Postprandial Glucose Responses Research Articles

GK-rats respond to gastric bypass surgery with improved glycemia despite unaffected insulin secretion and beta cell mass

Roux-en-Y gastric bypass (RYGB) is the most effective treatment for morbid obesity and results in rapid remission of type 2 diabetes (T2D), before significant weight loss occurs. The underlying mechanisms for T2D remission are not fully understood. To gain insight into these mechanisms we used RYGB-operated diabetic GK-rats and Wistar control rats. Twelve adult male Wistar- and twelve adult male GK-rats were subjected to RYGB- or sham-operation. Oral glucose tolerance tests (OGTT) were performed six weeks after surgery. RYGB normalized fasting glucose levels in GK-rats, without affecting fasting insulin levels. In both rat strains, RYGB caused increased postprandial responses in glucose, GLP-1, and GIP. RYGB caused elevated postprandial insulin secretion in Wistar-rats, but had no effect on insulin secretion in GK-rats. In agreement with this, RYGB improved HOMA-IR in GK-rats, but had no effect on HOMA-β. RYGB-operated GK-rats had an increased number of GIP receptor and GLP-1 receptor immunoreactive islet cells, but RYGB had no major effect on beta or alpha cell mass. Furthermore, in RYGB-operated GK-rats, increased Slc5a1, Pck2 and Pfkfb1 and reduced Fasn hepatic mRNA expression was observed. In summary, our data shows that RYGB induces T2D remission and enhanced postprandial incretin hormone secretion in GK-rats, without affecting insulin secretion or beta cell mass. Thus our data question the dogmatic view of how T2D remission is achieved and instead point at improved insulin sensitivity as the main mechanism of remission.

Evaluation of phenotypic characteristics predeterming different types of postprandial glucose response: an intervention study in overweight adults

Rationale: Time course of postprandial blood glucose concentrations (monophasic, MP vs. biphasic, BP) is used for long-term assessment of metabolic risks in overweight and obese subjects. Knowledge about phenotypic characteristics predeterming the type of postprandial glucose response would enable an early identification of subjects at risk.

Diet-induced obesity enhances postprandial glucagon-like peptide-1 secretion in Wistar rats, but not in diabetic Goto-Kakizaki rats.

Glucagon-like peptide-1 (GLP-1) is postprandially secreted from enteroendocrine L-cells and enhances insulin secretion. Currently, it is still controversial whether postprandial GLP-1 responses are altered in obesity and diabetes. To address the issue and to find out possible factors related, we compared postprandial GLP-1 responses in normal rats and in diabetic rats chronically fed an obesogenic diet. Male Wistar rats and diabetic Goto-Kakizaki (GK) rats were fed either a control diet or a high-fat/high-sucrose (HFS, 30 % fat and 40 % sucrose) diet for 26 weeks. Meal tolerance tests were performed for monitoring postprandial responses after a liquid diet administration (62·76 kJ/kg body weight) every 4 or 8 weeks. Postprandial glucose, GLP-1 and insulin responses in Wistar rats fed the HFS diet (WH) were higher than Wistar rats fed the control diet (WC). Although GK rats fed the HFS diet (GH) had higher glycaemic responses than GK rats fed the control diet (GC), these groups had similar postprandial GLP-1 and insulin responses throughout the study. Jejunal and ileal GLP-1 contents were increased by the HFS diet only in Wistar rats. Furthermore, mRNA expression levels of fatty acid receptors (Ffar1) in the jejunum were mildly (P = 0·053) increased by the HFS diet in Wistar rats, but not in GK rats. These results demonstrate that postprandial GLP-1 responses are enhanced under an obesogenic status in normal rats, but not in diabetic rats. Failure of adaptive enhancement of GLP-1 response in GK rats could be partly responsible for the development of glucose intolerance.

Exercise-Induced Improvements in Postprandial Glucose Response Are Blunted by Pre-Exercise Hyperglycemia: A Randomized Crossover Trial in Healthy Individuals.

