Postprandial Glycemic Response Research Articles

The Effect of the Oral Contraceptive Pill on Acute Glycaemic Response to an Oral Glucose Bolus in Healthy Young Women: A Randomised Crossover Study.

Background/Objective: The oral contraceptive pill (OCP) is widely used by women worldwide, yet the influence of the OCP on carbohydrate metabolism remains under-investigated, with existing studies being few and largely cross-sectional. The study objective was to assess, for the first time, the effect of the combined OCP on postprandial glycaemic response to an oral glucose bolus, using a randomised crossover design. Methods: The effect of a combined monophasic OCP phase on glucose homeostasis and metabolic profile was investigated in 21 healthy young women, who were regular users of either androgenic or anti-androgenic OCP formulations. Plasma glycaemic markers (glucose, insulin and C-peptide) were assessed prior to a 60 g glucose drink (fasting) and for a further 4 h postprandially; once during the "active" (hormone-containing) pill phase and once during the "inactive" (hormone-free) pill phase of the OCP usage cycle. Results: Despite no change in fasting values, in androgenic pill users, postprandial glucose and insulin responses to an oral glucose bolus were ~100% and ~50% greater, respectively, during the active versus inactive phase. In contrast, in anti-androgenic pill users there was no significant change in response between the two OCP usage cycle phases. Conclusions: These findings highlight an acute, but potentially detrimental, influence of the combined OCP on glucose homeostasis, particularly in users of formulations containing androgenic progestogens. Given the high global prevalence of OCP use and increasingly common prolonged active pill regimens, which may continue for months, years or even decades, potential cumulative effects of such changes on metabolic risk demand further investigation.

Establishing Protocols for Glycaemic Index Clinical Trials in an Academic Setting in Sri Lanka

The University of Peradeniya in Sri Lanka has initiated a Healthy Human Clinical Trial Unit (CTU) dedicated to post-prandial glycaemic response (PPGR) analysis. The present study, involving 42 participants aged 22-25 years, assessed the glycaemic index (GI) of four rice varieties: Super Kernel, Rathu Suduru, Ceylon Purple, and Red Fragrant. The results identified GI values ranging from 40 to 61, categorizing these varieties into low and medium GI groups, with Super Kernel and Rathu Suduru representing the lowest (40 ± 5.5) and the highest (61 ± 5.5) GI values, respectively. Glycaemic load (GL) values ranged from 8 to 12, falling into low and medium categories. This pioneering initiative validates the effectiveness of CTU in precise GI and GL evaluation for food labelling, which are essential for informing consumers about how different types of food impact the sugar levels in the bloodstream. Also, it is a precedent for future clinical nutrition research, emphasizing the need for consistent and harmonized methodologies in academic and regulatory contexts to support broader public health goals by providing accurate nutritional information to consumers. The processes and standards are detailed in a comprehensive guidebook (ISBN 978-624-94637-0-7), supporting the continuation and expansion of further PPGR studies.

Anekomochi glutinous rice provides low postprandial glycemic response by enhanced insulin action via GLP-1 release and vagal afferents activation

Glutinous rice (mochi rice), compared to non-glutinous rice (uruchi rice), exhibits a wide range of glycemic index (GI) values, from low to high. However, the underlying mechanisms behind the variation in GI values remain poorly understood. In this study, we aimed to identify rice cultivars with a low postprandial glycemic response and investigate the mechanisms, focusing on insulin and incretin hormones. We examined seven glutinous rice cultivars and three non-glutinous rice cultivars. We discovered that Anekomochi, a glutinous rice cultivar, has the lowest postprandial glycemic response. Anekomochi significantly enhanced glucagon-like peptide-1 (GLP-1) secretion while suppressing insulin secretion. These effects were completely blunted by inhibiting GLP-1 receptor signaling and denervating the common hepatic branch of vagal afferent nerves that are crucial for sensing intestinal GLP-1. Our findings demonstrate that Anekomochi markedly enhances insulin action via GLP-1 release and vagal afferent neural pathways, thereby leading to a lower postprandial glycemic response.

Effects of night-to-night variations in objectively measured sleep on blood glucose in healthy university students.

