Improvement of dietary quality with the aid of a low glycemic index diet in Asian patients with type 2 diabetes mellitus.

PubMed

Barakatun Nisak, Mohd Yusof; Ruzita, Abd Talib; Norimah, A Karim; Gilbertson, Heather; Nor Azmi, Kamaruddin

2010-06-01

This randomized controlled study was conducted to determine the effect of low glycemic index (GI) dietary advice on eating patterns and dietary quality in Asian patients with type 2 diabetes (T2DM). Asian patients with T2DM (N  =  104) were randomized into 2 groups that received either low GI or conventional carbohydrate exchange (CCE) dietary advice for 12 weeks. Nutritional prescriptions were based on the medical nutrition therapy for T2DM, with the difference being in the GI component of the carbohydrates. Dietary intake and food choices were assessed with the use of a 3-day food record. At week 12, both groups achieved the recommendations for carbohydrate (52 ± 4% and 54 ± 4% of energy) and fat (30 ± 4% and 28 ± 5% of energy) intake. There were no significant differences in the reported macronutrient intake in both groups. With the low GI diet, crude fiber and dietary calcium intake increased, while the dietary GI reduced. Subjects in the lowest dietary glycemic index/glycemic load (GI/GL) quartile consumed more parboiled/basmati rice, pasta, milk/dairy products, fruits, and dough, which are foods from the low GI category. There was a significant reduction in the hemoglobin A(1c) level at week 12 for patients in the lowest GI/GL quartile (Δ  =  -0.7 ± 0.1%) compared with those in the highest GI/GL quartile (Δ  =  -0.1 ± 0.2%). These results demonstrate the ability of low GI dietary advice to improve the dietary quality of Asian patients with T2DM.

Glycemic Index Diet: What's Behind the Claims

MedlinePlus

... choices for people with diabetes. An international GI database is maintained by Sydney University Glycemic Index Research Services in Sydney, Australia. The database contains the results of studies conducted there and ...

The glycemic index: methodological aspects related to the interpretation of health effects and to regulatory labeling.

PubMed

Aziz, Alfred

2009-01-01

The glycemic index (GI) is an experimental system that classifies carbohydrates (CHO) and CHO-containing foods according to their blood glucose-raising potential. It is based on the glycemic response following the ingestion of a test food containing a defined amount of available CHO relative to that of an equi-carbohydrate portion of either white bread or glucose. The concept has been extended to mixed meals and whole diets where the GI of the meal/diet is expressed as the weighted average of the GI of each food, based on the percentage of the total mealldiet CHO provided by each food. Over the last few decades, a substantial number of epidemiological and interventional studies have reported beneficial associationsleffects of lower GI diets across a wide spectrum of pathophysiological conditions, including diabetes, cardiovascular disease, obesity, and certain forms of cancer. This has prompted proponents of the GI to recommend its use for dietary planning and labeling purposes. However, the currently recommended GI methodology is not well standardized and has several flaws, which brings into question the strength of evidence attributed to the health effects of low-GI diets. This review focuses exclusively on the methodological aspects of the GI, how they might impact the interpretation of data related to the purported health benefits of low GI diets, and the considerations for the use of the GI in food labeling. In addition, alternative systems for classifying the glycemic effects of CHO-containing foods are briefly discussed.

Glycemic indices, glycemic load and glycemic response for seventeen varieties of dates grown in Saudi Arabia.

PubMed

AlGeffari, Metab Ali; Almogbel, Ebtehal Solaiman; Alhomaidan, Homaidan Turki; El-Mergawi, Ragab; Barrimah, Issam Alsaed

2016-01-01

Dates are consumed worldwide, and are an important fruit for many individuals in Saudi Arabia. Currently, limited information is available on the glycemic indices of different date varieties. To determine the glycemic index (GI), glycemic load (GL) and glycemic response for 17 common date varieties in Saudi Arabia. Prospective clinical trial on healthy subjects. College of Medicine, Qassim University, Buraydah, Saudi Arabia. The available carbohydrate content of Tamer stage dates was determined using standard laboratory methods. Healthy subjects (ten males and nine females) received 50 g of glucose (on three separate occasions) and 50 g equivalent of available carbohydrates from the seventeen varieties of date (each once). The GI and GL were then calculated. GI, GL, and glycemic response. The mean (SEM) GI of the date samples was 55.2 (7.7) (range, 42.8-74.6). Sellaj and Maktoomi exhibited the highest GI (74.6 [10.1] and 71.0 [11.1]), respectively, whereas Shaqra, Sukkary, and Sag'ai had the lowest GI (42.8 [5.5], 43.4 [4.7] and 44.6 [6]), respectively. The GL of the date samples ranged from 8.5 to 24. Sellaj had a high GL (24), whereas Ajwah and Shaqra had a low GL (8.5 and 9.2). The analyses suggested no significant difference in GI between the date varieties. However, the GL values differed significantly between the 17 date varieties (P < .001). The results provide reliable GI and GL values for 17 common date varieties in Saudi Arabia. The identification of date varieties with lower glycemic responses may help lower the GI of the diet of both healthy and diabetic Saudi individuals. We used dates at the Tamer stage, which may not be translatable to all types of dates.

Glycemic index, glycemic load and invasive breast cancer incidence in postmenopausal women: The PREDIMED study.

PubMed

Castro-Quezada, Itandehui; Sánchez-Villegas, Almudena; Martínez-González, Miguel Á; Salas-Salvadó, Jordi; Corella, Dolores; Estruch, Ramón; Schröder, Helmut; Álvarez-Pérez, Jacqueline; Ruiz-López, María D; Artacho, Reyes; Ros, Emilio; Bulló, Mónica; Sorli, Jose V; Fitó, Montserrat; Ruiz-Gutiérrez, Valentina; Toledo, Estefanía; Buil-Cosiales, Pilar; García Rodríguez, Antonio; Lapetra, José; Pintó, Xavier; Salaverría, Itziar; Tur, Josep A; Romaguera, Dora; Tresserra-Rimbau, Anna; Serra-Majem, Lluís

2016-11-01

The objective of this study was to evaluate the prospective associations between dietary glycemic index (GI) and glycemic load (GL) and the risk for invasive breast cancer incidence in postmenopausal women at high cardiovascular disease (CVD) risk. This study was conducted within the framework of the PREvención con DIeta MEDiterránea (PREDIMED) study, a nutritional intervention trial for primary cardiovascular prevention. We included 4010 women aged between 60 and 80 years who were initially free from breast cancer but at high risk for CVD disease. Dietary information was collected using a validated 137-item food frequency questionnaire. We assigned GI values using the International Tables of GI and GL values. Cases were ascertained through yearly consultation of medical records and through consultation of the National Death Index. Only cases confirmed by results from cytology tests or histological evaluation were included. We estimated multivariable-adjusted hazard ratios for invasive breast cancer risk across tertiles of energy-adjusted dietary GI/GL using Cox regression models. We repeated our analyses using yearly repeated measures of GI/GL intakes. No associations were found between baseline dietary GI/GL and invasive breast cancer incidence. The multivariable hazard ratio and 95% confidence interval (CI) for the top tertile of dietary GI was 1.02 (95% CI: 0.42-2.46) and for dietary GL was 1.00 (95% CI: 0.44-2.30) when compared with the bottom tertile. Repeated-measures analyses yielded similar results. In sensitivity analyses, no significant associations were observed for women with obesity or diabetes. Dietary GI and GL did not appear to be associated with an increased risk for invasive breast cancer in postmenopausal women at high CVD risk.

Dietary glycemic index is associated with less favorable anthropometric and metabolic profiles in polycystic ovary syndrome women with different phenotypes.

PubMed

Graff, Scheila Karen; Mário, Fernanda Missio; Alves, Bruna Cherubini; Spritzer, Poli Mara

2013-10-01

To compare glycemic index (GI) in the usual diet of polycystic ovary syndrome (PCOS) and control women and to investigate whether dietary GI is associated with body composition and anthropometric and metabolic variables across PCOS phenotypes. Cross-sectional study. University hospital outpatient clinic. Sixty-one women with PCOS and 44 nonhirsute women with ovulatory cycles. Metabolic work-up, biochemical and hormonal assays, assessment of body composition and rest metabolic rate, physical activity (pedometer), and food consumption (food frequency questionnaire). GI, glycemic load, dietary intake, and hormone and metabolic profile in PCOS versus control and in PCOS women stratified by tertiles of GI and PCOS phenotype. Mean age was 23.7 ± 6.3 years. Participants with PCOS had higher body fat percentage, fasting insulin, insulin resistance, lipid accumulation product, and androgen levels compared with control women. PCOS and control women in the highest tertile of GI had higher body mass index and waist circumference than those in the lowest tertile. Dietary GI was higher in the classic PCOS group. Obesity and this more severe PCOS phenotype explained 28.3% of variance in dietary GI. Dietary GI is increased in the classic PCOS phenotype and associated with a less favorable anthropometric and metabolic profile. Obesity and classic PCOS phenotype are age-independent predictors of higher dietary GI. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

[Glycemic, insulinemic index, glycemic load of soy beverage with low and high content of carbohydrates].

PubMed

Torres y Torres, Nimbe; Palacios-González, Berenice; Noriega-López, Lilia; Tovar-Palacio, Armando R

2006-01-01

Consumption of soy has increased in Western countries due to the benefits on health and the attitude of the people to consume natural products as alternative to the use of pharmacological therapies. However, there is no evidence whether the consumption of 25 g of soy protein as recommended by the Food and Drug Administration has some effect on glucose absorption and consequently on insulin secretion. The aim of the present study was to determine glycemic index (GI), insulinemic index (InIn), and glycemic load (GL) of several soy beverages containing low or high concentration of carbohydrates, and compare them with other foods such as peanuts, whole milk, soluble fiber and a mixed meal on GI and InIn. The results showed that soy beverages had low or moderate GI, depending of the presence of other compounds like carbohydrates and fiber. Consumption of soy beverages with low concentration of carbohydrates produced the lowest insulin secretion. Therefore, these products can be recommended in obese and diabetic patients. Finally soy beverages should contain low maltodextrins concentration and be added of soluble fiber.

Glycemic index, glycemic load, and pulse wave reflection in adults.

PubMed

Recio-Rodriguez, J I; Gomez-Marcos, M A; Patino-Alonso, M-C; Rodrigo-De Pablo, E; Cabrejas-Sánchez, A; Arietaleanizbeaskoa, M S; Repiso-Gento, I; Gonzalez-Viejo, N; Maderuelo-Fernandez, J A; Agudo-Conde, C; Garcia-Ortiz, L

2015-01-01

Diets with a high glycemic index (GI), high glycemic load (GL), or both, increase the risk of cardiovascular disease. This study examined the association of GI and GL in a regular diet with the peripheral augmentation index (i.e., a marker of vascular aging) in a sample of adults. Cross-sectional study. The findings presented in this manuscript are a subanalysis of the EVIDENT study whose purpose was to analyze the relationship between lifestyle and arterial aging. For the sample population, 1553 individuals aged 20-80 years were selected through random sampling from the patients of general practitioners at six health centers in Spain. GI and GL for each patient's diet were calculated from a previously validated, semi-quantitative, 137-item food frequency questionnaire. The peripheral augmentation index corrected for a heart rate of 75 bpm (PAIx75) was measured with pulse-wave application software (A-Pulse CASP). Based on a risk factor adjusted regression model, for every 5 unit increase in GI, the PAIx75 increased by 0.11 units (95% CI: 0.04-0.19). Similarly, for every increase in 10 units in GL, the PAIx75 increased by 1.13 (95% CI: 0.21-2.05). High PAIx75 values were observed in individuals with diets in the third GI tertile (i.e., the highest), and lower PAIx75 values in those with diets in the first tertile (i.e., the lowest), (93.1 vs. 87.5, respectively, p = 0.001). GI and GL were directly associated with PAIx75 values in adults without cardiovascular diseases regardless of age, gender, physical activity, and other confounders. Copyright © 2014 Elsevier B.V. All rights reserved.

The effect of high- and low-glycemic index energy restricted diets on plasma lipid and glucose profiles in type 2 diabetic subjects with varying glycemic control.

PubMed

Heilbronn, Leonie K; Noakes, Manny; Clifton, Peter M

2002-04-01

To determine whether glycemic index (GI) differentially affects improved glucose and lipid profiles observed during weight loss in overweight subjects previously diagnosed with type 2 diabetes with variable glucose tolerance. Twenty-three female and twenty-two male overweight subjects participated in 12 weeks of energy restriction (average BMI 33.2 kg/m2, age 56.7 years, glycated hemoglobin (GHb) 6.7%). After a four-week run-in on a high saturated fat (SFA) diet (1540 kcal/day, 17% SFA), the free-living subjects were randomly assigned to either a high- (75 GI units) or low- (43 GI units) GI diet (1440 kcal/day, 60% carbohydrate, 5% SFA) for eight weeks. Weight, serum lipids, plasma glucose and glycated hemoglobin were measured every four weeks. An oral glucose tolerance test (OGTT) was also performed at baseline, weeks 4 and 12. From the baseline OGTT results subjects were divided into three groups of low, median and high glucose tolerance. At baseline, BMI, age and glycated hemoglobin concentrations were not different between subjects allocated to the high- or low-GI diets. After four weeks, weight loss was 3.6+/-0.3 kg. Fasting glucose (-5.6%), glycated hemoglobin (-2.8%), area under the glucose curve (-13.0%) and triglyceride (-13.8%) concentrations were reduced (p < 0.02). Between weeks 4 and 12 reductions were observed in weight (-4.9%), fasting glucose (-4.6%), area under glucose curve (-10.1%), glycated hemoglobin (-7.2%), triglyceride (-7.5%) and LDL-C (-13.2%) concentrations. Weight loss was not different between low and high-GI diets. However, glycated hemoglobin was reduced twofold more in subjects consuming a low-GI diet as compared to subjects consuming a high-GI diet, but this was not statistically significant. LDL concentrations were also reduced more in subjects with low glucose tolerance on the low-GI diet (p = 0.02). Weight loss produces substantial improvements in glycemic control and lipoprotein metabolism. Lowering the glycemic index of high carbohydrate, low fat diets increases the fall in LDL cholesterol in subjects with type 2 diabetes with low glucose tolerance, but has little effect on glycemic control.

Effect of macronutrients and fiber on postprandial glycemic responses and meal glycemic index and glycemic load value determinations.

PubMed

Meng, Huicui; Matthan, Nirupa R; Ausman, Lynne M; Lichtenstein, Alice H

2017-04-01

Background: The potential confounding effect of different amounts and proportions of macronutrients across eating patterns on meal or dietary glycemic index (GI) and glycemic load (GL) value determinations has remained partially unaddressed. Objective: The study aimed to determine the effects of different amounts of macronutrients and fiber on measured meal GI and GL values. Design: Four studies were conducted during which participants [ n = 20-22; women: 50%; age: 50-80 y; body mass index (in kg/m 2 ): 25-30)] received food challenges containing different amounts of the variable nutrient in a random order. Added to the standard 50 g available carbohydrate from white bread was 12.5, 25, or 50 g carbohydrate; 12.5, 25, or 50 g protein; and 5.6, 11.1, or 22.2 g fat from rice cereal, tuna, and unsalted butter, respectively, and 4.8 or 9.6 g fiber from oat cereal. Arterialized venous blood was sampled for 2 h, and measured meal GI and GL and insulin index (II) values were calculated by using the incremental area under the curve (AUC i ) method. Results: Adding carbohydrate to the standard white-bread challenge increased glucose AUC i ( P < 0.0001), measured meal GI ( P = 0.0066), and mean GL ( P < 0.0001). Adding protein (50 g only) decreased glucose AUC i ( P = 0.0026), measured meal GI ( P = 0.0139), and meal GL ( P = 0.0140). Adding fat or fiber had no significant effect on these variables. Adding carbohydrate (50 g), protein (50 g), and fat (11.1 g) increased the insulin AUC i or II; fiber had no effect. Conclusions: These data indicate that uncertainty in the determination of meal GI and GL values is introduced when carbohydrate-containing foods are consumed concurrently with protein (equal amount of carbohydrate challenge) but not with carbohydrate-, fat-, or fiber-containing foods. Future studies are needed to evaluate whether this uncertainty also influences the prediction of average dietary GI and GL values for eating patterns. This trial was registered at clinicaltrials.gov as NCT01023646. © 2017 American Society for Nutrition.

Effect of macronutrients and fiber on postprandial glycemic responses and meal glycemic index and glycemic load value determinations123

PubMed Central

Meng, Huicui; Matthan, Nirupa R; Ausman, Lynne M; Lichtenstein, Alice H

2017-01-01

Background: The potential confounding effect of different amounts and proportions of macronutrients across eating patterns on meal or dietary glycemic index (GI) and glycemic load (GL) value determinations has remained partially unaddressed. Objective: The study aimed to determine the effects of different amounts of macronutrients and fiber on measured meal GI and GL values. Design: Four studies were conducted during which participants [n = 20–22; women: 50%; age: 50–80 y; body mass index (in kg/m2): 25–30)] received food challenges containing different amounts of the variable nutrient in a random order. Added to the standard 50 g available carbohydrate from white bread was 12.5, 25, or 50 g carbohydrate; 12.5, 25, or 50 g protein; and 5.6, 11.1, or 22.2 g fat from rice cereal, tuna, and unsalted butter, respectively, and 4.8 or 9.6 g fiber from oat cereal. Arterialized venous blood was sampled for 2 h, and measured meal GI and GL and insulin index (II) values were calculated by using the incremental area under the curve (AUCi) method. Results: Adding carbohydrate to the standard white-bread challenge increased glucose AUCi (P < 0.0001), measured meal GI (P = 0.0066), and mean GL (P < 0.0001). Adding protein (50 g only) decreased glucose AUCi (P = 0.0026), measured meal GI (P = 0.0139), and meal GL (P = 0.0140). Adding fat or fiber had no significant effect on these variables. Adding carbohydrate (50 g), protein (50 g), and fat (11.1 g) increased the insulin AUCi or II; fiber had no effect. Conclusions: These data indicate that uncertainty in the determination of meal GI and GL values is introduced when carbohydrate-containing foods are consumed concurrently with protein (equal amount of carbohydrate challenge) but not with carbohydrate-, fat-, or fiber-containing foods. Future studies are needed to evaluate whether this uncertainty also influences the prediction of average dietary GI and GL values for eating patterns. This trial was registered at clinicaltrials.gov as NCT01023646. PMID:28202475

Overall glycemic index and glycemic load of vegan diets in relation to plasma lipoproteins and triacylglycerols.

PubMed

Waldmann, Annika; Ströhle, Alexander; Koschizke, Jochen W; Leitzmann, Claus; Hahn, Andreas

2007-01-01

To investigate the overall glycemic index (GI), glycemic load (GL), and intake of dietary fiber, and to examine the associations between these factors and plasma lipoproteins and triacylglycerols in adult vegans in the German Vegan Study (GVS). Cross-sectional study, Germany. Healthy men (n = 67) and women (n = 87), who fulfilled the study criteria (vegan diet for >or=1 year prior to study start; minimum age of 18 years; no pregnancy/childbirth during the last 12 months) and who participated in all study segments. The average dietary GL of the GVS population was 144, and the average GI was 51.4. The adjusted geometric mean total, HDL, and LDL cholesterol concentrations decreased across the increasing quartiles of GL, carbohydrate and dietary fiber intake. The associations between total cholesterol, HDL cholesterol, LDL cholesterol and GL density and GI were inconsistent. Also, associations between GI, GL, the intake of carbohydrates, and triacylglycerol concentration were not observed. Fiber-rich vegan diets are characterized by a low GI and a low to moderate GL. The data do not support the hypothesis that a carbohydrate-rich diet per se is associated with unfavorable effects on triaclyglycerols that would be predicted to increase the risk of coronary heart disease. Copyright (c) 2007 S. Karger AG, Basel.

A prospective clinical pilot-trial comparing the effect of an optimized mixed diet versus a flexible low-glycemic index diet on nutrient intake and HbA(1c) levels in children with type 1 diabetes.

PubMed

Marquard, Jan; Stahl, Anna; Lerch, Christian; Wolters, Mareen; Grotzke-Leweling, Maike; Mayatepek, Ertan; Meissner, Thomas

2011-01-01

Low-glycemic index (GI) diet vs. high-GI diet improves glycemic control, but it is not clear whether a low-GI diet is superior to an optimized mixed diet (OMD). This was a 12-week parallel-group pilot-trial including 17 children with type 1 diabetes. A separate dietary education into the allocated diet (OMD vs. low-GI) was performed. Nutrition was recorded by means of a three-day dietary record. The primary objective was to determine the macro- and micronutrient composition of the different diets, the secondary objective was to determine the short-term effect on HbA(1c) levels. In the low-GI group carbohydrate intake decreased, fat intake increased by trend. In the OMD group fat and energy intake decreased. No changes of HbA(1c) levels between the groups were observed. OMD could have positive effects in overweight and obese diabetic children, since a reduction in fat and energy intake can be achieved. The findings of this pilot-trial suggest that OMD could be superior to a low-GI diet.

High hydrostatic pressure processing reduces the glycemic index of fresh mango puree in healthy subjects.

PubMed

Elizondo-Montemayor, Leticia; Hernández-Brenes, Carmen; Ramos-Parra, Perla A; Moreno-Sánchez, Diana; Nieblas, Bianca; Rosas-Pérez, Aratza M; Lamadrid-Zertuche, Ana C

2015-04-01

Dietary guidelines recommend the daily consumption of fruits; however, healthy and type 2 diabetes mellitus (T2DM) subjects receive conflicting messages regarding ingestion of fruits, such as mango, because of its sugar content. We investigated the effects of high hydrostatic pressure (HHP) processing of fresh mango puree (MP) on the glycemic indexes (GIs) and postprandial glycemic responses of 38 healthy Mexican subjects in a randomized cross-over clinical trial. Physicochemical characterization of MP included sugar profiles by HPLC-ELSD, starch, fibers, moisture, viscosity, swelling capacity and solubility properties of alcohol insoluble residue (AIR). The mean GI for HHP-MP was significantly lower (32.7 ± 13.4) than that of unprocessed-MP (42.7 ± 19.5). A significantly higher proportion of subjects showed a low GI following the consumption of HHP-MP compared to unprocessed-MP and none of them showed a high GI for the HHP-MP, compared to a significantly higher proportion for the unprocessed-MP. The viscosity and AIR solubility values of HHP-MP samples were significantly higher, which influenced glucose peaking later (Tmax) at 45 minutes and induced 20% lower AUC values than unprocessed-MP, corresponding to greater retardation indexes. The study findings support data stating that low GI fruits are appropriate for glycemic control and that mango may be included as part of healthy subjects' diets and potentially T2DM subjects' diets. Furthermore, HHP processing of mango may offer additional benefits for glycemic control, as its performance regarding GI, AUC and Tmax was significantly better than that of the unprocessed-MP. To our knowledge, this is the first report on the impact of this commercial non-thermal pasteurization technology on glucose metabolism.

Maternal dietary glycemic index and glycemic load in early pregnancy are associated with offspring adiposity in childhood: the Southampton Women's Survey.

PubMed

Okubo, Hitomi; Crozier, Sarah R; Harvey, Nicholas C; Godfrey, Keith M; Inskip, Hazel M; Cooper, Cyrus; Robinson, Siân M

2014-08-01

Maternal hyperglycemia in pregnancy is associated with greater adiposity in offspring. The glycemic index (GI) and glycemic load (GL) describe the glycemic response to carbohydrate ingestion. However, the influence of maternal dietary GI and GL in pregnancy on childhood adiposity is unknown. We examined relations of maternal dietary GI and GL in early and late pregnancy with offspring body composition. A total of 906 mother-child pairs from the prospective cohort the Southampton Women's Survey were included. Children underwent dual-energy X-ray absorptiometry measurements of body composition at birth and 4 and 6 y of age. Log-transformed fat mass and lean mass were standardized with a mean (±SD) of 0 ± 1. Maternal dietary GI and GL were assessed at 11 and 34 wk of gestation by using an administered food-frequency questionnaire. After control for potential confounders, both maternal dietary GI and GL in early pregnancy were positively associated with fat mass at 4 and 6 y of age [fat mass SDs per 10-unit GI increase: β = 0.43 (95% CI: 0.06, 0.80), P = 0.02 at 4 y of age; β = 0.40 (95% CI: 0.10, 0.70), P = 0.01 at 6 y of age; fat mass SDs per 50-unit GL increase: β = 0.43 (95% CI: 0.19, 0.67), P < 0.001 at 4 y of age; β = 0.27 (95% CI: 0.07, 0.47), P = 0.007 at 6 y of age]. In contrast, there were no associations between maternal dietary GI or GL in late pregnancy and offspring fat mass at these ages. Maternal dietary GI and GL were not associated with fat mass at birth or offspring lean mass at any of the ages studied. Higher maternal dietary GI and GL in early pregnancy are associated with greater adiposity in childhood. © 2014 American Society for Nutrition.

Effect of prior meal macronutrient composition on postprandial glycemic responses and glycemic index and glycemic load value determinations.

PubMed

Meng, Huicui; Matthan, Nirupa R; Ausman, Lynne M; Lichtenstein, Alice H

2017-11-01

Background: The potential impact of prior meal composition on the postprandial glycemic response and glycemic index (GI) and glycemic load (GL) value determinations remains unclear. Objective: We determined the effect of meals that varied in macronutrient composition on the glycemic response and determination of GI and GL values of a subsequent standard test food. Design: Twenty healthy participants underwent 6 test sessions within 12 wk. The subjects received each of 3 isocaloric breakfast meals (i.e., high carbohydrate, high fat, or high protein) on separate days in a random order, which was followed by a standard set of challenges (i.e., white bread and a glucose drink) that were tested on separate days in a random order 4 h thereafter. Each challenge provided 50 g available carbohydrate. Arterialized venous blood was sampled throughout the 2-h postchallenge period. GI, GL, and insulin index (II) values were calculated with the use of the incremental area under the curve (AUC i ) method, and serum lipids were determined with the use of standard assays. Results: The consumption of the high-protein breakfast before the white-bread challenge attenuated the rise in the postprandial serum glucose response ( P < 0.0001) and resulted in lower glucose AUC i ( P < 0.0001), GI ( P = 0.0096), and GL ( P = 0.0101) values than did the high-carbohydrate and high-fat breakfasts. The high-protein breakfast resulted in a lower insulin AUC i ( P = 0.0146) for white bread than did the high-fat breakfast and a lower II value ( P = 0.0285) than did the high-carbohydrate breakfast. The 3 breakfasts resulted in similar serum lipid responses to the white-bread challenge. Conclusions: These data indicate that the macronutrient composition of the prior meal influences the glycemic response and the determination of GI and GL values for white bread. Future studies are needed to determine whether the background food macronutrient composition influences mean dietary GI and GL values that are calculated for eating patterns, which may alter the interpretation of the associations between these values and chronic disease risk. This trial was registered at clinicaltrials.gov as NCT01023646. © 2017 American Society for Nutrition.

Comparison of a low-glycemic index vs standard diabetic diet.

PubMed

Visek, Jakub; Lacigova, Silvie; Cechurova, Daniela; Rusavy, Zdenek

2014-01-01

There is insufficient evidence for the efficacy of a low-glycemic index (GI) diet in the management of diabetes. The goal of this study was to measure the effect of a low GI versus a standard diabetic diet in adults with diabetes type 2. This was an open label, randomized, crossover study. Twenty persons with type 2 diabetes were randomized to two groups. Each group followed a standard diabetic diet or a low glycemic index diet for 3 months. The effectiveness of the two diets was evaluated using a hyperinsulinemic euglycemic clamp with endogenous glucose production measurement, indirect calorimetry and bioimpedance analysis. Outcome measures were body mass, BMI, body fat, glycosylated hemoglobin, fasting glucose, lipid profile, insulin sensitivity and hepatic glucose production. Body mass after 3 months following the diabetic diet was 93 kg (83-104) vs. low glycemic index diet 92 kg (85-104) P<0.05, BMI 31.3 kg/m(2) (27.5-35.9) vs. 30.7 kg/m(2) (27-35.3) P<0.05, body fat 28% (25.5-43) vs. 27% (23-43) P<0.05 (median and interquartile range). There was no statistically significant difference between diets for glycosylated hemoglobin, fasting glucose, lipid profile, insulin sensitivity or hepatic glucose production. The results are comparable with other studies showing a modest effect of a low GI diet in the management of diabetes. We found a modestly greater weight loss, body fat and BMI reduction on the low GI diet.

Glycemic index and glycemic load in the Opuntia ficus-indica fruit

PubMed

Ibarra-Salas, María de Jesús; Novelo-Huerta, Hilda Irene; De León-Salas, Marcela Alejandra; Sánchez-Murillo, Mayra Elisa; Mata-Obregón, María Del Carmen; Garza-Juárez, Aurora de Jesús

2017-01-01

There is evidence that support the clinical usage of glycemic index (GI) and glycemic load (GL) in the prevention of chronic disease. To determine the GI and GL of the Opuntia ficus-indica fruit. An analytic, transversal study was made involving 25 healthy volunteers accepted by an informed consent with a normal body mass index, glucose, glycoside hemoglobin, cholesterol and serum triglycerides. The homogeneity of the population was evaluated with anthropometrical and biochemical data using principal component analysis (PCA). The equivalent of 50 g of carbohydrates test food (tuna) and 50 g of dextrose as food standard was provided for the measure of the glucose curve. The GI was determined by calculating the area under the curve by the triangulation method. The CG was reported as the product of IG by carbohydrate loading provided. The IG of the tuna was 48.01 ± 17.4, classified as low, while the CG was 24.0 ± 8.7 rated as high. The chemometric analysis by PCA showed that the selection of the normal population for determining the IG, it is important to consider the values of cholesterol and triglycerides. Copyright: © 2017 SecretarÍa de Salud

Extended Prandial Glycemic Profiles of Foods as Assessed Using Continuous Glucose Monitoring Enhance the Power of the 120-Minute Glycemic Index

PubMed Central

Chlup, Rudolf; Peterson, Karolina; Zapletalová, Jana; Kudlová, Pavla; Sečkař, Pavel

2010-01-01

Background The glycemic index (GI) is routinely measured 120 minutes after food intake (GI120). The purpose of this prospective open label study was to assess (1) the dynamics of glycemia over the 210 minutes following food consumption and (2) the evolution of GIs based on 120-, 150-, 180-, and 210-minute glycemic profiles. Method Twenty healthy subjects (mean ± SE; 21.9 ± 1.39 years of age; body mass index 23.6 ± 0.63 kg/m2; 7 men and 13 women) completed the study. Each subject consumed 10 different foods with known GI120 on three separate occasions at four different times of day according to a defined meal plan over a 9-day period; 32 meals were evaluated. The GIs for intervals of 120, 150, 180 and 210 minutes after food consumption were determined using a continuous glucose monitoring system (CGMS) to measure glycemia. The Wilcoxon signed-rank test was applied to compare the GIs. Results Glycemia returned to baseline within 120 minutes for honey and tomato soup; within 210 minutes for white bread, choco-rice cookies, fish and potatoes, wafers, and meat ravioli with cheese; and later for dark chocolate, apricot dumplings, and choco-wheat cookies. The extended GIs were higher than the respective GI120s in eight of the foods. Conclusions The 120-minute glycemic index fails to fully account for changes in glycemia after ingestion of a mixed meal because glycemia remains above baseline for a longer period. The CGMS is a convenient method to determine the glucose response/GIs over intervals extended up to 210 minutes, which is adequate time for the absorption of most foods. PMID:20513328

Short-term effects of a low glycemic index carob-containing snack on energy intake, satiety, and glycemic response in normal-weight, healthy adults: Results from two randomized trials.

