Postprandial Glycemia Research Articles

Chitin-Glucan Supplementation Altered Gut Microbiota and Improved Postprandial Metabolism in Subjects at Cardiometabolic Risk

ObjectivesIn this exploratory study, we aimed at characterizing the impact of chitin-glucan (CG), an insoluble dietary fiber, on gut microbiota composition and functions as well as on the cardiometabolic profile in subjects at cardiometabolic risk. MethodsFifteen subjects were included in this double-blind, randomized, twice 3-week cross-over study and consumed 4.5g of CG or maltodextrin (control) as a supplement daily. Before and after the intervention phases, fasting and postprandial metabolic parameters and exhaled gases (hydrogen [H2] and methane [CH4]) were evaluated. Gut microbiota composition (16S next generation sequencing), fecal concentrations of bile acids, long- and short-chain fatty acids (LCFA, SCFA), zonulin, calprotectin and lipopolysaccharide binding protein (LBP) were analyzed. ResultsCompared to control, CG supplementation increased exhaled H2 following an enriched-fiber breakfast ingestion and decreased postprandial glycemia and triglyceridemia response to a standardized test meal challenge served at lunch. Of note, the decrease in postprandial glycemia was only observed in subjects with higher exhaled H2, assessed upon lactulose breath test performed at inclusion. CG decreased a family belonging to Actinobacteria phylum and increased 3 bacterial taxa: Erysipelotrichaceae UCG.003, Ruminococcaceae UCG.005 and Eubacterium ventriosum group. Fecal metabolites, inflammatory and intestinal permeability markers did not differ between groups. ConclusionsWe showed that CG supplementation modified the gut microbiota composition and improved postprandial glycemic response, an early determinant of cardiometabolic risk. Our results also suggest breath H2 production as a non-invasive parameter of interest for predicting the effectiveness of dietary fiber intervention. Funding SourcesThe FiberTAG project was initiated from a European Joint Programming Initiative “A Healthy Diet for a Healthy Life” (JPI HDHL). This study was supported by the Service Public de Wallonie. NMD is a recipient of a grant from Belgium National Scientific Research Fund and from UCLouvain. GGM is a recipient of a FSR grant from the UCLouvain.

1387-P: Impacts of Androgen-Deprivation Therapy on Glucose Metabolism

Study Objective: to assess the impacts of androgen deprivation therapy (ADT) in prostate cancer (PCa) management on glucose metabolism Study Design: follow-up study Materials and Methods: A total of 99 consecutive patients with PCa who received ADT followed-up at Pletnev and 62th Moscow Hospitals. The mean age was 69±8,64 y.o. Fasting plasma glucose (FPG) , HbA1c, body mass index (BMI) , waist circumference (WC) , were measured at baseline, after 3, 6 and 12 months ADT with gonadotropin releasing hormone agonists (GnRH agonists) . Ambulatory glycemic profiles (AGP) were obtained in patients with elevated glycemia who received ADT with GnRH agonists for at least 6 months by Flash glucose monitoring systems. Glucose variability indices (AUC, CONGA, JINDEX) were calculated. Study Results: During ADT there were an increase in FPG and HbA1c over 12 months of ADT regardless of baseline age, BMI, WC, with a maximum increase during the first 3 months of treatment, and progressively after 6 months and 12 months. FPG (mmol/l) initially, 3, 6 and 12 months, were respectively 5,18±0,91; 5,67±0,93; 5,77±0,96; 5,90±1,12 (for all differences p ≤ 0.001) . HbA1c (%) 5,36+0,66; 5,66±0,83; 5,77±0,82; 5,89±0,83 (for all differences p ≤ 0.001) . The proportion of individuals with prediabetes were increased, according to ADA criteria (5,6-6.9 mmol/l) after 3 months 36%, after 6 months 41%, and after 12 months 66%. The impact on glucose metabolism ware in also AGP changes, manifested by an increase in the total daily glycemic load (mean AUC 172,49 (p≤0.001) , glycemic variability (mean CONGA 6,817 (p≤0.001) , and an increased in postprandial glycemia (JINDEX 22,945 (p≤0.001) . Conclusion: ADT with GnRH agonists did worsen metabolic parameters: early, progressive, clinically significant impair of glucose metabolism regardless of baseline age, BMI, WC. AGP deteriorations were increased of glucose variability, total glycemic load gained and peak glycemic values rose. Disclosure E.Y.Gritskevich: None. A.Gritskevich: None. T.Demidova: None.

