Low Glycemic Load Research Articles

Safety and tolerability of a low glycemic load dietary intervention in adults with cystic fibrosis: a pilot study.

To achieve and maintain adequate weight, people with cystic fibrosis (CF) May often consume energy-dense, nutrient-poor foods high in added sugars and refined carbohydrates; however, little is known about the glycemic and metabolic effects of dietary composition in this patient population. The objective of this pilot study was to investigate the safety and tolerability of a low glycemic load (LGL) diet in adults with CF and abnormal glucose tolerance (AGT). Ten adults with CF and AGT completed this prospective, open-label pilot study. Mean age was 27.0 ± 2.1 years, 64% were female, and all had pancreatic insufficiency. Each participant followed his/her typical diet for 2 weeks, then transitioned to a LGL diet via meal delivery service for 8 weeks. The primary outcome was change in weight from baseline to study completion, with safety established if no significant decline was noted. Other key safety outcomes included change in hypoglycemia measured by patient report and continuous glucose monitoring (CGM). Exploratory outcomes included changes in other CGM measures, body composition by dual energy X-ray absorptiometry (DXA), and patient reported outcomes. There were no significant changes in weight or in subjectively-reported or objectively-measured hypoglycemia. Favorable non-significant changes were noted in CGM measures of hyperglycemia and glycemic variability, DXA measures of fat mass, and gastrointestinal symptom surveys. A LGL dietary intervention was safe and well tolerated in adults with CF and AGT. These results lay the groundwork for future trials investigating the impact of low-glycemic dietary interventions on metabolic outcomes in the CF population.

Preliminary Study on Pulse-Based Snack “Vadai” Reducing Postprandial Glycaemic Response in Healthy Malaysian Adults

Snack consumption contributes significantly to daily energy and nutrient intake. Low glycaemic index (GI) and glycaemic load (GL) snacks help modulate postprandial glucose (PPG) rise in prediabetes and diabetes. Masala Vadai (MS) and Medu Vadai (MD) are traditional Indian snacks made from pulses, where their GI and GL values and the effect on PPG remain unexplored. In this randomised cross-over trial, healthy adults (n=13, 19-30 years old, 22.3±2.3 kg/m2) consumed either MS, MD, or glucose solution as reference food (RF) containing 12.5g of available carbohydrate on three occasions with one week apart between each test. Capillary blood was measured at 0, 15, 30, 45, 60, 90, and 120 minutes to calculate incremental area under the curve (iAUC) and to estimate the GI. The results showed that when compared to RF, MD but not MS had significantly lower iAUC at 30-min (p=0.013) and 45-min (p=0.001). Both snacks had low peak blood glucose (p<0.001) and incremental peak blood glucose (p<0.001), wherein MD exhibited a more delayed effect than MS. However, time to peak blood glucose did not differ between the test foods and RF. MD and MS had low-medium GI (MD=47, MS=63) and low GL (MD=6, MS=8), respectively. In conclusion, MD attenuated PPG significantly more than MS in comparison to glucose solution, offering an advantage of glycaemic control. Even within similar pulse-based snacks, the GI value is important in influencing PPG. These findings will add to the GI compendium for Asian foods and will be useful to healthcare professionals in providing sound nutritional advice.

The acute effects of variations in the flour composition of crackers on the glycemic index and glycemic responses in healthy adults.

This study assessed the glycemic index (GI) and glycemic load (GL) of three crackers formulated with different flours: a control cracker (CC) made with conventional flour, one with 30% whole wheat flour substitution (WWC), and another with 30% sunflower seed flour substitution (SFC). This study aimed to explore the impact of these substitutions, which vary in protein and fiber content, on the glycemic responses compared to a reference glucose drink. In a randomized controlled, crossover design, 11 healthy participants (mean age 23.5 ± 1 years; 7 women; BMI 23 ± 1 kg/m2), consumed cracker meals (CC, WWC, and SFC) each providing 50 g of available carbohydrates, and a 50 g glucose reference in separate sessions. The SFC crackers provided low GI and GL values (GI: 53 on the glucose scale, GL: 6 per serving), whereas the WWC and CC crackers provided high GI (GI: 77 and 90 on the glucose scale, respectively) and medium GL values (11 and 12 per serving, respectively). Compared with the glucose reference and CC crackers, only SFC induced lower postprandial glucose concentrations, lower glucose excursions, and lower peak glucose values. All crackers were rated as enjoyable and associated with increased satiety. SFC moderated postprandial glycemic responses compared to CC and the reference (D-glucose), but not WWC. These effects may be attributed to the soluble fibers and protein content of the SFC. These findings suggest potential benefits for body weight management and glycemic control, warranting further investigation of the role of flour substitutions in healthy snack options. This trial has been registered at Clinicaltrials.gov (NCT05702372).