PubMed

Papakonstantinou, Emilia; Orfanakos, Nickolaos; Farajian, Paul; Kapetanakou, Anastasia E; Makariti, Ifigenia P; Grivokostopoulos, Nikolaos; Ha, Marie-Ann; Skandamis, Panagiotis N

2017-10-01

The potential positive health effects of carob-containing snacks are largely unknown. Therefore, the aims of these studies were to determine the glycemic index (GI) of a carob snack compared with chocolate cookie containing equal amounts of available carbohydrates and to compare the effects of a carob versus chocolate cookie preload consumed as snack before a meal on (a) short-term satiety response measured by subsequent ad libitum meal intake, (b) subjective satiety as assessed by visual analog scales and (c) postprandial glycemic response. Ten healthy, normal-weight volunteers participated in GI investigation. Then, 50 healthy, normal-weight individuals consumed, crossover, in random order, the preloads as snack, with 1-wk washout period. Ad libitum meal (lunch and dessert) was offered. Capillary blood glucose samples were collected at baseline, 2 h after breakfast, just before preload consumption, 2 h after preload, 3 h after preload, just before meal (lunch and dessert), 1 h after meal, and 2 h after meal consumption. The carob snack was a low GI food, whereas the chocolate cookie was a high GI food (40 versus 78, respectively, on glucose scale). Consumption of the carob preload decreased the glycemic response to a following meal and to the individual's feelings of hunger, desire to eat, preoccupation with food, and thirst between snack and meal, as assessed with the use of visual analog scales. Subsequently, participants consumed less amounts of food (g) and had lower total energy intake at mealtimes. The carob snack led to increased satiety, lower energy intake at meal, and decreased postmeal glycemic response possibly due to its low GI value. Identifying foods that promote satiety and decrease glycemic response without increasing the overall energy intake may offer advantages to body weight and glycemic control. Copyright © 2017 Elsevier Inc. All rights reserved.

Calculating meal glycemic index by using measured and published food values compared with directly measured meal glycemic index.

PubMed

Dodd, Hayley; Williams, Sheila; Brown, Rachel; Venn, Bernard

2011-10-01

Glycemic index (GI) testing is normally based on individual foods, whereas GIs for meals or diets are based on a formula using a weighted sum of the constituents. The accuracy with which the formula can predict a meal or diet GI is questionable. Our objective was to compare the GI of meals, obtained by using the formula and by using both measured food GI and published values, with directly measured meal GIs. The GIs of 7 foods were tested in 30 healthy people. The foods were combined into 3 meals, each of which provided 50 g available carbohydrate, including a staple (potato, rice, or spaghetti), vegetables, sauce, and pan-fried chicken. The mean (95% CI) meal GIs determined from individual food GI values and by direct measurement were as follows: potato meal [predicted, 63 (56, 70); measured, 53 (46, 62)], rice meal [predicted, 51 (45, 56); measured, 38 (33, 45)], and spaghetti meal [predicted, 54 (49, 60); measured, 38 (33, 44)]. The predicted meal GIs were all higher than the measured GIs (P < 0.001). The extent of the overestimation depended on the particular food, ie, 12, 15, and 19 GI units (or 22%, 40%, and 50%) for the potato, rice, and spaghetti meals, respectively. The formula overestimated the GI of the meals by between 22% and 50%. The use of published food values also overestimated the measured meal GIs. Investigators using the formula to calculate a meal or diet GI should be aware of limitations in the method. This trial is registered with the Australian and New Zealand Clinical Trials Registry as ACTRN12611000210976.

Acute effects of dietary glycemic index on antioxidant capacity in nutrient-controlled feeding study

USDA-ARS?s Scientific Manuscript database

Oxidative stress, caused by an imbalance between antioxidant capacity and reactive oxygen species, may be an early event in a metabolic cascade elicited by a high glycemic index (GI) diet, ultimately increasing the risk for cardiovascular disease and diabetes. We conducted a feeding study to evalua...

Glycation-altered proteolysis as a pathobiologic mechanism that links dietary glycemic index, aging, and age-related disease in non diabetics

USDA-ARS?s Scientific Manuscript database

Epidemiologic studies indicate that the risks for major age-related debilities including coronary heart disease, diabetes, and age-related macular degeneration (AMD) are diminished in people who consume lower glycemic index (GI) diets, but lack of a unifying physiobiochemical mechanism that explains...

Cfh genotype interacts with dietary glycemic index to modulate age-related macular degeneration-like features in mice

USDA-ARS?s Scientific Manuscript database

Age-related macular degeneration (AMD) is a leading cause of visual impairment worldwide. Genetics and diet contribute to the relative risk for developing AMD, but their interactions are poorly understood. Genetic variations in Complement Factor H (CFH), and dietary glycemic index (GI) are major ris...

Glycemic index and glycemic load of selected Chinese traditional foods

PubMed Central

Chen, Ya-Jun; Sun, Feng-Hua; Wong, Stephen Heung-sang; Huang, Ya-Jun

2010-01-01

AIM: To determine the glycemic index (GI) and glycemic load (GL) values of Chinese traditional foods in Hong Kong. METHODS: Fifteen healthy subjects (8 males and 7 females) volunteered to consume either glucose or one of 23 test foods after 10-14 h overnight fast. The blood glucose concentrations were analyzed immediately before, 15, 30, 45, 60, 90 and 120 min after food consumption using capillary blood samples. The GI value of each test food was calculated by expressing the incremental area under the blood glucose response curve (IAUC) value for the test food as a percentage of each subject’s average IAUC value for the glucose. The GL value of each test food was calculated as the GI value of the food multiplied by the amount of the available carbohydrate in a usual portion size, divided by 100. RESULTS: Among all the 23 Chinese traditional foods tested, 6 of them belonged to low GI foods (Tuna Fish Bun, Egg Tart, Green Bean Dessert, Chinese Herbal Jelly, Fried Rice Vermicelli in Singapore-style, and Spring Roll), 10 of them belonged to moderate GI foods (Baked Barbecued Pork Puff, Fried Fritter, “Mai-Lai” Cake, “Pineapple” Bun, Fried Rice Noodles with Sliced Beef, Barbecue Pork Bun, Moon Cakes, Glutinous Rice Ball, Instant Sweet Milky Bun, and Salted Meat Rice Dumpling), the others belonged to high GI foods (Fried Rice in Yangzhou-Style, Sticky Rice Wrapped in Lotus Leaf, Steamed Glutinous Rice Roll, Jam and Peanut Butter Toast, Plain Steamed Vermicelli Roll, Red Bean Dessert, and Frozen Sweet Milky Bun). CONCLUSION: The GI and GL values for these Chinese traditional foods will provide some valuable information to both researchers and public on their food preference. PMID:20333793

Glycemic index and glycemic load of selected Chinese traditional foods.

PubMed

Chen, Ya-Jun; Sun, Feng-Hua; Wong, Stephen Heung-Sang; Huang, Ya-Jun

2010-03-28

To determine the glycemic index (GI) and glycemic load (GL) values of Chinese traditional foods in Hong Kong. Fifteen healthy subjects (8 males and 7 females) volunteered to consume either glucose or one of 23 test foods after 10-14 h overnight fast. The blood glucose concentrations were analyzed immediately before, 15, 30, 45, 60, 90 and 120 min after food consumption using capillary blood samples. The GI value of each test food was calculated by expressing the incremental area under the blood glucose response curve (IAUC) value for the test food as a percentage of each subject's average IAUC value for the glucose. The GL value of each test food was calculated as the GI value of the food multiplied by the amount of the available carbohydrate in a usual portion size, divided by 100. Among all the 23 Chinese traditional foods tested, 6 of them belonged to low GI foods (Tuna Fish Bun, Egg Tart, Green Bean Dessert, Chinese Herbal Jelly, Fried Rice Vermicelli in Singapore-style, and Spring Roll), 10 of them belonged to moderate GI foods (Baked Barbecued Pork Puff, Fried Fritter, "Mai-Lai" Cake, "Pineapple" Bun, Fried Rice Noodles with Sliced Beef, Barbecue Pork Bun, Moon Cakes, Glutinous Rice Ball, Instant Sweet Milky Bun, and Salted Meat Rice Dumpling), the others belonged to high GI foods (Fried Rice in Yangzhou-Style, Sticky Rice Wrapped in Lotus Leaf, Steamed Glutinous Rice Roll, Jam and Peanut Butter Toast, Plain Steamed Vermicelli Roll, Red Bean Dessert, and Frozen Sweet Milky Bun). The GI and GL values for these Chinese traditional foods will provide some valuable information to both researchers and public on their food preference.

Impact of postharvest drying conditions on in vitro starch digestibility and estimated glycemic index of cooked non-waxy long-grain rice (Oryza sativa L.).

PubMed

Donlao, Natthawuddhi; Ogawa, Yukiharu

2017-02-01

Wet paddy needs to be dried to reduce its moisture content after harvesting. In this study, effects of postharvest drying condition on in vitro starch digestibility and estimated glycemic index of cooked rice (Oryza sativa L.) were investigated. Varying drying conditions, i.e. hot-air drying at 40, 65, 90 and 115 °C, and sun drying were applied to raw paddy. After husking and polishing, polished grains were cooked using an electric rice cooker. Cooked samples were analyzed for their moisture content and amount of resistant and total starch. Five samples in both intact grain and slurry were digested under simulated in vitro gastrointestinal digestion process. The in vitro starch digestion rate was measured and the hydrolysis index (HI) and estimated glycemic index (eGI) were calculated. Cooked rice obtained from hot-air drying showed relatively lower HI and eGI than that obtained from sun-drying. Among samples from hot-air drying treatment, eGI of cooked rice decreased with increasing drying temperature, except for the drying temperature of 115 °C. As a result, cooked rice from the hot-air drying at 90 °C showed lowest eGI. The results indicated that cooked rice digestibility was affected by postharvest drying conditions. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

Glycemic index and glycemic load of commercial Italian foods.

PubMed

Scazzina, F; Dall'Asta, M; Casiraghi, M C; Sieri, S; Del Rio, D; Pellegrini, N; Brighenti, F

2016-05-01

The glycemic index (GI) and glycemic load (GL) are useful parameters in the nutritional classification of carbohydrate foods. Diets characterized by a low GI and/or a low GL have been repeatedly and independently associated with decreased risk of diabetes and other chronic diseases. The aim of this study is to report the GI and GL value of carbohydrate-rich foods available on the Italian market and mostly consumed in Italy. GI values were determined according to FAO/WHO (1997) and ISO (2010). Overall, the 141 commercial foods that were analyzed represent food categories that are the source of >80% carbohydrate intake in Italy. The food items chosen were based mainly on the market share of the brand within each food category and grouped into 13 food categories: 1) beverages: fermented milk drink, juice, smoothie, soft drink; 2) biscuits; 3) breads; 4) bread substitutes; 5) breakfast cereals; 6) cakes and snacks; 7) candy and confectionery; 8) cereals; 9) desserts and ice-creams; 10) marmalade and jam; 11) pasta; 12) pizza; 13) sugar and sweetener. This database of commercial Italian foods partly overcomes the lack of information on GI and GL of local foods, contributing to a better understanding of the association between GI/GL and health and providing a more informed choice to Italian consumers and health practitioners. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Weighing the evidence of low glycemic index dietary intervention for the management of gestational diabetes mellitus: an Asian perspective.

PubMed

Mohd Yusof, Barakatun-Nisak; Firouzi, Somayyeh; Mohd Shariff, Zalilah; Mustafa, Norlaila; Mohamed Ismail, Nor Azlin; Kamaruddin, Nor Azmi

2014-03-01

This review aims to evaluate the effectiveness of low glycemic index (GI) dietary intervention for the treatment of gestational diabetes mellitus (GDM), specifically from the Asian perspective. A systematic review of the literature using multiple databases without time restriction was conducted. Three studies were retrieved based upon a priori inclusion criteria. While there was a trend towards improvement, no significant differences were observed in overall glycemic control and pregnancy outcomes in GDM women. However, a tendency for lower birth weight and birth centile if the intervention began earlier was noted. Low GI diets were well accepted and had identical macro-micronutrient compositions as the control diets. However, due to genetic, environment and especially food pattern discrepancies between Western countries and Asians, these results may not be contributed to Asian context. Clearly, there are limited studies focusing on the effect of low GI dietary intervention in women with GDM, particularly in Asia.

Effect of legumes as part of a low glycemic index diet on glycemic control and cardiovascular risk factors in type 2 diabetes mellitus: a randomized controlled trial.

PubMed

Jenkins, David J A; Kendall, Cyril W C; Augustin, Livia S A; Mitchell, Sandra; Sahye-Pudaruth, Sandhya; Blanco Mejia, Sonia; Chiavaroli, Laura; Mirrahimi, Arash; Ireland, Christopher; Bashyam, Balachandran; Vidgen, Edward; de Souza, Russell J; Sievenpiper, John L; Coveney, Judy; Leiter, Lawrence A; Josse, Robert G

2012-11-26

Legumes, including beans, chickpeas, and lentils, are among the lowest glycemic index (GI) foods and have been recommended in national diabetes mellitus (DM) guidelines. Yet, to our knowledge, they have never been used specifically to lower the GI of the diet. We have therefore undertaken a study of low-GI foods in type 2 DM with a focus on legumes in the intervention. A total of 121 participants with type 2 DM were randomized to either a low-GI legume diet that encouraged participants to increase legume intake by at least 1 cup per day, or to increase insoluble fiber by consumption of whole wheat products, for 3 months. The primary outcome was change in hemoglobin A1c (HbA1c) values with calculated coronary heart disease (CHD) risk score as a secondary outcome. The low-GI legume diet reduced HbA1c values by -0.5% (95% CI, -0.6% to -0.4%) and the high wheat fiber diet reduced HbA1c values by -0.3% (95% CI, -0.4% to -0.2%). The relative reduction in HbA1c values after the low-GI legume diet was greater than after the high wheat fiber diet by -0.2% (95% CI, -0.3% to -0.1%; P < .001). The respective CHD risk reduction on the low-GI legume diet was -0.8% (95% CI, -1.4% to -0.3%; P = .003), largely owing to a greater relative reduction in systolic blood pressure on the low-GI legume diet compared with the high wheat fiber diet (-4.5 mm Hg; 95% CI, -7.0 to -2.1 mm Hg; P < .001). Incorporation of legumes as part of a low-GI diet improved both glycemic control and reduced calculated CHD risk score in type 2 DM.

Effect of sourdough addition and storage time on in vitro starch digestibility and estimated glycemic index of tef bread.

PubMed

Shumoy, Habtu; Van Bockstaele, Filip; Devecioglu, Dilara; Raes, Katleen

2018-10-30

The effect of sourdough amount and storage time on starch digestibility and estimated glycemic index (eGI) of tef bread was investigated. The rapidly digestible starch (RDS), slowly digestible starch (SDS) and resistant starch (RS) of 0-30% sourdough fresh tef breads ranged from 49 to 58, 16 to 29 and 20 to 26 g/100 g starch, respectively. Storage of tef breads up to 5 days decreased the RDS by more than 2-fold while SDS and RS increased by 2 and 3 fold, respectively. The eGI for fresh and stored breads ranged from 39 to 89. Addition of sourdough increased the eGI of fresh breads while no uniform pattern was seen in the stored breads. As the storage time increased, all the breads showed a decrease in eGI. In vivo study is necessary to further investigate the effect of sourdough on GI of tef bread. Copyright © 2018 Elsevier Ltd. All rights reserved.

Effect of Glycemic Index of Breakfast on Energy Intake at Subsequent Meal among Healthy People: A Meta-Analysis

PubMed Central

Sun, Feng-Hua; Li, Chunxiao; Zhang, Yan-Jie; Wong, Stephen Heung-Sang; Wang, Lin

2016-01-01

Meals with low glycemic index (GI) may suppress short-term appetite and reduce subsequent food intake compared with high-GI meals. However, no meta-analysis has been conducted to synthesize the evidence. This meta-analytic study was conducted to assess the effect of high- and low-GI breakfast on subsequent short-term food intake. Trials were identified through MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled trials, and manual searches of bibliographies until May 2015. Randomized controlled and cross-over trials comparing the effect of low- with high-GI breakfast on subsequent energy intake among healthy people were included. Nine studies consisting of 11 trials met the inclusion criteria. Only one trial was classified with high methodological quality. A total of 183 participants were involved in the trials. The meta-analytic results revealed no difference in breakfast GI (high-GI vs. low-GI) on subsequent short-term energy intake. In conclusion, it seems that breakfast GI has no effect on short-term energy intake among healthy people. However, high quality studies are still warranted to provide more concrete evidence. PMID:26742058

Effects of carbohydrate quantity and glycemic index on resting metabolic rate and body composition during weight loss

USDA-ARS?s Scientific Manuscript database

Objective: To examine the effects of diets varying in carbohydrate and glycemic index (GI) on changes in body composition, resting metabolic rate (RMR), and metabolic adaptation during and after weight loss. Methods: Adults with obesity (n = 91) were randomized to one of four provided-food diets f...

Lowering the glycemic index of white bread using a white bean extract

PubMed Central

Udani, Jay K; Singh, Betsy B; Barrett, Marilyn L; Preuss, Harry G

2009-01-01

Background Phase 2® is a dietary supplement derived from the common white kidney bean (Phaseolus vulgaris). Phase 2 has been shown to inhibit alpha-amylase, the complex carbohydrate digesting enzyme, in vitro. The inhibition of alpha-amylase may result in the lowering of the effective Glycemic Index (GI) of certain foods. The objective of this study was to determine whether the addition of Phase 2 would lower the GI of a commercially available high glycemic food (white bread). Methods An open-label 6-arm crossover study was conducted with 13 randomized subjects. Standardized GI testing was performed on white bread with and without the addition of Phase 2 in capsule and powder form, each in dosages of 1500 mg, 2000 mg, and 3000 mg. Statistical analysis was performed by one-way ANOVA of all seven treatment groups using unadjusted multiple comparisons (t tests) to the white bread control. Results For the capsule formulation, the 1500 mg dose had no effect on the GI and the 2000 mg and 3000 mg capsule doses caused insignificant reductions in GI. For the powder, the 1500 mg and 2000 mg doses caused insignificant reductions in the GI, and the 3000 mg dose had a significant effect (-20.23 or 34.11%, p = 0.023) Conclusion Phase 2 white bean extract appears to be a novel and potentially effective method for reducing the GI of existing foods without modifying their ingredient profile. Trial Registration Trial Registration: ISRCTN50347345 PMID:19860922

Lowering the glycemic index of white bread using a white bean extract.

PubMed

Udani, Jay K; Singh, Betsy B; Barrett, Marilyn L; Preuss, Harry G

2009-10-28

Phase 2((R)) is a dietary supplement derived from the common white kidney bean (Phaseolus vulgaris). Phase 2 has been shown to inhibit alpha-amylase, the complex carbohydrate digesting enzyme, in vitro. The inhibition of alpha-amylase may result in the lowering of the effective Glycemic Index (GI) of certain foods. The objective of this study was to determine whether the addition of Phase 2 would lower the GI of a commercially available high glycemic food (white bread). An open-label 6-arm crossover study was conducted with 13 randomized subjects. Standardized GI testing was performed on white bread with and without the addition of Phase 2 in capsule and powder form, each in dosages of 1500 mg, 2000 mg, and 3000 mg. Statistical analysis was performed by one-way ANOVA of all seven treatment groups using unadjusted multiple comparisons (t tests) to the white bread control. For the capsule formulation, the 1500 mg dose had no effect on the GI and the 2000 mg and 3000 mg capsule doses caused insignificant reductions in GI. For the powder, the 1500 mg and 2000 mg doses caused insignificant reductions in the GI, and the 3000 mg dose had a significant effect (-20.23 or 34.11%, p = 0.023) Phase 2 white bean extract appears to be a novel and potentially effective method for reducing the GI of existing foods without modifying their ingredient profile. Trial Registration: ISRCTN50347345.

Dietary glycemic index, glycemic load and metabolic profile in children with phenylketonuria.

PubMed

Moretti, F; Pellegrini, N; Salvatici, E; Rovelli, V; Banderali, G; Radaelli, G; Scazzina, F; Giovannini, M; Verduci, E

2017-02-01

No data exist in the current literature on the glycemic index (GI) and glycemic load (GL) of the diet of phenylketonuric (PKU) children. The aims of this study were to examine the dietary GI and GL in PKU children on a low-phenylalanine (Phe)-diet and to evaluate whether an association may exist between the carbohydrate quality and the metabolic profile. Twenty-one PKU children (age 5-11 years) and 21 healthy children, gender and age matched, were enrolled. Dietary (including GI and GL) and blood biochemical assessments were performed. No difference was observed for daily energy intake between PKU and healthy children. Compared to healthy controls, PKU children consumed less protein (p = 0.001) and fat (p = 0.028), and more carbohydrate (% of total energy, p = 0.004) and fiber (p = 0.009). PKU children had higher daily GI than healthy children (mean difference (95% confidence interval), 13.7 (9.3-18.3)) and higher GL (31.7 (10.1-53.2)). PKU children exhibited lower blood total and low density lipoprotein cholesterol (LDL) levels (p < 0.01) and higher triglyceride level (p = 0.014) than healthy children, while glucose and insulin concentrations did not differ. In PKU children the dietary GL was associated with triglyceride glucose index (Spearman's correlation coefficient = 0.515, p = 0.034). In PKU children a relationship of the dietary treatment with GI and GL, blood triglycerides and triglyceride glucose index may exist. Improvement towards an optimal diet for PKU children could include additional attention to the management of dietary carbohydrate quality. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Glycemic index and postprandial blood glucose response to Japanese strawberry jam in normal adults.

PubMed

Kurotobi, Tomoka; Fukuhara, Kimiaki; Inage, Hiroko; Kimura, Shuichi

2010-01-01

We investigated in 30 healthy adults the glycemic index (GI) of five strawberry jams made from various sugar compositions. The jam containing the highest ratio of glucose showed a high GI, while that containing a high ratio of fructose, a jam made from polydextrose, showed a low GI. There was a high correlation (r=0.969, p=0.006) between the GI and the predicted GI calculated from the sugar composition of the jams. Moreover, the influence on postprandial blood glucose response after an intake of only 20 g of jam and one slice of bread with 20 g jam was measured in 8 healthy adults. The blood glucose level after an intake of 20 g of the high GI jam containing the high glucose ratio was higher than that of other jams at 15 min, but there was no significant difference after 30 min. Regardless of whether the GI was low or high, differences in the jams were not observed in the postprandial blood glucose level or the area under the curve after eating either one slice of bread (60 g) or one slice of bread with less than 20 g of jam.

Dietary Glycemic Index and Glycemic Load Are Positively Associated with Risk of Developing Metabolic Syndrome in Middle-Aged and Elderly Adults.

PubMed

Juanola-Falgarona, Martí; Salas-Salvadó, Jordi; Buil-Cosiales, Pilar; Corella, Dolores; Estruch, Ramón; Ros, Emili; Fitó, Montserrat; Recondo, Javier; Gómez-Gracia, Enrique; Fiol, Miquel; Lapetra, José; Lamuela-Raventós, Rosa M; Serra-Majem, Lluis; Pintó, Xavier; Muñoz, Miguel A; Ruiz-Gutiérrez, Valentina; Alfredo Martínez, José; Castro-Quezada, Itandehui; Bulló, Mònica

2015-10-01

To evaluate how glycemic index (GI) and glycemic load (GL) are associated with the metabolic syndrome (MetS) and its features in middle-aged and elderly adults at high cardiovascular risk. Prospective, longitudinal, population-based cohort. PREvención con DIeta MEDiterránea study. Men and women (N = 6,606) divided into three age groups (<65, 65-74, ≥75). Energy and nutrient intake was evaluated using a validated 137-item food frequency questionnaire. MetS and its features were defined in accordance with the criteria of the American Heart Association and National Heart, Lung, and Blood Institute. A positive association was observed between GI and MetS prevalence in the youngest and middle age groups for participants without diabetes mellitus, but no relationship was found for those with diabetes mellitus. During the median follow-up of 4.8 years, higher GI and GL were related to greater risk of MetS in the middle age group, independent of the presence of diabetes mellitus. Changes in dietary GI were associated with risk of developing the high fasting glucose component of the MetS in the oldest age category, and changes in dietary GL were associated with risk of developing abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol, and high blood pressure in the youngest age category. Dietary GI and GL have a potential role in the development of MetS and associated clinical features, with particular age-dependent considerations. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

The effect of protein and glycemic index on children's body composition: the DiOGenes randomized study.

PubMed

Papadaki, Angeliki; Linardakis, Manolis; Larsen, Thomas M; van Baak, Marleen A; Lindroos, Anna Karin; Pfeiffer, Andreas F H; Martinez, J Alfredo; Handjieva-Darlenska, Teodora; Kunesová, Marie; Holst, Claus; Astrup, Arne; Saris, Wim H M; Kafatos, Anthony

2010-11-01

To investigate the effect of protein and glycemic index (GI) on body composition among European children in the randomized, 6-month dietary intervention DiOGenes (diet, obesity, and genes) family-based study. In the study, 827 children (381 boys and 446 girls), aged 5 to 18 years, completed baseline examinations. Families with parents who lost ≥ 8% of their weight during an 8-week run-in low-calorie diet period were randomly assigned to 1 of 5 ad libitum diets: low protein (LP)/low glycemic index (LGI); LP/high GI (HGI); high protein (HP)/LGI; HP/HGI; and control diet. The target difference was 15 GI U between the LGI/HGI groups and 13 protein percentage points between the LP/HP groups. There were 658 children examined after 4 weeks. Advice on food-choice modification was provided at 6 visits during this period. No advice on weight loss was provided because the focus of the study was the ability of the diets to affect outcomes through appetite regulation. Anthropometric measurements and body composition were assessed at baseline, week 4, and week 26. In the study, 465 children (58.1%) completed all assessments. The achieved differences between the GI and protein groups were 2.3 GI U and 4.9 protein percentage points, respectively. The LP/HGI group increased body fat percentage significantly more than the other groups (P = .040; partial η(2) = 0.039), and the percentage of overweight/obese children in the HP/LGI group decreased significantly during the intervention (P = .031). Neither GI nor protein had an isolated effect on body composition. However, the LP/HGI combination increased body fat, whereas the HP/LGI combination was protective against obesity in this sample of children.

Carbohydrate nutrition, glycemic index, and the 10-y incidence of cataract.

PubMed

Tan, Jennifer; Wang, Jie Jin; Flood, Victoria; Kaushik, Shweta; Barclay, Alan; Brand-Miller, Jennie; Mitchell, Paul

2007-11-01

Although dietary carbohydrates are thought to play a role in cataractogenesis, few epidemiologic studies have examined links between carbohydrate nutrition and cataract. We investigated the associations between dietary glycemic index (GI), glycemic load (GL), total carbohydrate intake, and 10-y incident nuclear, cortical, and posterior subcapsular cataract. Of 3654 baseline participants in an Australian population aged >/=49 y (1992-1994), 933 were seen after 5 and/or 10 y, had completed a detailed semiquantitative food-frequency questionnaire, had no previous cataract surgery or baseline cataract, and had photographs taken to assess incident cataract with the Wisconsin Cataract Grading System. Dietary information was collected with a validated food questionnaire. GI was calculated from a customized database of Australian foods. GI, GL, and all other nutrients were energy adjusted. Hazard ratios (HRs) and 95% CIs were calculated with the use of discrete logistic models. After age, sex, diabetes, and other factors were controlled for, each SD increase in GI significantly predicted incident cortical cataract (HR: 1.19; 95% CI: 1.01, 1.39). Participants within the highest compared with the lowest quartile of GI were more likely to develop incident cortical cataract (HR: 1.77; 95% CI: 1.13, 2.78; P for trend = 0.035). These findings were similar after excluding participants with diabetes, although they were slightly attenuated and marginally nonsignificant (HR: 1.16; 95% CI: 0.98, 1.37, per SD increase in GI). No association was found between GI and nuclear or posterior subcapsular cataract and between GL or carbohydrate quantity and any cataract subtype. In an Australian cohort, poorer dietary carbohydrate quality, reflected by high GI, predicted incident cortical cataract.

Relation of dietary glycemic index, glycemic load, added sugar intake, or fiber intake to the development of body composition between ages 2 and 7 y.

PubMed

Buyken, Anette E; Cheng, Guo; Günther, Anke Lb; Liese, Angela D; Remer, Thomas; Karaolis-Danckert, Nadina

2008-09-01

Observational studies in adults suggest that a diet with a high glycemic index (GI) or glycemic load (GL), a high intake of sugary foods, or a low fiber intake may increase the risk of overweight. We aimed to examine prospectively whether dietary GI, GL, added sugar intake, or fiber intake between age 2 and 7 y are associated with the development of body composition. If so, we aimed to ascertain whether these associations are modified by meal frequency. Linear mixed-effect regression analyses were performed in 380 participants of the DOrtmund Nutrition and Anthropometric Longitudinally Designed (DONALD) Study for whom 4-6 weighed 3-d dietary records and anthropometric data were obtained between ages 2 and 7 y. Changes in dietary GI, GL, or added sugar intake between ages 2 and 7 y were not associated with concurrent changes in percentage body fat (%BF, as estimated from skinfold thicknesses) or body mass index SD scores. An increase in fiber intake was related to a concurrent decrease in %BF between ages 2 and 7 y only in children who consumed <6 meals/d as toddlers (beta +/- SE from fully adjusted model: -0.26 +/- 0.09%BF per 1-SD increase in fiber intake, P = 0.005), whereas children with a higher meal frequency had no concurrent change (0.07 +/- 0.07%BF per 1-SD increase in fiber intake, P = 0.3). Dietary GI, GL, or added sugar intake between ages 2 and 7 y does not appear to influence the development of body composition. Potential benefits associated with increasing fiber intake throughout childhood may be limited to toddlers with a lower meal frequency.

Methodological Challenges in the Application of the Glycemic Index in Epidemiological Studies Using Data from the European Prospective Investigation into Cancer and Nutrition1–3

PubMed Central

van Bakel, Marit M. E.; Slimani, Nadia; Feskens, Edith J. M.; Du, Huaidong; Beulens, Joline W. J.; van der Schouw, Yvonne T.; Brighenti, Furio; Halkjaer, Jytte; Cust, Anne E.; Ferrari, Pietro; Brand-Miller, Jennie; Bueno-de-Mesquita, H. Bas; Peeters, Petra; Ardanaz, Eva; Dorronsoro, Miren; Crowe, Francesca L.; Bingham, Sheila; Rohrmann, Sabine; Boeing, Heiner; Johansson, Ingegerd; Manjer, Jonas; Tjonneland, Anne; Overvad, Kim; Lund, Eiliv; Skeie, Guri; Mattiello, Amalia; Salvini, Simonetta; Clavel-Chapelon, Françoise; Kaaks, Rudolf

2009-01-01

Associations between the glycemic index (GI) or glycemic load (GL) and diseases are heterogeneous in epidemiological studies. Differences in assigning GI values to food items may contribute to this inconsistency. Our objective was to address methodological issues related to the use of current GI and GL values in epidemiological studies. We performed ecological comparison and correlation studies by calculating dietary GI and GL from country-specific dietary questionnaires (DQ) from 422,837 participants from 9 countries participating in the European Prospective Investigation into Cancer and Nutrition study and single standardized 24-h dietary recalls (24-HDR) obtained from a representative sample (n = 33,404) using mainly Foster Powell's international table as a reference source. Further, 2 inter-rater and 1 inter-method comparison were conducted, comparing DQ GI values assigned by independent groups with values linked by us. The ecological correlation between DQ and 24-HDR was good for GL (overall r = 0.76; P < 0.005) and moderate for GI (r = 0.57; P < 0.05). Mean GI/GL differences between DQ and 24-HDR were significant for most centers. GL but not GI from DQ was highly correlated with total carbohydrate (r = 0.98 and 0.15, respectively; P < 0.0001) and this was higher for starch (r = 0.72; P < 0.0001) than for sugars (r = 0.36; P < 0.0001). The inter-rater and inter-method variations were considerable for GI (weighted κ coefficients of 0.49 and 0.65 for inter-rater and 0.25 for inter-method variation, respectively) but only mild for GL (weighted κ coefficients > 0.80). A more consistent methodology to attribute GI values to foods and validated DQ is needed to derive meaningful GI/GL estimates for nutritional epidemiology. PMID:19158224

Associations of Glycemic Index and Load With Coronary Heart Disease Events: A Systematic Review and Meta-Analysis of Prospective Cohorts

PubMed Central

Mirrahimi, Arash; de Souza, Russell J.; Chiavaroli, Laura; Sievenpiper, John L.; Beyene, Joseph; Hanley, Anthony J.; Augustin, Livia S. A.; Kendall, Cyril W. C.; Jenkins, David J. A.