We examined associations between daily variations in objectively measured sleep and blood glucose in a sample of non-diabetic young adults to complement laboratory studies on how sleep affects blood glucose levels. 119 university students underwent sleep measurement using an Oura Ring 2 and continuous glucose monitoring (CGM) for up to 14 days. In 69 individuals who consumed a standardised diet across the study, multilevel models examined associations between sleep duration, timing and efficiency and daily CGM profiles. Separately, in 58 individuals, multilevel models were used to evaluate postprandial glycaemic responses to a test meal challenge on 7 days. Participants also underwent oral glucose tolerance testing once after a night of ad libitum sleep, and again following a night of sleep restriction by 1-2 hours relative to that individual's habitual sleep duration. Between-condition glucose and insulin excursions, HOMA-IR and Matsuda index were compared. Nocturnal sleep did not significantly influence following-day CGM profiles, postprandial glucose, or nocturnal mean glucose levels (all Ps>0.05). Longer sleep durations were associated with lower same-night glucose variability (all Ps<0.001). However, the range of variation of sugar levels was small and unlikely to be of functional significance. Considering naps in the analysis did not alter the findings. Sleep restriction by an average of 1.73 hours (SD=0.97) did not significantly impact excursions in glucose or insulin or insulin sensitivity the following morning (all Ps>0.05). Glucose handling in young, healthy adults may be more resilient to real-life fluctuations in sleep patterns than previously thought.

The effect of post-oral bitter compound interventions on the postprandial glycemia response: A systematic review and meta-analysis of randomised controlled trials

Background & AimsThe post-oral sensing of bitter compounds by a family of bitter taste receptors (TAS2Rs) is suggested to regulate postprandial glycemia in humans. However, reports are inconsistent. This systematic review used meta-analysis to synthesise the impact of bitter compound interventions on the postprandial glycaemic response in humans. MethodsElectronic databases (Medline, PubMed, and Web of Science) were systematically searched from inception to April 2024 to identify randomised controlled trials reporting the effect of interventions utilising post-oral bitter compounds vs. placebo on postprandial plasma glucose levels at t=2h (2h-PPG), and area under the curve (AUC) of glucose, insulin, and c-peptide. The random-effect and subgroup analysis were performed to calculate pooled weighted mean differences (WMD), overall and by predefined criteria. ResultsForty-six studies (within 34 articles) were identified; 29 and 17 studies described chronic and acute interventions, respectively. The chronic interventions reduced 2h-PPG (n= 21, WMD= -0.35 mmol/L, 95%CIs= -0.58, -0.11) but not AUC for glucose or insulin. Subgroup analysis showed the former was particularly evident in individuals with impaired glycemia, interventions longer than three months, or quinine family administration. The acute interventions did not improve the postprandial glycemia response, but subgroup analysis revealed a decrease in AUC-glucose after quinine family administration (n=4 WMD= -90.40 (nmol × time/L), 95%CIs= -132.70, -48.10). ConclusionChronic bitter compound interventions, particularly those from the quinine family, may have therapeutic potential in those with glycemia dysregulation. Acute intervention of the quinine family may also improve postprandial glucose. Given the very low quality of the evidence, further investigations with more rigorous methods are still required.

The effect of sprouted wheat wholemeal inclusion in bread recipes on postprandial blood glucose and satiety responses in healthy adults: a randomized trial

Sprouted wheat wholemeal was reported to enhance the nutritional and sensory properties of cereal products, but few human studies exist. The effect of blending 50 % sprouted wheat wholemeal in a bread recipe on the postprandial glycemic and satiety responses, and sensory-related sensations was investigated in this randomized crossover human study with 12 healthy participants. Capillary blood samples were collected and glycemic response was determined at 0, 15, 30, 45, 60, 90, 120 min. Satiety visual analogue scales were given every 30 min. While substituting bread wheat flour with sprouted wheat wholemeal significantly increased the α-amylase activity in the dough (p < 0.05), it did not alter in vitro digestibility or postprandial glycemic and satiety responses (p > 0.05). Likewise, participant overall acceptability was not adversely affected. Sprouted wheat wholemeal can be used as a functional ingredient in breadmaking, although it did not, in this study, significantly affect digestibility parameters.

