Low Glycemic Index Foods Research Articles

Endogenous protein and lipid facilitate the digestion process of starch in cooked quinoa flours

Quinoa, known for its nutritional quality and as a low GI food, has arose great interests of scientists in the recent past. Intrinsic properties of starch as well as endogenous proteins and lipids might be important factors influencing the digestion processes of cooked quinoas. This work aims to investigate the roles of endogenous proteins and lipids on starch digestibility in the quinoa flour, and uncover the physicochemical and textural properties related to the digestion process. Quinoa flours with/without proteins and/or lipids removal were obtained and then subjected to an in vitro digestion before/after cooking. Interestingly, the cooked whole quinoa flours had the highest starch digestibility and eGI, followed by the flours with protein or lipid removal, with the smallest digestibility found in the pure quinoa starch. This was in an opposite order of the equivalent raw quinoa flours, where proteins and lipids strongly inhibit the starch digestion. The cooked whole quinoa flours showed a first-order kinetic digestion pattern, with continuous hydrolysis of the long amylose chains, compared to combination of parallel and sequential digestion kinetic observed for other quinoa samples and the reduction in amylopectin with DP ∼20–250 noted during the fast digestion stage. Additionally, compared to whole quinoa flours, samples with protein and/or lipid removal displayed the higher final viscosity and shear-thinning property, with aggregated starch observed under confocal laser scanning microscopy. It suggested that gel network is a primary factor affecting the digestion process of starch in different quinoa flours. Ultimately, this work provides new insights for the development and processing of healthy quinoa products. • Whole quinoa flours had the highest starch digestibility and eGI. • The cooked whole quinoa flours showed a first-order kinetic digestion pattern. • Samples with protein and lipid removal displayed higher final viscosity. • Aggregated starch observed under confocal laser scanning microscopy. • Gel network is potentially a primary factor affecting the digestion process.

A Review on the Role of Low Glycemic Index Foods for Glycemic Control in Chronic Liver Disease

Liver is an essential organ that maintains fasting and postprandial blood glucose response via various metabolic pathways. The liver function gradually deteriorates in chronic liver disease (CLD) due to inflammation and destruction of liver parenchyma. The development of glucose intolerance and hepatogenous diabetes (HD) in patients with CLD is an inevitable event. Diabetes and CLD can coexist, and function synergistically to cause unfavorable clinical consequences, including poor treatment outcomes and frequent hospitalization. The complications associated with liver disease (malnutrition, hypoglycemia, acute kidney injury, lactic acidosis, etc.) and lack of guidelines limit pharmacological management of HD. Dietary recommendations by The European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines (2019), suggested weight reducing hypocaloric diet along with adequate branched-chain amino acid (BCAA) and micronutrient consumption to improve steatosis and insulin sensitivity in patients with CLD. Dietary glycemic index controls prognosis of obesity, non-alcoholic fatty liver disease (NAFLD) and diabetes. The importance of low GI diet in reducing fasting blood glucose, hepatic glucose influx and fat accumulation, thereby improving weight loss and NAFLD score, is being published in patients with diabetes or liver disease. Several countries have already incorporated GI into their national health policies, for identification of the nutrient value, resulting in establishment of worldwide GI and glycemic load tables for specific food items. However, the apparent complexity of GI and lack of low GI meal choices need to be resolved in order to enhance patient’s quality of life, health and well-being. Low GI nutritional supplements, comprising of balanced proportion of carbohydrate, protein, BCAAs, fibers and micronutrients, may reduce the complexity related to dietary management of HD. The review summarizes the importance of nutritional management in HD with focus on low GI diet in people with CLD.

Determination of the Glycemic Index of a Dish based on Oyster Mushrooms and the Influence of its Consumption on some Biochemical Parameters of Diabetic Peoples

The glycemic index (GI) is the ability of a food to vary postprandial blood sugar. Frequent consumption of high GI foods is believed to cause chronic hyperglycemia which worsens the complications due to diabetes. The search for low GI foods would be of great interest in the prevention of postprandial hyperglycemia. Our work therefore has focused on determining the GI of a dish based on Pleurotus pulmonarius and the influence of its consumption. The dish studied was sautéed Pleurotus mushrooms (P. pulmonarius) with unripe plantains. We included for this study after obtaining ethical clearance, thirty (30) male volunteers (15 diabetic subjects and 15 non-diabetic subjects) aged between 20 and 70 years old. We determined the influence of consumption on some biochemical parameters of the participants. To do this, we took blood samples at the beginning of the experiment (preprandial) and at the end of the experiment (postprandial). After obtaining the serum, we performed for each participant the lipid profile (total cholesterol, HDL cholesterol, LDL cholesterol and triglyceride) we determined cretinemia, transaminase and total protein increased in concentration at the end of the test experimentation. This work brings added value concerning the use of edible mushrooms in the management of type 2 diabetes. From this study, we can highlight the ability of the test dish to minimize excessively marked variations in postprandial glycemia in diabetics.