BackgroundExercise improves glycemic control but the magnitude, and in some cases, the direction of this effect is variable. Ambient hyperglycemia has been implicated in this exercise response heterogeneity. The current study investigated whether pre-exercise hyperglycemia directly impacts the effect of exercise on glycemic control.MethodsTwelve healthy normal glucose-tolerant males completed four trials in a randomized, crossover design. Each trial consisted of 24-h pre-intervention monitoring, a 7-h intervention, and 24-h post-intervention monitoring. Glycemic control was measured throughout the study by continuous glucose monitoring. The four interventions were no exercise (CON) or 45 min of cycling exercise (70%HRmax) preceded by 3.5 h of either normoglycemia (NG-Ex), steady-state hyperglycemia induced by constant glucose infusion (HG-Ex) or fluctuating glycemia induced by repeated glucose bolus infusions (FG-Ex).ResultsPhysical activity and diet were similar between trials, and energy expenditure during exercise was matched between exercise trials (all P > 0.05). Mean glucose during the 3.5 h ± infusion period was higher in HG-Ex (mean ± SEM; 7.2 ± 0.4 mmol/L) and FG-Ex (7.3 ± 0.3 mmol/L) compared to CON (4.8 ± 0.2 mmol/L) and NG-Ex (5.0 ± 0.2 mmol/L) trials (P < 0.01). Glycemic variability was greatest in FG-Ex (P < 0.01). Following the interventions, the postprandial glucose response (iAUC) was reduced by exercise in NG-Ex compared to CON (321.1 ± 38.6 vs. 445.5 ± 49.7 mmol/L.8h, P < 0.05, d=0.81). This benefit was blunted when exercise was preceded by steady-state (HG-Ex, 425.3 ± 45.7 mmol/L.8h) and fluctuating (FG-Ex, 465.5 ± 39.3 mmol/L.8h) hyperglycemia (both P > 0.05 vs. CON).ConclusionPre-exercise hyperglycemia blunted the glucoregulatory benefits of acute exercise upon postprandial glucose response, suggesting that exposure to hyperglycemia contributes to exercise response heterogeneity.Clinical Trial RegistrationClinicalTrials.gov, identifier NCT03284216.

Changes in the glucose and insulin responses according to high-protein snacks for diabetic patients.

BACKGROUND/OBJECTIVESThis study aimed to develop healthy, appetizing high-protein snacks with enhanced isolated soy protein for diabetic patients and determine the blood glucose and insulin response after being consumed by these patients.MATERIALS/METHODSThirty adult patients aged between 30 and 75 years, with a ≤ 10-year history of type 2 diabetes and hemoglobin A1c of < 7.5%, were enrolled in this study. They made 3 clinical visits at one-week intervals. The control group consumed 50 g carbohydrates (white bread), whereas the test groups consumed high-protein grain (HP_G) or high-protein chocolate (HP_C) after an 8-hrs fast. Blood (2 cm3) was drawn at 15, 30, 45, 60, 90, and 120 min before and after consumption to analyze the blood glucose and insulin concentrations.RESULTSCompared to the commercial snacks, the developed high-protein snacks had below-average calorie, carbohydrate, and fat content and a 2.5-fold higher protein content. In diabetic patients who consumed these snacks, the postprandial blood glucose increased between 15 min and 2 h after consumption, which was significantly slower than the time taken for the blood glucose to increase in the patients who consumed the control food product (P < 0.001). Insulin secretion was significantly lower at 45 min after consumption (P < 0.05), showing that the high-protein snacks did not increase the blood glucose levels rapidly. The incremental area under the curve (iAUC), which indicated the degree of blood sugar and insulin elevation after food intake, was higher in the control group than the groups given the 2 developed snacks (P < 0.001), and there was no significant difference in insulin secretion.CONCLUSIONSThe results of the postprandial blood glucose and insulin response suggest that high-protein snacks are potential convenient sources of high-quality protein and serve as a healthier alternative for patients with type 2 diabetes, who may have limited snack product choices. Such snacks may also provide balanced nutrition to pre-diabetic and obese individuals.