Effect of an intensive nutrition intervention of a high protein and low glycemic load diet on weight of kidney transplant recipients: a randomized clinical trial.

The purpose of this study is to evaluate the effect of a high protein and low glycemic load diet in preventing weight gain after kidney transplantation. We designed a prospective, single-center, open-label, randomized controlled study to compare the efficacy of a high protein (1.3-1.4 g/kg/day) and low glycemic load diet versus a conventional diet (0.8-1.0 g/kg/day of protein and no recommendations on glycemic load) in preventing weight gain (ClinicalTrials.gov identifier: NCT02883777). A total of 120 patients were evaluated. Patients were followed for 12 months, and the primary outcome was weight maintenance or weight gain lower than 5%. There were no differences in total energy intake, carbohydrates, and total fats between groups. Intervention group (IG) increased protein intake to 1.38 ± 0.56 g/kg/day and decreased the glycemic load to 87.27 ± 4.54 g/day, while control group (CG) had a dietary protein intake of 1.19 ± 0.43 g/kg/day and a glycemic load of 115.60 ± 7.01 g/day. Total fiber intake was greater and trans-fat was lower in IG. Dietetic cholesterol increased in IG over time and was significantly different between groups. Overall, patients had an increase in body weight over time, with a mean increment of 4.1 ± 5.5 kg (5.75%). The percentage of patients who achieved the primary outcome was 50% of sample size, without differences between groups. The glomerular filtration rate improved over time in both groups. Considering 24-h proteinuria and albuminuria, a similar rise was observed in both groups. The present dietary intervention was safe, but had no effect on weight gain in kidney transplant subjects. Our findings suggest that other strategies, including alternative dietary and/or pharmacological and psychological interventions might be tested in randomized control trials in order to improve patients' body weight outcomes after transplant.

High-fiber and low-glycemic index egg-roll cookies made from non-itchy taro (Colocasia esculenta var. Febi521)

Indigenous taro is a notable carbohydrate-rich food ingredient with significant dietary fiber. However, its natural itchiness has limited its widespread use. A new non-itchy variant, Febi521, was developed through in-vitro soma-clonal induction. This study aimed to create a high-fiber snack, specifically egg-roll cookies, using non-itchy taro (Colocasia esculenta var. Febi521). The cookies underwent comprehensive evaluation for their physical, chemical, and nutritional characteristics, including polyphenol content, glycemic index (GI), and glycemic load (GL). By fully substituting taro Febi521 flour in the recipe, we produced egg-roll cookies that were sensorially preferred, high in fiber (19.2 % wet basis), and had a low GI (39) and low GL (3). This formulation also met nutritional requirements for claims related to total fat, saturated fat, sodium, and cholesterol. Substituting taro flour increased fiber content threefold compared to wheat flour-based egg-roll cookies. This research highlights the potential of indigenous taro for diverse product development aimed at enhancing fiber intake among the population.

Low glycemic index or low glycemic load diets for people with overweight or obesity: Summary of a Cochrane review

Low glycemic index or low glycemic load diets for people with overweight or obesity: Summary of a Cochrane review

Glycemic Index, Glycemic Load and Dyslipidemia in Adolescents from Chiapas, Mexico.

Cardiovascular disease risk throughout the life course is increased by abnormal blood lipid levels in youth. The dietary glycemic index (GI) and glycemic load (GL) during adolescence might be related to abnormal blood lipids. This study aimed to analyze the association between dietary GI, GL and dyslipidemia in adolescents from two marginalized regions of Chiapas, Mexico. A cross-sectional study was conducted with 213 adolescents. Food intake was assessed using 24 h recalls. The association between dyslipidemia and dietary GI or GL was tested by using logistic regression models. Low HDL-c was the most prevalent risk factor (47.4%), followed by hypertriglyceridemia (25.4%). In this population, overall dietary GI was not associated with dyslipidemia. A high dietary GL was associated with 2.39 higher odds of low HDL-c (95% CI: 1.21-4.74) when compared to low GL. Female adolescents with high dietary GL had 3.20 higher odds of hypertriglyceridemia (95% CI: 1.03-9.88), whereas no association was found for males. No associations were observed between overall dietary GL and total cholesterol or LDL-c. In adolescents from urban and rural communities in Chiapas, a high dietary GL was associated with a detrimental effect on HDL-c. In female adolescents, high GL was associated with hypertriglyceridemia.