Postprandial glycemic response to isocaloric protein load in men with different types of fat distribution

Aim of the study was to quantify postprandial glucose levels in response to isocaloric protein load at main meals in men with different types of fat distribution. Material and methods. The study enrolled men aged 25 to 65 years. Group 1 (n = 17) consisted of obese men with subcutaneous fat distribution (SFD) type while group 2 (n = 16) was represented by obese men with abdominal type of fat distribution (AFD). Group 3 (comparators) consisted of 10 men with normal body weight (NBW). Glycemic response to standard isocaloric protein load was assessed by the results of glucose levels within 3 hours starting 5 minutes after end of food consumption on different days and mealtime. Standard protein lunch was introduced during the second day while standard protein dinner and breakfast were performed at the third and fourth days respectively. Results. It was found that protein intake leads to neither pronounced postprandial glycemic fluctuations nor decrease in glucose levels by the end of the 3rd hour of the test. Accordingly, it also doesn’t provoke hunger, unlike carbohydrate intake does. In men with NBW a more pronounced increase in glucose level after protein meal was found, both relative to the baseline levels and comparing with men from SFD and AFD groups. In NBW group at lunchtime and especially in the evening a double-humped glycemic curve was noted. Glycemic variability in men with different types of fat distribution was characterized by the fact that glycemic increment was more pronounced in men with AFD than in men with SFD whose glycemic curve was almost flat after all meals. Conclusions. Protein intake in men with NBW and different types of fat distribution does not lead to significant changes in postprandial glucose levels. Glycemic fluctuations don’t exceed 1 mmol/L within a 3-hour period after consuming of isocaloric breakfast, lunch or dinner. Protein intake results in greater postprandial glucose levels in men with AFD than in SFD men.

Understanding the multiscale structure and in vitro digestibility changes of corn starch-ferulic acid complexes induced by high hydrostatic pressure

High hydrostatic pressure (HHP) was used to synthesize corn starch (CS) and ferulic acid (FA) complex (CS-FA). Its effects on the structure of the complex at multiple scales and its digestibility were examined. The results demonstrated that HHP significantly influenced the digestibility of the CS-FA complex, decreasing the content of rapidly digestible starch (RDS) while increasing slowly digestible starch (SDS) and resistant starch (RS). Notably, the combined SDS and RS content in the HHP-treated CS-FA complex with 2.0 % FA addition (38.13 %) was significantly higher (p < 0.05) than those in the CS-FA complex without HHP treatment (29.21 %) and pure CS (21.72 %). The results indicated that HHP treatment reduced the enthalpy change (ΔH), number of short-range order structures, and relative crystallinity (RC) while increasing the average particle size of these CS-FA complexes. This treatment also increased the proportion of amorphous starch regions and the degree of agglomeration between the starch and FA. HHP treatment-induced CS-FA complexes exhibited a denser fractal structure and higher short-range order, affecting the interaction sites between the starch and digestive enzymes. These findings suggest the potential application of HHP treatment and FA in modulating the postprandial glycemic response to starchy food.

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&lt;0.001) and incremental peak blood glucose (p&lt;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 influence mechanism of pH and polyphenol structures on the formation, structure, and digestibility of pea starch-polyphenol complexes via high-pressure homogenization

The formation of starch-polyphenol complexes through high-pressure homogenization (HPH) is a promising method to reduce starch digestibility and control postprandial glycemic responses. This study investigated the combined effect of pH (5, 7, 9) and polyphenol structures (gallic acid, ferulic acid, quercetin, and tannic acid) on the formation, muti-scale structure, physicochemical properties, and digestibility of pea starch (PS)-polyphenol complexes prepared by HPH. Results revealed that reducing pH from 9 to 5 significantly strengthened the non-covalent binding between polyphenols and PS, achieving a maximum complex index of 13.89 %. This led to the formation of complexes with higher crystallinity and denser structures, promoting a robust network post-gelatinization with superior viscoelastic and thermal properties. These complexes showed increased resistance to enzymatic digestion, with the content of resistant starch increasing from 28.66 % to 42.00 %, rapidly digestible starch decreasing from 42.82 % to 21.88 %, and slowly digestible starch reducing from 71.34 % to 58.00 %. Gallic acid formed the strongest hydrogen bonds with PS, especially at pH 5, leading to the highest enzymatic resistance in PS-gallic acid complexes, with the content of resistant starch of 42.00 %, rapidly digestible starch of 23.35 % and slowly digestible starch of 58.00 %, and starch digestion rates at two digestive stages of 1.82 × 10–2 min−1 and 0.34 × 10–2 min−1. These insights advance our understanding of starch-polyphenol interactions and support the development of functional food products to improve metabolic health by mitigating rapid glucose release.