Manipulating the Microstructure of Potatoes for Slow Starch Digestion

ObjectivesPotatoes are nutritious foods that provide essential energy in the form of starch. However, numerous studies have shown that their consumption could lead to high postprandial glycemia. Our aim is to transform staple foods into a healthy diet with modulated postprandial glycaemia and sustained energy.MethodsPotatoes were blanched in a 500 ppm calcium solution for 30 min at 70 °C prior to streaming. We wanted to study if blanching potatoes in the presence of divalent cations increased pectin-cross linking and could lead to a lower cell wall permeability to digestive amylolytic enzymes. Potatoes were submitted to in-vitro simulated gastrointestinal digestion. The digestion of starch occurred in the intestinal phase in the presence of digestive enzymes (1350 U of pancreatic amylase, 3500 U of glucoamylase and 200 U of invertase). Aliquots were obtained at time intervals to quantify glucose release. The diffusivity rate of dextran probes (20 KDa, 60 KDa, and 150 KDa) into isolated potato cells was determined by the fluorescence recovery after photobleaching (FRAP) assay. Texture profile analysis (TPA) was also carried out to quantify multiple textural parameters.ResultsOur treatment increased the slowly digestible starch fraction of potatoes from 10.5% to 35.3%. Treated potatoes had 40.7% and 99.9% lower cell wall diffusivity of 20 KDa dextrans and 70 KDa dextrans, respectively. These results show that a-amylase (∼59 KDa) access to starch within the cells was significantly lower in our treated potatoes. Thus, is the driving factor for the slower starch digestibility rate. These results are unexpected since a-glucosidase is the gatekeeper for starch hydrolysis. Texture analysis showed that treated potatoes possess desirable attributes such as higher hardness which could drive consumer preference.ConclusionsDeveloping slowly digestible staple foods, such as potatoes, is a promising approach for moderating glycemia as well as extending satiation and energy, and, in the long-term, control food intake and bodyweight.Funding SourcesThis research was funded by A*STAR Biomedical Research Council grant IAF-PP (HBMS Domain): Food Structure Engineering for Nutrition and Health.

Menopause Is a Key Factor Influencing Postprandial Metabolism, Metabolic Health and Lifestyle: The ZOE PREDICT Study

ObjectivesThe menopause transition is associated with unfavourable alterations in metabolic and cardiovascular health. However, as an age-related biological event, it is difficult to untangle effects of age from menopause. Here, we investigate the impact of menopause on cardiometabolic health, lifestyle and diet in pre- and post-menopausal females and age-matched subgroups (including males) in the densely phenotyped ZOE PREDICT 1 cohort (NCT03479866). MethodsDemographic information, diet, cardiometabolic blood biomarkers and postprandial responses (lipid and glucose) to standardized test meals in clinic and free-living settings were assessed (n = 1002). Self-reported pre- (n = 366), peri- (n = 55) and post-menopausal (n = 207) females (aged 18–65 y) and an age-matched subgroup (aged 47–56 y) of males (n = 76), pre- (n = 83) and post-menopausal females (n = 64) were identified. Linear regression analysis assessed differences in cardiometabolic health, anthropometry, lifestyle and diet (adjusted for sex, age, BMI, menopausal hormonal treatment and smoking status). ResultsPost-menopausal females had poorer fasting and postprandial blood measures (glucose, HbA1c, inflammation (GlycA), glucose2hiauc and insulin2hiauc; by 6, 5, 4, 42 and 4% respectively) and sleep quality (12%) and higher sugar intakes (12%) compared with pre-menopausal females (p < 0·05 for all). In age-matched females, postprandial glycemia was significantly higher in post- versus pre-menopausal females (p < 0·05), including clinic postprandial glucose peak0-2h (7·6 ± 1·2 vs 7·2 ± 1·0), glycemic variability (using a continuous glucose monitor (CGM)) (18 ± 4% vs 16 ± 4%) and glucose2hiauc (CGM) following a standardized (typical UK/US nutrient composition) meal (13440 ± 5804 vs 12547 ± 5488). Compared to age-matched males, females (pre- and post-menopausal) had lower systolic blood pressure and ASCVD 10y risk (p < 0.05) and post-menopausal females only had worse glycemic variability (p < 0·001). ConclusionsIn the largest, in-depth nutrition metabolic study of menopause to date, we demonstrate unfavourable links between menopause transition and postprandial glycemic responses, sleep and diet. This emphasises the value of incorporating menopause as a factor in the delivery of nutrition advice. Funding SourcesZOE Ltd

31-OR: Almond Milk Has No Additional Benefits over 2% Milk on Postprandial Glycemia, Lipidemia, and Gastrointestinal Hormones in Patients with Type 2 Diabetes