Associations of the glycaemic index and the glycaemic load with risk of type 2 diabetes in 127 594 people from 20 countries (PURE): a prospective cohort study

The association between the glycaemic index and the glycaemic load with type 2 diabetes incidence is controversial. We aimed to evaluate this association in an international cohort with diverse glycaemic index and glycaemic load diets. The PURE study is a prospective cohort study of 127 594 adults aged 35-70 years from 20 high-income, middle-income, and low-income countries. Diet was assessed at baseline using country-specific validated food frequency questionnaires. The glycaemic index and the glycaemic load were estimated on the basis of the intake of seven categories of carbohydrate-containing foods. Participants were categorised into quintiles of glycaemic index and glycaemic load. The primary outcome was incident type 2 diabetes. Multivariable Cox Frailty models with random intercepts for study centre were used to calculate hazard ratios (HRs). During a median follow-up of 11·8 years (IQR 9·0-13·0), 7326 (5·7%) incident cases of type 2 diabetes occurred. In multivariable adjusted analyses, a diet with a higher glycaemic index was significantly associated with a higher risk of diabetes (quintile 5 vs quintile 1; HR 1·15 [95% CI 1·03-1·29]). Participants in the highest quintile of the glycaemic load had a higher risk of incident type 2 diabetes compared with those in the lowest quintile (HR 1·21, 95% CI 1·06-1·37). The glycaemic index was more strongly associated with diabetes among individuals with a higher BMI (quintile 5 vs quintile 1; HR 1·23 [95% CI 1·08-1·41]) than those with a lower BMI (quintile 5 vs quintile 1; 1·10 [0·87-1·39]; p interaction=0·030). Diets with a high glycaemic index and a high glycaemic load were associated with a higher risk of incident type 2 diabetes in a multinational cohort spanning five continents. Our findings suggest that consuming low glycaemic index and low glycaemic load diets might prevent the development of type 2 diabetes. Full funding sources are listed at the end of the Article.

Impact of a Mediterranean diet on food cravings in an Australian population

Food cravings are one of several important complexities between psychological and physiological triggers for food consumption. Cravings are commonly cited as contributing to over-consumption of hyperpalatable foods (sugary, salty, and fatty foods) and may be causal in obesity(1). The Mediterranean dietary pattern (MedDiet) is linked to reduced disease risk and improved health and wellbeing(2). Despite a lower intake of sugary and salty foods compared to a Western diet, free-living adults switching to the MedDiet find it satiating and achieve high adherence in Western countries. The MedDiet is known to improve mood and wellbeing, is high in fibre, monounsaturated fat and low in added sugar, and has a low glycaemic load, which could separately and synergistically reduce food cravings. The relationship between adherence to the MedDiet and food cravings has never been investigated. In the MedLey randomised controlled trial, we investigated the effects of a MedDiet on food cravings, compared with a habitual Australian diet (HabDiet)(3). Adherence to the MedDiet was scored out of 15 (maximum adherence). Participants completed three food cravings questionnaires at baseline and 6-months. The State questionnaire measures momentary cravings and has a maximum score of 75, indicating maximum food cravings. The Trait-reduced questionnaire measures general cravings and has a maximum score of score of 126, indicating more frequent and intense cravings for foods. The Food Cravings Inventory (FCI) measures cravings for four food domains: fatty foods, fast foods, sugary foods, and high carbohydrate (CHO) foods. MedDiet group (n = 58) responses were compared with the HabDiet group (n = 53) across visits using linear mixed effects modelling. Predicted differences were obtained for adherence scores of ≤8 (median adherence) and ≥9. Means ± SD or CIs are presented. Mean adherence increased from 7.1 ± 1.8 to 10.7 ± 1.48 in the MedDiet group (P<0.01), with no change in the HabDiet group (P = 1.00). Trait-reduced scores were not significantly different between groups at 6-months (P = 0.11), although there was a 5.57-point reduction within the MedDiet group (CI −12.56, −1.96, P = 0.04). State score was significantly lower in the MedDiet group than the HabDiet at 6-months (−4.4 (CI −7.53, −0.39), P = 0.03), and was significantly lower than at baseline (−5.9 (CI −9.33, −0.24,) P = 0.04). There were no differences between groups for the four domains of the FCI (P>0.05). Cravings for sugary foods was significantly reduced within the MedDiet group (−0.26 (CI −0.46, −0.05) P = 0.01). The predictive modelling suggested moving from an adherence score of 8 to 9 was associated with lower cravings for sugar (−0.03 ± 0.01, P = 0.03), fast food (−0.04 ± 0.02, P = 0.02) and CHO foods (−0.05 ± 0.02, P = 0.02). These results are suggestive that higher adherence to a MedDiet could reduce cravings compared to the Australian diet and suggest that the MedDiet may specifically reduce sugar cravings. Further investigation is warranted, through observational and intervention trials.