Lower nocturnal blood glucose response to a potato-based mixed evening meal compared to rice in individuals with type 2 diabetes

Guidelines for reducing postprandial blood glucose concentrations include avoiding high glycemic index (GI) foods, such as white potatoes. However, GI testing is often undertaken in the morning with foods consumed in isolation by non-clinical cohorts. We investigated the impact of potato preparation and consumption as part of a mixed-evening meal on postprandial and nocturnal glycemic responses, and postprandial insulin response, in individuals with Type 2 Diabetes Mellitus (T2DM). In a randomized, cross-over design, 24 males and females (age 58.3±9.3y; BMI: 31.7±6.8kg/m2) with T2DM (diet or metformin controlled) completed four experimental trials after consuming a standardized breakfast (25% daily energy intake (EI)) and lunch (35% EI). Dinner (40% EI) was consumed at 1800h being either: 1) boiled potato (BOIL); 2) roasted potato (ROAST); 3) boiled potato cooled for 24h (COOLED); or 4) basmati rice (CONTROL). Each meal contained 50% carbohydrate, 30% fat and 20% protein. Blood samples were collected prior to, immediately post meal and at 30-min intervals for a further 120min. A continuous glucose monitor was worn to assess nocturnal interstitial glucose concentrations. No differences were detected in postprandial venous glucose area under the curve (iAUC) between CONTROL and all three potato conditions. Postprandial insulin iAUC was greater following COOLED compared to CONTROL (P=0.003; 95% CI: 18.9-111.72 miU/mL). No significant differences between CONTROL and BOIL or ROAST were detected for postprandial insulin concentrations. All potato meals resulted in lower nocturnal glucose AUC than CONTROL (P<0.001; 95% CI 4.15-15.67mmol/L x h). Compared to an isoenergetic rice meal, boiled, roasted or boiled then cooled potato-based meals were not associated with unfavourable postprandial glucose responses or nocturnal glycemic control, and can be considered suitable for individuals with T2DM when consumed as part of a mixed-evening meal. Australian New Zealand Clinical Trials Registry https://www.anzctr.org.au/, ACTRN 12618000480280.

Acute glycemic and insulinemic effects of low-energy sweeteners: a systematic review and meta-analysis of randomized controlled trials

It has been suggested that low-energy sweeteners (LES) may be associated with an increased risk of metabolic diseases, possibly due to stimulation of glucose-responsive mechanisms. We conducted a systematic review and meta-analysis of human intervention studies examining the acute effect of LES intake on postprandial glucose (PPG) and postprandial insulin (PPI) responses, in order to comprehensively and objectively quantify these relations. We systematically searched the Medline, OVID FSTA, and SCOPUS databases until January 2020. Randomized controlled trials comparing acute postprandial effects on PPG and/or PPI after exposure to LES, either alone, with a meal, or with other nutrient-containing preloads to the same intervention without LES were eligible for inclusion. PPG and PPI responses were calculated as mean incremental area under the curve divided by time. Meta-analyses were performed using random effects models with inverse variance weighing. Twenty-six papers (34 PPG trials and 29 PPI trials) were included. There were no reports of statistically significant differences in the effects of LES on PPG and PPI responses compared with control interventions. Pooled effects of LES intake on the mean change difference in PPG and PPI were -0.02 mmol/L (95% CI: -0.09, 0.05) and -2.39 pmol/L (95% CI: -11.83, 7.05), respectively. The results did not appreciably differ by the type or dose of LES consumed, cointervention type, or fasting glucose and insulin levels. Among patients with type 2 diabetes, the mean change difference indicated a smaller PPG response after exposure to LES compared with the control (-0.3 mmol/L; 95% CI: -0.53, -0.07). Ingestion of LES, administered alone or in combination with a nutrient-containing preload, has no acute effects on the mean change in postprandial glycemic or insulinemic responses compared with a control intervention. Apart from a small beneficial effect on PPG (-0.3 mmol/L) in studies enrolling patients with type 2 diabetes, the effects did not differ by type or dose of LES, or fasting glucose or insulin levels. This review and meta-analysis was registered at PROSPERO as CRD42018099608.

Postprandial glycemic response differed by early life nutritional exposure in a longitudinal cohort: a single- and multi-biomarker approach.

Populations malnourished in early life are at increased risk for cardiometabolic diseases. We assessed if improved nutrition predicts cardiometabolic function, as assessed by postprandial biomarker responses. Participants had been randomized at the village level to receive one of two nutritional supplements as children. At mean age 44 y (range 37-53 years), we obtained plasma samples before and 2h after a mixed-component meal challenge. We assayed biomarkers including lipids, glycemic measurements, and inflammatory cytokines. We compared postprandial biomarker responses among those who received the improved nutrition intervention from conception through to their second birthday (the first 1000days) to those with other exposure status, including those who received the improved nutrition intervention at other ages, and those who received the less nutritious supplement. Among 1027 participants (59.4% female), 22.9% were exposed to improved nutrition in the first 1000days. Insulin increased the most in response to the meal challenge (over twofold), and non-esterified fatty acids decreased the most (by half). Glucose increased postprandial by 11.4% in the exposed group, compared with 15.7% in the other exposure group (p < 0.05), which remained significant after adjusting for confounders (- 4.7%; 95% confidence interval: - 9.3%, - 0.01%). Responses to the prandial challenges for the other biomarkers did not differ by intervention group (all p > 0.05). Early life exposure to improved nutrition was associated with a more favorable postprandial glucose response in this population. We did not observe a difference in overall cardiometabolic responses between the exposure groups.