Almond milk is often used in lieu of dairy milk with the perception of being a healthier substitute, however, its effect on postprandial glycemia compared to 2% milk is not understood. In this study, we compared the 4-hour postprandial effects of almond milk versus carbohydrate- or caloric-matched 2% milk, each served with a similar amount of oatmeal in patients with T2D. In this cross-over, three-way, open-label study, 22 overweight or obese patients with T2D consumed ½ cup (40 g) of oatmeal served with 360 mL almond milk (ALM) or carbohydrate-matched (246 ml) 2% milk (CarbM) or calorie-matched (182 ml) 2% milk, on separate days, in random order. The primary outcome was glucose incremental area under the curve (iAUC 0-240) while changes in other analytes were secondary outcomes. Blood samples for glucose, free fatty acids (FFA) , gastrointestinal (GI) satiety and hunger hormones were drawn at baseline, 15, 30, 60, 90, 120, 180 and 240 minutes. Incremental AUCs were compared between groups using Wilcoxon signed rank test. P-values for analytes other than glucose were adjusted with the false discovery rate (FDR) . P&amp;lt;5% for glucose or FDR&amp;lt;5% were considered significant. There were no differences in iAUC 0-240 for glucose, triglycerides, PYY, active GLP-1 or amylin, leptin, GIP, cholecystokinin, ghrelin or FFA in any pair-wise comparison. However, iAUC 0-240 for insulin and glucagon were significantly higher in CarbM vs. ALM (FDR 0.002 and 0.02 respectively) . In conclusion, compared to almond milk used with oatmeal, carbohydrate- or caloric-matched 2% milk has similar effects on postprandial glucose, FFA, triglycerides and GI hormones for up to 4 hrs, indicating no additional benefits of almond milk over 2% milk. On the contrary, carbohydrate-matched 2% milk increased insulin and glucagon secretion compared to almond milk. The long-term significance of this increase in insulin release needs to be further elaborated in a long-term study. Disclosure J.Mitri: Consultant; dairy management, Lnutra. S.Tomah: None. J.Dreyfuss: None. M.Al-badri: None. S.E.Dhaver: None. H.Gardner: None. M.Tasabehji: None. O.Hamdy: Advisory Panel; L-Nutra Inc., Nestlé, Consultant; Abbott, Sanofi, Research Support; Eli Lilly and Company, Gilead Sciences, Inc., National Dairy Council, Novo Nordisk, Stock/Shareholder; Healthimation.

Chitin-glucan supplementation improved postprandial metabolism and altered gut microbiota in subjects at cardiometabolic risk in a randomized trial

Chitin-glucan (CG), an insoluble dietary fiber, has been shown to improve cardiometabolic disorders associated with obesity in mice. Its effects in healthy subjects has recently been studied, revealing its interaction with the gut microbiota. In this double-blind, randomized, cross-over, twice 3-week exploratory study, we investigated the impacts of CG on the cardiometabolic profile and gut microbiota composition and functions in 15 subjects at cardiometabolic risk. They consumed as a supplement 4.5 g of CG daily or maltodextrin as control. Before and after interventions, fasting and postprandial metabolic parameters and exhaled gases (hydrogen [H2] and methane [CH4]) were evaluated. Gut microbiota composition (16S rRNA gene sequencing analysis), fecal concentrations of bile acids, long- and short-chain fatty acids (LCFA, SCFA), zonulin, calprotectin and lipopolysaccharide binding protein (LBP) were analyzed. Compared to control, CG supplementation increased exhaled H2 following an enriched-fiber breakfast ingestion and decreased postprandial glycemia and triglyceridemia response to a standardized test meal challenge served at lunch. Of note, the decrease in postprandial glycemia was only observed in subjects with higher exhaled H2, assessed upon lactulose breath test performed at inclusion. CG decreased a family belonging to Actinobacteria phylum and increased 3 bacterial taxa: Erysipelotrichaceae UCG.003, Ruminococcaceae UCG.005 and Eubacterium ventriosum group. Fecal metabolites, inflammatory and intestinal permeability markers did not differ between groups. In conclusion, we showed that CG supplementation modified the gut microbiota composition and improved postprandial glycemic response, an early determinant of cardiometabolic risk. Our results also suggest breath H2 production as a non-invasive parameter of interest for predicting the effectiveness of dietary fiber intervention.

Extra Virgin Olive Oil Reduces Gut Permeability and Metabolic Endotoxemia in Diabetic Patients.

Background: Extra virgin olive oil (EVOO) improves post-prandial glycemia, but the underlying mechanism has not been fully elucidated. We tested the hypothesis that EVOO improves post-prandial glycemia by reducing gut permeability-derived low-grade endotoxemia. Methods: Serum levels of lipopolysaccharides (LPS), zonulin, a marker of gut permeability, glucose, insulin and glucagon-like peptide 1 (GLP1) were measured in 20 patients with impaired fasting glucose (IFG) and 20 healthy subjects (HS) matched for sex and age. The same variables were measured in IFG patients (n = 20) and HS (n = 20) before and after a Mediterranean diet with 10 g EVOO added or not (n = 20) or in IFG patients (n = 20) before and after intake of 40 g chocolate with EVOO added or not. Results: Compared to HS, IFG had higher levels of LPS and zonulin. In HS, meal intake was associated with a significant increase of blood glucose, insulin, and GLP1 with no changes of blood LPS and zonulin. Two hours after a meal intake containing EVOO, IFG patients showed a less significant increase of blood glucose, a more marked increase of blood insulin and GLP1 and a significant reduction of LPS and zonulin compared to IFG patients not given EVOO. Correlation analysis showed that LPS directly correlated with blood glucose and zonulin and inversely with blood insulin. Similar findings were detected in IFG patients given a chocolate added or without EVOO. Conclusion: Addition of EVOO to a Mediterranean diet or chocolate improves gut permeability and low-grade endotoxemia.