Gluten-Free Diet in Co-Existent Celiac Disease and Type 1 Diabetes Mellitus: Is It Detrimental or Beneficial to Glycemic Control, Vascular Complications, and Quality of Life?

Celiac disease (CeD) is associated with type 1 diabetes mellitus (T1DM), and both have the same genetic background. Most patients with T1DM who develop CeD are either asymptomatic or have mild CeD-related gastrointestinal symptoms. Therefore, children affected by T1DM should undergo screening for asymptomatic CeD. The aim of this review is to highlight the influence of a gluten-free diet (GFD) on glycemic control, growth rate, microvascular complications, and quality of life in patients with T1DM and CeD. PubMed, Google Scholar, Web of Science, and Cochrane Central databases were searched. Reports reviewed were those published from 1969 to 2022 that focused on the interplay of T1DM and CeD and examined the effect of diet on glycemic control, growth rate, and quality of life. The most challenging aspect for a child with T1DM and CeD is that most GFD foods have a high glycemic index, while low glycemic index foods are recommended for T1DM. Interestingly, dietary therapy for CeD could improve the elevated HbA1c levels. Avoiding gluten added to a diabetic dietary regimen in T1DM patients might impose practical limitations and lead to important restrictions in the lifestyle of a young patient. Consequently, non-adherence to GFD in patients with T1DM and CeD is common. GFD in patients with T1DM and CeD seems to lower the incidence of micro- and macrovascular complications, but this requires further investigation. It seems that adherence to GFD in young patients with T1DM and CeD leads to regular growth and a stable body mass index without any negative effect on HbA1c or insulin requirements. Furthermore, the lipid profile and quality of life seem to have improved with the introduction of GFD.

Probing the Double-Layered Cotyledon Cell Structure of Navy Beans: Barrier Effect of the Protein Matrix on In Vitro Starch Digestion

The microstructure of legumes plays a crucial role in regulating starch digestion and postprandial glycemic responses. Starch granules are double encapsulated within the outer cell wall and the inner protein matrix of legume cotyledon cells. Despite progress in understanding the role of cell walls in delaying starch digestion, the role of the protein matrix has received little research attention. The aim of this study was to evaluate if the protein matrix and cell wall may present combined physical barriers retarding enzyme hydrolysis of intracellular starch. Intact cotyledon cells were isolated from navy beans and used to assess the barrier effect of the protein matrix on the digestion of starch under conditions simulating the upper gastrointestinal tract. The cells were pretreated with pepsin at 37 °C and pH 2.0 for 1, 4, or 24 h and without pepsin for 24 h (control) to facilitate removal of the intracellular protein matrix prior to cooking and simulated in vitro digestion. A longer pretreatment time resulted in a lower protein content of the cells and a higher initial rate and extent of starch hydrolysis. We suggest that in addition to the primary cell wall barrier, the protein matrix provides a secondary barrier restricting the accessibility of α-amylase to starch. This study provides a new fundamental understanding of the relationship between the structural organization of legume cotyledon cells and starch digestion that could inform the design of novel low glycemic index foods.

A Comprehensive Chemical and Nutritional Analysis of New Zealand Yacon Concentrate

Global interest in yacon (Smallanthus sonchifolius) is growing due to its potential as a functional food, attributable to its unique profile of bioactives and high fructooligosaccharide (FOS) content, which vary between cultivars. Our objective was to conduct a comprehensive chemical and nutritional analysis of New Zealand yacon concentrate (NZYC)-a sweet syrup derived from the roots of cultivar 'New Zealand', which was first grown in the 1980s. The major minerals in NZYC were potassium, phosphorus, and calcium. The FOS content ranged from 17.6 to 52.7 g/100g. Total phenolic content ranged from 565 to 785 mg gallic acid equivalents per 100 g; chlorogenic acid and caffeic acid were the major phenolic compounds. The major amino acids were L-arginine, L-glutamic acid, L-proline, L-aspartic acid, and asparagine. The major organic acids were citric, malic, quinic, and fumaric acids. Antioxidant activity ranged from 1084.14 to 3085.78 mg Trolox equivalents per 100 g depending on the assay used. The glycaemic index (GI) value was 40 ± 0.22, classifying it as a low-GI food. These results support the classification of NZYC as a nutraceutical food product for future diet therapy applications.