2012-01-01

Background Glycemic index (GI) and glycemic load (GL) have been associated with coronary heart disease (CHD) risk in some but not all cohort studies. We therefore assessed the association of GI and GL with CHD risk in prospective cohorts. Methods and Results We searched MEDLINE, EMBASE, and CINAHL (through April 5, 2012) and identified all prospective cohorts assessing associations of GI and GL with incidence of CHD. Meta-analysis of observational studies in epidemiology (MOOSE) methodologies were used. Relative measures of risk, comparing the group with the highest exposure (mean GI of cohorts=84.4 GI units, range 79.9 to 91; mean GL of cohorts=224.8, range 166 to 270) to the reference group (mean GI=72.3 GI units, range 68.1 to 77; mean GL=135.4, range 83 to 176), were pooled using random-effects models, expressed as relative risk (RR) with heterogeneity assessed by χ2 and quantified by I2. Subgroups included sex and duration of follow-up. Ten studies (n=240 936) were eligible. Pooled analyses showed an increase in CHD risk for the highest GI quantile compared with the lowest, with RR=1.11 (95% confidence interval [CI] 0.99 to 1.24) and for GL, RR=1.27 (95% CI 1.09 to 1.49), both with evidence of heterogeneity (I2>42%, P<0.07). Subgroup analyses revealed only a significant modification by sex, with the female cohorts showing significance for GI RR=1.26 (95% CI 1.12 to 1.41) and for GL RR=1.55 (95% CI 1.18 to 2.03). Conclusions High GI and GL diets were significantly associated with CHD events in women but not in men. Further studies are required to determine the relationship between GI and GL with CHD in men. PMID:23316283

Carbohydrate nutrition and risk of adiposity-related cancers: results from the Framingham Offspring cohort (1991-2013)

USDA-ARS?s Scientific Manuscript database

High carbohydrate intake, glycemic index (GI), and glycemic load (GL) are hypothesized to increase cancer risk through metabolic dysregulation of the glucose-insulin axis and adiposity-related mechanisms, but epidemiologic evidence is inconsistent. This prospective cohort study investigates the impa...

24-hour glucose profiles on diets varying in protein content and glycemic index.

PubMed

van Baak, Marleen A

2014-08-04

Evidence is increasing that the postprandial state is an important factor contributing to the risk of chronic diseases. Not only mean glycemia, but also glycemic variability has been implicated in this effect. In this exploratory study, we measured 24-h glucose profiles in 25 overweight participants in a long-term diet intervention study (DIOGENES study on Diet, Obesity and Genes), which had been randomized to four different diet groups consuming diets varying in protein content and glycemic index. In addition, we compared 24-h glucose profiles in a more controlled fashion, where nine other subjects followed in random order the same four diets differing in carbohydrate content by 10 energy% and glycemic index by 20 units during three days. Meals were provided in the lab and had to be eaten at fixed times during the day. No differences in mean glucose concentration or glucose variability (SD) were found between diet groups in the DIOGENES study. In the more controlled lab study, mean 24-h glucose concentrations were also not different. Glucose variability (SD and CONGA1), however, was lower on the diet combining a lower carbohydrate content and GI compared to the diet combining a higher carbohydrate content and GI. These data suggest that diets with moderate differences in carbohydrate content and GI do not affect mean 24-h or daytime glucose concentrations, but may result in differences in the variability of the glucose level in healthy normal weight and overweight individuals.

Glycemic Index, Glycemic Load, Carbohydrates, and Type 2 Diabetes

PubMed Central

Greenwood, Darren C.; Threapleton, Diane E.; Evans, Charlotte E.L.; Cleghorn, Christine L.; Nykjaer, Camilla; Woodhead, Charlotte; Burley, Victoria J.

2013-01-01

OBJECTIVE Diets with high glycemic index (GI), with high glycemic load (GL), or high in all carbohydrates may predispose to higher blood glucose and insulin concentrations, glucose intolerance, and risk of type 2 diabetes. We aimed to conduct a systematic literature review and dose–response meta-analysis of evidence from prospective cohorts. RESEARCH DESIGN AND METHODS We searched the Cochrane Library, MEDLINE, MEDLINE in-process, Embase, CAB Abstracts, ISI Web of Science, and BIOSIS for prospective studies of GI, GL, and total carbohydrates in relation to risk of type 2 diabetes up to 17 July 2012. Data were extracted from 24 publications on 21 cohort studies. Studies using different exposure categories were combined on the same scale using linear and nonlinear dose–response trends. Summary relative risks (RRs) were estimated using random-effects meta-analysis. RESULTS The summary RR was 1.08 per 5 GI units (95% CI 1.02–1.15; P = 0.01), 1.03 per 20 GL units (95% CI 1.00–1.05; P = 0.02), and 0.97 per 50 g/day of carbohydrate (95% CI 0.90–1.06; P = 0.5). Dose–response trends were linear for GI and GL but more complex for total carbohydrate intake. Heterogeneity was high for all exposures (I2 >50%), partly accounted for by different covariate adjustment and length of follow-up. CONCLUSIONS Included studies were observational and should be interpreted cautiously. However, our findings are consistent with protective effects of low dietary GI and GL, quantifying the range of intakes associated with lower risk. Future research could focus on the type of sugars and other carbohydrates associated with greatest risk. PMID:24265366

Prospective Study of Glycemic Load, Glycemic Index, and Carbohydrate Intake in Relation to Risk of Biliary Tract Cancer.

PubMed

Larsson, Susanna C; Giovannucci, Edward L; Wolk, Alicja

2016-06-01

Diets that induce a high glycemic response might increase the risk of biliary tract cancer (BTC). We evaluated the hypothesis that diets with high glycemic load (GL) and high glycemic index (GI), which are measures of the glycemic effect of foods, are associated with an increased incidence of BTC. We used data from a population-based prospective study of 76,014 Swedish adults (age 45-83 years; 57% men) who were free of cancer and had completed a food-frequency questionnaire in the autumn of 1997. Incident cancer cases were ascertained by linkage with the Swedish Cancer Registry. Data were analyzed using Cox proportional hazards regression models. During a mean follow-up of 13.3 years (1,010,777 person-years), we identified 140 extrahepatic BTC cases (including 77 gallbladder cancers) and 23 intrahepatic BTC cases. A high dietary GL was associated with an increased risk of BTC. The multivariable relative risks for the highest versus lowest quartile of dietary GL were 1.63 (95% confidence interval (95% CI), 1.01-2.63) for extrahepatic BTC, 2.14 (95% CI, 1.06-4.33) for gallbladder cancer, and 3.46 (95% CI, 1.22-9.84) for intrahepatic BTC. Dietary GI was statistically significantly positively associated with risk of extrahepatic BTC and gallbladder cancer. We observed no statistically significant association between carbohydrate intake and BTC risk, although all associations were positive. Although these data do not prove a causal relationship, they are consistent with the hypothesis that high-GL and high-GI diets are associated with an increased risk of BTC.

Fatigue Countermeasures in Aviation

DTIC Science & Technology

2009-01-01

on the Use of Hypnotics b. Improving Sleep and Alertness i. Healthy Sleep Practices ii. Napping iii. Circadian Adjustment iv. Exercise v. Nutrition ...observed that a 90% CHO meal with a high glycemic index (GI) shortened sleep latency by about 50% compared to a low glycemic index meal, and about 40% when...postduty day sleep is disturbed mini- mally by caffeine use . With tIle exception of caffeine and various nutritional supplements, no alertness

Comparison of appetite responses to high- and low-glycemic index postexercise meals under matched insulinemia and fiber in type 1 diabetes.

PubMed

Campbell, Matthew D; Gonzalez, Javier T; Rumbold, Penny L S; Walker, Mark; Shaw, James A; Stevenson, Emma J; West, Daniel J

2015-03-01

Patients with type 1 diabetes face heightened risk of hypoglycemia after exercise. Subsequent overfeeding, as a preventative measure against hypoglycemia, negates the energy deficit after exercise. Patients are also required to reduce the insulin dose administered with postexercise foods to further combat hypoglycemia. However, the insulin dose is dictated solely by the carbohydrate content, even though postprandial glycemia is vastly influenced by glycemic index (GI). With a need to control the postexercise energy balance, appetite responses after meals differing in GI are of particular interest. We assessed the appetite response to low-glycemic index (LGI) and high-glycemic index (HGI) postexercise meals in type 1 diabetes patients. This assessment also offered us the opportunity to evaluate the influence of GI on appetite responses independently of insulinemia, which confounds findings in individuals without diabetes. Ten physically active men with type 1 diabetes completed 2 trials in a randomized crossover design. After 45 min of treadmill exercise at 70% of the peak oxygen uptake, participants consumed an LGI (GI ∼37) or HGI (GI ∼92) meal with a matched macronutrient composition, negligible fiber content, and standardized insulin-dose administration. The postprandial appetite response was determined for 180 min postmeal. During this time, circulating glucose, insulin, glucagon, and glucagon-like peptide-1 (GLP-1) concentrations and subjective appetite ratings were determined. The HGI meal produced an ∼60% greater postprandial glucose area under the curve (AUC) than did the LGI meal (P = 0.008). Insulin, glucagon, and GLP-1 did not significantly differ between trials (P > 0.05). The fullness AUC was ∼25% greater after the HGI meal than after the LGI meal (P < 0.001), whereas hunger sensations were ∼9% lower after the HGI meal than after the LGI meal (P = 0.001). Under conditions of matched insulinemia and fiber, an HGI postexercise meal suppresses feelings of hunger and augments postprandial fullness sensations more so than an otherwise equivalent LGI meal in type 1 diabetes patients. © 2015 American Society for Nutrition.

Dietary Glycemic Index during Pregnancy Is Associated with Biomarkers of the Metabolic Syndrome in Offspring at Age 20 Years

PubMed Central

Danielsen, Inge; Granström, Charlotta; Haldorsson, Thorhallur; Rytter, Dorte; Hammer Bech, Bodil; Henriksen, Tine Brink; Vaag, Allan Arthur; Olsen, Sjurdur Frodi

2013-01-01

Objective Growing evidence indicates that metabolic syndrome is rooted in fetal life with a potential key role of nutrition during pregnancy. The objective of the study was to assess the possible associations between the dietary glycemic index (GI) and glycemic load (GL) during pregnancy and biomarkers of the metabolic syndrome in young adult offspring. Methods Dietary GI and GL were assessed by questionnaires and interviews in gestation week 30 and offspring were clinically examined at the age of 20 years. Analyses based on 428 mother-offspring dyads were adjusted for maternal smoking during pregnancy, height, pre-pregnancy body mass index (BMI), education, energy intake, and the offspring’s ambient level of physical activity. In addition, possible confounding by gestational diabetes mellitus was taken into account. Outcome Measures Waist circumference, blood pressure, HOMA insulin resistance (HOMA-IR) and plasma levels of fasting glucose, triglycerides, HDL cholesterol, LDL cholesterol, total cholesterol, insulin, and leptin were measured in the offspring. Results Significant associations were found between dietary GI in pregnancy and HOMA-IR (the relative increase in HOMA-IR per 10 units’ GI increase was 1.09 [95% CI: 1.01, 1.16], p = 0.02), insulin (1.09 [95% CI: 1.02, 1.16], p = 0.01) and leptin (1.21 [95% CI: 1.06, 1.38], p = 0.01) in the offspring; whereas no associations were detected for GL. Conclusions Our data suggests that high dietary GI in pregnancy may affect levels of markers for the metabolic syndrome in young adult offspring in a potentially harmful direction. PMID:23741411

Fad diets and obesity--Part II: An introduction to the theory behind low-carbohydrate diets.

PubMed

Moyad, Mark A

2004-06-01

Low-carbohydrate diets are not only highly popular but also controversial. The theory or general concept behind the low-carbohydrate dietary approach needs to receive more attention to provide more objectivity to this discussion. The theory or concept that actually has some evidence currently lies in the values of the glycemic index (GI) and glycemic load (GL). Basically, the higher the GI, the greater the glucose response. However, the GI system that was originally proffered in 1981 comes with one apparent limitation in that some foods or beverages need to be obtained in enormous amounts in order to observe such a glucose change. Therefore, the newer concept of GL (derived from the GI) is based on a more moderate-portion size and the resultant glucose change with some of the higher GI foods or beverages actually demonstrating a low GL. These and other limitations and some advantages of low-carbohydrate diets with an emphasis of what an actual GI or GL means are discussed.

Glycemic index and microstructure analysis of a newly developed fiber enriched cookie.

PubMed

Schuchardt, Jan Philipp; Wonik, Jasmin; Bindrich, Ute; Heinemann, Michaela; Kohrs, Heike; Schneider, Inga; Möller, Katharina; Hahn, Andreas

2016-01-01

A diet with a high glycemic index (GI) is associated with an elevated risk for obesity or type 2 diabetes. We investigated the GI of a newly-developed fiber enriched cookie and characterized the microstructure of ingredients used. In a study with 26 non-diabetic healthy volunteers it was shown that the fiber enriched cookie has a GI of 58.9 in relation to white bread as reference. Using a conversion factor of 1.4, the GI of the fiber enriched cookie in relation to a glucose-solution is 42.0 and can be classified as a low-GI food. Postprandial insulin concentration was significantly lower after consumption of fiber enriched cookies compared to white bread. Glucose release after in vitro digestion was significantly lower from fiber enriched cookies compared to other cookies tested. In addition to its high percentage of fiber, the cookies' low GI can be attributed to the limited gelatinization potential of the starch granules found in the ingredients used. Using confocal laser scanning microscopy it is shown that starch granule surface area of whole grain barley flour, spelt flour and oat flakes bears cluster-shaped protein-NSPS complexes that preferentially absorb water in conditions of water shortage and thereby prevent starch gelatinization.

Variable classifications of glycemic index determined by glucose meters.

PubMed

Lin, Meng-Hsueh Amanda; Wu, Ming-Chang; Lin, Jenshinn

2010-07-01

THE STUDY EVALUATED AND COMPARED THE DIFFERENCES OF GLUCOSE RESPONSES, INCREMENTAL AREA UNDER CURVE (IAUC), GLYCEMIC INDEX (GI) AND THE CLASSIFICATION OF GI VALUES BETWEEN MEASURED BY BIOCHEMICAL ANALYZER (FUJI AUTOMATIC BIOCHEMISTRY ANALYZER (FAA)) AND THREE GLUCOSE METERS: Accue Chek Advantage (AGM), BREEZE 2 (BGM), and Optimum Xceed (OGM). Ten healthy subjects were recruited for the study. The results showed OGM yield highest postprandial glucose responses of 119.6 +/- 1.5, followed by FAA, 118.4 +/- 1.2, BGM, 117.4 +/- 1.4 and AGM, 112.6 +/- 1.3 mg/dl respectively. FAA reached highest mean IAUC of 4156 +/- 208 mg x min/dl, followed by OGM (3835 +/- 270 mg x min/dl), BGM (3730 +/- 241 mg x min/dl) and AGM (3394 +/- 253 mg x min/dl). Among four methods, OGM produced highest mean GI value than FAA (87 +/- 5) than FAA, followed by BGM and AGM (77 +/- 1, 68 +/- 4 and 63 +/- 5, p<0.05). The results suggested that the AGM, BGM and OGM are more variable methods to determine IAUC, GI and rank GI value of food than FAA. The present result does not necessarily apply to other glucose meters. The performance of glucose meter to determine GI value of food should be evaluated and calibrated before use.

Effect of low glycemic index food and postprandial exercise on blood glucose level, oxidative stress and antioxidant capacity.

PubMed

Kasuya, Noriaki; Ohta, Shoichiro; Takanami, Yoshikazu; Kawai, Yukari; Inoue, Yutaka; Murata, Isamu; Kanamoto, Ikuo

2015-04-01

Low glycemic index (GI) food and postprandial exercise are non-drug therapies for improving postprandial hyperglycemia. The present randomized, crossover study investigated the effect of low GI food combined with postprandial exercise on postprandial blood glucose level, oxidative stress and antioxidant capacity. A total of 13 healthy subjects were each used in four experiments: i) rice only (control), ii) salad prior to rice (LGI), iii) exercise following rice (EX) and iv) salad prior to rice and exercise following rice (MIX). The blood glucose level, oxidative stress and antioxidant capacity were then measured. At 60 min after the meal, the blood glucose level was observed to be increased in the MIX group compared with that in the LGI group. Furthermore, at 180 min, the antioxidant capacity was found to be reduced in the MIX group compared with those of the LGI and EX groups. These findings suggest that low GI food combined with postprandial exercise does not improve postprandial hyperglycemia. It may be necessary to establish optimal timing and intensity when combining low GI food with postprandial exercise to improve postprandial hyperglycemia.

Assessing intentions to eat low-glycemic index foods by adults with diabetes using a new questionnaire based on the theory of planned behaviour.

PubMed

Watanabe, Tomoe; Berry, Tanya R; Willows, Noreen D; Bell, Rhonda C

2015-04-01

The Canadian Diabetes Association recommends that people with diabetes choose foods with low-glycemic index (GI). This study developed a questionnaire measuring Theory of Planned Behaviour (TPB) constructs relative to consuming a low-GI diet by people with diabetes so as to achieve a better understanding of which TPB constructs, demographic characteristics and diabetes-related variables best predict intention to consume a low-GI diet. A questionnaire to measure intentions to consume a low-GI diet was developed based on TPB constructs and was administered to 369 adults (30 to 75 years) with type 1 or type 2 diabetes. Responses were analyzed using multiple linear regression. More than 90% of participants (mean age, 56.5±10.8 years; mean body mass index, 30.5±7.2 kg/m(2)) cited reduction and maintenance of healthy blood glucose levels as an advantage of eating low-GI foods. Older age, higher income, female gender, having type 2 diabetes, diabetes treatment (diet only) and understanding of the GI were positively associated with intention to eat a low-GI diet. TPB constructs that significantly predicted intentions to eat a low-GI diet were instrumental attitude (beta = 0.24, p<0.001); subjective norms (beta = 0.13, p=0.007); and perceived behavioural control (beta = 0.55, p<0.001). This new questionnaire is a valid tool to assess TPB constructs contributing to intentions to eat a low-GI diet by people with diabetes. Future studies that use this questionnaire can shed light on how TPB concepts in clinical practice can help people with diabetes to change their dietary intake. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Comparable postprandial glucose reductions with viscous fiber blend enriched biscuits in healthy subjects and patients with diabetes mellitus: acute randomized controlled clinical trial.

PubMed

Jenkins, Alexandra L; Jenkins, David J A; Wolever, Thomas M S; Rogovik, Alexander L; Jovanovski, Elena; Bozikov, Velimir; Rahelić, Dario; Vuksan, Vladimir

2008-12-01

To compare the blood glucose-lowering effect of a highly viscous fiber blend (VFB) added to a starchy snack on postprandial glycemia between healthy participants and participants with diabetes mellitus. Ten healthy participants (4 men and 6 women, aged 28+/-2.6 years, body mass index [BMI], 24.3+/-0.8 kg/m(2)) and 9 participants with diabetes mellitus type 2 (3 men and 6 women, aged 68+/-3.8 years, BMI 28.8+/-1.2 kg/m(2)) on four separate occasions took either 50 g available carbohydrates as control biscuits, biscuits with 10 g of highly viscous fiber blend, white bread with 12 g of margarine, or white bread alone. Postprandial blood glucose response, glycemic index (GI), and palatability were determined. Mean (95% confidence interval) GI values of the viscous fiber blend biscuits were 26 (16-36) and 37 (27-47) GI units for healthy participants and participants with diabetes mellitus, respectively. These values were significantly lower than those of white bread, white bread with 12 g of margarine, and control biscuits (P<0.001, paired t test) both in healthy participants (GI 100, 108 [57-159], and 101 [44-158], respectively) and participants with diabetes mellitus (GI 100, 103 [79-127], and 94 [78-110], respectively). Viscous fiber blend significantly reduced the glycemic index by 74% (7.4 GI units/g of fiber) in healthy participants and by 63% (6.3 GI units/g of fiber) in participants with diabetes. The GI did not differ between control meals in both healthy participants and participants with diabetes. There were no significant differences in palatability among the types of meals, although participants with diabetes found the viscous fiber blend biscuits more palatable (P=0.002, t test). Viscous fiber blend is a very potent and palatable soluble fiber addition to a starchy snack, which is able to reduce the glycemic response to a similar extent in both healthy participants and individuals with diabetes mellitus. Biscuits with low GI, and possibly other viscous fiber blend fortified starchy foods, may potentially be a useful replacement of high GI snack foods in the diet.

Effect of Wheat Flour Noodles with Bombyx mori Powder on Glycemic Response in Healthy Subjects.

PubMed

Suk, Wanhee; Kim, JiEun; Kim, Do-Yeon; Lim, Hyunjung; Choue, Ryowon

2016-09-01

Recent trial results suggest that the consumption of a low glycemic index (GI) diet is beneficial in the prevention of high blood glucose levels. Identifying active hypoglycemic substances in ordinary foods could be a significant benefit to the management of blood glucose. It has been hypothesized that noodles with Bombyx mori powder are a low GI food. We evaluated GI and changes in postprandial glucose levels following consumption of those noodles and compared them with those following consumption of plain wheat flour noodles (control) and glucose (reference) in healthy subjects. Thirteen males (age: 34.2±4.5 years, body mass index: 23.2±1.1 kg/m 2 ) consumed 75 g carbohydrate portions of glucose and the 2 kinds of noodle after an overnight fast. Capillary blood was measured at time 0 (fasting), 15, 30, 45, 60, 90, 120, and 180 min from the start of each food intake. The GI values were calculated by taking the ratio of the incremental area under the blood glucose response curve (IAUC) for the noodles and glucose. There was a significant difference in postprandial glucose concentrations at 30 and 45 min between the control noodles and the noodles with Bombyx mori powder: the IAUC and GI for the noodles with Bombyx mori powder were significantly lower than those for glucose and plain wheat flour noodles. The wheat flour noodles with Bombyx mori powder could help prevent an increase in postprandial glucose response and possibly provide an alternative to other carbohydrate staple foods for glycemic management.

Effect of Wheat Flour Noodles with Bombyx mori Powder on Glycemic Response in Healthy Subjects

PubMed Central

Suk, Wanhee; Kim, JiEun; Kim, Do-Yeon; Lim, Hyunjung; Choue, Ryowon

2016-01-01

Recent trial results suggest that the consumption of a low glycemic index (GI) diet is beneficial in the prevention of high blood glucose levels. Identifying active hypoglycemic substances in ordinary foods could be a significant benefit to the management of blood glucose. It has been hypothesized that noodles with Bombyx mori powder are a low GI food. We evaluated GI and changes in postprandial glucose levels following consumption of those noodles and compared them with those following consumption of plain wheat flour noodles (control) and glucose (reference) in healthy subjects. Thirteen males (age: 34.2±4.5 years, body mass index: 23.2±1.1 kg/m2) consumed 75 g carbohydrate portions of glucose and the 2 kinds of noodle after an overnight fast. Capillary blood was measured at time 0 (fasting), 15, 30, 45, 60, 90, 120, and 180 min from the start of each food intake. The GI values were calculated by taking the ratio of the incremental area under the blood glucose response curve (IAUC) for the noodles and glucose. There was a significant difference in postprandial glucose concentrations at 30 and 45 min between the control noodles and the noodles with Bombyx mori powder: the IAUC and GI for the noodles with Bombyx mori powder were significantly lower than those for glucose and plain wheat flour noodles. The wheat flour noodles with Bombyx mori powder could help prevent an increase in postprandial glucose response and possibly provide an alternative to other carbohydrate staple foods for glycemic management. PMID:27752491

A low glycemic index staple diet reduces postprandial glucose values in Asian women with gestational diabetes mellitus.

PubMed

Hu, Zhi-Geng; Tan, Rong-Shao; Jin, Di; Li, Wei; Zhou, Xiao-Yan

2014-12-01

A low glycemic index (GI) diet is beneficial for glucose control in patients with diabetes mellitus. This study aimed to investigate the influence of a low-GI diet on postprandial glucose levels in women with gestational diabetes mellitus (GDM). Pregnant women with GDM were randomized to receive a normal diabetic control diet or a low-GI staple diet for 5 days. A low-GI staple food was used to replace rice in lunch and dinner for the low-GI staple diet group, whereas the total energy and carbohydrate levels remained equal in both groups. Fasting and postprandial glucose levels were determined daily. A total of 140 pregnant women with GDM were included in the study, including 66 in the low-GI staple diet group and 74 in the normal diabetic diet control group. No differences existed in baseline characteristics between the 2 groups (all P > 0.05). After dietary intervention, glucose levels were significantly reduced in the low-GI staple diet group (all P < 0.01) and the control group (all P < 0.008). Postintervention glucose values after breakfast, lunch, and dinner were significantly reduced in the treatment group compared with those in the control group (all P < 0.05). The percentage changes from baseline of all glucose values were significantly greater in the treatment group than in the control group (all P < 0.05). A low-GI staple diet significantly reduces postprandial glucose levels in women with GDM.

Effects of Lowering Glycemic Index of Dietary Carbohydrate on Plasma Uric Acid: The OmniCarb Randomized Clinical Trial

PubMed Central

Juraschek, Stephen P; McAdams-Demarco, Mara; Gelber, Allan C; Sacks, Frank M.; Appel, Lawrence J; White, Karen; Miller, Edgar R

2017-01-01

Objective The effects of carbohydrates on plasma uric acid levels are controversial. We determined the individual and combined effects of carbohydrate quality (glycemic index, GI) and quantity (proportion of total daily energy, %carb) on uric acid. Methods We conducted a randomized, crossover feeding trial in overweight or obese adults without cardiovascular disease (N=163). Participants were fed each of four diets over 5-week periods separated by 2-week washout periods. Body weight was kept constant. The four diets were: high GI (GI ≥65) with high %carb (58% kcal), low GI (GI ≤45) with low %carb (40% kcal), low GI with high %carb; and high GI with low %carb. Plasma uric acid was measured at baseline and after each feeding period for comparison between the 4 diets. Results Study participants were 52% women and 50% non-Hispanic black with a mean age of 52.6 years and a mean uric acid of 4.7 (SD, 1.2) mg/dL. Reducing GI lowered uric acid when the %carb was low (−0.24 mg/dL; P <0.001) or high (−0.17 mg/dL; P <0.001). Reducing the %carb marginally increased uric acid only when GI was high (P = 0.05). The combined effect of lowering GI and increasing the %carb was −0.27 mg/dL (P <0.001). This effect was observed even after adjustment for concurrent changes in kidney function, insulin sensitivity, and products of glycolysis. Conclusions Reducing GI lowers uric acid. Future studies should examine whether reducing GI can prevent gout onset or flares. TRIAL REGISTRATION clinicaltrials.gov, Identifier: NCT00608049 PMID:26636424

Minimally processed foods are more satiating and less hyperglycemic than ultra-processed foods: a preliminary study with 98 ready-to-eat foods.

PubMed

Fardet, Anthony

2016-05-18

Beyond nutritional composition, food structure is increasingly recognized to play a role in food health potential, notably in satiety and glycemic responses. Food structure is also highly dependent on processing conditions. The hypothesis for this study is, based on a data set of 98 ready-to-eat foods, that the degree of food processing would correlate with the satiety index (SI) and glycemic response. Glycemic response was evaluated according to two indices: the glycemic index (GI) and a newly designed index, the glycemic glucose equivalent (GGE). The GGE indicates how a quantity of a certain food affects blood glucose levels by identifying the amount of food glucose that would have an effect equivalent to that of the food. Then, foods were clustered within three processing groups based on the international NOVA classification: (1) raw and minimally processed foods; (2) processed foods; and (3) ultra-processed foods. Ultra-processed foods are industrial formulations of substances extracted or derived from food and additives, typically with five or more and usually many (cheap) ingredients. The data were correlated by nonparametric Spearman's rank correlation coefficient on quantitative data. The main results show strong correlations between GGE, SI and the degree of food processing, while GI is not correlated with the degree of processing. Thus, the more food is processed, the higher the glycemic response and the lower its satiety potential. The study suggests that complex, natural, minimally and/or processed foods should be encouraged for consumption rather than highly unstructured and ultra-processed foods when choosing weakly hyperglycemic and satiating foods.

Dietary glycemic index and glycemic load and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC).

PubMed

Romieu, Isabelle; Ferrari, Pietro; Rinaldi, Sabina; Slimani, Nadia; Jenab, Mazda; Olsen, Anja; Tjonneland, Anne; Overvad, Kim; Boutron-Ruault, Marie-Christine; Lajous, Martin; Kaaks, Rudolf; Teucher, Birgit; Boeing, Heiner; Trichopoulou, Antonia; Naska, Androniki; Vasilopoulo, Effie; Sacerdote, Carlotta; Tumino, Rosario; Masala, Giovanna; Sieri, Sabina; Panico, Salvatore; Bueno-de-Mesquita, H Bas; Van-der-A, Daphne; van Gils, Carla H; Peeters, Petra H M; Lund, Eiliv; Skeie, Guri; Asli, Lene Angell; Rodriguez, Laudina; Navarro, Carmen; Amiano, Pilar; Sanchez, Maria-José; Barricarte, Aurelio; Buckland, Genevieve; Sonestedt, Emily; Wirfält, Elisabet; Hallmans, Göran; Johansson, Ingegerd; Key, Timothy J; Allen, Naomi E; Khaw, Kay-Tee; Wareham, Nicholas J; Norat, Teresa; Riboli, Elio; Clavel-Chapelon, Françoise

2012-08-01

The glycemic potential of a diet is associated with chronically elevated insulin concentrations, which may augment breast cancer (BC) risk by stimulating insulin receptor or by affecting insulin-like growth factor I (IGF-I)-mediated mitogenesis. It is unclear whether this effect differs by BC phenotype. The objective was to investigate the relation between glycemic index (GI), glycemic load (GL), and total carbohydrate intake with BC by using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). We identified 11,576 women with invasive BC among 334,849 EPIC women aged 34-66 y (5th to 95th percentiles) at baseline over a median follow-up of 11.5 y. Dietary GI and GL were calculated from country-specific dietary questionnaires. We used multivariable Cox proportional hazards models to quantify the association between GI, GL, and carbohydrate intake and BC risk. BC tumors were classified by receptor status. Overall GI, GL, and carbohydrates were not related to BC. Among postmenopausal women, GL and carbohydate intake were significantly associated with an increased risk of estrogen receptor-negative (ER(-)) BC when extreme quintiles (Q) were compared [multivariable HR(Q5-Q1) (95% CI) = 1.36 (1.02, 1.82; P-trend = 0.010) and HR(Q5-Q1) = 1.41 (1.05, 1.89; P-trend = 0.009), respectively]. Further stratification by progesterone receptor (PR) status showed slightly stronger associations with ER(-)/PR(-) BC [HR(Q5-Q1) (95% CI) = 1.48 (1.07, 2.05; P-trend = 0.010) for GL and HR(Q5-Q1) = 1.62 (1.15, 2.30; P-trend = 0.005) for carbohydrates]. No significant association with ER-positive BC was observed. Our results indicate that a diet with a high GL and carbohydrate intake is positively associated with an increased risk of developing ER(-) and ER(-)/PR(-) BC among postmenopausal women.