STUDY OF GLYCEMIC INDEX OF DIABETES-SPECIFIC MODIFIED FORMULA AMONG HEALTHY ADULTS

Background: People with type 2 diabetes incorporate diabetes-specific nutritional formulas (DSNFs) in their nutrition therapy to enhance glycemic control and manage body weight. Among these formulas, the GEN-DM modified formula (GEN-DM MF) has been widely used for several years. However, the glycemic index (GI) of GEN-DM MF has not yet been determined. Objective: This study aimed to assess the GI of GEN-DM MF. Methods: Ten healthy adults with normal oral glucose tolerance were included. The plasma glucose was measured at 0 (baseline), 30, 60, 90 and 120 minutes after consuming 50 grams of glucose solution. On the subsequent two days, plasma glucose measurement was repeated using 84.46 g of GEN-DM MF containing 50 g of carbohydrates. The GI was calculated by dividing the incremental area under the glucose response curve (iAUC) of GEN-DM MF by the area under the glucose response curve of the glucose solution, then multiplying the result by 100. The glycemic load (GL) was calculated by multiplying the GI by the carbohydrate amount in one serving of GEN-DM MF (40 g) /100. Results: Six healthy men and four women with an average age of 35.80 ± 6.89 years, ranging from 28 to 44, were included in the study. The plasma glucose levels at 30 and 60 minutes following the GEN-DM MF were significantly lower than the corresponding glucose levels with p= 0.002 and 0.013, respectively. The GI and GL of GEN-DM MF were 37.75 and 9, respectively, which was classified as low GI and low GL. Conclusion: GEN-DM MF is classified as a low GI and low GL food, which could significantly lower plasma glucose levels among healthy individuals.

A Multiobjective Diet Planning Model for Diabetic Patients in the Moroccan Health Context Using Particle Swarm Intelligence

Recommended diets have a central role to play in creating a healthy dietary environment that enables populations to adopt and maintain health-promoting dietary practices. It’s well known that foods with a low glycemic load (GL) help release a concentration of glucose in the blood, These can contribute to the prevention of various glycemia-elated health problems. We aim to address an optimization model for diets in the Moroccan context that controls both glycemic load and total meal costs. The application of a multiple objective particle swarm method which aggregates the problem’s restrictions with optimized objectives functions helps maintain dietary diversity and facilitates the search for trade-offs between objectives and problem-specific requirements.

A comprehensive patient-specific prediction model for temporomandibular joint osteoarthritis progression

Temporomandibular joint osteoarthritis (TMJ OA) is a prevalent degenerative disease characterized by chronic pain and impaired jaw function. The complexity of TMJ OA has hindered the development of prognostic tools, posing a significant challenge in timely, patient-specific management. Addressing this gap, our research employs a comprehensive, multidimensional approach to advance TMJ OA prognostication. We conducted a prospective study with 106 subjects, 74 of whom were followed up after 2 to 3 y of conservative treatment. Central to our methodology is the development of an innovative, open-source predictive modeling framework, the Ensemble via Hierarchical Predictions through Nested cross-validation tool (EHPN). This framework synergistically integrates 18 feature selection, statistical, and machine learning methods to yield an accuracy of 0.87, with an area under the ROC curve of 0.72 and an F1 score of 0.82. Our study, beyond technical advancements, emphasizes the global impact of TMJ OA, recognizing its unique demographic occurrence. We highlight key factors influencing TMJ OA progression. Using SHAP analysis, we identified personalized prognostic predictors: lower values of headache, lower back pain, restless sleep, condyle high gray level-GL-run emphasis, articular fossa GL nonuniformity, and long-run low GL emphasis; and higher values of superior joint space, mouth opening, saliva Vascular-endothelium-growth-factor, Matrix-metalloproteinase-7, serum Epithelial-neutrophil-activating-peptide, and age indicate recovery likelihood. Our multidimensional and multimodal EHPN tool enhances clinicians' decision-making, offering a transformative translational infrastructure. The EHPN model stands as a significant contribution to precision medicine, offering a paradigm shift in the management of temporomandibular disorders and potentially influencing broader applications in personalized healthcare.