Phenolic profile, alpha-amylase inhibitory activity, and in vitro glycemic index of adzuki beans.

Regular consumption of low-glycemic index (GI) foods is a common strategy for type 2 diabetes patients. To evaluate the potential application of adzuki beans in low-GI foods, the phenolic profile and alpha-amylase inhibitor (α-AI) activity of four varieties of adzuki beans (G24, Te Xiao Li No. 1, Gui Nong No. 1, and Qian Xiao Hei) were determined. The starch digestibility properties and in vitro glycemic index (IVGI) of these beans were also evaluated using the in vitro digestion model coupled with 3,5-dinitrosalicylic acid colorimetry. The results indicated that these adzuki beans, containing numerous phenolics, showed inhibitory activities to alpha-amylase with the α-AI activities between 1.760 ± 0.044 and 3.411 ± 0.186 U/g. The resistant starch (RS) contributed predominantly to the total starch with proportions between (69.78 ± 2.45%) and (81.03 ± 0.06%); Te Xiao Li No. 1 was the highest compared with the other varieties. The adzuki beans were categorized into low- or medium-GI foods, and the IVGI ranged from (39.00 ± 0.36) to (56.76 ± 4.21). These results suggested that adzuki beans can be used as a component of low-GI foods.

Crystal Structure of 4,6-α-Glucanotransferase GtfC-ΔC from Thermophilic Geobacillus 12AMOR1: Starch Transglycosylation in Non-Permuted GH70 Enzymes.

GtfC-type 4,6-α-glucanotransferase (α-GT) enzymes from Glycoside Hydrolase Family 70 (GH70) are of interest for the modification of starch into low-glycemic index food ingredients. Compared to the related GH70 GtfB-type α-GTs, found exclusively in lactic acid bacteria (LAB), GtfCs occur in non-LAB, share low sequence identity, lack circular permutation of the catalytic domain, and feature a single-segment auxiliary domain IV and auxiliary C-terminal domains. Despite these differences, the first crystal structure of a GtfC, GbGtfC-ΔC from Geobacillus 12AMOR1, and the first one representing a non-permuted GH70 enzyme, reveals high structural similarity in the core domains with most GtfBs, featuring a similar tunneled active site. We propose that GtfC (and related GtfD) enzymes evolved from starch-degrading α-amylases from GH13 by acquiring α-1,6 transglycosylation capabilities, before the events that resulted in circular permutation of the catalytic domain observed in other GH70 enzymes (glucansucrases, GtfB-type α-GTs). AlphaFold modeling and sequence alignments suggest that the GbGtfC structure represents the GtfC subfamily, although it has a so far unique alternating α-1,4/α-1,6 product specificity, likely determined by residues near acceptor binding subsites +1/+2.

Development and characterization of resistant starch produced by an extrusion–debranching strategy with a high starch concentration

Amylose content is the main factor affecting resistant starch type III formation and can be effectively improved by debranching with pullulanase. Nonetheless, low substrate concentration and long treatment time limit the efficiency and yield of this method. We described a new extrusion–debranching strategy that can achieve industrially efficient enzymatic starch debranching to improve amylose and RS contents. Starch was fully gelatinized and partially degraded via first extrusion in a twin-screw extruder. The extruded starch and different amounts of pullulanase were mixed and subjected to a second extrusion, which resulted in the debranching of amylopectin. Tests with corn starch (CS) and pullulanase at 20, 40, 60, 80, and 100 U/g dry starch weight gave extruded corn starch (ECS) and enzymatically debranched ECS (EECS) after the first and second extrusions, respectively. Increasing the pullulanase amount to 100 U/g (EECS-100U) also increased the amylose content to 90.21%, with a starch concentration of 66.6% (w/v). EECS presented a B + V-type crystallinity pattern and showed excellent thermal stability, with melting temperatures of the first and second peaks ranging from 90 °C to 135 °C and from 140 °C to 170 °C, respectively. The short amylose exhibited rapid recrystallization. RS content increased with increasing amounts of pullulanase. EECS-100U exhibited the lowest digestibility, with a 41.50% RS content. These results suggest that the extrusion–debranching strategy for improving amylose content is both feasible and effective. The findings will provide guidance for the continuous industrialized production of amylose, RS, and low glycemic index foods.