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).

Diabetes Telemedicine Mediterranean Diet (DiaTeleMed) Study: study protocol for a fully remote randomized clinical trial evaluating personalized dietary management in individuals with type 2 diabetes

BackgroundThe Diabetes Telemedicine Mediterranean Diet (DiaTeleMed) Study is a fully remote randomized clinical trial evaluating personalized dietary management in individuals with type 2 diabetes (T2D). The study aims to test the efficacy of a personalized behavioral approach for dietary management of moderately controlled T2D, versus a standardized behavioral intervention that uses one-size-fits-all dietary recommendations, versus a usual care control (UCC). The primary outcome will compare the impact of each intervention on the mean amplitude of glycemic excursions (MAGE).MethodsEligible participants are between 21 and 80 years of age diagnosed with moderately controlled T2D (HbA1c: 6.0 to 8.0%) and managed on lifestyle alone or lifestyle plus metformin. Participants must be willing and able to attend virtual counseling sessions and log meals into a dietary tracking smartphone application (DayTwo), and wear a continuous glucose monitor (CGM) for up to 12 days. Participants are randomized with equal allocation (n = 255, n = 85 per arm) to one of three arms: (1) Personalized, (2) Standardized, or (3) UCC. Measurements occur at 0 (baseline), 3, and 6 months. All participants receive isocaloric energy and macronutrient targets to meet Mediterranean diet guidelines, in addition to 14 intervention contacts over 6 months (4 weekly then 10 biweekly) to cover diabetes self-management education. The first 4 UCC intervention contacts are delivered via synchronous videoconferences followed by educational video links. Participants in Standardized receive the same educational content as those in the UCC arm, following the same schedule. However, all intervention contacts are conducted via synchronous videoconferences, paired with Social Cognitive Theory (SCT)-based behavioral counseling, plus dietary self-monitoring of planned meals using a mobile app that provides real-time feedback on calories and macronutrients. Participants in the Personalized arm receive all elements of the Standardized intervention, in addition to real-time feedback on predicted post-prandial glycemic response (PPGR) to meals and snacks logged into the mobile app.DiscussionThe DiaTeleMed Study aims to address an important gap in the current landscape of precision nutrition by determining the contributions of behavioral counseling and personalized nutrition recommendations on glycemic control in individuals with T2D. The fully remote methodology of the study allows for scalability and innovative delivery of personalized dietary recommendations at a population level.Trial registrationClinicalTrials.gov NCT05046886. Registered on September 16, 2021.

Precision Nutrition for Management of Cardiovascular Disease Risk during Menopause.

Women can spend up to 40% of their lives in the postmenopausal state. As women begin to transition into menopause, known as perimenopause, changes in hormonal concentrations and body composition dramatically increase overall cardiometabolic risk. Dietary patterns and interventions can be utilized to prevent and treat cardiovascular disease (CVD) and some dietary patterns over others may be more beneficial due to their specific effects on the health aspects of menopause. In this narrative review, we summarize key cardiovascular alterations that occur during the menopause transition and explore current dietary recommendations to address CVD risk as well as explore the new frontier of precision nutrition and the implications for nutrition prescription during menopause. Popular dietary interventions for CVD such as the Dietary Approaches to Stop Hypertension (DASH) diet and the Mediterranean diet (MED) have limited data in women following menopause. However, both diets improve CVD risk biomarkers of total cholesterol and low-density lipoprotein cholesterol as well as lower oxidative stress and inflammation and improve endothelial function. As the menopause transition increases the risk for developing metabolic syndrome, insulin insensitivity, and dyslipidemia, the DASH diet and MED may be impactful dietary strategies for mediating CVD risk in menopausal women. However, these are "one-size-fits-all" approaches that neglect individual characteristics such as genetic predisposition and environmental factors. Precision nutrition considers individual factors for nutrition prescription, spanning from evaluating food intake preferences and behaviors to deep phenotyping. Data from a large-scale investigation of the menopause transition suggests nutritional strategies that address postprandial glycemic responses, and the gut microbiome may attenuate some of the unfavorable effects of menopause on CVD risk factors. Considering menopause, women are a clinical population that would greatly benefit from precision nutrition. Future research should explore the use of machine learning and artificial intelligence in a precision nutrition framework to modify the DASH diet and MED to address adverse effects that occur during the menopause transition are vital for supporting women's health as they age.