Low-Glycemic Load Diets and Thyroid Function: A Narrative Review and Future Perspectives.

Nutrition and calorie intake are associated with subtle changes of thyroid function tests in subjects with an intact Hypothalamic-Pituitary-Thyroid axis. Iodine deficiency and extreme fluctuations in calorie intake, such as those that occur during periods of starvation or overfeeding could lead to alterations in thyroid hormones. The dietary macronutrient and micronutrient composition could also influence the thyroid function. Recently, Low-Glycemic Load (LGL) diets have become very popular and are effective in the treatment and/or prevention of several medical conditions, including diabetes, obesity, cardiovascular disease, and epilepsy. In this review, we report on the available data from the literature regarding the association between LGL diets and thyroid function or dysfunction. Several studies conducted in this field to date have yielded inconsistent results.

Comparison of physical activity levels and dietary habits between women with polycystic ovarian syndrome and healthy controls of reproductive age: a case-control study

BackgroundPolycystic ovarian syndrome (PCOS) is a reproductive hormonal anomaly prevalent among women of reproductive age, with an alarmingly high prevalence of 52% among Pakistani women. This study aims to compare the daily physical activity and dietary habits of women with PCOS with age-matched healthy controls living in Lahore, Pakistan.MethodsA case–control study design was used to collect data from a private hospital situated in Lahore, Pakistan. Data was collected from 115 participants of reproductive age (18–45 years) using a researcher-administered questionnaire. Demographic variables, reproductive characteristics, anthropometric measurements, and seven days of physical activity levels using the international physical activity questionnaire (IPAQ-Short version) and seven days of dietary intake using the food frequency questionnaire (7 days-FFQ) were used to measure the dietary habits of the participants. Mosby’s Nutritac v4.0 software was used to estimate the macronutrients, vitamins, and minerals present in dietary intake. The glycaemic index and glycaemic load were calculated to compare the quality and quantity of carbohydrate consumption between the two groups.ResultsThe 49 PCOS cases, newly identified using the Rotterdam criteria, mean age 24.63 years (SD ± 4.76), and 66 healthy controls, mean age 23.24 years (SD ± 5.45), were compared. A significant difference (p ≤ 0.05) was found for reproductive characteristics, daily physical activity, and polyunsaturated fat and vitamin intake between the two groups. A binary logistic regression analysis showed that food with a low glycaemic index (GI ≤ 40) reduced the odds of PCOS occurrence by OR = 1.94. Similarly, food nutrients with a low glycaemic load (GL ≤ 10) can reduce PCOS occurrence by OR = 1.60.ConclusionThe daily physical activity levels and dietary habits of women of reproductive age can influence their reproductive characteristics and polycystic ovarian morphology. A diet with a low glycaemic load and index can produce beneficial reproductive health effects among women of reproductive age.

A REVIEW ON ROLE OF MILLETS IN PREVENTION AND MANAGEMENT OF DIABETES MELLITUS

Objectives: Diabetes mellitus (DM) disease incidence is growing with every passing day. It is a lifestyle-associated disease and may be prevented and managed with modifications in the food regimen together with prescribedmedications.In addition to staple foods such as wheat and rice that people have eaten for years, millet remains a nutritious and beneficial yet underutilized crop despite its various health benefits.. This review aims to give an overview of role of millets in prevention and management of diabetes mellitus. Materials and Methods: Ayurvedic Samhitas, Modern literature, Journals, Review articles, Pubmed, Google scholar. Result: The fiber content and high antioxidant content in millet gradually reduce blood glucose in diabetics. Most importantly, grains are the main source of complex carbohydrates, which make you feel full, leading to reduce blood sugar level. In addition, millets has a low glycemic load, this means they are absorbed intothe bloodstream with less insulin requirement. Conclusion: This systematic review and meta-analysis confirmed that the studied millets have great potential in dietary management and diabetes prevention. This also has nutritional implications and propagates the beneficial effects of millet on glycemic control.