The Impact of Removal of Exercise for 3 Days on Glycemic Control in Older Active Adults

Postprandial glycemia (PPG) predicts cardiovascular disease, and 3 days of physical inactivity impairs PPG in young, active adults. Whether this occurs in older, active adults who may be more prone to bouts of inactivity is unknown. This study determined if PPG was impaired in active older adults (old) following a 3 day removal of exercise compared to active young adults. In this randomized, crossover study, 10 older (73.0 ± 1.9 yrs) and 9 young (32.8 ± 1.8 yrs) habitually active (≥90 min/week of exercise) adults completed a 3 day period of exercise removal (NOEX) and a 3 day period of normal exercise maintenance (EX), separated by ≥ 1 week. Diet was standardized across phases. Glycemic control (GC) (2 hour PPG, peak glucose values, and standard deviation (STDEV) of blood glucose values) was assessed via continuous glucose monitoring (IPro2, Enlite Sensors, Medtronic Inc., Northridge, CA) during both phases. No differences in body mass index (Old: 26.5 ± 1.3, Young: 24.8 ± 1.0 kg/m2, p&gt;0.05) existed between groups. Both groups had a similar reduction in activity during NOEX (Old: ‐64.6% ± 6.2, Young: ‐55.7% ± 4.9, p&gt;0.05). There were significant main effects (p&lt;0.05) in PPG of age (Old: 116±1.2 mg/dL, Young: 106 ± 1.3 mg/dL), phase (Inactive: 113 ± 1.3 mg/dL, Active: 109 ± 1.2 mg/dL), and time (0 min: 99 ± 2.0, 30 min: 118 ± 2.0, 60 min: 117 ± 2.0, 90 min: 112 ± 2.0, 120 min: 108 ± 2.0 mg/dL), but no interaction (p&gt;0.05). Further, a trend (p=0.06) for significant main effect of age (Old: 149±5.6, Young: 133±5.9 mg/dL) and phase (p&lt;0.05; Inactive: 145±4.4, Active: 136±4.4 mg/dL) were found for peak glucose values. Significant main effects (p&lt;0.05) exist for age (Old: 15.3±1.2, Young: 11.3±1.2) and phase (Inactive: 14.4±0.97, Active: 12.2±0.97) for blood glucose STDEV. These results indicate that older adults have impaired GC compared to young adults and that removal of exercise impairs GC. Yet, the impairment in GC with exercise removal is not different between old and young adults when the decrease in daily physical activity is similar.

Religious/spiritual coping, symptoms of depression, stress, and anxiety in caregivers of children and adolescents with type 1 diabetes.

It was verified the level of religiosity and spirituality, and symptoms of depression, stress, and anxiety of caregivers of children and adolescents with type 1 diabetes, and its interference in glycaemic control. Socio-economic and demographic data were collected from caregivers of 59 children and adolescents with type 1 diabetes and obtained dosages of fasting glucose (FG); postprandial glycaemia (PPG); fructosamine (FRUTO); and HbA1c, as well as the glycaemic variability-∆HbA1c. Levels of religiosity were obtained by the DUREL scale; the use of religious/spiritual coping was verified by the SRCOPE-Brief scale. Symptoms of depression, anxiety, and stress were analysed by the DASS-21 scale. The correlations between the variables were analysed by the Pearson coefficient, with significance at 5% level. Inverse correlations were observed between caregivers' schooling with PPG (r = -0.30; P = 0.002) and FRUTO (r = -0.34; P = 0.008) and between family income and FRUTO (r = -0.37; P = 0.004). Direct, moderate correlations were observed between negative religious/spiritual coping (NSRCOPE) with symptoms of depression (r = 0.588; P < 0.0001), stress (r = 0.500; P < 0.0001), and anxiety (r = 0.551; P < 0.0001). The direct association between NSRCOPE with symptoms of depression, stress, and anxiety was the highlighted item in the present study emphasizing the need for greater attention to the emotional health of informal caregivers of children and adolescents with DM1. It is necessary to reflect on the religious/spiritual support especially for the main caregiver of children and adolescents with DM1.