Functional components profile and glycemic index of kidney beans.

Low glycemic index (GI) diet has been considered as a strategy for type II diabetes patients. In the present study, the phenolics profile, α-amylase inhibitor activities, starch composition as well as the glycemic index of seven varieties of kidney beans were studied. An enzymatic inhibitory reaction model was employed to determine the α-amylase inhibitor activity, and the in vitro digestion model coupled with the 3, 5-dinitrosalicylic acid colorimetry method was adopted to evaluate the starch composition and glycemic index. The results showed that gallic acid was dominant in kidney beans, and the colored beans contained more phenolics than the white ones. In addition, the α-amylase inhibitor activities of kidney beans ranged from 1.659 ± 0.050 to 4.162 ± 0.049 U/g DW, among which the Y2 variety was the top-ranked. Furthermore, kidney beans starch demonstrated brilliant resistance to digestion with the contribution of resistant starch to total starch between 70.90 ± 0.39% and 83.12 ± 0.42%. Eventually, these kidney beans were categorized as low GI foods, which ranged from 32.47 ± 0.13 to 52.99 ± 0.56, the resistant starch makes dominant contribution to the low GI. These results indicate that kidney beans can be served as ingredients in functional low GI foods.

In Vitro Digestibility, Pasting and Thermal Properties, and Structure of Cross‐Linked Arenga pinnata (Wurmb.) Merr. Starch

AbstractSodium trimetaphosphate (STMP) cross‐linked Arenga pinnata starch (CLAPS) with different degrees of cross‐linking (0–97.79%) are prepared and their structural characteristics and physicochemical properties are evaluated. Cross‐linking does not significantly change APS granular structure, but seems to lower the intensity of Maltese cross. With the cross‐linking degrees (CLD) increasing from 0.00% to 97.79%, the rapidly digestible starch (RDS) content of CLAPS is decreased from 66.50% to 16.34%, but the resistant starch (RS) content has the opposite trend and is increased from 29.87% to 82.77%. As the CLD increased, the solubility and swelling power of APS are significantly reduced from 10.24% and 16.52 g g−1 to 1.02% and 4.60 g g−1, respectively. Low CLD could increase viscosities of the APS, whereas high CLD significantly reduce the viscosities of the APS and the greater theCLD, the more obvious the reduction effect. Meanwhile, cross‐linked APS exhibits a high conclusion temperature and lower gelatinization enthalpy (ΔH). With the CLD increasing, short molecular ordered structure of CLAPS exhibits increasing trends. These results indicate that crosslinking with STMP can significantly alter digestibility and improve thermal stability of APS, which would provide a theoretical basis for development of APS products and could be used in low glycemic index (GI) foods.

Environmental Profile of a Novel High-Amylose Bread Wheat Fresh Pasta with Low Glycemic Index

To improve glycemic health, a high-amylose bread wheat flour fresh pasta characterized by a low in vitro glycemic index (GI) and improved post-prandial glucose metabolism was previously developed. In this study, well-known life cycle analysis software was used in accordance with the PAS 2050 and mid- and end-point ReCiPe 2016 standard methods to assess, respectively, its carbon footprint and overall environmental profile, as weighted by a hierarchical perspective. Even if both eco-indicators allowed the identification of the same hotspots (i.e., high-amylose bread wheat cultivation and consumer use of fresh pasta), the potential consumer of low-GI foods should be conscious that the novel low-GI fresh pasta had a greater environmental impact than the conventional counterpart made of common wheat flour, their corresponding carbon footprint or overall weighted damage score being 3.88 and 2.51 kg CO2e/kg or 184 and 93 mPt/kg, respectively. This was mainly due to the smaller high-amylose bread wheat yield per hectare. Provided that its crop yield was near to that typical for common wheat in Central Italy, the difference between both eco-indicators would be not greater than 9%. This confirmed the paramount impact of the agricultural phase. Finally, use of smart kitchen appliances would help to relieve further the environmental impact of both fresh pasta products.