Synchrotron infrared imaging of advanced glycation endproducts (AGEs) in cardiac tissue from mice fed high glycemic diets

PubMed Central

Birarda, Giovanni; Holman, Elizabeth A.; Fu, Shang; Weikel, Karen; Hu, Ping; Blankenberg, Francis G.; Holman, Hoi-Ying; Taylor, Allen

2015-01-01

Recent research findings correlate an increased risk for dieases such as diabetes, macular degeneration and cardiovascular disease (CVD) with diets that rapidly raise the blood sugar levels; these diets are known as high glycemic index (GI) diets which include white breads, sodas and sweet deserts. Lower glycemia diets are usually rich in fruits, non-starchy vegetables and whole grain products. The goal of our study was to compare and contrast the effects of a low vs. high glycemic diet using the biochemical composition and microstructure of the heart. The improved spatial resolution and signal-to-noise for SR-FTIR obtained through the coupling of the bright synchrotron infrared photon source to an infrared spectral microscope enabled the molecular-level observation of diet-related changes within unfixed fresh frozen histologic sections of mouse cardiac tissue. High and low glycemic index (GI) diets were started at the age of five-months and continued for one year, with the diets only differing in their starch distribution (high GI diet = 100% amylopectin versus low GI diet = 30% amylopectin/70% amylose). Serial cryosections of cardiac tissue for SR-FTIR imaging alternated with adjacent hematoxylin and eosin (H&E) stained sections allowed not only fine-scale chemical analyses of glycogen and glycolipid accumulation along a vein as well as protein glycation hotspots co-localizing with collagen cold spots but also the tracking of morphological differences occurring in tandem with these chemical changes. As a result of the bright synchrotron infrared photon source coupling, we were able to provide significant molecular evidence for a positive correlation between protein glycation and collagen degradation in our mouse model. Our results bring a new insight not only to the effects of long-term GI dietary practices of the public but also to the molecular and chemical foundation behind the cardiovascular disease pathogenesis commonly seen in diabetic patients. PMID:26500847

Glycemic index, glycemic load, and risk of type 2 diabetes: results from 3 large US cohorts and an updated meta-analysis123

PubMed Central

Bhupathiraju, Shilpa N; Tobias, Deirdre K; Malik, Vasanti S; Pan, An; Hruby, Adela; Manson, JoAnn E; Willett, Walter C; Hu, Frank B

2014-01-01

Background: Epidemiologic evidence for the relation between carbohydrate quality and risk of type 2 diabetes (T2D) has been mixed. Objective: We prospectively examined the association of dietary glycemic index (GI) and glycemic load (GL) with T2D risk. Design: We prospectively followed 74,248 women from the Nurses’ Health Study (1984–2008), 90,411 women from the Nurses’ Health Study II (1991–2009), and 40,498 men from the Health Professionals Follow-Up Study (1986–2008) who were free of diabetes, cardiovascular disease, and cancer at baseline. Diet was assessed by using a validated questionnaire and updated every 4 y. We also conducted an updated meta-analysis, including results from our 3 cohorts and other studies. Results: During 3,800,618 person-years of follow-up, we documented 15,027 cases of incident T2D. In pooled multivariable analyses, those in the highest quintile of energy-adjusted GI had a 33% higher risk (95% CI: 26%, 41%) of T2D than those in the lowest quintile. Participants in the highest quintile of energy-adjusted GL had a 10% higher risk (95% CI: 2%, 18%) of T2D. Participants who consumed a combination diet that was high in GI or GL and low in cereal fiber had an ∼50% higher risk of T2D. In the updated meta-analysis, the summary RRs (95% CIs) comparing the highest with the lowest categories of GI and GL were 1.19 (1.14, 1.24) and 1.13 (1.08, 1.17), respectively. Conclusion: The updated analyses from our 3 cohorts and meta-analyses provide further evidence that higher dietary GI and GL are associated with increased risk of T2D. PMID:24787496

Taking a low glycemic index multi-nutrient supplement as breakfast improves glycemic control in patients with type 2 diabetes mellitus: a randomized controlled trial.

PubMed

Li, Di; Zhang, Peiwen; Guo, Honghui; Ling, Wenhua

2014-12-10

Dietary therapy is the mainstay of treatment for diabetes. This study examined the effect of a low glycemic index (GI) multi-nutrient supplement, consumed in place of breakfast, on glycemic control in patients with type 2 diabetes mellitus (T2DM). A total of 71 participants were randomized at a 2:1 ratio into either a breakfast replacement group or a normal breakfast group for a 12-week interventional study. The primary outcome measure was change in hemoglobin A1c (HbA1c). Nutrition status and somatometry were studied as secondary outcomes. The breakfast replacement group displayed a -0.2% absolute reduction in HbA1c (95% CI (confidence interval), -0.38% to -0.07%, p = 0.004), while the HbA1c of the control group increased 0.3% (95% CI, 0.1% to 0.5%, p = 0.005). The baseline Mini Nutritional Assessment score for both groups was 26.0 and no significant changes occurred following intervention. However, there was a statistically significant difference in body mass index between the treatment and control groups (p = 0.032) due to the weight gain in the control group (increased 0.5 kg, 95% CI was 0.2 to 0.9, p = 0.007). These data suggest that breakfast replacement with a low GI multi-nutrient supplement can improve glycemic and weight control in T2DM.

Glycemic index and diabetes

MedlinePlus

... 0 to 55): Bulgar, barley Pasta, parboiled (converted) rice Quinoa High-fiber bran cereal, steel-cut or ... to 69): Pita bread, rye bread Couscous Brown rice Raisins High GI foods (70 and higher): White ...

The effect of consumption of low-glycemic-index and low-glycemic-load desserts on anthropometric parameters and inflammatory markers in patients with type 2 diabetes mellitus.

PubMed

Argiana, Vasiliki; Kanellos, Panagiotis Τ; Makrilakis, Konstantinos; Eleftheriadou, Ioanna; Tsitsinakis, Georgios; Kokkinos, Alexander; Perrea, Despina; Tentolouris, Nikolaos

2015-10-01

The aim of the present study was to examine the effects of consumption of desserts with low glycemic index (GI) and low glycemic load (GL), as part of a balanced hypo-caloric diet, on anthropometric and biochemical parameters in patients with type 2 diabetes mellitus (T2DM). A total of 61 subjects with T2DM were randomly assigned to the intervention (n = 30) or to the control group (n = 31). Both groups followed the same hypo-caloric (-500 kcal) diet for 12 weeks. Consumption of four portions of low-GI/low-GL desserts/week was included in the diet in the intervention group while one portion of a favorite usual sweet/week was allowed to be consumed in the control group. Thirty subjects in the control and 28 subjects in the intervention group completed the trial. Body weight, body mass index, and waist circumference were reduced significantly in both groups. Arterial blood pressure, fasting blood glucose, glycosylated hemoglobin, insulin, and γ-GT were reduced significantly only in the intervention group; however, there were no significant differences between the two groups at endpoint. C-reactive protein was reduced in the intervention, and HDL cholesterol was also reduced in the control group; the reductions were significantly different at the end of the trial. No significant changes were observed in the other plasma lipids, uric acid, leptin, adiponectin, and interleukin-6 in either study group. Consumption of desserts with low GI/GL in a balanced hypo-caloric diet has a positive impact on anthropometric and metabolic parameters of patients with T2DM.

Measuring the glycemic index of foods: interlaboratory study.

PubMed

Wolever, Thomas M S; Brand-Miller, Jennie C; Abernethy, John; Astrup, Arne; Atkinson, Fiona; Axelsen, Mette; Björck, Inger; Brighenti, Furio; Brown, Rachel; Brynes, Audrey; Casiraghi, M Cristina; Cazaubiel, Murielle; Dahlqvist, Linda; Delport, Elizabeth; Denyer, Gareth S; Erba, Daniela; Frost, Gary; Granfeldt, Yvonne; Hampton, Shelagh; Hart, Valerie A; Hätönen, Katja A; Henry, C Jeya; Hertzler, Steve; Hull, Sarah; Jerling, Johann; Johnston, Kelly L; Lightowler, Helen; Mann, Neil; Morgan, Linda; Panlasigui, Leonora N; Pelkman, Christine; Perry, Tracy; Pfeiffer, Andreas F H; Pieters, Marlien; Ramdath, D Dan; Ramsingh, Rayna T; Robert, S Daniel; Robinson, Carol; Sarkkinen, Essi; Scazzina, Francesca; Sison, Dave Clark D; Sloth, Birgitte; Staniforth, Jane; Tapola, Niina; Valsta, Liisa M; Verkooijen, Inge; Weickert, Martin O; Weseler, Antje R; Wilkie, Paul; Zhang, Jian

2008-01-01

Many laboratories offer glycemic index (GI) services. We assessed the performance of the method used to measure GI. The GI of cheese-puffs and fruit-leather (centrally provided) was measured in 28 laboratories (n=311 subjects) by using the FAO/WHO method. The laboratories reported the results of their calculations and sent the raw data for recalculation centrally. Values for the incremental area under the curve (AUC) reported by 54% of the laboratories differed from central calculations. Because of this and other differences in data analysis, 19% of reported food GI values differed by >5 units from those calculated centrally. GI values in individual subjects were unrelated to age, sex, ethnicity, body mass index, or AUC but were negatively related to within-individual variation (P=0.033) expressed as the CV of the AUC for repeated reference food tests (refCV). The between-laboratory GI values (mean+/-SD) for cheese-puffs and fruit-leather were 74.3+/-10.5 and 33.2+/-7.2, respectively. The mean laboratory GI was related to refCV (P=0.003) and the type of restrictions on alcohol consumption before the test (P=0.006, r2=0.509 for model). The within-laboratory SD of GI was related to refCV (P<0.001), the glucose analysis method (P=0.010), whether glucose measures were duplicated (P=0.008), and restrictions on dinner the night before (P=0.013, r2=0.810 for model). The between-laboratory SD of the GI values is approximately 9. Standardized data analysis and low within-subject variation (refCV<30%) are required for accuracy. The results suggest that common misconceptions exist about which factors do and do not need to be controlled to improve precision. Controlled studies and cost-benefit analyses are needed to optimize GI methodology. The trial was registered at clinicaltrials.gov as NCT00260858.

Zùsto: A new sweetening agent with low glycemic index.

PubMed

Pen, Joeri Jan; Khorosheva, Galina; Van de Velde, Ursule; Debroye, Corinne; Huyghebaert, André; Rottiers, Raoul; Keymeulen, Bart

2018-02-01

Sweetening agents are sugar substitutes with a low glycemic index, used to obtain a better glycemic control in diabetes patients. However, they also may have a role in other subjects, as a high glycemic index is thought to cause many pathological conditions. Unfortunately, not all artificial sweeteners are perceived as sweet as sugar by patients. Consumers refer often to an after taste present in foods sweetened with intensive sweeteners. The objective of this study was to explore whether Zùsto ® had a low glycemic index, to replace glucose as a sweetener. In this study, the glycemic index (GI) of a new sweetening agent, Zùsto ® , is compared to that of glucose 25 g, a standard sugar-loaded drink used in the oral glucose tolerance test to detect diabetes, as primary endpoint. Zùsto ® is composed of non-digestible, water soluble fibers and sweeteners. 10 healthy, female non-obese volunteers received glucose and Zùsto ® , albeit by an interval of a week. Evolution of glycemia, C-peptide and insulin release was measured at different time-points after intake. The results show that, when calculating the mean incremental Area Under the Curve (AUC), the AUC of glucose was around five times as high as that of Zùsto ® ; a GI of 22 for Zùsto ® was calculated. Furthermore, Zùsto ® had no significant effect on the glycemia, contrary to glucose, for at least 60'. This was also the case concerning C-peptide and insulin release, but the difference lasted even for 180'. Moreover, Zùsto ® was perceived as sweet by all volunteers, with no particular aftertaste. Zùsto ® could be a viable alternative for fast sugars and other sweetening agents, both for diabetic patients and other subjects, requiring however a larger trial to confirm these results. CLINICALTRIALS.GOV: NCT02607345. Copyright © 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

A randomized controlled trial to investigate the impact of a low glycemic index (GI) diet on body mass index in obese adolescents

PubMed Central

2014-01-01

Background The role of a low glycemic index (GI) diet in the management of adolescent obesity remains controversial. In this study, we aim to evaluate the impact of low GI diet versus a conventional Chinese diet on the body mass index (BMI) and other obesity indices of obese adolescents. Methods Obese adolescents aged 15–18 years were identified from population-recruited, territory-wide surveys. Obesity was defined as BMI ≥95th percentile of Hong Kong local age- and sex-specific references. Eligible subjects were randomized to either an intervention with low GI diet (consisting of 45-50% carbohydrate, 30-35% fat and 15-20% protein) or conventional Chinese diet as control (consisting of 55-60% carbohydrate, 25-30% fat and 10-15% protein). We used random intercept mixed effects model to compare the differential changes across the time points from baseline to month 6 between the 2 groups. Results 104 obese adolescents were recruited (52 in low GI group and 52 in control group; 43.3% boys). Mean age was 16.7 ± 1.0 years and 16.8 ±1.0 years in low GI and control group respectively. 58.7% subjects completed the study at 6 months (65.4% in low GI group and 51.9% in control group). After adjustment for age and sex, subjects in the low GI group had a significantly greater reduction in obesity indices including BMI, body weight and waist circumference (WC) compared to subjects in the control group (all p <0.05). After further adjustment for physical activity levels, WC was found to be significantly lower in the low GI group compared to the conventional group (p = 0.018). Conclusion Low GI diet in the context of a comprehensive lifestyle modification program may be an alternative to conventional diet in the management of obese adolescents. Trial registration number ClinicalTrials.gov Ref. No: NCT01278563 PMID:24552366

A Low Glycemic Index and Glycemic Load Diet Decreases Insulin-like Growth Factor-1 among Adults with Moderate and Severe Acne: A Short-Duration, 2-Week Randomized Controlled Trial.

PubMed

Burris, Jennifer; Shikany, James M; Rietkerk, William; Woolf, Kathleen

2018-04-21

A high glycemic index (GI) and glycemic load (GL) diet may stimulate acne proliferative pathways by influencing biochemical factors associated with acne. However, few randomized controlled trials have examined this relationship, and this process is not completely understood. This study examined changes in biochemical factors associated with acne among adults with moderate to severe acne after following a low GI and GL diet or usual eating plan for 2 weeks. This study utilized a parallel randomized controlled design to compare the effect of a low GI and GL diet to usual diet on biochemical factors associated with acne (glucose, insulin, insulin-like growth factor [IGF]-1, and insulin-like growth factor binding protein [IGFBP]-3) and insulin resistance after 2 weeks. Sixty-six participants were randomly allocated to the low GI and GL diet (n=34) or usual eating plan (n=32) and included in the analyses. The primary outcomes were biochemical factors of acne and insulin resistance with dietary intake as a secondary outcome. Independent sample t tests assessed changes in biochemical factors associated with acne, dietary intake, and body composition pre- and postintervention, comparing the two dietary interventions. IGF-1 concentrations decreased significantly among participants randomized to a low GI and GL diet between pre- and postintervention time points (preintervention=267.3±85.6 mg/mL, postintervention=244.5±78.7 ng/mL) (P=0.049). There were no differences in changes in glucose, insulin, or IGFBP-3 concentrations or insulin resistance between treatment groups after 2 weeks. Carbohydrate (P=0.019), available carbohydrate (P<0.001), percent energy from carbohydrate (P<0.001), GI (P<0.001), and GL (P<0.001) decreased significantly among participants following a low GI/GL diet between the pre- and postintervention time points. There were no differences in changes in body composition comparing groups. In this study, a low GI and GL diet decreased IGF-1 concentrations, a well-established factor in acne pathogenesis. Further research of a longer duration should examine whether a low GI and GL diet would result in a clinically meaningful difference in IGF-1 concentrations leading to a reduction in acne. This trial was registered at clinicaltrials.gov as NCT02913001. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

A comparative study on starch digestibility, glycemic index and resistant starch of pigmented ('Njavara' and 'Jyothi') and a non-pigmented ('IR 64') rice varieties.

PubMed

Deepa, G; Singh, Vasudeva; Naidu, K Akhilender

2010-12-01

In vitro starch digestibility and glycemic indices of three rice varieties- 'Njavara', 'Jyothi' (pigmented rice verities) and 'IR 64' (non-pigmented rice) with similar amylose content were studied. Starch digestibility studies showed differences in glycemic response in three types of rice. The rate of starch hydrolysis was maximum (67.3%) in 'Njavara' rice compared to other two rice varieties. 'Njavara' exhibited the lowest kinetic constant (k) indicating inherent resistance to enzymatic hydrolysis. The glycemic load (GL) and glycemic index (GI) of 'Njavara' were similar to 'Jyothi' and 'IR 64'. Resistant starch content was high in pigmented rice varieties compared to 'IR 64'. The resistant starch content of dehusked and cooked rice increased with the storage time at refrigeration temperature (4°C). 'Njavara' is an easily digestible rice and can be used for baby and geriatric foods.

Examining Diet-Related Care Practices Among Adults with Type 2 Diabetes: A Focus on Glycemic Index Choices.

PubMed

Avedzi, Hayford M; Mathe, Nonsikelelo; Bearman, Stephanie; Storey, Kate; Johnson, Jeffrey A; Johnson, Steven T

2017-03-01

We examined self-care dietary practices and usual intakes among adults with Type 2 diabetes in Alberta, Canada, using data from the Healthy Eating and Active Living for Diabetes study. Participants completed a modified Fat/Sugar/Fruit/Vegetable Screener and answered questions about the number of days per week they followed specific diabetes self-care dietary recommendations. Capillary blood samples were collected to assess glycemic control measured by hemoglobin A1c (HbA1c). ANOVA was used to examine differences in dietary self-care, intakes, and glycemic control across categories of days/week of practicing recommended dietary behaviour. Participants (n = 196) were 51% women, mean ± SD age 59.6 ± 8.5 years, with BMI 33.6 ± 6.5 kg/m 2 , and diabetes duration of 5.1 ± 6.3 years. Sixteen percent of participants were unfamiliar with low-GI eating and 28% did not include low-GI foods in their diet. Overall, lower mean intake of saturated fat, trans fat, added sugars, higher fibre, and greater GI were each associated with meeting diabetes-related dietary behaviours including: eating ≥5 servings of vegetables and fruit; avoiding processed high fat foods; and replacing high with low-GI foods (P < 0.05). No clear pattern was observed for low-GI eating and HbA1c.

Glycemic index, glycemic load, dietary carbohydrate, and dietary fiber intake and risk of liver and biliary tract cancers in Western Europeans.

PubMed

Fedirko, V; Lukanova, A; Bamia, C; Trichopolou, A; Trepo, E; Nöthlings, U; Schlesinger, S; Aleksandrova, K; Boffetta, P; Tjønneland, A; Johnsen, N F; Overvad, K; Fagherazzi, G; Racine, A; Boutron-Ruault, M C; Grote, V; Kaaks, R; Boeing, H; Naska, A; Adarakis, G; Valanou, E; Palli, D; Sieri, S; Tumino, R; Vineis, P; Panico, S; Bueno-de-Mesquita, H B; Siersema, P D; Peeters, P H; Weiderpass, E; Skeie, G; Engeset, D; Quirós, J R; Zamora-Ros, R; Sánchez, M J; Amiano, P; Huerta, J M; Barricarte, A; Johansen, D; Lindkvist, B; Sund, M; Werner, M; Crowe, F; Khaw, K T; Ferrari, P; Romieu, I; Chuang, S C; Riboli, E; Jenab, M

2013-02-01

The type and quantity of dietary carbohydrate as quantified by glycemic index (GI) and glycemic load (GL), and dietary fiber may influence the risk of liver and biliary tract cancers, but convincing evidence is lacking. The association between dietary GI/GL and carbohydrate intake with hepatocellular carcinoma (HCC; N = 191), intrahepatic bile duct (IBD; N = 66), and biliary tract (N = 236) cancer risk was investigated in 477 206 participants of the European Prospective Investigation into Cancer and Nutrition cohort. Dietary intake was assessed by country-specific, validated dietary questionnaires. Hazard ratios and 95% confidence intervals were estimated from proportional hazard models. HBV/HCV status was measured in a nested case-control subset. Higher dietary GI, GL, or increased intake of total carbohydrate was not associated with liver or biliary tract cancer risk. For HCC, divergent risk estimates were observed for total sugar = 1.43 (1.17-1.74) per 50 g/day, total starch = 0.70 (0.55-0.90) per 50 g/day, and total dietary fiber = 0.70 (0.52-0.93) per 10 g/day. The findings for dietary fiber were confirmed among HBV/HCV-free participants [0.48 (0.23-1.01)]. Similar associations were observed for IBD [dietary fiber = 0.59 (0.37-0.99) per 10 g/day], but not biliary tract cancer. Findings suggest that higher consumption of dietary fiber and lower consumption of total sugars are associated with lower HCC risk. In addition, high dietary fiber intake could be associated with lower IBD cancer risk.

Effect of adding the novel fiber, PGX®, to commonly consumed foods on glycemic response, glycemic index and GRIP: a simple and effective strategy for reducing post prandial blood glucose levels--a randomized, controlled trial.

PubMed

Jenkins, Alexandra L; Kacinik, Veronica; Lyon, Michael; Wolever, Thomas Ms

2010-11-22

Reductions in postprandial glycemia have been demonstrated previously with the addition of the novel viscous polysaccharide (NVP), PolyGlycopleX® (PGX®), to an OGTT or white bread. This study explores whether these reductions are sustained when NVP is added to a range of commonly consumed foods or incorporated into a breakfast cereal. Ten healthy subjects (4M, 6F; age 37.3 ± 3.6 y; BMI 23.8 ± 1.3 kg/m2), participated in an acute, randomized controlled trial. The glycemic response to cornflakes, rice, yogurt, and a frozen dinner with and without 5 g of NVP sprinkled onto the food was determined. In addition, 3 granolas with different levels of NVP and 3 control white breads and one white bread and milk were also consumed. All meals contained 50 g of available carbohydrate. Capillary blood samples were taken fasting and at 15, 30, 45, 60, 90 and 120 min after the start of the meal. The glycemic index (GI) and the glycemic reduction index potential (GRIP) were calculated. The blood glucose concentrations at each time and the iAUC values were subjected to repeated-measures analysis of variance (ANOVA) examining for the effect of test meal. After demonstration of significant heterogeneity, differences between individual means was assessed using GLM ANOVA with Tukey test to adjust for multiple comparisons. Addition of NVP reduced blood glucose response irrespective of food or dose (p < 0.01). The GI of cornflakes, cornflakes+NVP, rice, rice+NVP, yogurt, yogurt+NVP, turkey dinner, and turkey dinner+NVP were 83 ± 8, 58 ± 7, 82 ± 8, 45 ± 4, 44 ± 4, 38 ± 3, 55 ± 5 and 41 ± 4, respectively. The GI of the control granola, and granolas with 2.5 and 5 g of NVP were 64 ± 6, 33 ± 5, and 22 ± 3 respectively. GRIP was 6.8 ± 0.9 units per/g of NVP. Sprinkling or incorporation of NVP into a variety of different foods is highly effective in reducing postprandial glycemia and lowering the GI of a food. NCT00935350.

Natural History of Age-Related Retinal Lesions That Precede AMD in Mice Fed High or Low Glycemic Index Diets

PubMed Central

Weikel, Karen A.; FitzGerald, Paul; Shang, Fu; Caceres, M. Andrea; Bian, Qingning; Handa, James T.; Stitt, Alan W.

2012-01-01

Purpose. Epidemiologic data indicate that people who consume low glycemic index (GI) diets are at reduced risk for the onset and progression of age-related macular degeneration (AMD). The authors sought corroboration of this observation in an animal model. Methods. Five- and 16-month-old C57BL/6 mice were fed high or low GI diets until they were 17 and 23.5 months of age, respectively. Retinal lesions were evaluated by transmission electron microscopy, and advanced glycation end products (AGEs) were evaluated by immunohistochemistry. Results. Retinal lesions including basal laminar deposits, loss of basal infoldings, and vacuoles in the retinal pigment epithelium were more prevalent in the 23.5- than in the 17-month-old mice. Within each age group, consumption of a high GI diet increased the risk for lesions and the risk for photoreceptor abnormalities and accumulation of AGEs. Conclusions. Consuming high GI diets accelerates the appearance of age-related retinal lesions that precede AMD in mice, perhaps by increasing the deposition of toxic AGEs in the retina. The data support the hypothesis that consuming lower GI diets, or simulation of their effects with nutraceuticals or drugs, may protect against AMD. The high GI-fed C57BL/6 mouse is a new model of age-related retinal lesions that precede AMD and mimic the early stages of disease and may be useful for drug discovery. PMID:22205601

Carbohydrate intake and glycemic index affect substrate oxidation during a controlled weight cycle in healthy men.

PubMed

Kahlhöfer, J; Lagerpusch, M; Enderle, J; Eggeling, B; Braun, W; Pape, D; Müller, M J; Bosy-Westphal, A

2014-09-01

Because both, glycemic index (GI) and carbohydrate content of the diet increase insulin levels and could thus impair fat oxidation, we hypothesized that refeeding a low GI, moderate-carbohydrate diet facilitates weight maintenance. Healthy men (n=32, age 26.0±3.9 years; BMI 23.4±2.0 kg/m(2)) followed 1 week of controlled overfeeding, 3 weeks of caloric restriction and 2 weeks of hypercaloric refeeding (+50, -50 and +50% energy requirement) with low vs high GI (41 vs 74) and moderate vs high CHO intake (50% vs 65% energy). We measured adaptation of fasting macronutrient oxidation and the capacity to supress fat oxidation during an oral glucose tolerance test. Changes in fat mass were measured by quantitative magnetic resonance. During overfeeding, participants gained 1.9±1.2 kg body weight, followed by a weight loss of -6.3±0.6 kg and weight regain of 2.8±1.0 kg. Subjects with 65% CHO gained more body weight compared with 50% CHO diet (P<0.05) particularly with HGI meals (P<0.01). Refeeding a high-GI diet led to an impaired basal fat oxidation when compared with a low-GI diet (P<0.02), especially at 65% CHO intake. Postprandial metabolic flexibility was unaffected by refeeding at 50% CHO but clearly impaired by 65% CHO diet (P<0.05). Impairment in fasting fat oxidation was associated with regain in fat mass (r=0.43, P<0.05) and body weight (r=0.35; P=0.051). Both higher GI and higher carbohydrate content affect substrate oxidation and thus the regain in body weight in healthy men. These results argue in favor of a lower glycemic load diet for weight maintenance after weight loss.

Effects of Low versus High Glycemic Index Sugar-Sweetened Beverages on Postprandial Vasodilatation and Inactivity-Induced Impairment of Glucose Metabolism in Healthy Men

PubMed Central

Keller, Judith; Kahlhöfer, Julia; Peter, Andreas; Bosy-Westphal, Anja

2016-01-01

Intake of sugar-sweetened beverages (SSB) may contribute to cardiovascular risk. The aim of this study was to investigate whether functional sugars with low compared to high glycemic index (GI) have beneficial effects on arterial stiffness during a period of low-physical activity. In a controlled cross-over dietary intervention (55% CHO, 30% fat, 15% protein), 13 healthy men (age: 23.7 ± 2.2 years, body mass index: 23.6 ± 1.9 kg/m2) completed 2 × 1 week of low physical activity following 1 week of normal physical activity (2363 ± 900 vs. 11,375 ± 3124 steps/day). During inactive phases participants consumed either low-GI (isomaltulose) or high-GI SSB (maltodextrin-sucrose), providing 20% of energy requirements. Postprandial vasodilatation (augmentation index, AIx), insulin sensitivity (IS) and Glucagon-like-peptide 1 (GLP-1) responses were measured during a meal test before and after SSB-intervention. Compared to maltodextrin-sucrose-SSB, postprandial vasodilatation was prolonged (AIx after 120 min: 9.9% ± 4.3% vs. 11.4% ± 3.7%, p < 0.05) and GLP-1 secretion was higher with isomaltulose-SSB (total area under the GLP-1 curve (tAUCGLP)-1: 8.0 ± 4.4 vs. 5.4 ± 3.4 pM × 3 h; p < 0.05). One week of low-physical activity led to impaired IS that was attenuated with low-GI SSB consumption, but did not affect arterial stiffness (p > 0.05). Higher postprandial GLP-1 secretion after intake of low compared to high-GI beverages may contribute to improved postprandial vasodilatation. Although one week of low-physical activity led to marked impairment in IS, it had no effect on arterial stiffness in healthy men. PMID:27973411

Effects of Low versus High Glycemic Index Sugar-Sweetened Beverages on Postprandial Vasodilatation and Inactivity-Induced Impairment of Glucose Metabolism in Healthy Men.

PubMed

Keller, Judith; Kahlhöfer, Julia; Peter, Andreas; Bosy-Westphal, Anja

2016-12-10

Intake of sugar-sweetened beverages (SSB) may contribute to cardiovascular risk. The aim of this study was to investigate whether functional sugars with low compared to high glycemic index (GI) have beneficial effects on arterial stiffness during a period of low-physical activity. In a controlled cross-over dietary intervention (55% CHO, 30% fat, 15% protein), 13 healthy men (age: 23.7 ± 2.2 years, body mass index: 23.6 ± 1.9 kg/m²) completed 2 × 1 week of low physical activity following 1 week of normal physical activity (2363 ± 900 vs. 11,375 ± 3124 steps/day). During inactive phases participants consumed either low-GI (isomaltulose) or high-GI SSB (maltodextrin-sucrose), providing 20% of energy requirements. Postprandial vasodilatation (augmentation index, AIx), insulin sensitivity (IS) and Glucagon-like-peptide 1 (GLP-1) responses were measured during a meal test before and after SSB-intervention. Compared to maltodextrin-sucrose-SSB, postprandial vasodilatation was prolonged (AIx after 120 min: 9.9% ± 4.3% vs. 11.4% ± 3.7%, p < 0.05) and GLP-1 secretion was higher with isomaltulose-SSB (total area under the GLP-1 curve (tAUC GLP )-1: 8.0 ± 4.4 vs. 5.4 ± 3.4 pM × 3 h; p < 0.05). One week of low-physical activity led to impaired IS that was attenuated with low-GI SSB consumption, but did not affect arterial stiffness ( p > 0.05). Higher postprandial GLP-1 secretion after intake of low compared to high-GI beverages may contribute to improved postprandial vasodilatation. Although one week of low-physical activity led to marked impairment in IS, it had no effect on arterial stiffness in healthy men.

Post-exercise appetite was affected by fructose content but not glycemic index of pre-exercise meals.

PubMed

Sun, Feng-Hua; Wong, Stephen Heung-Sang; Liu, Zhi-Gang

2016-01-01

The purpose of this study was to investigate whether both glycemic index (GI) and breakfast fructose content affect appetite during the postprandial period and recovery period after 1 hr of brisk walking. Ten healthy young men (age: 21.7 ± 1.5 y, body mass index: 20.9 ± 1.1 kg∙m(-2), VO2max: 53.7 ± 3.7 mL∙kg(-1)∙min(-1)) completed 1 hr of brisk walking at 46% VO2max 2 hr after eating one of three isocaloric breakfasts: a low-GI breakfast not including fructose content (LGI), a low-GI breakfast including fructose beverage (LGIF) and a high-GI breakfast (HGI). All breakfasts provided 1.0 g∙kg(-1) body weight carbohydrates, and the calculated GI values for the three breakfasts were 41, 39, and 72, respectively. In the LGIF and HGI trials, approximately 25% of participants' energy was derived from either fructose or glucose beverage. Appetite scores were measured every 30 min during the 2-hr postprandial period and 1-hr recovery period. During the postprandial period, the incremental areas under the blood response curve values of glucose and insulin were higher in the HGI trial, compared with those in the LGI and LGIF trials. At 30 and 60 min during the recovery period, the appetite scores were lower in the LGIF trial than those in the LGI and HGI trials. No differences were observed between the LGI and HGI trials. Breakfast fructose content, rather than GI, seems to affect appetite during the recovery period after 1 hr of brisk walking. Copyright © 2015 Elsevier Ltd. All rights reserved.

Randomized Controlled Trial Investigating the Effects of a Low-Glycemic Index Diet on Pregnancy Outcomes in Women at High Risk of Gestational Diabetes Mellitus: The GI Baby 3 Study.

PubMed

Markovic, Tania P; Muirhead, Ros; Overs, Shannon; Ross, Glynis P; Louie, Jimmy Chun Yu; Kizirian, Nathalie; Denyer, Gareth; Petocz, Peter; Hyett, Jon; Brand-Miller, Jennie C

2016-01-01

Dietary interventions can improve pregnancy outcomes in women with gestational diabetes mellitus (GDM). We compared the effect of a low-glycemic index (GI) versus a conventional high-fiber (HF) diet on pregnancy outcomes, birth weight z score, and maternal metabolic profile in women at high risk of GDM. One hundred thirty-nine women [mean (SD) age 34.7 (0.4) years and prepregnancy BMI 25.2 (0.5) kg/m(2)] were randomly assigned to a low-GI (LGI) diet (n = 72; target GI ∼50) or a high-fiber, moderate-GI (HF) diet (n = 67; target GI ∼60) at 14-20 weeks' gestation. Diet was assessed by 3-day food records and infant body composition by air-displacement plethysmography, and pregnancy outcomes were assessed from medical records. The LGI group achieved a lower GI than the HF group [mean (SD) 50 (5) vs. 58 (5); P < 0.001]. There were no differences in glycosylated hemoglobin, fructosamine, or lipids at 36 weeks or differences in birth weight [LGI 3.4 (0.4) kg vs. HF 3.4 (0.5) kg; P = 0.514], birth weight z score [LGI 0.31 (0.90) vs. HF 0.24 (1.07); P = 0.697], ponderal index [LGI 2.71 (0.22) vs. HF 2.69 (0.23) kg/m(3); P = 0.672], birth weight centile [LGI 46.2 (25.4) vs. HF 41.8 (25.6); P = 0.330], % fat mass [LGI 10 (4) vs. HF 10 (4); P = 0.789], or incidence of GDM. In intensively monitored women at risk for GDM, a low-GI diet and a healthy diet produce similar pregnancy outcomes. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Price and Availability of Sugar-Free, Sugar-Reduced and Low Glycemic Index Cereal Products in Northwestern México.