Whey protein supplementation improves postprandial glycemia in persons with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials

Whey protein (WP) can increase insulin secretion, produce an incretin effect, delay gastric emptying, and regulate appetite, resulting in improved glycemic control. We hypothesized that WP supplementation is associated with postprandial glycemia regulation in persons with type 2 diabetes mellitus (T2DM) and conducted a quantitative meta-analysis of randomized controlled trials (RCTs) to test this hypothesis. We searched PubMed, Embase, Cochrane Library, Scopus databases, and the ClinicalTrials.gov registry for relevant RCTs published before March 2022. We assessed the pooled effects using a random-effects model on glucose and insulin levels at 60 and 120 minutes, total glucagon-like peptide-1 (tGLP-1) at 30 and 60 minutes, and the incremental area under the curve (iAUC) of glucose, insulin, tGLP-1, and glucose-dependent insulinotropic polypeptide. Five RCTs involving 134 persons were included. Postprandial glycemia was significantly lower at 60 minutes (weighted mean difference: −2.67 mmol/L; 95% confidence interval, −3.62 to −1.72 mmol/L) and 120 minutes (−1.59 mmol/L; −2.91 to −0.28 mmol/L) in WP group than in placebo group. The iAUC of insulin was significantly higher in WP group (24.66 nmol/L × min, 1.65-47.66 nmol/L × min) than in placebo group. Although other results favored the WP group, differences between the groups were not statistically significant. The present study showed that premeal WP supplementation is beneficial for postprandial glycemia in persons with mild or well-controlled T2DM without substantial adverse effects. However, the level of certainty of current evidence is not high enough. Further larger and well-designed clinical trials are warranted for evaluating optimal dose and long-term effects of WP supplementation.

Influence of resistant starch resulting from the cooling of rice on postprandial glycemia in type 1 diabetes

IntroductionCarbohydrates are one of the macronutrients which have the most substantial influence on glycemic response. The cooling of rice after cooking causes retrogradation of starch, which becomes a non-absorbable product in the human digestive tract.Aim of the studyThis study aimed to assess whether cooling of rice affects postprandial glycemia in subjects with type 1 diabetes.Materials and methodsThe study included 32 patients with type 1 diabetes. Each participant of the study consumed two standardized test meals consisting of long-grain white rice. One of the test meals was served immediately after preparation, and another was cooled for 24 h at 4 °C after preparation and reheated before being served. Postprandial glycemia was measured for 3 h using the FreeStyle Libre flash glucose monitoring system for each patient.ResultsAfter consumption of the test meal containing rice subjected to the cooling process when compared to fresh rice, a significantly lower value of maximum glycemia (11 vs. 9.9 mmol/L, p = 0.0056), maximum glycemic increase (2.7 vs. 3.9 mmol/L, p < 0.0001), areas under the glycemic curve (135 vs. 336 mmol/L * 180 min, p < 0.0001) and significantly shorter time to peak (35 vs. 45 min, p = 0.031) was observed. There was a significantly higher number of hypoglycemic episodes among the patients after consuming test meals with cooled rice compared to fresh ones during 180 min of observation (12(38) vs. 3(9), p = 0.0039).ConclusionsConsumption of rice subjected to the cooling process results in a lower increase of postprandial blood glucose in subjects with type 1 diabetes. At the same time it increases the risk of postprandial hypoglycemia using a standard insulin dose.

The Inhibitory Effects of New Zealand Pine Bark (Enzogenol®) on α-Amylase, α-Glucosidase, and Dipeptidyl Peptidase-4 (DPP-4) Enzymes.

The New Zealand pine bark extract (Enzogenol®) has previously been shown to elicit acute hypoglycaemic effects in humans. The present study investigated the underlying mechanisms of Enzogenol® in reducing postprandial glucose in humans. The potential inhibitory action of Enzogenol® against digestive enzymes: α-amylase and α-glucosidase, and dipeptidyl peptidase-4 (DPP-4) enzyme was determined. Enzogenol® demonstrated the ability to inhibit all three enzymes: α-amylase enzyme activity (IC50 3.98 ± 0.11 mg/mL), α-glucosidase enzyme activity (IC50 13.02 ± 0.28 μg/mL), and DPP-4 enzyme activity (IC50 2.51 ± 0.04 mg/mL). The present findings indicate the potential for Enzogenol® to improve postprandial glycaemia by delaying carbohydrate digestion via the inhibition of digestive enzymes (α-amylase and α-glucosidase), and enhancing the incretin effect via inhibiting the dipeptidyl-peptidase-4 enzyme. The inhibitory actions of Enzogenol® on enzymes should therefore be further validated in humans for its potential use in type 2 diabetes mellitus prevention and management.

Effect of Aqueous Cinnamon Extract on the Postprandial Glycemia Levels in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial.

Cinnamon is a spice used in traditional cuisine that has been investigated due to hypoglycemic properties. The objective of this study was to investigate the effect of aqueous cinnamon extract on postprandial glycemia levels in type 2 diabetes mellitus (DM2) adults. This clinical trial enrolled 36 adults with DM2, randomly allocated in two groups: the control group (n = 18) took only an oral glucose tolerance test (OGTT) and the intervention group (n = 18) took OGTT immediately followed by aqueous cinnamon extract (6 g/100 mL) ingestion. Blood glucose levels were measured on fasting and after 30, 60, 90 and 120 min in both groups. The chemical analysis of the aqueous cinnamon extract included total phenols content determination and antioxidant activity assessment through FRAP and DPPH methods. The data reveal that aqueous cinnamon extract ingestion did not show a significant difference in the incremental area under the curve (p = 0.834), maximum glucose concentration (p = 0.527) and glucose concentration variation (p = 0.873) compared with the control group. Cinnamon extract possess a total phenol content of 1554.9 mg/L gallic acid equivalent and a strong antioxidant capacity, revealed by the DPPH (5125.0 µmol Trolox/L) and FRAP (3658.8 µmol Trolox/L) tests. Aqueous cinnamon extract did not significantly influence postprandial glucose response in diabetic patients during an OGTT.