The intestinal microbiome is a co-determinant of the postprandial plasma glucose response.

Elevated postprandial plasma glucose is a risk factor for development of type 2 diabetes and cardiovascular disease. We hypothesized that the inter-individual postprandial plasma glucose response varies partly depending on the intestinal microbiome composition and function. We analyzed data from Danish adults (n = 106), who were self-reported healthy and attended the baseline visit of two previously reported randomized controlled cross-over trials within the Gut, Grain and Greens project. Plasma glucose concentrations at five time points were measured before and during three hours after a standardized breakfast. Based on these data, we devised machine learning algorithms integrating bio-clinical, as well as shotgun-sequencing-derived taxa and functional potentials of the intestinal microbiome to predict individual postprandial glucose excursions. In this post hoc study, we found microbial and clinical features, which predicted up to 48% of the inter-individual variance of postprandial plasma glucose responses (Pearson correlation coefficient of measured vs. predicted values, R = 0.69, 95% CI: 0.45 to 0.84, p<0.001). The features were age, fasting serum triglycerides, systolic blood pressure, BMI, fasting total serum cholesterol, abundance of Bifidobacterium genus, richness of metagenomics species and abundance of a metagenomic species annotated to Clostridiales at order level. A model based only on microbial features predicted up to 14% of the variance in postprandial plasma glucose excursions (R = 0.37, 95% CI: 0.02 to 0.64, p = 0.04). Adding fasting glycaemic measures to the model including microbial and bio-clinical features increased the predictive power to R = 0.78 (95% CI: 0.59 to 0.89, p<0.001), explaining more than 60% of the inter-individual variance of postprandial plasma glucose concentrations. The outcome of the study points to a potential role of the taxa and functional potentials of the intestinal microbiome. If validated in larger studies our findings may be included in future algorithms attempting to develop personalized nutrition, especially for prediction of individual blood glucose excursions in dys-glycaemic individuals.

Resistance exercise attenuates postprandial metabolic responses to a high-fat meal similarly in younger and older men

This study examined whether an acute bout of resistance exercise (RE) attenuated postprandial responses to a high fat meal (HFM) similarly in younger versus older adult men, and probed relationships among skeletal muscle mass (SMM), age, the metabolic load index (MLI) response, and the improvement in the MLI elicited by RE versus CON. Eleven younger (24 ± 4y) and 9 older (61 ± 5y) men completed RE or control (CON) the night prior to a HFM. Before and 1, 3, and 5 hours after the HFM, blood triglycerides (TG), glucose (GLU), MLI, and cholesterol concentrations were quantified. Following a 7 ± 1-day washout period, participants returned and completed the opposite condition. Independent of age, TGs were 32.1 ± 27.1 mg/dL and 52.7 ± 26.8 mg/dL lower in RE than CON at 3 and 5 hours, respectively. MLI was also 24.3 to 56.9 mg/dL lower in RE than CON from 1 to 5 hours post-meal independent of age. The TG and MLI area under the curves (AUCs) were 15% to 31% lower in RE than CON. The GLU response was greater in the older than younger men at 1 to 5 hours post-meal. Moreover, the average GLU response was 5.6 ± 2.5 mg/dL lower in RE versus CON and was inversely related to SMM across the sample (r = −0.615). However, age, volume, or SMM were not related to the MLIAUC, nor to the improvement elicited by RE. Therefore, although the older men displayed a greater postprandial glucose response than the younger men, RE attenuated the postprandial metabolic response to a HFM similarly in younger and older men.