PubMed

Arámburo-Gálvez, Jesús G; Ontiveros, Noé; Vergara-Jiménez, Marcela J; Magaña-Ordorica, Dalia; Gracia-Valenzuela, Martina H; Cabrera-Chávez, Francisco

2017-12-18

Sugar-free (SF), sugar-reduced (SR), or low-glycemic-index (low GI) cereal products could be helpful for the dietary treatment of disorders related to glucose homeostasis. However, access and economic aspects are barriers that could hamper their consumption. Thus, the availability and price of such cereal products were evaluated in Northwestern México. The products were categorized in 10 groups. The data were collected in five cities by store visitation (from November 2015 to April 2016). The availability in specialized stores and supermarkets was expressed as availability rates based on the total number of products. The price of the SF, SR, and low GI products were compared with their conventional counterparts. Availability rates were higher in supermarkets than in specialized stores by product numbers (14.29% versus 3.76%, respectively; p < 0.001) and by product categories (53.57% versus 26.92%, respectively; p < 0.001). Five categories of products labeled as SF, SR, and low GI (oats, cookies and crackers, flours, snacks, and tostadas/totopos) had higher prices than their conventional counterparts ( p < 0.05). In conclusion, in Northwestern Mexico, the availability of SF, SR, and low GI cereal-based foods is relatively low, and these foods are more expensive than their conventional counterparts.

Decreases in dietary glycemic index are related to weight loss among individuals following therapeutic diets for type 2 diabetes.

PubMed

Turner-McGrievy, Gabrielle M; Jenkins, David J A; Barnard, Neal D; Cohen, Joshua; Gloede, Lise; Green, Amber A

2011-08-01

This study assessed the effect of changes in glycemic index (GI) and load (GL) on weight loss and glycated hemoglobin (HbA1c) among individuals with type 2 diabetes beginning a vegan diet or diet following the 2003 American Diabetes Association (ADA) recommendations. The study was a 22-wk, randomized trial of 99 participants with type 2 diabetes who were counseled to follow 1 of 2 diet treatments. GI and GL changes were assessed based on 3-d dietary records. The relationships between GI/GL and changes in weight and HbA1C were calculated. In an intention-to-treat analysis (n = 99), the vegan group reduced GI to a greater extent than the ADA group (P < 0.05), but GL was reduced further in the ADA than the vegan group (P < 0.001). GI predicted changes in weight (P = 0.001), adjusting for changes in fiber, carbohydrate, fat, alcohol, energy intake, steps per day, group, and demographics, such that for every point decrease in GI, participants lost ~0.2 kg (0.44 lb). GI was not a predictor for changes in HbA1C after controlling for weight loss (P = 0.33). Weight loss was a predictor of changes in HbA1C (P = 0.047). GL was not related to weight loss or changes in HbA1C. A low-GI diet appears to be one of the determinants of success of a vegan or ADA diet in reducing body weight among people with type 2 diabetes. The reduction of body weight, in turn, was predictive of decreasing HbA1C.

Decreases in Dietary Glycemic Index Are Related to Weight Loss among Individuals following Therapeutic Diets for Type 2 Diabetes1234

PubMed Central

Turner-McGrievy, Gabrielle M.; Jenkins, David J. A.; Barnard, Neal D.; Cohen, Joshua; Gloede, Lise; Green, Amber A.

2011-01-01

This study assessed the effect of changes in glycemic index (GI) and load (GL) on weight loss and glycated hemoglobin (HbA1c) among individuals with type 2 diabetes beginning a vegan diet or diet following the 2003 American Diabetes Association (ADA) recommendations. The study was a 22-wk, randomized trial of 99 participants with type 2 diabetes who were counseled to follow 1 of 2 diet treatments. GI and GL changes were assessed based on 3-d dietary records. The relationships between GI/GL and changes in weight and HbA1C were calculated. In an intention-to-treat analysis (n = 99), the vegan group reduced GI to a greater extent than the ADA group (P < 0.05), but GL was reduced further in the ADA than the vegan group (P < 0.001). GI predicted changes in weight (P = 0.001), adjusting for changes in fiber, carbohydrate, fat, alcohol, energy intake, steps per day, group, and demographics, such that for every point decrease in GI, participants lost ~0.2 kg (0.44 lb). GI was not a predictor for changes in HbA1C after controlling for weight loss (P = 0.33). Weight loss was a predictor of changes in HbA1C (P = 0.047). GL was not related to weight loss or changes in HbA1C. A low-GI diet appears to be one of the determinants of success of a vegan or ADA diet in reducing body weight among people with type 2 diabetes. The reduction of body weight, in turn, was predictive of decreasing HbA1C. PMID:21653575

Dietary glycemic index, glycemic load, and refined carbohydrates are associated with risk of stroke: a prospective cohort study in urban Chinese women.

PubMed

Yu, Danxia; Zhang, Xianglan; Shu, Xiao-Ou; Cai, Hui; Li, Honglan; Ding, Ding; Hong, Zhen; Xiang, Yong-Bing; Gao, Yu-Tang; Zheng, Wei; Yang, Gong

2016-11-01

Epidemiologic evidence on dietary carbohydrates and stroke risk remains controversial. Very few prospective cohort studies have been conducted in Asian populations, who usually consume a high-carbohydrate diet and have a high burden of stroke. We examined dietary glycemic index (GI), glycemic load (GL), and intakes of refined and total carbohydrates in relation to risks of total, ischemic, and hemorrhagic stroke and stroke mortality. This study included 64,328 Chinese women, aged 40-70 y, with no history of cardiovascular disease, diabetes, or cancer. A validated, interviewer-administered food-frequency questionnaire was used to assess usual dietary intakes at baseline and during follow-up. Incident stroke cases and deaths were identified via follow-up interviews and death registries and were confirmed by review of medical records and death certificates. During mean follow-ups of 10 y for stroke incidence and 12 y for stroke mortality, we ascertained 2991 stroke cases (2750 ischemic and 241 hemorrhagic) and 609 stroke deaths. After potential confounders were controlled for, we observed significant positive associations of dietary GI and GL with total stroke risk; multivariable-adjusted HRs (95% CIs) for high compared with low levels (90th compared with 10th percentile) were 1.19 (1.04, 1.36) for GI and 1.27 (1.04, 1.54) for GL (both P-linearity < 0.05 and P-overall significance < 0.05). Similar linear associations were found for ischemic stroke, but the associations with hemorrhagic stroke appeared to be J-shaped. Similar trends of positive associations with stroke risks were suggested for refined carbohydrates but not for total carbohydrates. No significant associations were found for stroke mortality after multivariable adjustment. Our results suggest that high dietary GI and GL, primarily due to high intakes of refined grains, are associated with increased risks of total, ischemic, and hemorrhagic stroke in middle-aged and older urban Chinese women. © 2016 American Society for Nutrition.

High Dietary Glycemic Load is Associated with Poor Functional Outcome in Patients with Acute Cerebral Infarction.

PubMed

Song, Tae Jin; Chang, Yoonkyung; Chun, Min Young; Lee, Chan Young; Kim, A Ram; Kim, Yuri; Kim, Yong Jae

2018-04-01

Elevated postprandial blood glucose is a critical risk factor for stroke. The dietary glycemic load (GL) and glycemic index (GI) are frequently used as markers of the postprandial blood glucose response to estimate the overall glycemic effect of diets. We hypothesized that high dietary GL, GI, or total carbohydrate intake is associated with a poor functional outcome in patients with acute ischemic stroke. We prospectively included 263 first-ever ischemic stroke patients who completed a semiquantitative food-frequency questionnaire. The dietary GL, GI, and total carbohydrate intake were investigated by examining the average frequency of intake during the previous year based on reference amounts for various food items. Poor functional outcome was defined as a score on the modified Rankin Scale (mRS) of ≥3 at 3 months after stroke. The patients were aged 65.4±11.7 years (mean±standard deviation), and 58.2% of them were male. A multivariate analysis adjusted for age, sex, marital status, prestroke mRS score, diabetes mellitus, hyperlipidemia, body mass index, triglycerides, low-density lipoprotein, hemoglobin A1c, stroke classification, and National Institutes of Health Stroke Scale score, early neurological deterioration, and high-grade white-matter hyperintensities revealed that the dietary GL and total carbohydrate intake were associated with a poor functional outcome, with odds ratios for the top quartile relative to the bottom quartile of 28.93 (95% confidence interval=2.82-296.04) and 36.84 (95% confidence interval=2.99-453.42), respectively (p for trend=0.002 and 0.002, respectively). In contrast, high dietary GI was not associated with a poor functional outcome (p for trend=0.481). Increased dietary GL and carbohydrate intake were associated with a poor short-term functional outcome after an acute ischemic stroke. Copyright © 2018 Korean Neurological Association.

The effect of dietary glycemic index and glycemic load on inflammatory biomarkers: a systematic review and meta-analysis of randomized clinical trials.

PubMed

Milajerdi, Alireza; Saneei, Parvane; Larijani, Bagher; Esmaillzadeh, Ahmad

2018-04-01

To our knowledge, there is no study available that summarizes earlier findings on the effect of dietary glycemic index (GI) and glycemic load (GL) on inflammatory biomarkers. This systematic review and meta-analysis was conducted to systematically review the available clinical trials that examined the effects of low-GI (LGI) and low-GL (LGL) diets on several inflammatory biomarkers in adults. We searched for relevant articles published up to June 2017 through PubMed, Medline, SCOPUS, EMBASE, and Google Scholar with the use of relevant keywords. Clinical trials that examined the effect of dietary GI and GL on inflammation in adults were included. Overall, 28 randomized controlled trials (RCTs) including 2961 participants (59% women, 41% men) were included in this meta-analysis. By combining findings from 14 studies on high-sensitivity C-reactive protein (hs-CRP) concentrations, we found no significant effect of LGI or LGL diets on serum hs-CRP concentrations compared with the control diet [weighted mean difference (WMD) for dietary GI: -0.05 mg/L (95% CI: -0.21, 0.10 mg/L); and WMD for dietary GL: 0.08 mg/L (95% CI: -0.26, 0.42 mg/L), respectively]. After combining effect sizes from 5 studies, we did not find significant changes in serum tumor necrosis factor α (TNF-α) concentrations comparing control diets with LGI (WMD: -0.18 mg/L; 95% CI: -0.43, 0.06 mg/L) or LGL (WMD: -0.20 mg/L; 95% CI: -0.33, 0.07 mg/L) diets. Significant changes were also not seen in leptin and interleukin 6 (IL-6) concentrations after the consumption of LGI or LGL diets. We did not find any significant effect of dietary GI or GL on serum concentrations of inflammatory cytokines, including hs-CRP, leptin, IL-6, and TNF-α in adults. Additional RCTs-in particular, feeding trials-are required to shed light on this issue.

Metabolic changes after a hypocaloric, low-glycemic-index diet in obese children.

PubMed

Parillo, M; Licenziati, M R; Vacca, M; De Marco, D; Iannuzzi, A

2012-07-01

A low glycemic index (LGI) diet has been proposed as a treatment for obesity in adults; few studies have evaluated LGI diets in obese children. The purpose of the study was to compare the effects of two diets, with similar energy intakes, but different glycemic indexes in a pediatric outpatient setting. A parallel- group, randomized controlled trial was conducted, and 22 obese outpatient children with a body mass index (BMI) Z-score >2 (11 females and 11 males, BMI 28.9±2.9 kg/m²) were included in the study. Patients were randomly allocated to a hypocaloric LGI (GI:60), or to a hypocaloric high glycemic index (HGI) diet (GI:90). The LGI and HGI diets were almost equivalent for macronutrient composition. Anthropometric and biochemical parameters were measured at baseline and after 6 months. In both groups there were significant decreases in BMI, BMI Z-score, blood pressure, and high-sensitivity C-reactive protein. Only LGI diets produced a significant decrease in waist circumference and homeostasis model assessment. Analysis of variance demonstrated that the BMI Z-score decrease from baseline values was significantly greater after the LGI diet than after the HGI diet [-0.20 (95% confidence interval (CI) -0.29 to -0.10) vs -0.34 (95%CI -0.43 to -0.24)], mean difference between groups -0.14 (95%CI -0.27 to -0.01), p<0.05). Changes in triglyceride concentrations were significantly lower in LGI as compared to HGI diet (p<0.05). This study demonstrates that a hypocaloric LGI diet has beneficial metabolic effects in comparison to a hypocaloric HGI diet in obese children.

Glycemic Responses, Appetite Ratings and Gastrointestinal Hormone Responses of Most Common Breads Consumed in Spain. A Randomized Control Trial in Healthy Humans

PubMed Central

Gonzalez-Anton, Carolina; Rico, Maria C.; Sanchez-Rodriguez, Estefania; Ruiz-Lopez, Maria D.; Gil, Angel; Mesa, Maria D.

2015-01-01

The present study was carried out to determine the glycemic index (GI), glycemic load (GL), insulinemic index (InI), appetite ratings and postprandial plasma concentrations of gastrointestinal hormones related to the control of food intake after the ingestion of the five most common breads consumed in Spain with different compositions and manufacturing processes. Twenty-two healthy adults participated in a randomized crossover study. The breads tested were Ordinary, Precooked-Frozen, Candeal-flour, Alfacar whites and Wholemeal. All breads portions were calculated to supply 50 g of available carbohydrates. In addition, 50 g of glucose was used as a reference. A linear mixed-effects model was used to compare data calculated for all breads with glucose load. The GI value varied from 61 for the Wholemeal, to Alfacar 68, Ordinary 76, and 78 and 86 for the Precooked-Frozen and Candeal-flour breads, respectively. Wholemeal and Alfacar had lower GI than glucose. All tested breads had a lower GL (ranged 9 to 18) compared with glucose. Wholemeal GL was similar to Alfacar, but lower than the other white breads. InI were significantly lower for all breads (ranged 68 to 73) compared with glucose, and similar among them. The intake of the Wholemeal bread led to a higher release of gastric inhibitory polypeptide compared with the Ordinary and Precooked breads and to a higher release of pancreatic polypeptide compared with the Precooked-Frozen bread. All breads affected appetite ratings similarly. In conclusion, based on GL, the Wholemeal bread would be expected to exert a favorable glycemic response. PMID:26024293

Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome.

PubMed

Marsh, Kate A; Steinbeck, Katharine S; Atkinson, Fiona S; Petocz, Peter; Brand-Miller, Jennie C

2010-07-01

Women with polycystic ovarian syndrome (PCOS) are intrinsically insulin resistant and have a high risk of cardiovascular disease and type 2 diabetes. Weight loss improves risk factors, but the optimal diet composition is unknown. Low-glycemic index (low-GI) diets are recommended without evidence of their clinical effectiveness. We compared changes in insulin sensitivity and clinical outcomes after similar weight losses after consumption of a low-GI diet compared with a conventional healthy diet in women with PCOS. We assigned overweight and obese premenopausal women with PCOS (n = 96) to consume either an ad libitum low-GI diet or a macronutrient-matched healthy diet and followed the women for 12 mo or until they achieved a 7% weight loss. We compared changes in whole-body insulin sensitivity, which we assessed using the insulin sensitivity index derived from the oral-glucose-tolerance test (ISI(OGTT)); glucose tolerance; body composition; plasma lipids; reproductive hormones; health-related quality of life; and menstrual cycle regularity. The attrition rate was high in both groups (49%). Among completers, ISI(OGTT) improved more with the low-GI diet than with the conventional healthy diet (mean +/- SEM: 2.2 +/- 0.7 compared with 0.7 +/- 0.6, respectively; P = 0.03). There was a significant diet-metformin interaction (P = 0.048), with greater improvement in ISI(OGTT) among women prescribed both metformin and the low-GI diet. Compared with women who consumed the conventional healthy diet, more women who consumed the low-GI diet showed improved menstrual cyclicity (95% compared with 63%, respectively; P = 0.03). Among the biochemical measures, only serum fibrinogen concentrations showed significant differences between diets (P < 0.05). To the best of our knowledge, this study provides the first objective evidence to justify the use of low-GI diets in the management of PCOS.

Postprandial glucose response to selected tropical fruits in normal glucose-tolerant Nigerians.

PubMed

Edo, A; Eregie, A; Adediran, O; Ohwovoriole, A; Ebengho, S

2011-01-01

The glycemic response to commonly eaten fruits in Nigeria has not been reported. Therefore, this study assessed the plasma glucose response to selected fruits in Nigeria. Ten normal glucose-tolerant subjects randomly consumed 50 g carbohydrate portions of three fruits: banana (Musa paradisiaca), pineapple (Ananus comosus), and pawpaw (Carica papaya), and a 50-g glucose load at 1-week intervals. Blood samples were collected in the fasting state and half-hourly over a 2-h period post-ingestion of the fruits or glucose. The samples were analyzed for plasma glucose concentrations. Plasma glucose responses were assessed by the peak plasma glucose concentration, maximum increase in plasma glucose, 2-h postprandial plasma glucose level, and incremental area under the glucose curve and glycemic index (GI). The results showed that the blood glucose response to these three fruits was similar in terms of their incremental areas under the glucose curve, maximum increase in plasma glucose, and glycemic indices (GIs). The 2-h postprandial plasma glucose level of banana was significantly higher than that of pineapple, P < 0.025. The mean ± SEM GI values were as follows: pawpaw; 86 ± 26.8%; banana, 75.1 ± 21.8%; pineapple, 64.5 ± 11.3%. The GI of glucose is taken as 100. The GI of pineapple was significantly lower than that of glucose (P < 0.05). Banana, pawpaw, and pineapple produced a similar postprandial glucose response. Measured portions of these fruits may be used as fruit exchanges with pineapple having the most favorable glycemic response.

Dietary fiber and the glycemic index: a background paper for the Nordic Nutrition Recommendations 2012

PubMed Central

Øverby, Nina Cecilie; Sonestedt, Emily; Laaksonen, David E.; Birgisdottir, Bryndis Eva

2013-01-01

The aim of this study is to review recent data on dietary fiber (DF) and the glycemic index (GI), with special focus on studies from the Nordic countries regarding cardiometabolic risk factors, type 2 diabetes, cardiovascular disease, cancer, and total mortality. In this study, recent guidelines and scientific background papers or updates on older reports on DF and GI published between 2000 and 2011 from the US, EU, WHO, and the World Cancer Research Fund were reviewed, as well as prospective cohort and intervention studies carried out in the Nordic countries. All of the reports support the role for fiber-rich foods and DF as an important part of a healthy diet. All of the five identified Nordic papers found protective associations between high intake of DF and health outcomes; lower risk of cardiovascular disease, type 2 diabetes, colorectal and breast cancer. None of the reports and few of the Nordic papers found clear evidence for the GI in prevention of risk factors or diseases in healthy populations, although association was found in sub-groups, e.g. overweight and obese individuals and suggestive for prevention of type 2 diabetes. It was concluded that DF is associated with decreased risk of different chronic diseases and metabolic conditions. There is not enough evidence that choosing foods with low GI will decrease the risk of chronic diseases in the population overall. However, there is suggestive evidence that ranking food based on their GI might be of use for overweight and obese individuals. Issues regarding methodology, validity and practicality of the GI remain to be clarified. PMID:23538683

Variable Classifications of Glycemic Index Determined by Glucose Meters

PubMed Central

Lin, Meng-Hsueh Amanda; Wu, Ming-Chang; Lin, Jenshinn

2010-01-01

The study evaluated and compared the differences of glucose responses, incremental area under curve (IAUC), glycemic index (GI) and the classification of GI values between measured by biochemical analyzer (Fuji automatic biochemistry analyzer (FAA)) and three glucose meters: Accue Chek Advantage (AGM), BREEZE 2 (BGM), and Optimum Xceed (OGM). Ten healthy subjects were recruited for the study. The results showed OGM yield highest postprandial glucose responses of 119.6 ± 1.5, followed by FAA, 118.4 ± 1.2, BGM, 117.4 ± 1.4 and AGM, 112.6 ± 1.3 mg/dl respectively. FAA reached highest mean IAUC of 4156 ± 208 mg × min/dl, followed by OGM (3835 ± 270 mg × min/dl), BGM (3730 ± 241 mg × min/dl) and AGM (3394 ± 253 mg × min/dl). Among four methods, OGM produced highest mean GI value than FAA (87 ± 5) than FAA, followed by BGM and AGM (77 ± 1, 68 ± 4 and 63 ± 5, p<0.05). The results suggested that the AGM, BGM and OGM are more variable methods to determine IAUC, GI and rank GI value of food than FAA. The present result does not necessarily apply to other glucose meters. The performance of glucose meter to determine GI value of food should be evaluated and calibrated before use. PMID:20664730

Glycemic index, glycemic load and endometrial cancer risk: results from the Australian National Endometrial Cancer study and an updated systematic review and meta-analysis.

PubMed

Nagle, Christina M; Olsen, Catherine M; Ibiebele, Torukiri I; Spurdle, Amanda B; Webb, Penelope M

2013-03-01

The relationship between habitual consumption of foods with a high glycemic index (GI) and/or a diet with a high glycemic load (GL) and risk of endometrial cancer is uncertain, and relatively few studies have investigated these associations. The objectives of this study were to examine the association between GI/GL and risk of endometrial cancer using data from an Australian population-based case-control study and systematically review all the available evidence to quantify the magnitude of the association using meta-analysis. The case-control study included 1,290 women aged 18-79 years with newly diagnosed, histologically confirmed endometrial cancer and 1,436 population controls. Controls were selected to match the expected Australian state of residence and age distribution (in 5-year bands) of cases. For the systematic review, relevant studies were identified by searching PubMed and Embase databases through to July 2011. Random-effects models were used to calculate the summary risk estimates, overall and dose-response. In our case-control study, we observed a modest positive association between high dietary GI (OR 1.43, 95 % CI 1.11-1.83) and risk of endometrial cancer, but no association with high dietary GL (OR 1.15, 95 % CI 0.90-1.48). For the meta-analysis, we collated information from six cohort and two case-control studies, involving a total of 5,569 cases. The pooled OR for the highest versus the lowest intake category of GI was 1.15 (0.95-1.40); however, there was significant heterogeneity (p 0.004) by study design (RR 1.00 [95 % CI 0.87-1.14] for cohort studies and 1.56 [95 % CI 1.21-2.02] for case-control studies). There was no association in the dose-response meta-analysis of GI (RR per 5 unit/day increment of GI 1.00, 95 % CI 0.97-1.03). GL was positively associated with endometrial cancer. The pooled RR for the highest versus the lowest GL intake was 1.21 (95 % CI 1.09-1.33) and 1.06 (95 % CI 1.01-1.11) per 50 unit/day increment of GL in the dose-response meta-analysis. The pooled results from observational studies, including our case-control results, provide evidence of a modest positive association between high GL, but not GI, and endometrial cancer risk.

Impairment of fat oxidation under high- vs. low-glycemic index diet occurs before the development of an obese phenotype.

PubMed

Isken, F; Klaus, S; Petzke, K J; Loddenkemper, C; Pfeiffer, A F H; Weickert, M O

2010-02-01

Exposure to high vs. low glycemic index (GI) diets increases fat mass and insulin resistance in obesity-prone C57BL/6J mice. However, the longer-term effects and potentially involved mechanisms are largely unknown. We exposed four groups of male C57BL/6J mice (n = 10 per group) to long-term (20 wk) or short-term (6 wk) isoenergetic and macronutrient matched diets only differing in starch type and as such GI. Body composition, liver fat, molecular factors of lipid metabolism, and markers of insulin sensitivity and metabolic flexibility were investigated in all four groups of mice. Mice fed the high GI diet showed a rapid-onset (from week 5) marked increase in body fat mass and liver fat, a gene expression profile in liver consistent with elevated lipogenesis, and, after long-term exposure, significantly reduced glucose clearance following a glucose load. The long-term high-GI diet also led to a delayed switch to both carbohydrate and fat oxidation in the postprandial state, indicating reduced metabolic flexibility. In contrast, no difference in carbohydrate oxidation was observed after short-term high- vs. low-GI exposure. However, fatty acid oxidation was significantly blunted as early as 3 wk after beginning of the high-GI intervention, at a time where most measured phenotypic markers including body fat mass were comparable between groups. Thus long-term high-GI feeding resulted in an obese, insulin-resistant, and metabolically inflexible phenotype in obesity-prone C57BL/6J mice. Early onset and significantly impaired fatty acid oxidation preceded these changes, thereby indicating a potentially causal involvement.

The glycemic and peak incremental indices of honey, sucrose and glucose in patients with type 1 diabetes mellitus: effects on C-peptide level-a pilot study.

PubMed

Abdulrhman, Mamdouh; El-Hefnawy, Mohamed; Hussein, Rasha; El-Goud, Ahmad Abou

2011-06-01

Our study was a case-control cross-sectional study that was conducted on 20 children and adolescents suffering from type 1 diabetes mellitus and ten healthy non-diabetic children and adolescents serving as controls. The mean age of patients was 10.95 years. Oral sugar tolerance tests using glucose, sucrose and honey and measurement of fasting and postprandial serum C-peptide levels were done for all subjects in three separate sittings. The glycemic index (GI) and the peak incremental index (PII) were then calculated for each subject. Honey, compared to sucrose, had lower GI and PII in both patients (P < 0.001) and control (P < 0.05) groups. In the patients group, the increase in the level of C-peptide after using honey was not significant when compared with using either glucose or sucrose. However, in the control group, honey produced a significant higher C-peptide level, when compared with either glucose or sucrose. In conclusion, honey, because of its lower GI and PII when compared with sucrose, may be used as a sugar substitute in patients with type 1 diabetes mellitus.

Effect of a Mediterranean Diet Intervention on Dietary Glycemic Load and Dietary Glycemic Index: The PREDIMED Study.

PubMed

Rodríguez-Rejón, Ana Isabel; Castro-Quezada, Itandehui; Ruano-Rodríguez, Cristina; Ruiz-López, María Dolores; Sánchez-Villegas, Almudena; Toledo, Estefanía; Artacho, Reyes; Estruch, Ramón; Salas-Salvadó, Jordi; Covas, María Isabel; Corella, Dolores; Gómez-Gracia, Enrique; Lapetra, José; Pintó, Xavier; Arós, Fernando; Fiol, Miquel; Lamuela-Raventós, Rosa María; Ruiz-Gutierrez, Valentina; Schröder, Helmut; Ros, Emilio; Martínez-González, Miguel Ángel; Serra-Majem, Lluis

2014-01-01

Objective. To compare the one year effect of two dietary interventions with MeDiet on GL and GI in the PREDIMED trial. Methods. Participants were older subjects at high risk for cardiovascular disease. This analysis included 2866 nondiabetic subjects. Diet was assessed with a validated 137-item food frequency questionnaire (FFQ). The GI of each FFQ item was assigned by a 5-step methodology using the International Tables of GI and GL Values. Generalized linear models were fitted to assess the relationship between the intervention group and dietary GL and GI at one year of follow-up, using control group as reference. Results. Multivariate-adjusted models showed an inverse association between GL and MeDiet + extra virgin olive oil (EVOO) group: β = -8.52 (95% CI: -10.83 to -6.20) and MeDiet + Nuts group: β = -10.34 (95% CI: -12.69 to -8.00), when comparing with control group. Regarding GI, β = -0.93 (95% CI: -1.38 to -0.49) for MeDiet + EVOO, β = -1.06 (95% CI: -1.51 to -0.62) for MeDiet + Nuts when comparing with control group. Conclusion. Dietary intervention with MeDiet supplemented with EVOO or nuts lowers dietary GL and GI.

The use of different reference foods in determining the glycemic index of starchy and non-starchy test foods.

PubMed

Venn, Bernard J; Kataoka, Minako; Mann, Jim

2014-05-31

Glycemic index (GI) is intended to be a property of food but some reports are suggestive that GI is influenced by participant characteristics when glucose is used as a reference. To examine the influence of different reference foods on observed GI. The GIs of five varieties of rice and a sugary beverage (LoGiCane™) were tested in 31 European and 32 Chinese participants using glucose or jasmine rice as reference foods. The GIs of two ready-to-eat breakfast cereals (Kellogg's cornflakes and Sustain) were tested in 20 younger and 60 older people using glucose or Sustain as reference foods. The GIs of rice tended to be higher in the Chinese compared with the Europeans when glucose was used as a reference (jasmine 80 vs 68, P = 0.033; basmati 67 vs 57, P = 0.170; brown 78 vs 65, P = 0.054; Doongara 67 vs 55, P = 0.045; parboiled 72 vs 57, P = 0.011). There were no between-group differences in GI when jasmine rice was the reference. The GIs of breakfast cereals tended to be lower in younger compared with older groups (cornflakes 64 vs 81, P = 0.008; Sustain 56 vs 66, P = 0.054). There was no between-group difference in the GI of cornflakes when Sustain was the reference (cornflakes 115 vs 120, P = 0.64). There was no ethnic difference in GI when glucose was the reference for another sugary food (LoGiCane™ 60 vs 62; P = 0.69). A starchy reference may be more appropriate than a glucose beverage when attempting to derive universally applicable GI values of starchy foods. The Chinese/European trial is registered with the Australian New Zealand Clinical Trials Registry as ACTRN12612000519853.

The effect of a low-glycemic diet vs a standard diet on blood glucose levels and macronutrient intake in children with type 1 diabetes.

PubMed

Rovner, Alisha J; Nansel, Tonja R; Gellar, Lauren

2009-02-01

A low-glycemic index (GI) diet may lower postprandial hyperglycemia and decrease the risk for postabsorptive hypoglycemia in people with type 1 diabetes. However, insufficient evidence exists on the efficacy of a low-GI diet to support practice recommendations. The goal of this study was to examine the blood glucose response to and the macronutrient composition of low-GI meals vs usual meals consumed ad libitum at home in children with type 1 diabetes. A within-subject, crossover design was employed. Twenty-three participants were recruited between June and August 2006. Participants wore a continuous blood glucose monitoring system and completed diet diaries on 2 days. On 1 day, participants consumed their usual meal; on another day, participants consumed low-GI meals ad libidum. Order of the 2 days was counterbalanced. The mean GI was 34+/-6 for the low-GI day and 57+/-6 for the usual meal day (P<0.0001). During the low-GI day, mean daytime blood glucose values (125+/-28 mg/dL [6.9+/-1.5 nmol/L] vs 185+/-58 mg/dL [10.3+/-3.2 nmol/L], P<0.001), blood glucose area above 180 mg/dL (4,486+/-6,138 vs 26,707+/-25,038, P<0.006), and high blood glucose index (5.1+/-5.1 vs 13.6+/-7.6, P<0.001) were lower compared to the usual mean day. During the low-GI day, subjects consumed more fiber (24.5+/-12.3 g vs 14.5+/-6.1 g, P<0.007) and less fat (45.7+/-12.2 g vs 76.8+/-32.4 g, P<0.005); however, there were no differences in energy, carbohydrate, or protein intake. In this pilot study, a low-GI diet was associated with improved diet quality and a reduction in hyperglycemia.

Digestibility of pasta made with three wheat types: a preliminary study.

PubMed

Simonato, Barbara; Curioni, Andrea; Pasini, Gabriella

2015-05-01

The aim of this study was to assess the digestibility of the protein and starch in pasta made with different cereals, i.e. Triticum durum, Triticum polonicum and Triticum dicoccum, and to measure the glycemic index (GI) of the different types of pasta. The digestibility of the starch in T.polonicum pasta differed significantly from the others. It seemed to be less digested than dicoccum and durum wheat pasta. T.polonicum pasta also had a lower glycemic index, while there were no significant differences in the protein digestibility of the three types of pasta. Copyright © 2014 Elsevier Ltd. All rights reserved.

Soy foods have low glycemic and insulin response indices in normal weight subjects.