Effect of the consumption of a fibrous extract of stevia rebaudiana stems on glycemia

Objective: To evaluate the effect of the ingestion of a fibrous extract of Stevia rebaudiana Bertoni stems on postprandial glycemia levels in healthy subjects. Materials and Methods: Cross-sectional, experimental research, carried out with ethical conditions of consent and reliability, in the Laboratory for the Evaluation of Nutritional Status of the Autonomous University of Carmen. For the clinical and anthropometric assessment of the participants, a medical history and body composition scan were used, respectively. The study population consisted of 16 healthy women with normal body mass indices (20-25 kg/m2). Instruments: a) Clinical-dietetic record and b) Biochemical data obtained from blood sampling obtained at different times. The data analysis was carried out with descriptive statistics. Results: The results shown in the group of participants in this study, it was observed that the mean value of the area under the curve (AUC) of glucose was 709.18 ± 23.60, while that of the fibrous extract of stevia stems was 556.59 ± 50.47 . Conclusions: Stevia rebaudiana stems, due to their dietary fiber content, can be an alternative for the use and revaluation of sustained waste in the circular economy in the development of functional products, giving it an added value that contributes in some way to reducing overweight and obesity, with a hypoglycemic effect in patients with type 2 diabetes mellitus (DM). Keywords: Stevia; Plant Stems; Blood glucose

Administration of Jerusalem artichoke reduces the postprandial plasma glucose and glucose-dependent insulinotropic polypeptide (GIP) concentrations in humans

BackgroundThe consumption of Jerusalem artichoke has multiple beneficial effects against diabetes and obesity.ObjectiveThe aim of this study was to determine the effect of a single administration of Jerusalem artichoke tubers on postprandial glycemia and the concentrations of incretin hormones in humans.MethodGrated Jerusalem artichoke was administered prior to a meal (Trial 1; white rice for prediabetic participants, n = 10). Dose-dependent effect of Jerusalem artichoke (Trial 2; white rice for prediabetic participants, n = 4) and effect prior to the fat-rich meal were also investigated (Trial 3; healthy participants, n = 5) in this pilot study. Circulating glucose, insulin, triglyceride, glucagon, active glucagon-like peptide-1 (GLP-1), and active glucose-dependent insulinotropic polypeptide (GIP) concentrations were subsequently measured in all the trials.ResultsJerusalem artichoke significantly reduced the glucose and GIP concentrations after the consumption of either meal in Trial 1 and Trial 3, whereas there were no differences in the insulin, glucagon, and active GLP-1 concentrations. Also, there was no significant difference in the triglyceride concentration after the ingestion of the fat-rich meal in Trial 3. The glucose and GIP-lowering effects were dose-dependent, and the consumption of at least 100 g of Jerusalem artichoke was required to have these effects in Trial 2.ConclusionThis study demonstrates that a single administration of Jerusalem artichoke tubers reduces postprandial glucose and active GIP concentrations in prediabetic and healthy individuals.

Matched whole grain wheat and refined wheat milled products do not differ in glycemic response or gastric emptying in a randomized, crossover trial

Epidemiologic and some clinical studies support the view that whole grain foods have lower glycemic response than refined grain foods. However, from the perspective of food material properties, it is not clear why whole grain cereals containing mostly insoluble and nonviscous dietary fibers (e.g., wheat) would reduce postprandial glycemia. We hypothesized that glycemic response for whole grain wheat milled products would not differ from that of refined wheat when potentially confounding variables (wheat source, food form, particle size, viscosity) were matched. Our objective was to study the effect of whole grain wheat compared with refined wheat milled products on postprandial glycemia, gastric emptying, and subjective appetite. Using a randomized crossover design, healthy participants (n=16) consumed 6 different medium-viscosity porridges made from whole grain wheat or refined wheat milled products, all from the same grain source and mill: whole wheat flour, refined wheat flour, cracked wheat, semolina, reconstituted wheat flour with fine bran, and reconstituted wheat flour with coarse bran. Postprandial glycemia, gastric emptying, and appetitive response were measured using continuous glucose monitors, the 13C-octanoic acid (8:0) breath test, and visual analog scale (VAS) ratings. Bayes factors were implemented to draw inferences about null effects. Little-to-no differences were observed in glycemic responses, with lower incremental AUC between 0 and 120min glycemic responses only for semolina [mean difference (MD): -966mg min/dL; 95% CI: -1775, -156mg min/dL; P = 0.02) and cracked wheat (MD: -721mg min/dL; 95% CI: -1426, -16mg min/dL; P = 0.04) than for whole wheat flour porridge. Bayes factors suggested weak to strong evidence for a null effect (i.e., no effect of treatment type) in glycemic response, gastric emptying, and VAS ratings. Although whole grain wheat foods provide other health benefits, they did not in their natural composition confer lower postprandial glycemia or gastric emptying than their refined wheat counterparts.This trial was registered at clinicaltrials.gov as NCT03467659.

