carbohydrate-restricted diet typically contains less than 15% of the total energy intake from carbohydrates and about 30% from proteins. High glycemic index carbohydrates are the only cause of the glucose spike, so the main benefit of a LCH diet is not to cause postprandial hyperglycemia, which is considered to be the most serious risk factor for arteriosclerosis in diabetic patients. Life With Diabetes1 says that all absorbable carbohydrate foods turn to glucose in the blood, while fats and proteins do not, at least directly. Compared to a calorie-restricted diet, a carbohydrate-restricted diet accelerates fat metabolism yielding to ketogenic energy and helps gluconeogenesis in the liver, resulting in a more effective control of weight.

Sleep Hygiene and Recovery Strategies in Elite Soccer Players.

In elite soccer, players are frequently exposed to various situations and conditions that can interfere with sleep (e.g., playing night matches interspersed with 3 days; performing activities demanding high levels of concentration close to bedtime; use of products containing caffeine or alcohol in the period preceding bedtime; regular daytime napping throughout the week; variable wake-up times or bedtime), potentially leading to sleep deprivation. We outline simple, practical, and pharmaceutical-free sleep strategies that are coordinated to the constraints of elite soccer in order to promote sleep. Sleep deprivation is best alleviated by sleep extension; however, sleep hygiene strategies (i.e., consistent sleep pattern, appropriate napping, and active daytime behaviors) can be utilized to promote restorative sleep. Light has a profound impact on sleep, and sleep hygiene strategies that support the natural environmental light-dark cycle (i.e., red-light treatment prior to sleep, dawn-simulation therapy prior to waking) and prevent cycle disruption (i.e., filtering short wavelengths prior to sleep) may be beneficial to elite soccer players. Under conditions of inordinate stress, techniques such as brainwave entrainment and meditation are promising sleep-promoting strategies, but future studies are required to ascertain the applicability of these techniques to elite soccer players. Consuming high-electrolyte fluids such as milk, high-glycemic index carbohydrates, some forms of protein immediately prior to sleep, as well as tart cherry juice concentrate and tryptophan may promote rehydration, substrate stores replenishment, muscle-damage repair and/or restorative sleep. The influence of cold water immersion performed close to bedtime on subsequent sleep is still debated. Conversely, the potential detrimental effects of sleeping medication must be recognized. Sleep initiation is influenced by numerous factors, reinforcing the need for future research to identify such factors. Efficient and individualized sleep hygiene strategies may consequently be proposed.