PubMed

Blair, Robert M; Henley, E C; Tabor, Aaron

2006-12-27

Foods with a low glycemic index (GI) may provide a variety of health benefits. The objective of the present study was to measure the GI and insulin index (II) of select soy foods. The study was conducted in two parts with low-carbohydrate products being tested separately. In Experiment 1, subjects averaged 23.2 years of age with BMI = 22.0 kg/m2, while subjects in Experiment 2 averaged 23.9 years of age with BMI = 21.6 kg/m2. The reference (glucose) and test foods were served in portions containing 10 g of carbohydrates in Experiment 1 (two test foods) and 25 g of carbohydrates in Experiment 2 (four test foods). Subjects consumed the reference food twice and each test food once. For each test, subjects were instructed to consume a fixed portion of the reference food or test food together with 250 g of water within 12 min. Blood samples were collected before each test and at 15, 30, 45, 60, 90, and 120 min after consumption of reference or test foods to quantify glucose and insulin. Two-hour blood glucose and plasma insulin curves were constructed and areas under the curves were calculated. GI and II values for each subject and test food were calculated. In Experiment 1, both low-carbohydrate soy foods were shown to have significantly (P < 0.05) lower GI and II values than the reference food. In Experiment 2, three of the four test foods had significantly (P < 0.05) lower GI and II values than the reference food. All but one of the soy foods tested had a low GI, suggesting that soy foods may be an appropriate part of diets intended to improve control of blood glucose and insulin levels.

Soy foods have low glycemic and insulin response indices in normal weight subjects

PubMed Central

2006-01-01

Background Foods with a low glycemic index (GI) may provide a variety of health benefits. The objective of the present study was to measure the GI and insulin index (II) of select soy foods. Methods The study was conducted in two parts with low-carbohydrate products being tested separately. In Experiment 1, subjects averaged 23.2 years of age with BMI = 22.0 kg/m2, while subjects in Experiment 2 averaged 23.9 years of age with BMI = 21.6 kg/m2. The reference (glucose) and test foods were served in portions containing 10 g of carbohydrates in Experiment 1 (two test foods) and 25 g of carbohydrates in Experiment 2 (four test foods). Subjects consumed the reference food twice and each test food once. For each test, subjects were instructed to consume a fixed portion of the reference food or test food together with 250 g of water within 12 min. Blood samples were collected before each test and at 15, 30, 45, 60, 90, and 120 min after consumption of reference or test foods to quantify glucose and insulin. Two-hour blood glucose and plasma insulin curves were constructed and areas under the curves were calculated. GI and II values for each subject and test food were calculated. Results In Experiment 1, both low-carbohydrate soy foods were shown to have significantly (P < 0.05) lower GI and II values than the reference food. In Experiment 2, three of the four test foods had significantly (P < 0.05) lower GI and II values than the reference food. Conclusion All but one of the soy foods tested had a low GI, suggesting that soy foods may be an appropriate part of diets intended to improve control of blood glucose and insulin levels. PMID:17192192

Effect of Grewia asiatica fruit on glycemic index and phagocytosis tested in healthy human subjects.

PubMed

Mesaik, Muhammad Ahmed; Ahmed, Asif; Khalid, Ahmed Shukralla; Jan, Saleem; Siddiqui, Afaq Ahmed; Perveen, Shahida; Azim, Muhammad Kamran

2013-01-01

The Grewia asiatica (commonly known as Phalsa or Fasla) is a shrub or small tree found in southern Asia. It produces purple to black color fruit when ripe. In folk medicine the edible Grewia asiatica fruit is used in a number of pathological conditions. The current study described the effects of Grewia asiatica fruit on glycemic index (GI) and phagocytosis in healthy non-diabetic human subjects. The results showed that Grewia asiatica fruit has low GI value of 5.34 with modest hypoglycemic activity. Luminol-enhanced chemiluminescence assay was carried out to determine the production of reactive oxygen species (ROS) in the oxidative burst activity of whole blood. ROS production was found to be significantly affected, having the 78.3, 58.6 and 30.8% when the subjects were fed with D-glucose, mixture of D-glucose and Grewia asiatica fruit and Grewia asiatica fruit alone respectively as compared to the control. The aqueous, methanolic and butanolic extracts of Grewia asiatica fruits were found to produce a stimulatory effect on ROS production however; the chloroform, hexane and ethanol-acetate extracted exerted significant inhibitory effect. These results demonstrated that Grewia asiatica fruit has desirable effects on blood glucose metabolism manifested as low glycemic response and modulation of ROS production.

Effect of a Mediterranean Diet Intervention on Dietary Glycemic Load and Dietary Glycemic Index: The PREDIMED Study

PubMed Central

Rodríguez-Rejón, Ana Isabel; Ruano-Rodríguez, Cristina; Ruiz-López, María Dolores; Sánchez-Villegas, Almudena; Toledo, Estefanía; Estruch, Ramón; Covas, María Isabel; Corella, Dolores; Gómez-Gracia, Enrique; Lapetra, José; Pintó, Xavier; Arós, Fernando; Fiol, Miquel; Lamuela-Raventós, Rosa María; Ruiz-Gutierrez, Valentina; Schröder, Helmut; Ros, Emilio; Martínez-González, Miguel Ángel; Serra-Majem, Lluis

2014-01-01

Objective. To compare the one year effect of two dietary interventions with MeDiet on GL and GI in the PREDIMED trial. Methods. Participants were older subjects at high risk for cardiovascular disease. This analysis included 2866 nondiabetic subjects. Diet was assessed with a validated 137-item food frequency questionnaire (FFQ). The GI of each FFQ item was assigned by a 5-step methodology using the International Tables of GI and GL Values. Generalized linear models were fitted to assess the relationship between the intervention group and dietary GL and GI at one year of follow-up, using control group as reference. Results. Multivariate-adjusted models showed an inverse association between GL and MeDiet + extra virgin olive oil (EVOO) group: β = −8.52 (95% CI: −10.83 to −6.20) and MeDiet + Nuts group: β = −10.34 (95% CI: −12.69 to −8.00), when comparing with control group. Regarding GI, β = −0.93 (95% CI: −1.38 to −0.49) for MeDiet + EVOO, β = −1.06 (95% CI: −1.51 to −0.62) for MeDiet + Nuts when comparing with control group. Conclusion. Dietary intervention with MeDiet supplemented with EVOO or nuts lowers dietary GL and GI. PMID:25295183

Mechanistically linking age-related diseases and dietary carbohydrate via autophagy and the ubiquitin proteolytic systems

USDA-ARS?s Scientific Manuscript database

Epidemiological data indicate that consuming diets that deliver sugar to the blood rapidly (called high glycemic index, GI) is associated with enhanced risk for age-related diseases such as cardiovascular disease, type 2 diabetes, cataract and age-related macular degeneration (AMD). These debilities...

In vitro starch digestibility and predicted glycemic index of microwaved and conventionally baked pound cake.

PubMed

Sánchez-Pardo, María Elena; Ortiz-Moreno, Alicia; Mora-Escobedo, Rosalva; Necoechea-Mondragón, Hugo

2007-09-01

The present study compares the effect of baking process (microwave vs conventional oven) on starch bioavailability in fresh pound cake crumbs and in crumbs from pound cake stored for 8 days. Proximal chemical analysis, resistant starch (RS), retrograded starch (RS3) and starch hydrolysis index (HI) were evaluated. The empirical formula suggested by Granfeldt was used to determine the predicted glycemic index (pGI). Pound cake, one of Mexico's major bread products, was selected for analysis because the quality defects often associated with microwave baking might be reduced with the use of high-fat, high-moisture, batted dough. Differences in product moisture, RS and RS3 were observed in fresh microwave-baked and conventionally baked pound cake. RS3 increased significantly in conventionally baked products stored for 8 days at room temperature, whereas no significantly changes in RS3 were observed in the microwaved product. HI values for freshly baked and stored microwaved product were 59 and 62%, respectively (P > 0.05), whereas the HI value for the conventionally baked product decreased significantly after 8 days of storage. A pound cake with the desired HI and GI characteristics might be obtained by adjusting the microwave baking process.

The effect of a low fructose and low glycemic index/load (FRAGILE) dietary intervention on indices of liver function, cardiometabolic risk factors, and body composition in children and adolescents with nonalcoholic fatty liver disease (NAFLD).

PubMed

Mager, Diana R; Iñiguez, Ingrid Rivera; Gilmour, Susan; Yap, Jason

2015-01-01

Nonalcoholic fatty liver disease (NAFLD) is a common liver disease in obese children. Diets high in added fructose (high fructose corn syrup; HFCS) and glycemic index (GI)/glycemic load (GL) are associated with increased risk of NAFLD. Lifestyle modification is the main treatment, but no guidelines regarding specific dietary interventions for childhood NAFLD exist. We hypothesized that reductions in dietary fructose (total, free, and HFCS)/GI/GL over 6 months would result in improvements in body composition and markers of liver dysfunction and cardiometabolic risk in childhood NAFLD. Children and adolescents with NAFLD (n = 12) and healthy controls (n = 14) 7-18 years were studied at baseline and 3 and 6 months post-dietary intervention. Plasma markers of liver dysfunction (ALT, AST, γGT), cardiometabolic risk (TG, total cholesterol, LDL-HDL cholesterol, Apo-B100, Apo-B48, Apo-CIII, insulin, homeostasis model of assessment of insulin resistance [HOMA-IR]), inflammation (TNF-α, IL-6, IL-10), anthropometric, and blood pressure (BP) were studied using validated methodologies. Significant reductions in systolic BP (SBP), percentage body fat (BF), and plasma concentrations of ALT (P = .04), Apo-B100 (P < .001), and HOMA-IR were observed in children with NAFLD at 3 and 6 months (P < .05). Dietary reductions in total/free fructose/HFCS and GL were related to reductions in SBP (P = .01), ALT (P = .004), HOMA-IR (P = .03), and percentage BF in children with NAFLD. Reductions in dietary GI were associated with reduced plasma Apo-B100 (P = .02) in both groups. With the exception of Apo-B100, no changes in laboratory variables were observed in the control group. Modest reductions in fructose (total/free, HFCS) and GI/GL intake result in improvements of plasma markers of liver dysfunction and cardiometabolic risk in childhood NAFLD. © 2013 American Society for Parenteral and Enteral Nutrition.

Effect of domestic cooking on the starch digestibility, predicted glycemic indices, polyphenol contents and alpha amylase inhibitory properties of beans (Phaseolis vulgaris) and breadfruit (Treculia africana).

PubMed

Chinedum, E; Sanni, S; Theressa, N; Ebere, A

2018-01-01

The effect of processing on starch digestibility, predicted glycemic indices (pGI), polyphenol contents and alpha amylase inhibitory properties of beans (Phaseolis vulgaris) and breadfruit (Treculia africana) was studied. Total starch ranged from 4.3 to 68.3g/100g, digestible starch ranged from 4.3 to 59.2 to 65.7g/100g for the raw and processed legumes; Resistance starch was not detected in most of the legumes except in fried breadfruit and the starches in both the raw and processed breadfruit were more rapidly digested than those from raw and cooked beans. Raw and processed breadfruit had higher hydrolysis curves than raw and processed beans with the amylolysis level in raw breadfruit close to that of white bread. Raw beans had a low glycemic index (GI); boiled beans and breadfruit had intermediate glycemic indices respectively while raw and fried breadfruit had high glycemic indices. Aqueous extracts of the food samples had weak α-amylase inhibition compared to acarbose. The raw and processed legumes contained considerable amounts of dietary phenols and flavonoids. The significant correlation (r=0.626) between α-amylase inhibitory actions of the legumes versus their total phenolic contents suggests the contribution of the phenolic compounds in these legumes to their α-amylase inhibitory properties. Copyright © 2017 Elsevier B.V. All rights reserved.

Does eating particular diets alter risk of age-related macular degeneration in users of the Age-Related Eye Disease Study supplements?

USDA-ARS?s Scientific Manuscript database

Background: Recent information suggests that the Age-Related Eye Disease Study (AREDS) supplement, enhanced intake of omega-3 fatty acids, and diminishing dietary glycemic index (dGI) are protective against advanced age-related macular degeneration (AMD). Methods: Dietary information was collected a...

Effect of the glycemic index of the diet on weight loss, modulation of satiety, inflammation, and other metabolic risk factors: a randomized controlled trial.

PubMed

Juanola-Falgarona, Martí; Salas-Salvadó, Jordi; Ibarrola-Jurado, Núria; Rabassa-Soler, Antoni; Díaz-López, Andrés; Guasch-Ferré, Marta; Hernández-Alonso, Pablo; Balanza, Rafael; Bulló, Mònica

2014-07-01

Low-glycemic index (GI) diets have been proven to have beneficial effects in such chronic conditions as type 2 diabetes, ischemic heart disease, and some types of cancer, but the effect of low-GI diets on weight loss, satiety, and inflammation is still controversial. We assessed the efficacy of 2 moderate-carbohydrate diets and a low-fat diet with different GIs on weight loss and the modulation of satiety, inflammation, and other metabolic risk markers. The GLYNDIET study is a 6-mo randomized, parallel, controlled clinical trial conducted in 122 overweight and obese adults. Participants were randomly assigned to one of the following 3 isocaloric energy-restricted diets for 6 mo: 1) a moderate-carbohydrate and high-GI diet (HGI), 2) a moderate-carbohydrate and low-GI diet (LGI), and 3) a low-fat and high-GI diet (LF). At weeks 16 and 20 and the end of the intervention, changes in body mass index (BMI; in kg/m(2)) differed significantly between intervention groups. Reductions in BMI were greater in the LGI group than in the LF group, whereas in the HGI group, reductions in BMI did not differ significantly from those in the other 2 groups (LGI: -2.45 ± 0.27; HGI: -2.30 ± 0.27; LF: -1.43 ± 0.27; F = 4.616, P = 0.012; pairwise comparisons: LGI compared with HGI, P = 1.000; LGI compared with LF, P = 0.016; HGI compared with LF, P = 0.061). The decrease in fasting insulin, homeostatic model assessment of insulin resistance, and homeostatic model assessment of β cell function was also significantly greater in the LGI group than in the LF group (P < 0.05). Despite this tendency for a greater improvement with a low-GI diet, the 3 intervention groups were not observed to have different effects on hunger, satiety, lipid profiles, or other inflammatory and metabolic risk markers. A low-GI and energy-restricted diet containing moderate amounts of carbohydrates may be more effective than a high-GI and low-fat diet at reducing body weight and controlling glucose and insulin metabolism. This trial was registered at Current Controlled Trials (www.controlled-trials.com) as ISRCTN54971867. © 2014 American Society for Nutrition.

Effect of glycemic index and carbohydrate intake on kidney function in healthy adults.

PubMed

Juraschek, Stephen P; Chang, Alex R; Appel, Lawrence J; Anderson, Cheryl A M; Crews, Deidra C; Thomas, Letitia; Charleston, Jeanne; Miller, Edgar R

2016-07-08

Replacing carbohydrate with protein acutely increases glomerular filtration rate (GFR) but is associated with faster, long-term kidney disease progression. The effects of carbohydrate type (i.e. glycemic index, GI) on kidney function are unknown. We conducted an ancillary study of a randomized, crossover feeding trial in overweight/obese adults without diabetes or kidney disease (N = 163). Participants were fed each of four healthy, DASH-like diets for 5 weeks, separated by 2-week washout periods. Weight was kept constant. The four diets were: high GI (GI ≥65) with high %carb (58 % kcal) (reference diet), low GI (≤45) with low %carb (40 % kcal), low GI with high %carb; and high GI with low %carb. Plasma was collected at baseline and after each feeding period. Study outcomes were cystatin C, β2-microglobulin (β2M), and estimated GFR based on cystatin C (eGFRcys). Mean (SD) age was 52 (11) years; 52 % were women; 50 % were black. At baseline, mean (SD) cystatin C, β2M, and eGFRcys were 0.8 (0.1) mg/L, 1.9 (0.4) mg/L, and 104 (16) mL/min/1.73 m(2). Compared to the high GI/high %carb diet, reducing GI, %carb, or both increased eGFRcys by 1.9 mL/min/1.73 m(2) (95 % CI: 1.1, 2.7; P < 0.001), 3.0 mL/min/1.73 m(2) (1.9, 4.0; P < 0.001), and 4.5 mL/min/1.73 m(2) (3.5, 5.4; P < 0.001), respectively. Increases in eGFRcys from reducing GI were significantly associated with increases in eGFRcys from reducing %carb (P < 0.001). Results for cystatin C and β2M reflected eGFRcys. Reducing GI increased GFR. Reducing %carb by increasing calories from protein and fat, also increased GFR. Future studies on GI should examine the long-term effects of this increase in GFR on kidney injury markers and clinical outcomes. Clinical Trials.gov, number: NCT00608049 (first registered January 23, 2008).

Antioxidant and Antihyperglycemic Properties of Three Banana Cultivars (Musa spp.)

PubMed Central

Oboh, Ganiyu

2016-01-01

Background. This study sought to investigate the antioxidant and antihyperglycemic properties of Musa sapientum (Latundan banana) (MSL), Musa acuminata (Cavendish banana) (MAC), and Musa acuminate (Red Dacca) (MAR). Materials and Methods. The sugar, starch, amylose, and amylopectin contents and glycemic index (GI) of the three banana cultivars were determined. Furthermore, total phenol and vitamin C contents and α-amylase and α-glucosidase inhibitory effects of banana samples were also determined. Results. MAC and MAR had the highest starch, amylose, and amylopectin contents and estimated glycemic index (eGI) with no significant different while MSL had the lowest. Furthermore, MAR (1.07 mg GAE/g) had a higher total phenol content than MAC (0.94 mg GAE/g) and MSL (0.96 mg GAE/g), while there was no significant difference in the vitamin C content. Furthermore, MAR had the highest α-amylase (IC50 = 3.95 mg/mL) inhibitory activity while MAC had the least (IC50 = 4.27 mg/mL). Moreover, MAC and MAR inhibited glucosidase activity better than MSL (IC50 3.47 mg/mL). Conclusion. The low sugar, GI, amylose, and amylopectin contents of the three banana cultivars as well as their α-amylase and α-glucosidase inhibitory activities could be possible mechanisms and justification for their recommendation in the management of type-2 diabetes. PMID:27872791

Antioxidant and Antihyperglycemic Properties of Three Banana Cultivars (Musa spp.).

PubMed

Adedayo, Bukola C; Oboh, Ganiyu; Oyeleye, Sunday I; Olasehinde, Tosin A

2016-01-01

Background . This study sought to investigate the antioxidant and antihyperglycemic properties of Musa sapientum (Latundan banana) (MSL), Musa acuminata (Cavendish banana) (MAC), and Musa acuminate (Red Dacca) (MAR). Materials and Methods. The sugar, starch, amylose, and amylopectin contents and glycemic index (GI) of the three banana cultivars were determined. Furthermore, total phenol and vitamin C contents and α -amylase and α -glucosidase inhibitory effects of banana samples were also determined. Results . MAC and MAR had the highest starch, amylose, and amylopectin contents and estimated glycemic index (eGI) with no significant different while MSL had the lowest. Furthermore, MAR (1.07 mg GAE/g) had a higher total phenol content than MAC (0.94 mg GAE/g) and MSL (0.96 mg GAE/g), while there was no significant difference in the vitamin C content. Furthermore, MAR had the highest α -amylase (IC 50 = 3.95 mg/mL) inhibitory activity while MAC had the least (IC 50 = 4.27 mg/mL). Moreover, MAC and MAR inhibited glucosidase activity better than MSL (IC 50 3.47 mg/mL). Conclusion . The low sugar, GI, amylose, and amylopectin contents of the three banana cultivars as well as their α -amylase and α -glucosidase inhibitory activities could be possible mechanisms and justification for their recommendation in the management of type-2 diabetes.

An isocaloric low glycemic index diet improves insulin sensitivity in women with polycystic ovary syndrome.

PubMed

Barr, Suzanne; Reeves, Sue; Sharp, Kay; Jeanes, Yvonne M

2013-11-01

Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting 5% to 10% of women worldwide. Approximately half of women with PCOS are lean, yet may still present with central obesity and metabolic disturbances. Low-glycemic index (GI) dietary intervention studies have demonstrated improvements in insulin sensitivity in insulin-resistant populations; however, there is little evidence of this effect in women with PCOS. This research aimed to determine the efficacy of an isocaloric low-GI dietary intervention on insulin sensitivity, independent of weight change, in women with PCOS. A nonrandomized 12-week low-GI dietary intervention, preceded by a 12-week habitual diet control phase and proceeded by a 12-week follow-up phase was conducted. Dietary intake, body composition, and metabolic risk markers were determined at baseline, after completion of the habitual diet control phase, and after the low-GI dietary intervention. Twenty-six participants were recruited at baseline, 22 commenced and 21 participants completed the low-GI dietary intervention phase. The primary outcome was change in insulin sensitivity. Secondary outcomes included assessment of changes to lipids, body composition, and estimated macronutrient intake. Repeated measures analysis of variance with Bonferroni correction were used to detect changes to outcomes across study timepoints. Twenty-one women with PCOS with mean (± standard deviation) age of 32.1±6.7 years completed the 12-week low-GI dietary intervention. As expected, no significant changes occurred during the 12-week habitual diet control phase. However, during the dietary intervention phase, dietary GI decreased from 54.5±3.5 to 48.6±5.1 (P<0.001) with a concurrent small reduction in saturated fat intake (12.4%±3% to 11.7%±3% contribution from energy, P=0.03), despite no specific recommendations to modify fat intake. Measures of insulin sensitivity and nonesterified fatty acid improved after intervention (P=0.03 and P=0.01, respectively). This is the first study to implement an isocaloric low-GI diet in women with PCOS and findings may contribute to the limited research in this area. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Randomized trial on the effects of a 7-d low-glycemic diet and exercise intervention on insulin resistance in older obese humans123

PubMed Central

Solomon, Thomas PJ; Haus, Jacob M; Kelly, Karen R; Cook, Marc D; Riccardi, Michelle; Rocco, Michael; Kashyap, Sangeeta R; Barkoukis, Hope

2009-01-01

Background: The optimal combination of diet and exercise that produces the greatest reversal of obesity-related insulin resistance is unknown. Objectives: We examined the effects of a combined 7-d low–glycemic index (low-GI) diet and exercise training intervention on insulin sensitivity in older obese humans. Design: Participants [n = 32; mean (±SEM) age: 66 ± 1 y; body mass index (in kg/m2): 33.8 ± 0.7] were randomly assigned to a parallel, double-blind, controlled-feeding trial and underwent supervised aerobic exercise (EX; 60 min/d at 80–85% maximum heart rate) in combination with either a low-GI (LoGI + EX: 41.1 ± 0.4) or a high-GI (HiGI + EX: 80.9 ± 0.6) diet. All meals were provided and were isocaloric to individual energy requirements. Insulin sensitivity and hepatic glucose production were assessed with a 40–mU ⋅ m−2 · min−1 hyperinsulinemic euglycemic clamp combined with a [6,6-2H2]-glucose infusion. Results: After the intervention, small decreases were observed in body weight (−1.6 ± 0.2 kg; P < 0.0001) and fat mass (−1.7 ± 0.9%; P = 0.004) in both groups. Maximal aerobic capacity (V̇O2max) also improved slightly (0.06 ± 0.02 L/min; P = 0.004). Resting systolic blood pressure, fasting glucose, insulin, triglycerides, and cholesterol all decreased after the study (all P < 0.05). Larger changes in systolic blood pressure and V̇O2max were seen in the LoGI + EX group. Insulin-stimulated glucose disposal (P < 0.001), insulin suppression of hepatic glucose production (P = 0.004), and postabsorptive fat oxidation (P = 0.03) improved equally in both groups after the intervention. Conclusions: These findings suggest that the metabolic improvements after short-term exercise training in older obese individuals are dependent on increased physical activity and are not influenced by a low-GI diet. However, a low-GI diet has added benefit in alleviating hypertension, thus reducing the risk of diabetic and vascular complications. PMID:19793849

[Glycemic index of two varieties of pasta and two varieties of rice].

PubMed

Ridner, Edgardo; Di Sibio, Antonio

2015-06-01

The IG has been extensively studied as an indicator of the physiological effects of a carbohydrate meal with applications in the management and prevention of diabetes, dyslipidemia and obesity. A standard assay was performed to measure the glycemic index (GI) of two significant sources of carbohydrates following the World Health Organization (WHO) recommended methodology, determining the incremental area under the blood glucose response curve of a 50g carbohydrate portion of the test food compared to the same amount of carbohydrate from a glucose solution by the same subject measured in capillary whole blood before and 15, 30, 45, 60, 90 and 120 minutes after ingestion in a total of 9 subjects. The following results were obtained: Parboil rice: 73, Long Grain White Rice: 59; Pasta of durum wheat (Triticum durum): 71, Pasta of regular flour (Triticum aestivium): 38. This test confirms the low glycemic index of pasta made from durum wheat, and is the first measurement for pasta of common wheat flour properly characterized. It also indicates the values of the prevailing presentations of rice in the region, adding a reference for professionals and authorities.

Evaluation of the glycemic indices of three commonly eaten mixed meals in Okada, Edo State.

PubMed

Omage, Kingsley; Omage, Sylvia O

2018-01-01

People do not generally eat single or individual meals; rather they eat mixed meals, consisting of two or more individual meals. These mixed meals usually have glycemic indices which differ from that of the individual food type. This study was aimed at evaluating the glycemic indices of three commonly consumed mixed meals eaten in Okada; rice and beans (test food 1), rice and plantain (test food 2), beans and plantain (test food 3). Two hundred and forty healthy subjects aged between 18 and 30 participated in this study. They were randomized into three groups of eighty persons each, and fed with the standard food (50 g glucose) on day one and one of the test foods on day two, after an overnight fast. Blood samples were taken at 0, 30, 60, 90, and 120 min after the food had been eaten. The results showed that the Glycemic Index (GI) values for the test foods were high: 86.60 (test food 1), 89.74 (test food 2), 86.93(test food 3). The incremental increase in blood glucose was monitored and calculated for each food and when compared with that of the standard food (glucose), there was significant differences ( p  < .036) for test food 1 and ( p  < .068) for test food 3; both at 30 min. At 120 min, no significant differences in blood glucose levels were observed ( p  > .05). The results from this study indicated that the GI of the mixed meals was affected by the constituent nutrient and the response is also affected by the proportion of each nutrient. Our findings show that the selected test foods (mixed meals) consumed in Okada have high GI values.

Glycemic responses of patients with type 2 diabetes to individual carbohydrate-rich foods and mixed meals.

PubMed

Robert, S Daniel; Ismail, Aziz Al-Safi

2012-01-01

Our purpose was to determine whether the glycemic index (GI) of individual foods applies to mixed meals. The glycemic responses elicited by portions of 4 individual foods with 25 g of available carbohydrate when served alone (rice, lacy pancake, flatbread and noodles) and when made into typical Malaysian mixed meals (coconut milk rice, lacy pancake with chicken curry, flatbread with dhal curry and fried noodles) were measured in 10 subjects with type 2 diabetes. To allow calculation of the GI of the foods and the relative glycemic responses of the mixed meals, each subject also tested 25 g of glucose 3 times. Capillary blood glucose was measured at 30-min intervals for 180 min after consuming each test meal. The mean ± SEM incremental area under the curve (AUC) after flatbread (345 ± 26 mmol × min/l) was significantly greater than after rice (238 ± 35) and lacy pancake (235 ± 31, p < 0.05), with noodles being intermediate (294 ± 35). The AUC after the flatbread with dhal curry (341 ± 49), coconut milk rice (238 ± 39) and fried noodle (272 ± 42) mixed meals were similar to those after the individual foods, but the AUC after the lacy pancake with chicken curry mixed meal (388 ± 52) was significantly greater than after the individual food item (p < 0.01). The results support the utility of the GI of individual foods such as rice, flatbread and noodles when applied to mixed meals. The reason for the higher response after the lacy pancake mixed meal compared to the individual food is not clear and may warrant further research. Copyright © 2011 S. Karger AG, Basel.

Reduction of postprandial blood glucose in healthy subjects by buns and flatbreads incorporated with fenugreek seed powder.

PubMed

Robert, Sathyasurya Daniel; Ismail, Aziz Al-Safi; Rosli, Wan Ishak Wan

2016-10-01

This study aimed to determine whether fenugreek seed powder could reduce the glycemic response and glycemic index (GI) when added to buns and flatbreads. In a randomised, controlled crossover trial, ten healthy human subjects (five men, five women) were given 50 g glucose (reference food, twice); buns (0 and 10 % fenugreek seed powder); and flatbreads (0 and 10 % fenugreek seed powder) on six different occasions. Finger prick capillary blood samples were collected at 0, 15, 30, 45, 60, 90 and 120 min after the start of the meal. The palatability of the test meals was scored using Likert scales. The incremental areas under the glucose curve value of buns and flatbreads with 10 % fenugreek (138 ± 17 mmol × min/L; 121 ± 16 mmol × min/L) were significantly lower than those of 0 % fenugreek bun and flatbreads (227 ± 15 mmol × min/L; 174 ± 14 mmol × min/L, P = <0.01). Adding 10 % fenugreek seed powder reduced the GI of buns from 82 ± 5 to 51 ± 7 (P < 0.01) and to the GI of flatbread from 63 ± 4 to 43 ± 5 (P < 0.01). These results suggest that replacing 10 % of refined wheat flour with fenugreek seed powder significantly reduces the glycemic response and the GI of buns and flatbreads. Thus, fenugreek powder may be a useful functional ingredient to reduce postprandial glycemia.

Dietary Fiber Intake Is Associated with HbA1c Level among Prevalent Patients with Type 2 Diabetes in Pudong New Area of Shanghai, China

PubMed Central

Jiang, Junyi; Qiu, Hua; Zhao, Genming; Zhou, Yi; Zhang, Zhijie; Zhang, Hong; Jiang, Qingwu; Sun, Qiao; Wu, Hongyan; Yang, Liming; Ruan, Xiaonan; Xu, Wang-Hong

2012-01-01

Background Dietary factors play an important role in glycemic control in diabetic patients. However, little is known about their effects among Chinese diabetic patients, whose diets are typically abundant in fiber and high in glycemic index (GI) values. Methodology/Principal Findings 934 patients with type 2 diabetes and 918 healthy volunteers from Pudong New Area, Shanghai, China, were interviewed during the period of Oct-Dec, 2006 to elicit demographic characteristics and lifestyle factors. Dietary habits were assessed using a validated food frequency questionnaire. Anthropometric measurements, bio-specimen collection and biochemical assays were conducted at the interview according to a standard protocol. In this population, diabetic patients consumed lower levels of energy and macronutrients but had higher levels of fasting plasma glucose (FPG), glycolated hemoglobin A1c (HbA1c), triglyceride and body mass index than healthy adults. While the average consumption levels of the nutrients among diabetic patients did not vary along duration of the disease, the average levels of FPG and HbA1c increased with increasing duration. Regardless of diabetes duration, HbA1c level was observed lower in patients having a higher fiber or lower GI intake. Compared with those with the lowest tertile intake of fiber, the adjusted odds ratios (ORs) for poor glycemic control reduced from 0.75 (95%CI: 0.54–1.06) to 0.51 (95%CI: 0.34–0.75) with increasing tertile intake (P for trend <0.001). Conclusions Dietary fiber may play an important role in reducing HbA1c level. Increasing fiber intake may be an effective approach to improve glycemic control among Chinese diabetic patients. PMID:23077514

Metabolic responses to prolonged consumption of glucose- and fructose-sweetened beverages are not associated with postprandial or 24-hour glucose and insulin excursions

USDA-ARS?s Scientific Manuscript database

It has been proposed that the adverse metabolic effects of chronic consumption of sugar-sweetened beverages which contain both glucose and fructose are a consequence of increased circulating glucose and insulin excursions, i.e dietary glycemic index (GI). Objective: We determined if the greater adv...

Increased intake of carbohydrates from sources with a higher glycemic index and lower consumption of whole grains during puberty are prospectively associated with higher IL-6 concentrations in younger adulthood among healthy individuals.