Pasta Structure Affects Mastication, Bolus Properties, and Postprandial Glucose and Insulin Metabolism in Healthy Adults

ABSTRACTBackgroundStructure and protein–starch interactions in pasta products can be responsible for lower postprandial glycemic responses compared with other cereal foods.ObjectivesWe tested the effect on postprandial glucose metabolism induced by 2 pasta products, couscous, and bread, through their structural changes during mastication and simulated gastric digestion.MethodsTwo randomized controlled trials (n = 30/trial) in healthy, normal-weight adults (mean BMI of 23.9 kg/m2 (study 1) and 23.0 kg/m2 (study 2)) evaluated postprandial glucose metabolism modulation to portions of durum wheat semolina spaghetti, penne, couscous, and bread each containing 50 g available carbohydrate. A mastication trial involving 26 normal-weight adults was conducted to investigate mastication processes and changes in particle size distribution and microstructure (light microscopy) of boluses after mastication and in vitro gastric digestion.ResultsBoth pasta products resulted in lower areas under the 2-h curve for blood glucose (−40% for spaghetti and −22% for penne compared with couscous; −41% for spaghetti and −30% for penne compared with bread), compared with the other grain products (P < 0.05). Pasta products required more chews (spaghetti: 34 ± 18; penne: 38 ± 20; bread: 27 ± 13; couscous: 24 ± 17) and longer oral processing (spaghetti: 21 ± 13 s; penne: 23 ± 14 s; bread: 18 ± 9 s; couscous: 14 ± 10 s) compared with bread or couscous (P < 0.01). Pastas contained more large particles (46–67% of total particle area) compared with bread (0–30%) and couscous (1%) after mastication and in vitro gastric digestion. After in vitro gastric digestion, pasta samples still contained large areas of nonhydrolyzed starch embedded within the protein network; the protein in bread and couscous was almost entirely digested, and the starch was hydrolyzed.ConclusionsPreservation of the pasta structure during mastication and gastric digestion explains slower starch hydrolysis and, consequently, lower postprandial glycemia compared with bread or couscous prepared from the same durum wheat semolina flour in healthy adults.The postprandial in vivo trials were registered at clinicaltrials.gov as NCT03098017 and NCT03104686.

The relative contribution of diurnal and nocturnal glucose exposures to HbA1c in type 1 diabetes males: a pooled analysis

PurposeThe exact contribution of daily glucose exposure to HbA1c in people with type 1 diabetes (T1D) remains controversial. We examined the contribution of pre- and postprandial glycaemia, nocturnal and early-morning glycaemia, and glycaemic variability to HbA1c levels in T1D. In this analysis, we used clinical data, namely age, BMI and HbA1c, as well as glycaemic metrics (24-h glycaemia, postprandial, nocturnal, early-morning glycaemia, wake-up glucose, and glycaemic variability) obtained over a four-week period of continuous glucose monitoring (CGM) wear in thirty-two males with T1D.MethodsThe trapezoid method was used estimate the incremental area under the glucose curve (iAUC) for 24-h, postprandial (3-h period following breakfast, lunch, and dinner, respectively), nocturnal (between 24:00–04:00 AM), and early-morning (2-h period 2-h prior to wake-up) glycaemia. Linear regression analysis was employed whereby CGM-derived glycaemic metrics were explanatory variables and HbA1c was the outcome.ResultsThirty-two T1D males (mean ± SD: age 29 ± 4 years; HbA1c 7.3 ± 0.9% [56 ± 13 mmol/mol]; BMI 25.80 ± 5.01 kg/m2) were included in this analysis. In linear models adjusted for age and BMI, HbA1c was associated with 24-h mean glucose (r2 = 0.735, p < 0.001), SD (r2 = 0.643, p = 0.039), and dinner iAUC (r2 = 0.711, p = 0.001). CGM-derived metrics and non-glycaemic factors explained 77% of the variance in HbA1c, in which postprandial glucose accounted for 32% of the variance explained. The single greatest contributor to HbA1c was dinner iAUC resulting in 0.6%-point (~7 mmol/mol) increase in HbA1c per SD increase in dinner iAUC.ConclusionsUsing comprehensive CGM profiling, we show that postprandial glucose, specifically evening-time postprandial glucose, is the single largest contributing factor to HbA1c in T1D.Trial registration numberNCT02204839 (July 30th 2014); NCT02595658 (November 3rd 2015).