A novel konjac rice formula with glucomannan and tapioca starch improve postprandial glycemic response – a randomized single-blind clinical trial

PurposeDue to white rice’s association with diabetes and other chronic diseases in many Asian countries, many industries are working to develop high-fiber rice substitutes with similar organoleptic characteristics. Konjac rice (KR) is a promising option, but maintaining its optimal fiber content for health benefits while preserving its ideal sensory profile remains a challenge. This study aims to investigate whether a KR formula, combining tapioca flour and glucomannan gel, possesses similar organoleptic attributes to white rice while preventing glycemic response elevation.Design/methodology/approachIn a six-week randomized single-blind clinical trial, 13 normoweight nondiabetic subjects received varying konjac-based rice and white rice ratios. Blood glucose levels were measured at intervals, and glycemic response was assessed using incremental area under the curve (iAUC). Visual analog scale gauged satiety, and organoleptic properties were evaluated.FindingsSubstituting white rice with pure and partial konjac-based rice significantly lowered postprandial blood sugar levels and glycemic response (p = 0.002). iAUC for pure KR and KR 1:1 was notably lower than white rice (p = 0.002). Subjects reported a sense of fullness comparable to white rice, with no significant organoleptic score differences (p = 0.260).Research limitations/implicationsThe study’s generalizability is compromised due to the limited number of participants, impacting external validity. The examined parameters offer a rough understanding of konjac grain’s impact on postprandial glycemic responses but do not elucidate underlying mechanisms or the duration of its inhibitory effect on glucose absorption. Long-term effects on metabolic, hormonal parameters and the colon’s microbial flora composition and function remain unexplored, constraining comprehensive insights into konjac grain’s extended implications.Practical implicationsThis study introduces a novel KR formula to address the escalating diabetes risks associated with white rice consumption. Substituting white rice with KR significantly reduces postprandial blood sugar levels, highlighting its potential in preventing type 2 diabetes (T2D). Tapioca flour enhances palatability, making KR a viable option. While promising, long-term effectiveness and safety require further research, emphasizing comprehensive lifestyle interventions. The study contributes valuable insights to innovative dietary strategies for prevalent health conditions, emphasizing the need for ongoing efforts in public health.Social implicationsWhite rice, a staple in Asian societies, is linked to a heightened risk of T2D due to increased production and inadequate dietary fiber. This connection contributes to the economic burden on governments through health insurance and lost productivity. Encouraging alternatives rich in fiber can mitigate this burden, offering a socioeconomically beneficial solution to preventable chronic diseases.Originality/valueThis trial demonstrates konjac-based rice’s potential in curbing glycemic responses, hinting at its role in preventing T2D. Glucomannan’s viscosity, satiety induction and potential gut health impact are highlighted. Further research is warranted for long-term effectiveness and safety. These findings contribute to the growing evidence supporting glucomannan as a valuable tool in addressing prevalent health conditions.

In Vivo Glycemic Response of Fruit-Based Mango (Mangifera indica) and Pineapple (Ananas comosus) Bars in In Vitro and In Silico Enzyme Inhibitory Effects Studies.