PubMed

Goletzke, Janina; Buyken, Anette E; Joslowski, Gesa; Bolzenius, Katja; Remer, Thomas; Carstensen, Maren; Egert, Sarah; Nöthlings, Ute; Rathmann, Wolfgang; Roden, Michael; Herder, Christian

2014-10-01

Chronic low-grade inflammation represents a likely intermediary in the relation between carbohydrate nutrition and both type 2 diabetes and cardiovascular disease. This study assessed the prospective association between carbohydrate quantity and quality [dietary glycemic index (GI), glycemic load (GL), and added sugar, fiber, and whole-grain intake] during puberty, a potentially critical period for later disease, and low-grade inflammation in younger adulthood. The analysis was based on 205 participants (113 girls and 92 boys) from the DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) study with at least 2 3-d weighed dietary records during puberty (girls: 9-14 y, boys: 10-15 y) and blood samples in younger adulthood (18-36 y). Multivariable linear regression models were used to analyze the associations between carbohydrate nutrition and circulating concentrations of pro- and anti-inflammatory immune mediators [high-sensitivity C-reactive protein (hs-CRP), interleukin (IL) 6, IL-18, and adiponectin]. A higher intake of carbohydrates during puberty (P-trend = 0.005), particularly from higher-GI food sources (P-trend = 0.01), was prospectively related to higher concentrations of IL-6 in younger adulthood, independently of baseline BMI and early life, socioeconomic, and other nutritional factors. Furthermore, a higher dietary GL (P-trend = 0.002) and a lower intake of whole grains (P-trend = 0.01) were independently associated with higher IL-6 concentrations in adults. Dietary GI and added sugar and fiber intakes were not independently associated with IL-6 (P-trend ≥ 0.09). Carbohydrate nutrition during puberty was not independently related to hs-CRP, IL-18, and adiponectin concentrations (all P-trend > 0.1). During puberty, a higher intake of carbohydrates from higher-GI food sources and lower whole-grain consumption prospectively predict greater IL-6 concentrations in young adulthood. These data support the hypothesis that diet during puberty influences later inflammation and metabolic dysfunction. © 2014 American Society for Nutrition.

Talinum triangulare Whole wheat meal fortified with soy flour consumed with Talinum triangulare (gbure) soup glycemic index and the test human subjects' lipid profiles.

PubMed

Emaleku, Sunday Adeola; Omueti, Olusola D; Emaleku, Godsent Oluwakemi

2017-08-24

Cardiovascular diseases (CVDs) and diabetes mellitus (DM) are some of the leading causes of death in the world, and diet has roles in their etiology. This research study therefore investigates the glycemic index (GI) of soy flour fortified whole wheat meal (SFFWWM) consumed with Talinum triangulare (gbure) soup and the effects of the meal on the lipid profiles of the test human subjects. The control human subjects and test human subjects were fed D-glucose (DG) and whole wheat meal (WWM) with Talinum triangulare soup respectively on the first day of the experiment, and SFFWWM with the same soup the next day (for test subjects only) after 10-12h overnight fasting. Blood glucose levels of the subjects were taken before and 2h after meals' consumption at 30min interval and blood samples collected for lipid profiles evaluations. The result of the study showed that; SFFWWM consumed with Talinum trianguilare soup has a non-significant lower GI than WWM consumed with the same soup, but a significant lower GI than DG at (P<0.05). Furthermore, there was no significant difference in lipid profiles of the test human subjects between when they consumed WWM and SFFWWM with the soup however, SFFWWM reduced TC, TG, LDL-C and VDL-C and increased HDL-C and TP than WMM at (P<0.05). In addition, GI is positively correlated with TC, TG, LDL-C and VLDL-C, but is negatively correlated with TP and HDL-C. It can therefore be concluded that; fortifying WWM with soy flour would reduce the risk factors of CVDs and DM, the diseases recently claiming thousands of today. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Effect of carbohydrate restriction in patients with hyperinsulinemic hypoglycemia after Roux-en-Y gastric bypass.

PubMed

Botros, Nadia; Rijnaarts, Iris; Brandts, Hans; Bleumink, Gysele; Janssen, Ignace; de Boer, Hans

2014-11-01

Hyperinsulinemic hypoglycemia is a rare complication of Roux-en-Y gastric bypass (RYGB) surgery. Meals with a high carbohydrate (carb) content and high glycemic index (GI) may provoke these hypoglycemic attacks. The aim of this study is to assess the effects of reducing meal carb content and GI on glycemic responses in patients with post-RYGB hypoglycemia. Fourteen patients with post-RYGB hypoglycemia underwent two meal tests: a mixed meal test (MMT) with a carb content of 30 g and a meal test with the low GI supplement, Glucerna SR 1.5® (Glucerna meal test (GMT)). Plasma glucose and serum insulin levels were measured for a period of 6 h. Peak glucose levels were reached at T 30 during GMT and at T 60 during MMT, and they were 1.5 ± 0.3 mmol/L lower during GMT than during MMT (7.5 ± 0.4 vs 9.0 ± 0.4 mmol/L, P < 0.005). GMT induced the most rapid rise in plasma insulin: at T 30 plasma, insulin was 30.7 ± 8.5 mU/L higher during GMT than during MMT (P < 0.005). None of the carb-restricted meals induced post-prandial hypoglycemia. A 30-g carb-restricted meal may help to prevent post-prandial hypoglycemia in patients with post-RYGB hypoglycemia. The use of a liquid, low GI, supplement offers no additional advantage.

Effect of glycemic index and fructose content in lunch on substrate utilization during subsequent brisk walking.

PubMed

Sun, Feng-Hua; Wong, Stephen Heung-Sang; Chen, Ya-Jun; Huang, Ya-Jun; Hsieh, Sandy Shen-Yu

2011-12-01

The purpose of the present study was to investigate the effect of glycemic index (GI) and fructose content in lunch on substrate utilization during subsequent brisk walking. Ten healthy young males completed 3 main trials in a counterbalanced crossover design. They completed 60 min of brisk walking at approximately 50% maximal oxygen consumption after consuming a standard breakfast and 1 of 3 lunch meals, i.e., a low GI meal without fructose (LGI), a low GI meal that included fructose beverage (LGIF), or a high GI meal (HGI). The 3 lunch meals were isocaloric and provided 1.0 g·kg⁻¹ carbohydrate. Substrate utilization was measured using indirect respiratory calorimetry method. Blood samples were collected at certain time points. During the 2-h postprandial period after lunch, the incremental area under the blood response curve values of glucose and insulin were higher (p < 0.05) in the HGI trial than those in the LGI and LGIF trials (HGI vs. LGI and LGIF: glucose, 223.5 ± 24.4 vs. 92.5 ± 10.4 and 128.0 ± 17.7 mmol·min·L⁻¹; insulin, 3603 ± 593 vs. 1425 ± 289 and 1888 ± 114 mU·min·L⁻¹). During brisk walking, decreased carbohydrate oxidation was observed (p < 0.05) in the LGI trial than in the LGIF and HGI trials (LGI vs. LGIF and HGI: 60.8 ± 4.0 vs. 68.1 ± 6.0 and 74.4 ± 4.7 g). No difference was found in fat oxidation among the 3 trials (LGI vs. LGIF vs. HGI: 21.6 ± 2.3 vs. 19.2 ± 2.3 vs. 16.4 ± 2.2 g). It appeared that fructose content was an important influencing factor when considering the effect of different GI lunch meals on substrate utilization during subsequent moderate intensity exercise.

The Influence of Glycemic Index on Cognitive Functioning: A Systematic Review of the Evidence1

PubMed Central

Philippou, Elena; Constantinou, Marios

2014-01-01

The impact of the rate of carbohydrate absorption, as measured by the carbohydrate’s glycemic index (GI) on cognitive performance, is not clear. The aim of this review was to systematically assess the relevant research studies. A systematic review of English-language articles using Medline, Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO, and PsycARTICLES (up to July 2012) using the search terms “glyc(a)emic index” or “glycaemic load” combined with “cognitive function” or “cognition” or “memory” was carried out. Inclusion and exclusion criteria were prespecified. Eligibility of the identified studies was assessed independently by the 2 reviewers. Independent extraction of data was carried out by the 2 authors using predefined data fields. The primary outcome measure was the effect on cognitive function (CF) after the consumption of meals varying in GI. Eleven eligible studies were identified. The age range of the participants varied from 6 to 82 y old. Overall, the findings were inconsistent, with some studies showing benefits toward either the high-GI or the low-GI meal, others not finding any differences between the 2 meals, and other studies showing a positive or negative effect on performance on only some cognitive domain or domains after consumption of 1 of the 2 meals. A number of methodologic and confounding factors were identified that could explain these inconsistencies. These include the study design, the selected sample (size, age, blood glucose regulation), the timing of testing, the cognitive domain being examined, the number and type of cognitive tests used, the meals provided (composition, size), the timing of blood samples collected, as well as the possibility of bias because participants and investigators were not blinded to randomization. A low-GI meal may favor CF in adults, but the findings at present are inconclusive. On the basis of this review, it is suggested that future studies address the identified methodologic issues and some recommendations are proposed to this effect. PMID:24618754

Reduction of postprandial glycemia by the novel viscous polysaccharide PGX, in a dose-dependent manner, independent of food form.

PubMed

Jenkins, Alexandra L; Kacinik, Veronica; Lyon, Michael R; Wolever, Thomas Ms

2010-04-01

Health benefits of viscous fiber intake are well established; nevertheless few effective and palatable preparations are available. The objective of the study therefore was to determine palatability and effectiveness of escalating doses of PGX, a novel viscous polysaccharide (NVP), in reducing postprandial glycemia when added to a liquid and a solid meal. Two open-label, randomized, controlled trials were undertaken. Glycemic Index Laboratories, Inc, Toronto, Ontario, Canada. Two groups of 10 healthy subjects each (group 1: 5 M, 5 F; 35.6 +/- 13.2 y; 24.6 +/- 2.1 kg/m(2); and group 2: 3 M, 7 F; 33.5 +/- 11.1 y; 26.3 +/- 5.2 kg/m(2)) were studied. Zero, 2.5, 5, and 7.5 g of NVP were added to a glucose drink (group 1) or to white bread and margarine (WB + Marg) (group 2). Subjects repeated glucose control (group 1) or WB control (group 2) 3 times to allow calculation of the glycemic index (GI). Measures of Outcomes: Palatability of foods and capillary blood glucose concentrations were measured fasting and at 15, 30, 45, 60, 90, and 120 minutes after the start of the meal. Addition of NVP to the meal reduced blood glucose incremental areas under the curve irrespective of dose, reaching significance at the 7.5 g dose when added to glucose (p < 0.01), and at the 5 and 7.5 g doses when added to WB + Marg (p < 0.001). The GI values of glucose with 0, 2.5, 5, or 7.5 g of NVP were (mean +/- standard error of the mean [SEM]) 100.0 +/- 0.0, 83.7 +/- 9.0, 77.7 +/- 8.2, and 72.5 +/- 5.9, respectively; the GI of the WB alone, or of WB + Marg, with 0, 2.5, 5, or 7.5 g of NVP was 71.0 +/- 0.0, 66.8 +/- 3.0, 47.5 +/- 5.9, 37.3 +/- 5.9, and 33.9 +/- 3.6, respectively. Addition of NVP to different food matrices is highly effective in lowering the glycemic index of a food in a dose-responsive manner.

Effects of soy-soluble fiber and flaxseed gum on the glycemic and insulinemic responses to glucose solutions and dairy products in healthy adult males.

PubMed

Au, Marco M C; Goff, H Douglas; Kisch, Julie A; Coulson, Alex; Wright, Amanda J

2013-01-01

Soy-soluble polysaccharides and flaxseed gum are underutilized dietary fibers of interest to the food industry. However, because the ability of soluble fibers to modulate postprandial glucose and insulin metabolism has been related to their viscous effects, the utility of these and other low-viscosity soluble fibers remains unproven. The objective of this study was to examine the associations between soy-soluble polysaccharides and flaxseed gum concentration, product viscosity, and the postprandial glycemic and insulinemic responses in the context of glucose solutions as well as fluid and gelled dairy products. Twelve healthy males participated in a randomized crossover postprandial study in which they visited the laboratory following overnight fasts on 11 occasions to consume one of 11 study treatments, each consisting of 50 g available carbohydrates. The study treatments included a glucose reference (in duplicate), glucose solutions containing soy-soluble polysaccharides (6%), flaxseed gum (0.7%), or guar gum (0.23%), all matched for an apparent viscosity of 61 mPa·s at 50 s⁻¹, as well as dairy-based beverages and puddings with 0% or 1% soluble fiber added. Blood samples were collected at fasting and up to 2 hours postprandially for determination of glucose and insulin concentrations. Area under the curve (AUC), peak concentration, and time-to-peak values as well as glycemic index (GI) and insulinemic index (II) were calculated. Fiber fortification of a 50 g glucose solution had no effect on postprandial blood glucose or insulin levels, even at a high concentration (i.e., 6% soy-soluble polysaccharides). Glucose AUC and GI values for the dairy-based beverage (p < 0.05) and pudding (p < 0.01) controls were significantly lower than the glucose reference. Glucose AUC and GI values for the soy-soluble polysaccharide-fortified dairy products (p < 0.01) and flaxseed gum-fortified dairy products (p < 0.001) were significantly lower than the glucose reference. No significant differences were observed between the fiber-fortified fluid and gelled dairy-based study treatments and no significant differences were observed in terms of the insulin AUC, II, and peak insulin concentration between any of the dairy products. All dairy products had lower glycemic responses relative to the reference, with no effect of beverage versus pudding matrix observed and minimal impact of 1% flaxseed gum or soy-soluble polysaccharides. Product apparent viscosity, but not fiber concentration, was significantly and inversely correlated with glucose AUC and GI.

Decreasing high postprandial stearic acid in impaired fasting glucose by dietary regulation.

PubMed

Liu, L; Chu, X; Na, L; Yuan, F; Li, Y; Sun, C

2016-07-01

The objective of this study was to determine the postprandial change in free fatty acid (FFA) profiles in subjects with impaired fasting glucose (IFG), and to evaluate the effect of low glycemic index (GI) load on postprandial FFA profiles and inflammation. First, 50 IFG and 50 healthy subjects were recruited; and 2 -h postprandial changes in FFA profiles were determined. Second, the 50 IFG subjects then received three different loads: glucose load (GL), high glycemic index (HGI) load and low glycemic index (LGI) load, respectively. FFA profile, glucose, insulin, glucagon-like peptide 1 (GLP-1) and inflammatory biomarkers were assayed at 0, 30, 60, 90 and 120 min. Postprandial stearic acid (C18:0) increased compared with baseline in all subjects, whereas the change in postprandial C18:0 was more marked in IFG subjects than in healthy subjects. Compared with subjects who received the GL and HGI load, the area under the curve for insulin, GLP-1, C18:0 and tumor necrosis factor-alpha significantly decreased and adiponectin increased in subjects who received the LGI load. The rise in postprandial C18:0 in IFG subjects was inhibited by LGI load.

In vitro starch digestion and cake quality: impact of the ratio of soluble and insoluble dietary fiber.

PubMed

Oh, Im Kyung; Bae, In Young; Lee, Hyeon Gyu

2014-02-01

The influence of the ratio of soluble dietary fiber (SDF) and insoluble dietary fiber (IDF) on the in vitro starch digestion, predicted glycemic index (pGI), and the physicochemical properties of fiber-enriched cakes were evaluated. The hydration and pasting properties were affected by the ratio of SDF and IDF. According to the increase of IDF ratio (SDF ratio reduction) in 3 g fiber-enriched cakes, slowly digestible starch (SDS) contents increased, while the rapidly digestible starch (RDS) contents decreased. The pGI values were significantly different with control in 3 g fiber-enriched cake containing more than 50% IDF contents (p<0.05). But the pGI values of 6g fiber-enriched cake samples were not significantly different by SDF and IDF ratio. With the exception of the SDF 100% cake, volume index, hardness, and color values of the fiber-enriched cakes increased according to reductions in the SDF ratio. The cakes containing 3 g of total dietary fiber (the same ratio of SDF and IDF) per serving were shown to have low pGI and acceptable quality attributes. Specially, total dietary fiber amount and IDF ratio are more effective than SDF ratio to lower the pGI value. Copyright © 2013 Elsevier B.V. All rights reserved.

Goal difficulty and goal commitment affect adoption of a lower glycemic index diet in adults with type 2 diabetes.

PubMed

Miller, Carla K; Headings, Amy; Peyrot, Mark; Nagaraja, Haikady

2012-01-01

Few studies have examined the effect of goal difficulty on behavioral change even though goal setting is widely used in diabetes education. The effect of a goal to consume either 6 or 8 servings/day of low glycemic index (LGI) foods was evaluated in this study. Adults 40-65 years old with type 2 diabetes were randomly assigned to the 6 or 8 serving/day treatment group following a 5-week GI intervention. Perceived goal difficulty, commitment, satisfaction, and self-efficacy were evaluated, and four day food records assessed dietary intake. Both groups increased consumption of LGI foods (P<0.001); there were no significant differences in the change in consumption between groups. Participants who were more committed to the goal perceived the goal to be less difficult (P<0.01). Those with greater efficacy beliefs were more committed to their goal, perceived the goal to be less difficult, and were more satisfied with their performance (all P<0.05). A specific goal regarding LGI foods can facilitate the adoption of a lower GI diet. Future research is needed to determine if goal commitment or goal difficulty mediate the process. Clinicians should help clients set specific goals regarding dietary change. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Synergistic effect of green tea, cinnamon and ginger combination on enhancing postprandial blood glucose.

PubMed

Azzeh, Firas Sultan

2013-01-15

This study was maintained to determine the immediate effect of green tea, cinnamon, ginger and combination of them on postprandial glucose levels. The Glycemic Index (GI) for previous treatments was measured as an indicator for postprandial glucose pattern. Twenty-two healthy volunteers from both genders were enrolled in this study. Mean age was 21.3 years and mean BMI was 24.6 kg m(-2). For each herb and combination treatment, a concentration of 2.5% aqueous tea extract was prepared. The GI of green tea, cinnamon and ginger were 79, 63 and 72 respectively. Herbs combination exerted GI of 60, which was the lowest. Combination of these herbs showed the best lowering effect on postprandial glucose levels as compared with each herb alone. A potential synergism from the active ingredients of blended herbs was determined.

Co-Ingestion of Rice Bran Soymilk or Plain Soymilk with White Bread: Effects on the Glycemic and Insulinemic Response.

PubMed

Camps, Stefan Gerardus; Lim, Joseph; Ishikado, Atsushi; Inaba, Yumi; Suwa, Makoto; Matsumoto, Motonobu; Henry, Christiani Jeyakumar

2018-04-04

The regular consumption of soy products is associated with inverse incidence of type 2 diabetes, and there has been an increasing interest in the glycemia reducing potential of rice bran and its components. In this study, we investigated whether consuming soymilk with the addition of rice bran (fiber) can reduce the glycemic response of a carbohydrate meal. Seventeen healthy Asian men (BMI: 18.5-29 kg/m²) participated in this randomized crossover trial. On four occasions, they consumed white bread (two times) and white bread with two different soymilks differing in protein and rice bran content. Blood samples were taken to measure glucose and insulin response over a period of 3 hours. Taking the glycemic index (GI) value of white bread as a reference value of 100, the GI of white bread when co-ingested with rice bran soymilk (RBS) was 83.1 (±7.7) and sugar-free soymilk (SFS) was 77.5 (±10.1), both were lower than white bread ( p < 0.05). The insulin response of both soymilk treatments was similar to white bread ( p > 0.05). The glucose/insulin ratio of RBS and SFS were respectively 43.1 (± 6.1) and 60.0 (± 17.0) and were lower ( p < 0.05) than white bread (123.5 ± 21.1) during the first 30 min. In conclusion, co-ingestion of low amounts of soy protein with a carbohydrate meal stimulated early-phase insulin secretion and thereby increased blood glucose clearance effectiveness. Furthermore, rice bran-fortified soymilk reduced the glycemic response similarly to soymilk with a greater dose of soy protein. Rice bran and its components offer therapeutic potential for glycemic and insulinemic control.

Effects of a low-glycemic index diet during pregnancy on offspring growth, body composition, and vascular health: a pilot randomized controlled trial.

PubMed

Kizirian, Nathalie V; Kong, Yang; Muirhead, Roslyn; Brodie, Shannon; Garnett, Sarah P; Petocz, Peter; Sim, Kyra A; Celermajer, David S; Louie, Jimmy C Y; Markovic, Tania P; Ross, Glynis P; Ward, Leigh C; Brand-Miller, Jennie C; Skilton, Michael R

2016-04-01

Elevated maternal blood glucose concentrations may contribute to macrosomia, adiposity, and poorer vascular health in the offspring. The aim was to explore the effect of a low-glycemic index (low-GI) diet during pregnancy on offspring growth, adiposity, and arterial wall thickness during infancy. This was a longitudinal follow-up study in a self-selected subgroup of mother-infant pairs (n= 59) participating in a larger randomized trial comparing the effects on perinatal outcomes of a low-GI diet and a conventional high-fiber (HF) diet during pregnancy. Infant anthropometric measurements were taken every month for 6 mo and then at 9 and 12 mo of age. Adiposity was assessed at birth and at 3 mo by air-displacement plethysmography by using the Pea Pod system (Cosmed) and at 6 and 12 mo by bioimpedance analysis (Bodystat). Aortic intima-media thickness was assessed at 12 mo by high-resolution ultrasound (Philips). Maternal dietary GI was lower in the low-GI group than in the HF group (51 ± 1 compared with 57 ± 1;P< 0.001). No differences in neonatal outcomes were observed in the main trial. In the self-selected subsample, birth weight and length z scores were lower in the low-GI group than in the HF group (birth weight z score: 0.2 ± 0.2 compared with 0.7 ± 0.2, respectively;P= 0.04; birth length z score: 0.3 ± 0.2 compared with 0.9 ± 0.2, respectively;P= 0.04), but adiposity from birth to 12 mo of age and growth trajectories from 1 to 12 mo of age were similar. Aortic intima-media thickness was lower in the low-GI group than in the HF group (657 ±12 compared with 696 ± 12 μm, respectively;P= 0.02), which was partly mediated by differences in birth weight. In women at risk of gestational diabetes mellitus, a low-GI diet influences offspring birth weight, birth length, and arterial wall thickness in early childhood, but not adiposity or growth trajectory during the first year of life. This trial was registered at anzctr.org.au as ACTRN12610000681055. © 2016 American Society for Nutrition.

Mediterranean Diet Pyramid: A Proposal for Italian People

PubMed Central

D’Alessandro, Annunziata; De Pergola, Giovanni

2014-01-01

Bread was a staple in the traditional Mediterranean diet of the early 1960s, as well as nowadays; however, it was a stone ground sourdough bread in Nicotera and probably in the Greek cohorts of the Seven Countries Study. In the present review, the nutritional characteristics of this food are analyzed in relation to its protective effects on coronary heart disease, metabolic diseases and cancer. According to our traditions, cultural heritage and scientific evidence, we propose that only cereal foods with low glycemic index (GI) and rich in fiber have to be placed at the base of the Mediterranean diet pyramid, whereas refined grains and high GI starchy foods have to be sited at the top. PMID:25325250

Mediterranean diet pyramid: a proposal for Italian people.

PubMed

D'Alessandro, Annunziata; De Pergola, Giovanni

2014-10-16

Bread was a staple in the traditional Mediterranean diet of the early 1960s, as well as nowadays; however, it was a stone ground sourdough bread in Nicotera and probably in the Greek cohorts of the Seven Countries Study. In the present review, the nutritional characteristics of this food are analyzed in relation to its protective effects on coronary heart disease, metabolic diseases and cancer. According to our traditions, cultural heritage and scientific evidence, we propose that only cereal foods with low glycemic index (GI) and rich in fiber have to be placed at the base of the Mediterranean diet pyramid, whereas refined grains and high GI starchy foods have to be sited at the top.

Effect of popping on sorghum starch digestibility and predicted glycemic index.

PubMed

Nathakattur Saravanabavan, Sanddhya; Manchanahally Shivanna, Meera; Bhattacharya, Sila

2013-04-01

Effect of popping on carbohydrate, protein, phytic acid and minerals of three varieties (pop sorghum, maldandi and red sorghum) of sorghum were studied. Significant changes (p ≤ 0.05) in the starch degradability including total and soluble amylose content, and resistant starch occurred due to popping; in-vitro protein digestibility along with the content of albumin proteins increased. Starch characteristics had substantial differences among these three varieties which are based on the nature of endosperm and amylose content. Phytic acid content had a reduction of 20%-25% after popping. Glycemic index (GI) determined from kinetic study of enzymatic hydrolysis of sorghum starch was between 85 and 92; the rate constant for hydrolysis for these three varieties were in the range of 0.025 and 0.029 min(-1). Popping helped to control phytic acid content in sorghum and enhanced protein as well as starch digestibility.

Development and evaluation of nutritional, sensory and glycemic properties of finger millet (Eleusine coracana L.) based food products.

PubMed

Shobana, Shanmugam; Selvi, Ravi Poovizhi; Kavitha, Vasudevan; Gayathri, Nagamuthu; Geetha, Gunasekaran; Gayathri, Rajagopal; Vijayalakshmi, Parthasarthy; Balasubramaniam, K Kandappa Gounder; Ruchi, Vaidya; Sudha, Vasudevan; Anjana, Ranjit Mohan; Unnikrishnan, Ranjit; Malleshi, Nagappa Gurusiddappa; Henry, C Jk; Krishnaswamy, Kamala; Mohan, Viswanathan

2018-01-01

Finger millet (Eleusine coracana L.) (FM) is rich in dietary fibre and is therefore expected to elicit a lower glycemic response compared to other grains. However, there is little data on the glycemic properties of FM-based products. We evaluated the nutritional, sensory and glycemic properties of decorticated millet with lower polish (DFM-LDP), flakes (FMF), vermicelli (FMV) and extruded snack (FMES) (both FMV and FMES with 7-8% added soluble fibre). The nutrient contents of the FM products were evaluated by standard AOAC (Association of Official Analytical Chemists) and AACC (American Association of Cereal Chemists) methods. Sensory evaluation was conducted monadically using a 9-point hedonic scale using untrained panel members. GI testing was conducted using a standardized validated protocol. The study was conducted according to the guidelines laid down by the Declaration of Helsinki, and was approved by the Ethics Committee of the Madras Diabetes Research Foundation. The products had dietary fibre (DF) content between 5.8-15.6 g%. FMES was unique in having a very low fat content (0.17%). Evaluation of sensory perception revealed moderate acceptance of millet based products. The glycemic indices (GI) (mean±SEM) of the products were 84.7±7.7%, 82.3±6.4%, 65.5±5.1% and 65.0±6.6% for DFM-LDP, FMF, FMV and FMES respectively. DFM-LDP and FMF (purely finger millet based products) elicited higher glycemic responses. Comparatively, FMV and FMES (with added functional ingredients) exhibited medium GI values and, are healthier dietary options. It is possible to prepare FM products with lower GI by utilizing functional ingredients.

Investigating the relationship between lentil carbohydrate fractions and in vivo postprandial blood glucose response by use of the natural variation in starch fractions among 20 lentil varieties.

PubMed

Ramdath, D Dan; Liu, Qiang; Donner, Elizabeth; Hawke, Aileen; Kalinga, Danusha; Winberg, Jordan; Wolever, Thomas M S

2017-10-18

Consumption of pulses is associated with many health benefits by mechanisms that are not fully understood. This study sought to identify the starch component(s) in cooked lentils responsible for lowering postprandial glycemic response (PPGR). Rapidly digestible (RDS), slowly digestible (SDS) and resistant starch (RS) content of 20 varieties of cooked lentil were determined by in vitro methods and 8 varieties, representing a linear range of SDS, were chosen for a human trial with 10 participants to determine PPGR and glycemic index (GI). Among the 20 lentil varieties, RS accounted for 35% of the variation of in vitro area under the starch hydrolysis curve (SHAUC) (r = -0.587; p < 0.01), but RDS (r = 0.401; p = 0.080) and SDS (r = -0.022; p = 0.927) were not significantly related to SHAUC. Multiple linear regression of in vitro data resulted in an equation [SHAUCest = 30.9RDS - 63.6RS + 9680] that accounted for 70% of the variance in SHAUC, with SDS excluded due to collinearity. In the human trial all 8 lentils had low GI values (10 to 23). Neither GI nor area under the glucose response curve (AUC) was significantly related to RDS, SDS or RS (minimum p = 0.24). However, SHAUC and SHAUCest, respectively, were related to both GI (r = 0.704, p = 0.051; r = 0.773, p = 0.024) and AUC (r = 0.765, p = 0.027; r = 0.822, p = 0.012). These results confirm that lentils have low GI values, which is not reliably predicted by their RDS, SDS and RS contents when considered individually. However, in vitro SHAUC and a combination of RDS and RS may be predictive of the PPGR of lentils.

Cereal processing influences postprandial glucose metabolism as well as the GI effect.

PubMed

Vinoy, Sophie; Normand, Sylvie; Meynier, Alexandra; Sothier, Monique; Louche-Pelissier, Corinne; Peyrat, Jocelyne; Maitrepierre, Christine; Nazare, Julie-Anne; Brand-Miller, Jeannie; Laville, Martine

2013-01-01

Technological processes may influence the release of glucose in starch. The aim of this study was to compare the metabolic response and the kinetics of appearance of exogenous glucose from 2 cereal products consumed at breakfast. Twenty-five healthy men were submitted to a randomized, open, crossover study that was divided into 2 parts: 12 of the 25 subjects were included in the "isotope part," and the 13 other subjects were included in the "glycemic part." On test days, subjects received biscuits (low glycemic index [GI], high slowly available glucose [SAG]) or extruded cereals (medium GI, low SAG) as part of a breakfast similar in terms of caloric and macronutrient content. The postprandial phase lasted 270 minutes. The rate of appearance (RaE) of exogenous glucose was significantly lower after consumption of biscuits in the first part of the morning (90-150 minutes) than after consumption of extruded cereals (p ≤ 0.05). Conversely, at 210 minutes, it was significantly higher with biscuits (p ≤ 0.01). For the first 2 hours, plasma glucose and insulin were significantly lower after biscuits during the glycemic part. C-peptide plasma concentrations were significantly lower at 90, 120, and 150 minutes after ingestion of the biscuits (p ≤ 0.05). The consumption of biscuits with a high content of slowly digestible starch reduces the appearance rate of glucose in the first part of the morning and prolongs this release in the late phase of the morning (210 minutes). Our results also emphasize that modulation of glucose availability at breakfast is an important factor for metabolic control throughout the morning in healthy subjects due to the lowering of blood glucose and insulin excursions.

Effect of Processing on Postprandial Glycemic Response and Consumer Acceptability of Lentil-Containing Food Items.

PubMed

Ramdath, D Dan; Wolever, Thomas M S; Siow, Yaw Chris; Ryland, Donna; Hawke, Aileen; Taylor, Carla; Zahradka, Peter; Aliani, Michel

2018-05-11

The consumption of pulses is associated with many health benefits. This study assessed post-prandial blood glucose response (PPBG) and the acceptability of food items containing green lentils. In human trials we: (i) defined processing methods (boiling, pureeing, freezing, roasting, spray-drying) that preserve the PPBG-lowering feature of lentils; (ii) used an appropriate processing method to prepare lentil food items, and compared the PPBG and relative glycemic responses (RGR) of lentil and control foods; and (iii) conducted consumer acceptability of the lentil foods. Eight food items were formulated from either whole lentil puree (test) or instant potato (control). In separate PPBG studies, participants consumed fixed amounts of available carbohydrates from test foods, control foods, or a white bread standard. Finger prick blood samples were obtained at 0, 15, 30, 45, 60, 90, and 120 min after the first bite, analyzed for glucose, and used to calculate incremental area under the blood glucose response curve and RGR; glycemic index (GI) was measured only for processed lentils. Mean GI (± standard error of the mean) of processed lentils ranged from 25 ± 3 (boiled) to 66 ± 6 (spray-dried); the GI of spray-dried lentils was significantly ( p < 0.05) higher than boiled, pureed, or roasted lentil. Overall, lentil-based food items all elicited significantly lower RGR compared to potato-based items (40 ± 3 vs. 73 ± 3%; p < 0.001). Apricot chicken, chicken pot pie, and lemony parsley soup had the highest overall acceptability corresponding to "like slightly" to "like moderately". Processing influenced the PPBG of lentils, but food items formulated from lentil puree significantly attenuated PPBG. Formulation was associated with significant differences in sensory attributes.