In vitro digestion and fermentation characteristics of eight kinds of pulses and suggestions for different populations.

Pulse-based diets are attracting attention for their potential in combating diet-related non-communicable diseases. However, limited research studies have focused on the digestive and fermentative properties of pulses, which are crucial for exerting benefits. Here, we investigated the in vitro digestibility of starch/protein, along with the fermentation characteristics, of eight pulses and their pastes, including white kidney beans, adzuki beans, cowpeas, broad beans, mung beans, chickpeas, white lentils, and yellow peas. The findings indicated that pulse flours and pastes were low GL food (estimated GL < 10) and had a low degree of protein hydrolysis during simulated gastrointestinal digestion. During in vitro fermentation, pulses flours and pastes decreased the fermentation pH, increased the level of short-chain fatty acids (mainly consisting of valeric acid, followed by acetic acid, propionic acid, butyric acid, isobutyric acid, and isovaleric acid), and positively modulated the microbiota composition over time, specifically reducing the ratio of Firmicutes to Bacteroidetes. In addition, we found that boiling could affect the in vitro digestion and fermentation characteristics of pulses, possibly depending on their intrinsic nutrient characteristics. This research could provide a comprehensive summary of the nutrient content, digestibility, and fermentation of eight pulses and their pastes. Guided by factor analysis, for different individuals' consumption, pulses, cowpeas, broad beans, white lentils, and white kidney beans were preferred for diabetic individuals, yellow peas and white lentils were preferred for intestinal homeostasis disorders, and white lentils, broad beans, white kidney beans, and cowpeas were suitable for obese individuals, in which white lentils were considered healthier and suggested for healthy adults.

Investigation on the Mineral Configurations, Antioxidant Power, and Durability in Processed Tamarind (Tamarindus indica L.) Seed Powder

ABSTRACT: The pulp from the tamarind (Tamarindus indica L.) manufacturing sector disposes of the tamarind seed as waste materials. In the present investigation, processed Tamarindus indica L. seed powders' mineral compositions, antioxidant activities, and duration of shelf life have been investigated. Standard techniques were used to analyze the mineral compositions, antioxidant activity (Total Phenolic, Flavonoid content and 2,2-diphenyl-1-picrylhydrazyl) and shelf life (Total plate count (TPC), fungi, and mold) in processed tamarind powder at periodic intervals of 0, 2, 4, 6, and 8 months. The subsequent minerals were substantially more abundant in the roasted T.indica seed flour. The roasted T. India seed powder had high antioxidant powers of 19.83mg of TFC, 49.5mg of TPC, and 31 g/ml of 2,2-diphenyl-1-picrylhydrazyl (DPPH). The roasting method increases the best antioxidant potency and low glycemic index and glycemic load. The total plate counts of the processed T. India seed powder were within the legally permitted ranges of 107 cfu/g, and fungi and mold proliferation were at extremely low levels, so the powder could be used to make additional nutritional products. Roasted seed powder can be employed as a therapeutic food and as a food supplement because of its vital mineral elements and strong antioxidant potential.

The Health Effects of Low Glycemic Index and Low Glycemic Load Interventions on Prediabetes and Type 2 Diabetes Mellitus: A Literature Review of RCTs.

Diets with a low glycemic index (GI) and a low glycemic load (GL) can improve glycemic control, blood lipids, blood pressure and BMI in prediabetes and type 2 diabetes (T2DM), but evidence regarding other aspects of cardiometabolic health is limited. We searched the literature for RCTs published from 2013 to 2023 and reviewed the evidence on low-GI/GL diets and their effects on different aspects of health in prediabetes and T2DM, aiming to build a report on all relevant outcomes included in the studies. We included 14 RCTs with 1055 participants, who were mostly middle-aged individuals with T2DM. Interventions were mostly low GI and lasted 1-36 months. Low-GI/GL foods and diets showed benefits in terms of short-term glycemic control, weight and adiposity. Longer-term trials would be necessary to determine whether these benefits persist over time and/or lead to lower CVD risk and mortality. Effects on lipid profile were inconsistent. Some studies also reported positive effects of low-GI/GL interventions on blood pressure, inflammatory biomarkers, renal function and gut microbiota composition. Future trials should focus on some of these novel outcome measures, which may provide important insights into the metabolic effects of low-GI diets on individuals with diabetes.