The habitual consumption of snacks has the potential to enrich or harm the diet. They can contribute to excessive caloric intake and hyperglycemia. Thus, there is an increasing interest in snacks with health-promoting properties. This study aimed to demonstrate the beneficial effect of two fruit-based bars on glucose levels through in vitro, in vivo, and in silico assays. Mango (Mangifera indica L.) and pineapple (Ananas comosus L.) bars (MB and PB) were prepared, and chemical composition, postprandial glycemic response, glycemic index (GI), and glycemic load (GL) were evaluated. The inhibitory effect of fruit bar extracts on α-amylase and α-glucosidase activity and their respective molecular docking was assessed. MB and PB showed the lowest postprandial glycemic response vs. the control bar (p < 0.005), a lower GI (CB: 64.20, PB: 53.20, MB: 40.40), and a GL of 10.9 (CB), 7.9 (PB), and 6.1 (MB), (p < 0.05). MB and PB showed the highest inhibition % of α-amylase (61.44 and 59.37%, respectively) and α-glucosidase (64.97 and 64.57%). Naringenin (-1692.5985 and -2757.674 kcal/mol) and ferulic acid (-1692.8904 and -2760.3513 kcal/mol) exhibited more favorable interaction energies against α-amylase and α-glucosidase activity. The presence of polyphenols from the fruit influenced enzymatic inhibition. Likewise, the dietary fiber in the bars evaluated allowed us to observe a positive effect that favors glycemic control, making them a healthy alternative for snacking.

Reformulating ice cream to improve postprandial glucose response: an opportunity for industry to create shared value.

Ultra-processed foods are associated with metabolic dysfunction and driving chronic diseases. The Metabolic Matrix is a tool used to reformulate products to promote positive metabolic outcomes. The Kuwait Danish Dairy Company (KDD) has used this tool to develop a no-added-sugar products. This clinical trial tested the glycaemic response of a no-added-sugar ice cream in individuals with type 2 diabetes. The hypothesis was that the no-added-sugar ice cream would have a substantially better postprandial glycemic response than conventional ice cream in patients with type 2 diabetes. In this randomized cross over designed study, postprandial glycemic response was measured after 300 grams of no-added-sugar ice cream or normal ice cream was consumed. Despite similar composition and palatability, the postprandial responses were better with the no-added sugar ice cream, albeit that the natural sugar in the product still resulted in a marked postprandial glycaemic response. This finding emphasizes the necessity of clearly communicating to both patients and healthcare professionals that "no-added-sugar" does not equate to "zero total sugar." The path to improved metabolic health involves not only product improvement but also transparent messaging to enable informed dietary choices. Reformulation resulting in palatable no-added sugar products provides an opportunity for companies to Create Shared Value by addressing the important social problems such as obesity and type 2 diabetes, by creating scalable solutions, that are profitable. Clinical trial registration:ClinicalTrials.gov, identifiers NCT06135935.

Highly Soluble β-Glucan Fiber Modulates Mechanisms of Blood Glucose Regulation and Intestinal Permeability.

β-glucans found in cereal grains have been previously demonstrated to improve blood glucose control; however, current understanding points to their high viscosity as the primary mechanism of action. In this work, we present a novel, highly soluble, low-viscosity β-glucan fiber (HS-BG fiber) and a preclinical dataset that demonstrates its impact on two mechanisms related to the prevention of hyperglycemia. Our results show that HS-BG inhibits the activity of two key proteins involved in glucose metabolism, the α-glucosidase enzyme and the SGLT1 transporter, thereby having the potential to slow starch digestion and subsequent glucose uptake. Furthermore, we demonstrate in a multi-donor fecal fermentation model that HS-BG is metabolized by several different members of the gut microbiome, producing high amounts of short-chain fatty acids (SCFAs), known agonists of GPR43 receptors in the gut related to GLP-1 secretion. The production of SCFAs was verified in the translational gut model, SHIME®. Moreover, HS-BG fiber fermentation produces compounds that restored permeability in disrupted epithelial cells, decreased inflammatory chemokines (CXCL10, MCP-1, and IL-8), and increased anti-inflammatory marker (IL-10), which could improve insulin resistance. Together, these data suggest that the novel HS-BG fiber is a promising new functional ingredient that can be used to modulate postprandial glycemic responses while the high solubility and low viscosity enable easy formulation in both beverage and solid food matrices.

Prediction of personalised postprandial glycaemic response in type 1 diabetes mellitus.