Basic and clinical science posters: Type 1 diabetes

Aim To assess interpersonal postprandial glucose responses (PPGRs) to meals matched for energy, macronutrient content, glycaemic index (GI) and insulin administration in people with type 1 diabetes. Methods One hundred and twenty people with type 1 diabetes (mean ± SD: Age 31 ± 7 years, BMI 26.9 ± 2.3kg.m2, HbA1c 7.6 ± 0.8% [55.8 ± 8.2mmol/mol]) consumed two carbohydrate-based standardised meals (millet oat-porridge [OP] or shredded wheat [SW]), twice, on four separate occasions. Each meal was matched for energy, fibre, and macronutrient composition (carbohydrate=1g/kg), GI, and prandial insulin administration. Continuous glucose monitoring captured interstitial glucose (IG) responses for 240min following the consumption of each meal. Results Despite identical energy, fibre and macronutrient content, GI and prandial insulin administration, the average PPGR differed significantly between OP and SW respectively (IG AUC: 1807 ± 588 vs 1678 ± 533mmol/l/min; p=0.05). PPGRs to each meal type showed a high degree of reproducibility within individuals (OP r=0.994, p < 0.001 vs SW r=0.987 p < 0.001), but large interpersonal variation within each meal type (CV%: OP 32.5% vs SW 31.7%). Higher PPGR was positively associated with PPGR variability (r=0.698, p < 0.001), HbA1c (r=0.223, p=0.014), BMI (r=0.316, p < 0.001), and Age (r=0.277, p < 0.001). Conclusions People with type 1 diabetes exhibit significant interpersonal PPGRs independent of energy, fibre and carbohydrate content, GI and prandial insulin administration. This highlights that variability in mealtime glucose control is interpersonal, and influenced by personal characteristics and/or food features beyond those currently used to inform mealtime self-management recommendations.

Alternating Bouts of Sitting and Standing Attenuate Postprandial Glucose Responses—Corrigendum

Alternating Bouts of Sitting and Standing Attenuate Postprandial Glucose Responses—Corrigendum

Application of n-of-1 Clinical Trials in Personalized Nutrition Research: A Trial Protocol for Westlake N-of-1 Trials for Macronutrient Intake (WE-MACNUTR).

ABSTRACTPersonalized dietary recommendations can help with more effective disease prevention. This study aims to investigate the individual postprandial glucose response to diets with diverse macronutrient proportions at both the individual level and population level, and explore the potential of the novel single-patient (n-of-1) trial for personalization of diet. Secondary outcomes include individual phenotypic responses and the effects of dietary ingredients on the composition of gut microbiota. Westlake N-of-1 Trials for Macronutrient Intake is a multiple crossover feeding trial consisting of 3 successive 12-d dietary intervention pairs including a 6-d washout period before each 6-d isocaloric dietary intervention: a 6-d high-fat, low-carbohydrate diet, and a 6-d low-fat, high-carbohydrate diet. The results will help provide personalized dietary recommendations for macronutrients in terms of postprandial blood glucose responses. The proposed n-of-1 trial methods could help in optimizing individual health and advancing health care.This trial was registered with clinicaltrials.gov (NCT04125602).

Why are physical activity breaks more effective than a single session of isoenergetic exercise in reducing postprandial glucose? A systemic review and meta-analysis

ABSTRACT Previous studies revealed that interrupting sitting time with short, frequent physical activity (PA) breaks were more effective than a single session of isoenergetic exercise in reducing postprandial glucose. However, in those studies, the expected glucose-lowering effects of single-session exercises were diminished or even eliminated by exercise-induced glucose counterregulation as evidenced by the higher glucose levels during or after exercise compared to uninterrupted sitting. This study was aimed to investigate whether glucose counterregulation is a potential explanation of PA breaks being more effective than a single session of isoenergetic exercise in reducing postprandial glucose. We meta-analysed the standardized mean differences (SMD) of glucose incremental area under the curve (iAUC). PA breaks were more effective than single-session exercise in reducing glucose iAUC (5 studies, SMD = −0.581; 95% confidence interval [CI], −0.777 to −0.385; P < 0.0001) when exercise-induced glucose counterregulation occurred. There was no significant difference in glucose iAUC between PA breaks and single-session exercises (2 studies, SMD = 0.302; 95% CI, −0.107 to 0.711; P = 0.451) when glucose counterregulation did not occur. We concluded that the exercise-induced glucose counterregulation was a potential explanation of PA breaks being more effective than a single session of isoenergetic exercise in reducing postprandial glucose responses. (PROSPERO ID: CRD42020175737).