Proximate composition and glycaemic index of destarched rice

There is strong evidence linking low glycaemic diets and reduced risk of developing diabetes mellitus (DM). This study was designed to develop low glycaemic index (GI) food using rice. Rice was subjected to enzymatic treatment at 40 °C for 8 mins for destarching. After the incubation, the proximate composition and GI of the processed rice were determined. Proximate analysis was carried out using the standard methods of AOAC, whereas GI was assessed using a postprandial oral glucose test. The results showed a significant reduction (p < 0.05) in percentage carbohydrates in the processed rice compared with the unprocessed control. Other parameters such as % moisture and lipids were also reduced in the processed rice when compared with the unprocessed control. Furthermore, the percentage of proteins and fibres were significantly increased in the processed rice compared to the unprocessed control. The GI of the processed rice was 69.86% as against the 86.43% of unprocessed rice, representing a 16.57% reduction. Overall, the results suggest that the enzymatic treatment of the rice have the potential of reducing both the starch content and GI of the rice. This can be explored in the development of a diabetic diet.

The Effect of Two Different Insulin Formulations on Postprandial Hyperglycemia after High and Low Glycemic-Index Meal in Type 1 Diabetes.

Despite multiple pharmacological options, including rapid-acting insulin analogs, postprandial hyperglycemia is still highly prevalent in patients with type 1 and type 2 diabetes. We hypothesize that the new rapid-acting insulin formulation, the so-called faster-acting Aspart, may have a different effect in controlling postprandial hyperglycemic burden according to the quality of the meal compared to the traditional Aspart. Twenty-five patients with type 1 diabetes were consecutively recruited at the diabetes care center of the University Hospital affiliate of the Magna Græcia University of Catanzaro. Each patient performed four meal tests one week apart, two with a predefined high glycemic index (HGI) food and two with a low glycemic index (LGI) food using insulin Aspart once and Faster Aspart the other time. The 0–30 min, 0–60 min, and 0–120 min glucose Area Under the Curve (AUC) of postprandial glycemic excursion, calculated from continuous glucose monitoring data, were significantly lower with Faster Aspart administered before the HGI test meal as compared to Aspart. A significant difference in favor of Faster Aspart was also found when comparing the 0–60 min and 0–120 min AUC after the LGI meal. Faster Aspart may provide better postprandial glucose control than Aspart regardless of the glycemic index of the meal.

Formulasi dan karakteristik fisikokimia banana bar pisang candi (Musa paradisiaca linn) dan tepung sorgum sebagai alternatif pangan low GI (indeks glikemik rendah) bagi penyandang obesitas

Obesity is a condition where there is excessive accumulation of fat in the body. As a result, weight is far above standard and can endanger health. People with obesity have a higher risk of developing the disease than people with normal nutritional status. An alternative in overcoming this is the intake of foods that have a low GI. It is necessary to develop low GI food types as an alternative to food or snacks that have a low glycemic index value, such as banana bars. The purpose of this study was to obtain the formulation and physicochemical characteristics of the Banana Bar temple banana (Musa paradisiaca Linn) and sorghum flour as an alternative to Low GI (Low Glycemic Index) food for obese people. The research consist of three stages, the first is formulation and manufacture of Banana Bars from candi banana, maizena and sorghum flour, the second is sensory and physicochemical characterization of Banana Bars, the third is Glycemic index analysis of Banana Bar products. The results showed that the most preferred banana bar was the 40% candi banana, 30% sorghum flour and coconut sugar. The physicochemical characteristics of Banana Bar products have a protein content of 4.09, 0.32 fat, 41.87 water content, 0.88 ash, 52.29 carbohydrates, and 0.56 crude fiber. While the glycemic index value of Banana Bar products is 72.95 (medium).

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.

Lotus Seed Starch: A Novel Functional Ingredient with Promising Properties and Applications in Food—A Review

AbstractLotus (Nelumbo nucifera G.) seeds are rich in nutrients and mainly used for food and medicinal applications. The seeds are an important food item in many countries and are generally considered a low glycemic index food. Starch is a major component of lotus seeds and may amount to over 50% of the dry weight. The quality of lotus seed products is mainly determined their starch properties, such as gelatinization and retrogradation. This review comprehensively summarizes recent developments in isolation, modifications, and applications of lotus seed starch (LS). This survey highlights different properties of native and modified LS in comparison with other starches. Native LS has been found with high amylose content (20–35%), high peak gelatinization temperatures (>70 °C), and pasting temperatures (>75 °C). The high amylose content has contributed to lower swelling power and fast retrogradation of LS. The modification of LS has been done using different methods, including thermal, microwave, high pressure, chemical, and enzymatic processing for functionality improvement. Native and modified LS have promising potential to be a valuable functional ingredient in different food and other applications. Finally, an outlook on the future possibilities for utilization of LS is provided.