Patients with type 1 diabetes (T1D) face unique challenges in glycaemic control due to the complexity and uniqueness of the dietary structure in China, especially in terms of postprandial glycaemic response (PPGR). This study aimed to establish a personalized model for predicting PPGR in patients with T1D. Data provided by the First People's Hospital of Yunnan Province, 13 patients with T1D, were recruited and provided with an intervention for at least two weeks. All patients were asked to wear a continuous glucose monitoring (CGM) device under free-living conditions during the study period. To tackle the challenge of incomplete data from wearable devices for CGM measurements, the GAIN method was used in this paper to achieve a more rational interpolation process. In this study, patients' PPGRs were calculated, and a LightGBM prediction model was constructed based on a Bayesian hyperparameter optimisation algorithm and a random search algorithm, which integrated glucose measurement, insulin dose, dietary nutrient content, blood measurement and anthropometry as inputs. The experimental outcomes revealed that the PPGR prediction model presented in this paper demonstrated superior accuracy (R=0.63) compared to both the carbohydrate content only model (R=0.14) and the baseline model emulating the standard of care for insulin administration (R=0.43). In addition, the interpretation of the model using the SHAP method showed that blood glucose levels at meals and blood glucose trends 30 minutes before meals were the most important features of the model. The proposed model offers a heightened precision in predicting PPGR in patients with T1D, so it can better guide the diet plan and insulin intake dose of patients with T1D.

Glucose Assist TM, a Novel Combination of Slow Digestible Carbohydrates and Plant Proteins, Improved Postprandial Glycemic Response in Healthy Adults

Glucose Assist TM, a Novel Combination of Slow Digestible Carbohydrates and Plant Proteins, Improved Postprandial Glycemic Response in Healthy Adults

Diabetes Telemedicine Mediterranean Diet (DiaTeleMed) Study: study protocol for a fully remote randomized clinical trial evaluating personalized dietary management in individuals with type 2 diabetes.

The Diabetes Telemedicine Mediterranean Diet (DiaTeleMed) Study is a fully remote randomized clinical trial evaluating personalized dietary management in individuals with type 2 diabetes (T2D). The study aims to test the efficacy of a personalized behavioral approach for dietary management of moderately-controlled T2D, versus a standardized behavioral intervention that uses one-size-fits-all dietary recommendations, versus a usual care control (UCC). The primary outcome will compare the impact of each intervention on the mean amplitude of glycemic excursions (MAGE). Eligible participants are between 21 to 80 years of age diagnosed with moderately-controlled T2D (HbA1c: 6.0-8.0%), and managed on lifestyle alone or lifestyle plus metformin. Participants must be willing and able to attend virtual counseling sessions and log meals into a dietary tracking smartphone application (DayTwo), and wear a continuous glucose monitor (CGM) for up to 12 days. Participants are randomized with equal allocation (n = 255, n = 85 per arm) to one of three arms: 1) Personalized, 2) Standardized, or 3) UCC. Measurements occur at 0 (baseline), 3, and 6 months. All participants receive isocaloric energy and macronutrients targets to meet Mediterranean diet guidelines plus 14 intervention contacts over 6 months (4 weekly then 10 biweekly) to cover diabetes self-management education. The first 4 UCC intervention contacts are delivered via synchronous videoconferences followed by educational video links. Participants in Standardized receive the same education content as UCC on the same schedule. However, all intervention contacts are conducted via synchronous videoconferences, paired with Social Cognitive Theory (SCT)-based behavioral counseling, plus dietary self-monitoring of planned meals using a mobile app that provides real-time feedback on calories and macronutrients. Participants in the Personalized arm receive all elements of the Standardized intervention, plus real-time feedback on predicted post-prandial glycemic response (PPGR) to meals and snacks logged into the mobile app. The DiaTeleMed study will address an important gap in the current landscape of precision nutrition by determining the contributions of behavioral counseling and personalized nutrition recommendations on glycemic control in individuals with T2D. The fully remote methodology of the study allows for scalability and innovative delivery of personalized dietary recommendations at a population level. The DiaTeleMed Study is registered with ClinicalTrials.gov (Identifier: NCT05046886).