Diet's Role in Modifying Risk of Alzheimer's Disease: History and Present Understanding.

Diet is an important nonpharmacological risk-modifying factor for Alzheimer's disease (AD). The approaches used here to assess diet's role in the risk of AD include multi-country ecological studies, prospective and cross-sectional observational studies, and laboratory studies. Ecological studies have identified fat, meat, and obesity from high-energy diets as important risk factors for AD and reported that AD rates peak about 15-20 years after national dietary changes. Observational studies have compared the Western dietary pattern with those of the Dietary Approaches to Stop Hypertension (DASH), Mediterranean (MedDi), and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets. Those studies identified AD risk factors including higher consumption of saturated and total fats, meat, and ultraprocessed foods and a lower risk of AD with higher consumption of fruits, legumes, nuts, omega-3 fatty acids, vegetables, and whole grains. Diet-induced factors associated with a significant risk of AD include inflammation, insulin resistance, oxidative stress, elevated homocysteine, dietary advanced glycation end products, and trimethylamine N-oxide. The molecular mechanisms by which dietary bioactive components and specific foods affect risk of AD are discussed. Given most countries' entrenched food supply systems, the upward trends of AD rates would be hard to reverse. However, for people willing and able, a low-animal product diet with plenty of anti-inflammatory, low-glycemic load foods may be helpful.

Valorization of Different Dairy By-Products to Produce a Functional Dairy–Millet Beverage Fermented with Lactobacillus paracasei as an Adjunct Culture

Fermented dairy products not only have a long shelf-life but also have beneficial nutritional values. The products are deficient in dietary fiber and certain bioactive compounds. Adding grains to dairy products is a widespread practice to improve the nutritional and economic aspects. In this work, we studied the effect of fermented millet–milk beverages (FMBs) using pearl millet grains and three different dairy by-products (sweet whey, sweet buttermilk, and skimmed milk). A control treatment prepared with water was also manufactured for comparison. Samples were continuously prepared and fermented using a commercial yogurt starter culture (YC-381) containing L. delbrueckii subsp. bulgaricus, Streptococcus thermophilus, and a pure strain of L. paracasei subsp. Paracasei. Four FMBs (water based: WB-FMB, whey based: WHB-FMB, buttermilk based: BMB-FMB, and skimmed milk based: SMB-FMB) were analyzed during cold storage at 4 °C for up to 15 days for chemical, microbiological properties, minerals content, antioxidant properties, glycemic index, and glycemic load on days 1, 8, and 15. The sensory characteristics of the FMBs were also evaluated during cold storage (4 °C/15 days). In general, the progression of acidity was slower in SMB-FMB and WHB-FMB samples during fermentation compared to in the BMB-FMB sample. The longest fermentation time was for the SMB-FBM sample (3 h), while the shortest was for the BMB-FMB sample (1.5 h). Reflecting the good manufacturing practices, all samples were free of coliform, mold, and yeast. No bacterial growth was detected in the WB-FMB sample at days 8 and 15 of storage, while the growth of Lactobacillus spp. and S. thermophilus was significantly higher (9.97 ± 0.01 and 9.48 ± 0.06, respectively) in the BMB-FMB sample compared to in the other three FMBs. The FMBs produced using dairy by-products had more antioxidant properties. All samples were better perceived during sensory evaluation by panelists than the water-based sample, except for the BMB-FMB sample, in which a bitter taste appeared. In the BMB-FMB sample, the proteolytic degree was significantly higher (4.8 ± 0.09) after 3 h of fermentation by about 460% than in the fresh sample. All samples had a low glycemic index and glycemic load. In addition, acidity progression was slower in SMB-FMB and WHB-FMB samples during fermentation and storage compared to the WB-FMB sample. Therefore, it could be recommended that it is more beneficial to prepare fermented millet–milk beverages using dairy by-products and suitable starter cultures under optimal fermentation conditions instead of using water to maximize the nutritional and economic aspects.