Glycaemic response of pseudocereal‐based gluten‐free food products: a review

SummaryRapid digestion and absorption of carbohydrates have become a health issue (high glycaemic index, GI), which can be a matter of greater concern when consumed in large quantities. Depending upon the influence of carbohydrates on the blood sugar levels, GI classifies carbohydrates (on a scale of 100) as low (<55), medium (55–70) and high (>70) GI foods. Among the pseudocereals, chia seed possesses relatively lower GI (28.53), as compared to buckwheat (52.35), amaranth (47.65) and quinoa (61.50). Consumers now prefer foods with a high GI over the ones with low GI to prevent various metabolic alterations. Celiac disease is a lifelong disorder prevalent worldwide and can only be controlled by following a strict lifelong gluten‐free diet. Therefore, pseudocereals could be a potential alternate for low GI food and developing gluten‐free food products, including bread, cookies, noodles and pasta. This review synthesises the recently published literatures on pseudocereals as a lowering GI and healthy food option. This review also gives insights into developing pseudocereals as a potential and novel ingredient for gluten‐free food applications and the latest research conducted worldwide.

Utilising a Real-Time Continuous Glucose Monitor as Part of a Low Glycaemic Index and Load Diet and Determining Its Effect on Improving Dietary Intake, Body Composition and Metabolic Parameters of Overweight and Obese Young Adults: A Randomised Controlled Trial.

A randomised controlled trial to measure the effects of integrating real-time continuous glucose monitor (rtCGM) into a low glycaemic index (GI) and glycaemic load (GL) dietary intervention on dietary intake, body composition and specific metabolic parameters was carried out. A total of 40 overweight young adults [(means ± SD) age: 26.4 ± 5.3 years, BMI: 29.4 ± 4.7 kg/m2] were randomised into an intervention and control groups for a period of eight weeks. Both groups received nutrition education on low GI and GL foods. The intervention group also received an rtCGM system to monitor their glucose levels 24 h a day. While controlling for physical activities and GI and GL nutrition knowledge, the results indicated that the rtCGM system further improved body weight, BMI, fat mass, fasting plasma glucose, HbA1c, total cholesterol, HDL cholesterol and LDL cholesterol in the intervention group (p < 0.05). This trial unveils the robustness of the rtCGM where non-diabetic overweight and obese young adults can benefit from this device and utilise it as a management tool for overweight and obesity and a primary prevention tool for type 2 diabetes, as it provides real-time and personalised information on physiological changes.

Dietary Intakes of Animal and Plant Proteins and Risk of Colorectal Cancer: The EPIC-Italy Cohort.

Simple SummaryAfter breast and prostate cancer, colorectal (CRC) is the third most frequent cancer in men and women. It is unclear if protein-rich diets other than red meat elevate risk or even lower CRC occurrence at specific colon locations. The aim of this study is to assess the associations of animal and plant protein intakes with CRC risk in middle-aged Italian men and women. Our findings show that replacing animal proteins with plant proteins was associated with a lower risk of rectal cancer but not of colon cancer, while replacing animal proteins with plant-based proteins from high-glycemic-index (GI) foods was associated with an increased colon cancer risk. These results have important public health implications as they suggest that both refined high-GI foods and meat might have site-specific roles in the pathogenesis of CRC.We prospectively investigated the associations of protein intake with colorectal cancer (CRC) risk in middle-aged Italian men and women. Food consumption was assessed by validated Epic semiquantitative food-frequency questionnaires. Multivariable Cox models stratified by center, age, and sex, adjusted for confounders, estimated the associations of animal and plant protein consumption with CRC risk by subsite. Among 44,824 men and women, we identified 539 incident CRCs after a median follow-up of 14 years. Replacing animal proteins with plant proteins was associated with a decreased risk of rectal (HR, 0.71; 95% CI, 0.55–0.92) but not colon cancer. By contrast, replacing animal proteins with plant proteins from high-glycemic-index (GI) foods was associated with an increased risk of proximal and distal (including sigma) colon cancer (HR, 1.23; 95% CI, 1.07–1.40) but not when animal proteins were replaced with plant proteins from low-GI foods (HR, 0.93; 95% CI, 0.79–1.11). Further evaluation revealed that the increased colon cancer risk was limited to the substitution of proteins from red and processed meat, as well as dairy and eggs, with vegetable proteins from high-GI foods. Participants in the highest quintile of animal protein intake had higher plasma glucose and cholesterol levels than those in the lowest quintile. By contrast, higher intake of plant proteins from low-GI foods was inversely associated with fasting insulin and HOMA-IR levels. In conclusion, replacing animal proteins with plant proteins from high-GI foods was associated with an increased risk of colon cancer.