Glycemic Response to a Renal‐Specific Oral Nutritional Supplement in Patients With Diabetes Undergoing Hemodialysis: A Randomized Crossover Trial

Diabetes and malnutrition are common in patients with kidney failure. We aimed to evaluate the postprandial glucose response to oral nutritional supplement drinks (ONSs) in patients with diabetes undergoing hemodialysis treatment. A randomized, single-blind crossover study was conducted in patients with diabetes, and requiring chronic hemodialysis. Patients consumed either a renal-specific ONS, macronutrient-matched ONS, or standard ONS on 3 separate study days, during dialysis, following an overnight fast. Blood was collected before and 15, 30, 45, 60, 90, 120, and 180 minutes post ingestion. Mean net incremental area under the curve (iAUC) and peak incremental blood glucose concentration were compared across conditions, using analyses of variance. Consumption of the renal-specific ONS resulted in the lowest mean net iAUC (87.9 ± 169.0 mmol/L per 3 hours) compared with macronutrient-matched (188.0 ± 127.5 mmol/L per 3 hours) and standard ONS (199.5 ± 169.2 mmol/L per 3 hours) (F2,30 = 5.115, P = 0.012, partial n2 = 0.254). Pairwise comparisons demonstrated a mean difference of 100.1 mmol/L per 3 hours (95% CI, -2.8 to 202.9) in mean iAUC between the renal-specific ONS and macronutrient-matched ONS (P = 0.058). Peak blood glucose concentration, corrected for baseline, was significantly lower after the renal-specific ONS (1.40 ± 1.0 mmol/L) compared with both macronutrient-matched (2.02 ± 0.71 mmol/L, P = 0.036) and standard ONS (2.3 ± 1.06 mmol/L, P = 0.017). A renal-specific ONS elicits a lower postprandial glucose response than either macronutrient-matched ONS or standard ONS in patients with diabetes during hemodialysis.

Combined effect of durian (Durio zibethinus Murr.) and β-glucan on glycaemic response and food intake in male rats

Durian (Durio zibethinus Murr.) is notorious for its stench. However, durian has a smooth texture and creamy taste, and is rich in macronutrients, bioactive compounds, and volatile compounds. These qualities could be useful in combination with other food components such as β-glucan. β-Glucan is a type of soluble fibre that has been approved by the European Food Safety Authority (EFSA) for beneficially reducing the postprandial glucose response. The aims of this study were to determine the total polyphenol content in durian and to determine the combined effects of durian and β-glucan on glycaemic response and food intake in rats. The total polyphenols content in the durians (variety D24) was 131.40 (22.20) mg GAE/100 g fresh weight. Durian significantly reduced (p &lt; 0.05) postprandial glucose responses at 15, 30, 60, and 120 mins compared with control. A combination of durian and β-glucan significantly (p &lt; 0.05) reduced glucose responses at 30, 60 and 90 mins compared with control. A combination of durian and β-glucan significantly (p &lt; 0.05) reduced glucose responses at 120 mins compared with control and β-glucan. Food intake of the durian + β-glucan group was significantly (p &lt; 0.05) lower than the control, durian and β-glucan groups. This study suggests that a combination of durian and β-glucan potentially reduces glycaemic response and food intake but this needs to be tested in humans.

Gamma-Polyglutamic Acid-Rich Natto Suppresses Postprandial Blood Glucose Response in the Early Phase after Meals: A Randomized Crossover Study.

We evaluated the suppressive effects of high-gamma-polyglutamic acid (γ-PGA) natto on postprandial blood glucose level and insulin response. After confirming the eligibility of candidates using a pre-selective test with packaged white rice, a meal loading test including low- or high-γ-PGA natto (with 57.6 mg (LPGA) and 439.6 mg (HPGA) of γ-PGA, respectively) was conducted in men aged 20 to 70 years (n = 29) and postmenopausal women aged ≤70 years (n = 7). On each examination day, blood samples were obtained after they fasted overnight and for 120 min after test meal loading. The primary outcome of this study was the difference between the measurements of the incremental area under the curve (IAUC) for blood glucose 0 to 30 min after loading of LPGA and HPGA meals. The IAUCs for blood glucose and insulin after the HPGA meal were lower than those after the LPGA meal within 45 min (0 to 15 and 0 to 30 min: p < 0.001, 0 to 45 min: p < 0.01) and 1 h (all p < 0.001) of loading, respectively. The suppressive effects of HPGA natto on postprandial glucose response in the early phase, which possibly relates to the risk of dysglycemia and cardiovascular disease, were clarified.