Postprandial Glucose Responses to Standardised Meals Consumed After Moderate- and High-Intensity Exercise Bouts Across Standard School Days in Healthy Adolescents

Exercise-induced moderation of postprandial glycaemia in adolescents is unclear and has not been examined under free-living conditions. We assessed the effect of moderate-intensity exercise (MIE) and high-intensity intermittent exercise (HIIE) bouts on subsequent postprandial glycaemic responses across three standard school days. Fourteen healthy adolescents (13 ± 1 years) completed three conditions in the following order across consecutive days: MIE, 30-min continuous brisk walking; CON, no-exercise control; HIIE, 30-min of 10 × 30-s sprints interspersed with 2.5-min brisk walking bouts. Participants consumed three standardised meals (breakfast, lunch and dinner) at standardised times. Interstitial glucose, energy intake, sedentary time and physical activity were assessed under free-living conditions. Linear mixed models compared glucose outcomes between conditions, and Cohen’s d effect sizes were calculated. Although non-significant, the reduction in post-breakfast glucose iAUC was moderate for MIE (-0.24 mmol·L-1; P = 0.59; d = 0.77) and large for HIIE (-0.26 mmol·L-1; P = 0.44; d = 0.86) compared with CON. Non-significant, moderate (0.37 mmol·L-1; P = 0.22; d = 0.70) and large (0.42 mmol·L-1; P = 0.20; d = 0.81) increases in post-lunch glucose iAUC were observed for MIE and HIIE compared with CON. Nevertheless, the 24-h mean glucose was stable at ~5.4 mmol·L-1 across conditions. The glycaemic variability indices calculated over 24-h after the onset of exercise for each condition including standard deviation (P = 0.59) and mean amplitude of glycaemic excursion (P = 0.82) were not different between conditions. Thirty-minute bouts of MIE and HIIE did not change postprandial glycaemia or 24-h glycaemic variability significantly in the small sample of healthy adolescents. However, the moderate and large effect sizes suggest both MIE and HIIE reduced breakfast glucose iAUC compared with CON, yet led to increases in post-lunch iAUC in the two exercise conditions. The mismatch between the probability values and effect sizes was a consequence of our COVID-reduced sample. The ramifications of these exercise effects are unclear and need to be confirmed in a larger sample of adolescents.

Carbohydrate-Energy Replacement Following High-Intensity Interval Exercise Blunts Next-Day Glycemic Control in Untrained Women.

BackgroundImproved glycemic control has been reported for ∼24 h following low-volume high-intensity interval exercise (HIIE), but it is unclear if this is a direct effect of exercise or an indirect effect of the exercise-induced energy deficit. The purpose of this study was to investigate the effect of carbohydrate-energy replacement after low-volume HIIE on 24 h glycemic control in women.MethodsSeven untrained women (age: 22 ± 2 yr; BMI: 22 ± 3 kg/m2; VO2peak: 33 ± 7 ml/kg/min) completed three 2-day trials in the mid-follicular phase of the menstrual cycle. Continuous glucose monitoring was used to measure blood glucose concentrations during, and for 24 h following three conditions: (1) HIIE followed by a high-carbohydrate energy replacement drink (EX-HC); (2) HIIE followed by a non-caloric taste-matched placebo drink (EX-NC); and (3) seated control with no drink (CTL). HIIE involved an evening session (1,700 h) of 10 × 1-min cycling efforts at ∼90% maximal heart rate with 1 min recovery. Diet was standardized and identical across all three 2-day trials, apart from the post-exercise carbohydrate drink in EX-HC, which was designed to replenish the exercise-induced energy expenditure. Postprandial glycemic responses to the following days breakfast, snack, lunch, and dinner, as well as 24 h indices of glycemic control, were analyzed.ResultsThe day after HIIE, postprandial glycemia following breakfast and snack were reduced in EX-NC compared to EX-HC, as reflected by lower 3 h glucose mean (breakfast: 5.5 ± 0.5 vs. 6.7 ± 1, p = 0.01, Cohen’s d = 1.4; snack: 4.9 ± 0.3 vs. 5.7 ± 0.8 mmol/L, p = 0.02, d = 1.4) and/or area under the curve (AUC) (breakfast: 994 ± 86 vs. 1,208 ± 190 mmol/L x 3 h, p = 0.01, d = 1.5). Postprandial glycemic responses following lunch and dinner were not different across conditions (p > 0.05). The 24 h glucose mean (EX-NC: 5.2 ± 0.3 vs. EX-HC: 5.7 ± 0.7 mmol/L; p = 0.02, d = 1.1) and AUC (EX-NC: 7,448 ± 425 vs. EX-HC: 8,246 ± 957 mmol/L × 24 h; p = 0.02, d = 1.1) were reduced in EX-NC compared to EX-HC.ConclusionPost-exercise carbohydrate-energy replacement attenuates glycemic control the day following a single session of low-volume HIIE in women.