Foods Consumed with Rice that Elicit a Reduction in Glucose Response among Healthy Individuals

Purpose: The purpose of this article is to report and summarise various foods consumed with rice that has shown a positive impact on glucose response. The rationale of this review is that it is useful for public health researchers and nutritionists concerning foods that are beneficial in reducing the glucose response for health monitoring. This review is also useful for individuals interested in improving their daily diet for better health. Design: This study searched latest PubMed and ScienceDirect international articles from 2015 to 2020. The articles included in the search were those that include mixed rice meal studies, impact on glycaemic response or index. The selected studies were those that involved healthy participants from various regions. An example of word search in PubMed is “Rice glycaemic index”, "oryza" [MeSH Terms] OR "oryza" [All Fields] OR "rice" [All Fields]) AND "glycaemic" [All Fields])). Findings: The key findings of this review are any type of rice (white rice, basmati rice, long grain or red rice) has shown to have a beneficial outcome on postprandial glucose response when consumed with the meals tested. Originality/value: Most of the foods listed in this review are readily available in many parts of the world. This means access to these foods is easy and advocating its consumption is essential. Diversification regarding style or intake of rice across the globe depends on culture and tradition. Understanding glycaemic index and its impact on health particularly diabetes and heart diseases will help reduce the intake of medications. It will also be more cost-effective and improve general well-being and health.

The Impact of Dietary Glycemic Index and Glycemic Load on Postprandial Lipid Kinetics, Dyslipidemia and Cardiovascular Risk.

Many recent studies have acknowledged postprandial hypetriglyceridemia as a distinct risk factor for cardiovascular disease. This dysmetabolic state is the result of the hepatic overproduction of very low-density lipoproteins (VLDLs) and intestinal secretion of chylomicrons (CMs), which leads to highly atherogenic particles and endothelial inflammation. Postprandial lipid metabolism does not only depend on consumed fat but also on the other classes of nutrients that a meal contains. Various mechanisms through which carbohydrates exacerbate lipidemia have been identified, especially for fructose, which stimulates de novo lipogenesis. Glycemic index and glycemic load, despite their intrinsic limitations, have been used as markers of the postprandial glucose and insulin response, and their association with metabolic health and cardiovascular events has been extensively studied with contradictory results. This review aims to discuss the importance and pathogenesis of postprandial hypertriglyceridemia and its association with cardiovascular disease. Then, we describe the mechanisms through which carbohydrates influence lipidemia and, through a brief presentation of the available clinical studies on glycemic index/glycemic load, we discuss the association of these indices with atherogenic dyslipidemia and address possible concerns and implications for everyday practice.

Extending the Overnight Fast: Sex Differences in Acute Metabolic Responses to Breakfast.

Fasting for over 24 h is associated with worsening glucose tolerance, but the effect of extending the overnight fast period (a form of time-restricted feeding) on acute metabolic responses and insulin sensitivity is unclear. The aim of this pilot study was to determine the acute impact of an increased fasting period on postprandial glycaemia, insulinemia, and acute insulin sensitivity responses to a standard meal. Twenty-four lean, young, healthy adults (12 males, 12 females) consumed a standard breakfast after an overnight fast of 12, 14, and 16 h. Each fast duration was repeated on three separate occasions (3 × 3) in random order. Postprandial glucose and insulin responses were measured at regular intervals over 2 h and quantified as incremental area under the curve (iAUC). Insulin sensitivity was determined by homeostatic modelling assessment (HOMA). After 2 h, ad libitum food intake at a buffet meal was recorded. In females, but not males, insulin sensitivity improved (HOMA%S +35%, p = 0.016, marginally significant) with longer fast duration (16 h vs. 12 h), but paradoxically, postprandial glycaemia was higher (glucose iAUC +37%, p = 0.002). Overall, males showed no differences in glucose or insulin homeostasis. Both sexes consumed more energy (+28%) at the subsequent meal (16 h vs. 12 h). Delaying the first meal of the day by 4 h by extending the fasting period may have adverse metabolic effects in young, healthy, adult females, but not males.