Effect of Processing on Postprandial Glycemic Response and Consumer Acceptability of Lentil-Containing Food Items

PubMed Central

Wolever, Thomas M. S.; Hawke, Aileen; Zahradka, Peter; Aliani, Michel

2018-01-01

The consumption of pulses is associated with many health benefits. This study assessed post-prandial blood glucose response (PPBG) and the acceptability of food items containing green lentils. In human trials we: (i) defined processing methods (boiling, pureeing, freezing, roasting, spray-drying) that preserve the PPBG-lowering feature of lentils; (ii) used an appropriate processing method to prepare lentil food items, and compared the PPBG and relative glycemic responses (RGR) of lentil and control foods; and (iii) conducted consumer acceptability of the lentil foods. Eight food items were formulated from either whole lentil puree (test) or instant potato (control). In separate PPBG studies, participants consumed fixed amounts of available carbohydrates from test foods, control foods, or a white bread standard. Finger prick blood samples were obtained at 0, 15, 30, 45, 60, 90, and 120 min after the first bite, analyzed for glucose, and used to calculate incremental area under the blood glucose response curve and RGR; glycemic index (GI) was measured only for processed lentils. Mean GI (± standard error of the mean) of processed lentils ranged from 25 ± 3 (boiled) to 66 ± 6 (spray-dried); the GI of spray-dried lentils was significantly (p < 0.05) higher than boiled, pureed, or roasted lentil. Overall, lentil-based food items all elicited significantly lower RGR compared to potato-based items (40 ± 3 vs. 73 ± 3%; p < 0.001). Apricot chicken, chicken pot pie, and lemony parsley soup had the highest overall acceptability corresponding to “like slightly” to “like moderately”. Processing influenced the PPBG of lentils, but food items formulated from lentil puree significantly attenuated PPBG. Formulation was associated with significant differences in sensory attributes. PMID:29751679

Cereal Processing Influences Postprandial Glucose Metabolism as Well as the GI Effect

PubMed Central

Vinoy, Sophie; Normand, Sylvie; Meynier, Alexandra; Sothier, Monique; Louche-Pelissier, Corinne; Peyrat, Jocelyne; Maitrepierre, Christine; Nazare, Julie-Anne; Brand-Miller, Jeannie; Laville, Martine

2013-01-01

Objective: Technological processes may influence the release of glucose in starch. The aim of this study was to compare the metabolic response and the kinetics of appearance of exogenous glucose from 2 cereal products consumed at breakfast. Methods: Twenty-five healthy men were submitted to a randomized, open, crossover study that was divided into 2 parts: 12 of the 25 subjects were included in the “isotope part,” and the 13 other subjects were included in the “glycemic part.” On test days, subjects received biscuits (low glycemic index [GI], high slowly available glucose [SAG]) or extruded cereals (medium GI, low SAG) as part of a breakfast similar in terms of caloric and macronutrient content. The postprandial phase lasted 270 minutes. Results: The rate of appearance (RaE) of exogenous glucose was significantly lower after consumption of biscuits in the first part of the morning (90–150 minutes) than after consumption of extruded cereals (p ≤ 0.05). Conversely, at 210 minutes, it was significantly higher with biscuits (p ≤ 0.01). For the first 2 hours, plasma glucose and insulin were significantly lower after biscuits during the glycemic part. C-peptide plasma concentrations were significantly lower at 90, 120, and 150 minutes after ingestion of the biscuits (p ≤ 0.05). Conclusion: The consumption of biscuits with a high content of slowly digestible starch reduces the appearance rate of glucose in the first part of the morning and prolongs this release in the late phase of the morning (210 minutes). Our results also emphasize that modulation of glucose availability at breakfast is an important factor for metabolic control throughout the morning in healthy subjects due to the lowering of blood glucose and insulin excursions. PMID:24015715

Glycemic potency of muffins made with wheat, rice, corn, oat and barley flours: a comparative study between in vivo and in vitro.

PubMed

Soong, Yean Yean; Quek, Rina Yu Chin; Henry, Christiani Jeyakumar

2015-12-01

Muffins made with wheat flour are a popular snack consumed in western and emerging countries. This study aimed to examine the content of amylose, glycemic response (GR) and glycemic index (GI) of muffins baked with refined wheat and rice flours, as well as wholegrain corn, oat and barley flours. This study adopted a randomized, controlled, crossover, non-blind design. Twelve healthy participants consumed wheat, rice, corn, oat and barley muffins once and the reference glucose solution three times in a random order on non-consecutive day. Capillary blood samples were taken every 15 min in the first 60 min and every 30 min for the remaining 60 min for blood glucose analysis. The Megazyme amylose/amylopectin assay procedure was employed to measure amylose content. The GR elicited from the consumption of wheat, rice and corn muffins was comparable between these samples but significantly greater when compared with oat and barley muffins. Consumption of wholegrain muffins, apart from corn muffin, blunted postprandial GR when compared with muffins baked with refined cereal flours. Muffins baked with wheat, rice, corn, oat and barley flours gave rise to GI values of 74, 79, 74, 53 and 55, respectively. The content of amylose was significantly higher in corn, oat and barley muffins than wheat and rice muffins. The greater content of amylose and fibre may play a part in the reduced glycemic potency of oat and barley muffins. Wheat flour can be substituted with oat and barley flours for healthier muffins and other bakery products.

Physical properties and estimated glycemic index of protein-enriched sorghum based chips.

PubMed

Jiang, Hongrui; Hettiararchchy, Navam S; Horax, Ronny

2018-03-01

Sorghum is a gluten-free grain and more attention has been given to the nutritional properties and recently its usage as a wheat replacement in food products. In the present work, protein-enriched sorghum based snack chips, prepared from sorghum meal with soy protein isolates and soy flour to meet the final protein content of 35.7%, were produced. The effect of varying baking powder (1.5-2.5%), dough sheet thickness (0.7-1.7 mm), and baking time (6-12 min) on the physical properties of the snack chips was investigated using a central composite design of response surface methodology. Under baking temperature of 160 °C, with baking powder added, the water activity and puffiness of chips significantly increased. Baking time was the most significant factor for all the parameters detected except for puffiness. The optimized conditions of preparing protein-enriched sorghum chips were baking powder 2.5%, dough sheet thickness 0.7 mm, and baking time 7.66 min. The estimated glycemic index (eGI) of the protein-enriched sorghum chips (eGI = 59.8) was significantly lower than soybean-free sorghum chips. The gluten-free protein-enriched sorghum chips developed could be considered as protein rich with lower intermediate-glycemic index classified healthy snacks and potential commercialization.

A low-glycemic index meal and bedtime snack prevents postprandial hyperglycemia and associated rises in inflammatory markers, providing protection from early but not late nocturnal hypoglycemia following evening exercise in type 1 diabetes.

PubMed

Campbell, Matthew D; Walker, Mark; Trenell, Michael I; Stevenson, Emma J; Turner, Daniel; Bracken, Richard M; Shaw, James A; West, Daniel J

2014-07-01

To examine the influence of the glycemic index (GI) of foods consumed after evening exercise on postprandial glycemia, metabolic and inflammatory markers, and nocturnal glycemic control in type 1 diabetes. On two evenings (∼1700 h), 10 male patients (27 ± 5 years of age, HbA1c 6.7 ± 0.7% [49.9 ± 8.1 mmol/mol]) were administered a 25% rapid-acting insulin dose with a carbohydrate bolus 60 min before 45 min of treadmill running. At 60 min postexercise, patients were administered a 50% rapid-acting insulin dose with one of two isoenergetic meals (1.0 g carbohdyrate/kg body mass [BM]) matched for macronutrient content but of either low GI (LGI) or high GI (HGI). At 180 min postmeal, the LGI group ingested an LGI snack and the HGI group an HGI snack (0.4 g carbohdyrate/kg BM) before returning home (∼2300 h). Interval samples were analyzed for blood glucose and lactate; plasma glucagon, epinephrine, interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α); and serum insulin, cortisol, nonesterified fatty acid, and β-hydroxybutyrate concentrations. Interstitial glucose was recorded for 20 h postlaboratory attendance through continuous glucose monitoring. Following the postexercise meal, an HGI snack induced hyperglycemia in all patients (mean ± SD glucose 13.5 ± 3.3 mmol/L) and marked increases in TNF-α and IL-6, whereas relative euglycemia was maintained with an LGI snack (7.7 ± 2.5 mmol/L, P < 0.001) without inflammatory cytokine elevation. Both meal types protected all patients from early hypoglycemia. Overnight glycemia was comparable, with a similar incidence of nocturnal hypoglycemia (n = 5 for both HGI and LGI). Consuming LGI food with a reduced rapid-acting insulin dose following evening exercise prevents postprandial hyperglycemia and inflammation and provides hypoglycemia protection for ∼8 h postexercise; however, the risk of late nocturnal hypoglycemia remains. © 2014 by the American Diabetes Association.

Dietary hyperglycemia, glycemic index and metabolic retinal diseases.

PubMed

Chiu, Chung-Jung; Taylor, Allen

2011-01-01

The glycemic index (GI) indicates how fast blood glucose is raised after consuming a carbohydrate-containing food. Human metabolic studies indicate that GI is related to patho-physiological responses after meals. Compared with a low-GI meal, a high-GI meal is characterized with hyperglycemia during the early postprandial stage (0-2h) and a compensatory hyperlipidemia associated with counter-regulatory hormone responses during late postprandial stage (4-6h). Over the past three decades, several human health disorders have been related to GI. The strongest relationship suggests that consuming low-GI foods prevents diabetic complications. Diabetic retinopathy (DR) is a complication of diabetes. In this aspect, GI appears to be useful as a practical guideline to help diabetic people choose foods. Abundant epidemiological evidence also indicates positive associations between GI and risk for type 2 diabetes, cardiovascular disease, and more recently, age-related macular degeneration (AMD) in people without diabetes. Although data from randomized controlled intervention trials are scanty, these observations are strongly supported by evolving molecular mechanisms which explain the pathogenesis of hyperglycemia. This wide range of evidence implies that dietary hyperglycemia is etiologically related to human aging and diseases, including DR and AMD. In this context, these diseases can be considered as metabolic retinal diseases. Molecular theories that explain hyperglycemic pathogenesis involve a mitochondria-associated pathway and four glycolysis-associated pathways, including advanced glycation end products formation, protein kinase C activation, polyol pathway, and hexosamine pathway. While the four glycolysis-associated pathways appear to be universal for both normoxic and hypoxic conditions, the mitochondria-associated mechanism appears to be most relevant to the hyperglycemic, normoxic pathogenesis. For diseases that affect tissues with highly active metabolism and that frequently face challenge from low oxygen tension, such as retina in which metabolism is determined by both glucose and oxygen homeostases, these theories appear to be insufficient. Several lines of evidence indicate that the retina is particularly vulnerable when hypoxia coincides with hyperglycemia. We propose a novel hyperglycemic, hypoxia-inducible factor (HIF) pathway, to complement the current theories regarding hyperglycemic pathogenesis. HIF is a transcription complex that responds to decrease oxygen in the cellular environment. In addition to playing a significant role in the regulation of glucose metabolism, under hyperglycemia HIF has been shown to increase the expression of HIF-inducible genes, such as vascular endothelial growth factor (VEGF) leading to angiogenesis. To this extent, we suggest that HIF can also be described as a hyperglycemia-inducible factor. In summary, while management of dietary GI appears to be an effective intervention for the prevention of metabolic diseases, specifically AMD and DR, more interventional data is needed to evaluate the efficacy of GI management. There is an urgent need to develop reliable biomarkers of exposure, surrogate endpoints, as well as susceptibility for GI. These insights would also be helpful in deciphering the detailed hyperglycemia-related biochemical mechanisms for the development of new therapeutic agents. 2010 Elsevier Ltd. All rights reserved.

Effect of Pseudocereal-Based Breakfast Meals on the First and Second Meal Glucose Tolerance in Healthy and Diabetic Subjects

PubMed Central

Gabrial, Shreef G. N.; Shakib, Marie-Christine R.; Gabrial, Gamal N.

2016-01-01

BACKGROUND: Many studies have indicated that the incidence of serious diabetic complications may be reduced through strict glycemic control. A low glycemic index diet is one tool to improve insulin resistance and improve glycemic control in type 2 diabetes mellitus (T2DM). AIM: The objective was to study the effect of pseudocereals-based breakfasts (quinoa and buckwheat) on glucose variations at first meal (breakfast) and second meal (standardised lunch) in healthy and diabetic subjects. SUBJECTS AND METHODS: Twelve healthy subjects and 12 patients with Type 2 DM (not- insulin dependent) were recruited in the study. Subjects were provided with quinoa and buckwheat breakfast meals. A standardised lunch was provided 4 h after breakfast. Postprandial blood glucose response after breakfast and the second meal effect was measured in healthy and diabetic subjects. Incremental area under the curve (IAUC) values for glucose was measured in response to the breakfast and lunch. The glycemic index of the 2 pseudocereals-based test breakfasts was determined. A white wheat bread (WWB) was served as a reference breakfast meal. RESULTS: In post-breakfast analyses, healthy subjects showed that buckwheat meal had significantly lower IAUC values for blood glucose compared to WWB reference meal (P < 0.001) while quinoa meal showed no significance. In diabetic subjects, buckwheat and quinoa meals had significantly lower IAUC values for blood glucose compared to WWB reference meal (P < 0.001 and P < 0.05 respectively). Blood glucose concentrations started to decline gradually for the quinoa and buckwheat but not for WWB in all healthy and diabetic subjects and returned to near-fasting baseline levels by 210 min. Post-lunch analyses indicated higher IAUC for the two breakfast types in healthy and diabetic subjects. In addition, the quinoa and buckwheat breakfast meals were followed by a significantly flatter blood glucose response to the second meal for the period between 270 and 330 min. At the end of the second meal period, values were below or near-fasting baseline levels in the breakfast period. The blood glucose concentration after consuming quinoa meal showed a high peak at 30 min similar to that of WWB reference meal. This peak resulted in a high glycemic index (GI) for quinoa (89.4). The GI of buckwheat recorded a low value (26.8). CONCLUSION: The two studied pseudocereals; quinoa and buckwheat have high potential to improve glucose tolerance at the first and second meal (lunch) and are recommended to be introduced in our daily diet for healthy and diabetic subjects. PMID:28028392

[Carbohydrates and mental performance--the role of glycemic index of food products].

PubMed

Ciok, Janusz; Dolna, Agnieszka

2006-03-01

The role of carbohydrates in proper functioning of central nervous system measured by parameters of cognitive performance was described. The only source of energy for the brain is glucose, which stimulates the production and secretion of acetylocholine. Important are also enough high blood level of insulin and the level of insulin growth factor (IGF). Many studies had showed that breakfast intake improves the ability of concentration, reaction time, learning ability, mood and memory. Not sufficient amount of nutritional carbohydrates may in opposite be negative for the results of some tests measuring cognitive performance. The results of studies showing that the disturbances in utilization of carbohydrates, present in the patients with diabetes, increase the risk of abnormalities of cognitive performance. There is some evidence that the kind of ingested carbohydrates is important. Several studies suggest that the intake of carbohydrates characterized by low glycemic index (GI) may be favorable for some parameters of cognitive performance, because of prolonged time of stable glicaemia after food ingestion.

Effects of honey, sucrose and glucose on blood glucose and C-peptide in patients with type 1 diabetes mellitus.

PubMed

Abdulrhman, Mamdouh; El Hefnawy, Mohamed; Ali, Rasha; Abdel Hamid, Iman; Abou El-Goud, Ahmad; Refai, Doaa

2013-02-01

This study was a case control cross sectional study that was conducted on 50 patients with type 1 diabetes mellitus and 30 controls without diabetes. The mean age of patients was 10.02 years. Oral sugar tolerance tests using glucose, sucrose and honey and measurement of fasting and postprandial serum C-peptide levels were done for all subjects in three separate sittings. The glycemic index (GI) and the peak incremental index (PII) were then calculated for each subject. Honey, compared to sucrose, had lower GI and PII in both patients and controls (P < 0.01). In both patients and controls, the increase in the level of C-peptide after honey was significant when compared with either glucose or sucrose (P < 0.01). Because of its possible stimulatory effect on diseased beta cells, honey might be considered in future therapeutic trials targeting beta cells of pancreas. Copyright © 2012 Elsevier Ltd. All rights reserved.

Carbohydrate intake, glycemic index and prostate cancer risk.

PubMed

Vidal, Adriana C; Williams, Christina D; Allott, Emma H; Howard, Lauren E; Grant, Delores J; McPhail, Megan; Sourbeer, Katharine N; Hwa, Lin Pao; Boffetta, Paolo; Hoyo, Cathrine; Freedland, Stephen J

2015-03-01

Reported associations between dietary carbohydrate and prostate cancer (PC) risk are poorly characterized by race. We analyzed the association between carbohydrate intake, glycemic index (GI), and PC risk in a study of white (N = 262) and black (N = 168) veterans at the Durham VA Hospital. Cases were 156 men with biopsy-confirmed PC and controls (N = 274) had a PSA test but were not recommended for biopsy. Diet was assessed before biopsy with a self-administered food frequency questionnaire. Logistic regression models were used to estimate PC risk. In multivariable analyzes, higher carbohydrate intake, measured as percent of energy from carbohydrates, was associated with reduced PC risk (3rd vs. 1st tertile, OR = 0.41, 95% CI 0.21-0.81, P = 0.010), though this only reached significance in white men (p-trend = 0.029). GI was unrelated to PC risk among all men, but suggestively linked with reduced PC risk in white men (p-trend = 0.066) and increased PC risk in black men (p-trend = 0.172), however, the associations were not significant. Fiber intake was not associated with PC risk (all p-trends > 0.55). Higher carbohydrate intake was associated with reduced risk of high-grade (p-trend = 0.016), but not low-grade PC (p-trend = 0.593). Higher carbohydrate intake may be associated with reduced risk of overall and high-grade PC. Future larger studies are needed to confirm these findings. © 2014 Wiley Periodicals, Inc.

Carbohydrate intake, glycemic index and prostate cancer risk

PubMed Central

Vidal, Adriana C.; Williams, Christina D.; Allott, Emma H.; Howard, Lauren E.; Grant, Delores J.; McPhail, Megan; Sourbeer, Katharine N.; Pao-Hwa, Lin; Boffetta, Paolo; Hoyo, Cathrine; Freedland, Stephen J.

2014-01-01

BACKGROUND Reported associations between dietary carbohydrate and prostate cancer (PC) risk are poorly characterized by race. METHODS We analyzed the association between carbohydrate intake, glycemic index (GI), and PC risk in a study of white (N=262) and black (N=168) veterans at the Durham VA Hospital. Cases were 156 men with biopsy-confirmed PC and controls (N=274) had a PSA test but were not recommended for biopsy. Diet was assessed before biopsy with a self-administered food frequency questionnaire. Logistic regression models were used to estimate PC risk. RESULTS In multivariable analyses, higher carbohydrate intake, measured as percent of energy from carbohydrates, was associated with reduced PC risk (3rd vs. 1st tertile, OR=0.41, 95%CI 0.21–0.81, p=0.010), though this only reached significance in white men (p-trend=0.029). GI was unrelated to PC risk among all men, but suggestively linked with reduced PC risk in white men (p-trend=0.066) and increased PC risk in black men (p-trend=0.172), however the associations were not significant. Fiber intake was not associated with PC risk (all p-trends >0.55). Higher carbohydrate intake was associated with reduced risk of high-grade (p-trend=0.016), but not low-grade PC (p-trend=0.593). CONCLUSIONS Higher carbohydrate intake may be associated with reduced risk of overall and high-grade PC. Future larger studies are needed to confirm these findings. PMID:25417840

Evaluation of postprandial glucose excursion using a novel minimally invasive glucose area-under-the-curve monitoring system.

PubMed

Kuranuki, Sachi; Sato, Toshiyuki; Okada, Seiki; Hosoya, Samiko; Seko, Akinobu; Sugihara, Kaya; Nakamura, Teiji

2013-01-01

To develop a minimally invasive interstitial fluid extraction technology (MIET) to monitor postprandial glucose area under the curve (AUC) without blood sampling, we evaluated the accuracy of glucose AUC measured by MIET and compared with that by blood sampling after food intake. Interstitial fluid glucose AUC (IG-AUC) following consumption of 6 different types of foods was measured by MIET. MIET consisted of stamping microneedle arrays, placing hydrogel patches on the areas, and calculating IG-AUC based on glucose levels in the hydrogels. Glycemic index (GI) was determined using IG-AUC and reference AUC measured by blood sampling. IG-AUC strongly correlated with reference AUC (R = 0.91), and GI determined using IG-AUC showed good correlation with that determined by reference AUC (R = 0.88). IG-AUC obtained by MIET can accurately predict the postprandial glucose excursion without blood sampling. In addition, feasibility of GI measurement by MIET was confirmed.

Cr-enriched yeast: beyond fibers for the management of postprandial glycemic response to bread.

PubMed

Yanni, Amalia E; Stamataki, Nikoleta; Stoupaki, Maria; Konstantopoulos, Panagiotis; Pateras, Irene; Tentolouris, Nikolaos; Perrea, Despoina; T Karathanos, Vaios

2017-06-01

Efforts regarding the amelioration of postprandial glycemic response to bread are mainly focused in the addition of soluble dietary fibers. The current study presents another approach which is based on the supplementation of flour with Cr-enriched yeast. Cr is known for its beneficial effects on improvement of glucose tolerance and enhancement of insulin sensitivity. Twelve normoglycemic subjects were provided with white bread (WB, reference food) or whole wheat bread with Cr-enriched yeast (WWCrB, rich in insoluble fibers) or white wheat bread with Cr-enriched yeast (WCrB, poor in fibers) or whole wheat-rye-barley bread enriched with oat beta glucans (BGB, rich in soluble fibers) with 1-week intervals in amounts that yielded 50 g of available carbohydrates. Postprandial glucose, insulin and ghrelin responses as well as glycemic index (GI) were evaluated. Ingestion of WWCrB, WCrB and BGB elicited lower incremental area under the curve (iAUC) for 120-min glycemic response compared to WB (1033.02 ± 282.32, 701.69 ± 330.86 and 748.95 ± 185.42 vs 2070.87 ± 518.44 mg/dL min, respectively, P < 0.05 for WCrB and BGB). The GI was calculated as 62.35 ± 11.78 for WWCrB, 34.22 ± 11.93 for WCrB and 37.90 ± 5.00 for BGB (P < 0.05 vs WB, GI = 100). iAUC for 120-min insulin response to BGB was significantly lower than WB (2780.04 ± 303.26 vs 3915.53 ± 490.57 μU/mL min, P < 0.05), while ghrelin remained suppressed for almost 120 min after the consumption of WWCrB and BGB. Supplementation of flour with Cr-enriched yeast induces milder postprandial glycemic response to bread without the necessity of high fiber amounts, providing with another strategy for the management of glycemic control.

Association between carbohydrate quality and inflammatory markers: systematic review of observational and interventional studies.

PubMed

Buyken, Anette E; Goletzke, Janina; Joslowski, Gesa; Felbick, Anna; Cheng, Guo; Herder, Christian; Brand-Miller, Jennie C

2014-04-01

Chronic low-grade inflammation is a likely intermediary between quality of carbohydrate and chronic disease risk. We conducted a systematic literature search to evaluate the relevance of carbohydrate quality on inflammatory markers in observational and intervention studies. MEDLINE, EMBASE, and the Cochrane Library were searched for studies on associations between glycemic index (GI), glycemic load (GL), dietary fiber or fiber supplements or whole grain intake, and high-sensitivity C-reactive protein (hsCRP) or interleukin 6 (IL-6). Included studies had to be conducted on adults (healthy, overweight, with type 2 diabetes or metabolic syndrome features, but without inflammatory disease) with ≥20 participants and a 3-wk duration. In total, 22 of the 60 studies that met our inclusion criteria examined GI/GL: 5 of 9 observational studies reported lower concentrations of hsCRP or IL-6 among persons with a lower dietary GI/GL; 3 of 13 intervention studies showed significant antiinflammatory effects of a low-GI/GL diet, and 4 further studies suggested beneficial effects (trends or effects in a subgroup). For fiber intake, 13 of 16 observational studies reported an inverse relation with hsCRP or IL-6, but only 1 of 11 intervention studies showed a significant antiinflammatory effect of fiber intake, and a further trial reported a beneficial trend. For whole-grain intake, 6 of 7 observational studies observed an inverse association with inflammatory markers, but only 1 of 7 intervention studies reported significant antiinflammatory effects, 1 further study was suggestive (in a subgroup) of such, and another study found an adverse effect (trend only). Evidence from intervention studies for antiinflammatory benefits is less consistent for higher-fiber or whole-grain diets than for low-GI/GL diets. Benefits of higher fiber and whole-grain intakes suggested by observational studies may reflect confounding.

Evaluation of finger millet incorporated noodles for nutritive value and glycemic index.

PubMed

Shukla, Kamini; Srivastava, Sarita

2014-03-01

The present study was undertaken to develop finger millet incorporated noodles for diabetic patients. Finger millet variety VL-149 was taken. The finger millet flour and refined wheat flour (RWF) were evaluated for nutrient composition. The finger millet flour (FMF) was blended in various proportions (30 to 50%) in refined wheat flour and used for the preparation of noodles. Control consisted of RWF noodles. Sensory quality and nutrient composition of finger millet noodles was evaluated. The 30% finger millet incorporated noodles were selected best on the basis of sensory evaluation. Noodles in that proportion along with control were evaluated for glycemic response. Nutrient composition of noodles showed that 50% finger millet incorporated noodles contained highest amount of crude fat (1.15%), total ash (1.40%), crude fiber (1.28%), carbohydrate (78.54%), physiological energy (351.36 kcal), insoluble dietary fiber (5.45%), soluble dietary fiber (3.71%), iron (5.58%) and calcium (88.39%), respectively. However, control RWF noodles contained highest amount of starch (63.02%), amylose (8.72%) and amylopectin (54.29%). The glycemic index (GI) of 30% finger millet incorporated noodles (best selected by sensory evaluation) was observed significantly lower (45.13) than control noodles (62.59). It was found that finger millet flour incorporated noodles were found nutritious and showed hypoglycemic effect.

The association between pregame snacks and exercise intensity, stress, and fatigue in children.

PubMed

Sacheck, Jennifer M; Rasmussen, Helen M; Hall, Meghan M; Kafka, Tamar; Blumberg, Jeffrey B; Economos, Christina D

2014-05-01

To investigate the association between pregame snacks varying in macronutrient content and exercise intensity, physiological stress, and fatigue in young soccer players. One hour before a 50-min soccer game, children (n = 79; 9.1 ± 0.8 y) were randomly assigned to consume a raisin-, peanut-butter-, or cereal-based snack. Body mass index, blood glucose, and salivary measures of stress (cortisol and immunoglobulin A-IgA) were measured pre- and post-game. Exercise intensity was measured by accelerometry. Self-administered questionnaires were used to assess diet quality and fatigue. Analysis of covariance was used to examine the relationship between pregame snacks and biochemical outcomes. Postgame glucose and cortisol increased [12.9 ± 21.3 mg/dL (p < .001) and 0.04 ± 0.10 μg/dL (p < .05), respectively] and IgA decreased (-2.3 ± 9.6 μg/mL; p < .001) from pregame values. The pregame snack was not associated with exercise intensity or post-game outcome; however, children consuming the cereal-based (high-sugar and high-glycemic index (GI)) snack exercised more intensely than the 2 lower-GI snack groups (p < .05). Children who consumed the high-sugar, high-GI snack also reported more symptoms of fatigue (p < .05). A high-sugar, high-GI pregame snack was associated with exercise intensity and fatigue but not changes in blood sugar or stress biomarkers following a soccer game in children.

Cyclodextrins in Food Technology and Human Nutrition: Benefits and Limitations.

PubMed

Fenyvesi, É; Vikmon, M; Szente, L

2016-09-09

Cyclodextrins are tasteless, odorless, nondigestible, noncaloric, noncariogenic saccharides, which reduce the digestion of carbohydrates and lipids. They have low glycemic index and decrease the glycemic index of the food. They are either non- or only partly digestible by the enzymes of the human gastrointestinal (GI) tract and fermented by the gut microflora. Based on these properties, cyclodextrins are dietary fibers useful for controlling the body weight and blood lipid profile. They are prebiotics, improve the intestinal microflora by selective proliferation of bifidobacteria. These antiobesity and anti-diabetic effects make them bioactive food supplements and nutraceuticals. In this review, these features are evaluated for α-, β- and γ-cyclodextrins, which are the cyclodextrin variants approved by authorities for food applications. The mechanisms behind these effects are reviewed together with the applications as solubilizers, stabilizers of dietary lipids, such as unsaturated fatty acids, phytosterols, vitamins, flavonoids, carotenoids and other nutraceuticals. The recent applications of cyclodextrins for reducing unwanted components, such as trans-fats, allergens, mycotoxins, acrylamides, bitter compounds, as well as in smart active packaging of foods are also overviewed.

Characterization of Lentinus edodes β-glucan influencing the in vitro starch digestibility of wheat starch gel.

PubMed

Zhuang, Haining; Chen, Zhongqiu; Feng, Tao; Yang, Yan; Zhang, Jingsong; Liu, Guodong; Li, Zhaofeng; Ye, Ran

2017-06-01

Lentinus edodes β-glucan (abbreviated LEBG) was prepared from fruiting bodies of Lentinus edodes. The average molecular weight (Mw) and polydispersity index (Mw/Mn) of LEBG were measured to be 1.868×10 6 g/mol and 1.007, respectively. In addition, the monosaccharide composition of LEBG was composed of arabinose, galactose, glucose, xylose, mannose with a molar ratio of 5:11:18:644:16. After adding LEBG, both G' and G″ of starch gel increased. This is mainly because the connecting points between the molecular chains of LEBG and starch formed so that gel network structures were enhanced. The peak temperature in the heat flow diagram shifted to a higher temperature and the peak area of the endothermic enthalpy increased. Furthermore, LEBG can significantly inhibit starch hydrolysis. The predicted glycemic index (pGI) values were reduced when starch was replaced with LEBG at 20% (w/w). It might indicate that LEBG was suitable to develop low GI noodle or bread. Copyright © 2016 Elsevier Ltd. All rights reserved.

Quality properties of fruits as affected by drying operation.

PubMed

Omolola, Adewale O; Jideani, Afam I O; Kapila, Patrick F

2017-01-02

The increasing consumption of dried fruits requires further attention on the quality parameters. Drying has become necessary because most fruits are highly perishable owing to their high moisture content and the need to make them available all year round and at locations where they are not produced. In addition to preservation, the reduced weight and bulk of dehydrated products decreases packaging, handling and transportation costs. Quality changes associated with drying of fruit products include physical, sensory, nutritional, and microbiological. Drying gives rise to low or moderate glycemic index (GI) products with high calorie, vitamin and mineral contents. This review examines the nutritional benefits of dried fruits, protective compounds present in dried fruits, GI, overview of some fruit drying methods and effects of drying operations on the quality properties such as shrinkage, porosity, texture, color, rehydration, effective moisture diffusivity, nutritional, sensory, microbiological and shelf stability of fruits.

Low glycemic index breakfasts and reduced food intake in preadolescent children.

PubMed

Warren, Janet M; Henry, C Jeya K; Simonite, Vanessa

2003-11-01

Recent reports have suggested that a low glycemic index (GI) diet may have a role in the management of obesity through its ability to increase the satiety value of food and modulate appetite. To date, no long-term clinical trials have examined the effect of dietary GI on body weight regulation. The majority of evidence comes from single-day studies, most of which have been conducted in adults. The purpose of this study was to investigate the effect of 3 test breakfasts-low-GI, low-GI with 10% added sucrose, and high-GI-on ad libitum lunch intake, appetite, and satiety and to compare these with baseline values when habitual breakfast was consumed. A 3-way crossover study using block randomization of breakfast type was conducted in a school that already ran a breakfast club. A total of 37 children aged 9 to 12 years (15 boys and 22 girls) completed the study. The proportion of nonoverweight to overweight/obese children was 70:30. Children were divided into 5 groups, and a rolling program was devised whereby, week by week, each group would randomly receive 1 of 3 test breakfasts for 3 consecutive days, with a minimum of 5 weeks between the test breakfasts. Participants acted as their own control. The 3 test breakfasts were devised to match the energy and nutritional content of an individual's habitual breakfast as far as possible. All test breakfasts were composed of fruit juice, cereal, and milk with/without bread and margarine; foods with an appropriate GI value were selected. After each test breakfast, children were instructed not to eat or drink anything until lunchtime, except water and a small serving of fruit supplying approximately 10 g of carbohydrate, which was provided. Breakfast palatability, satiation after breakfast, and satiety before lunch were measured using rating scales based on previously used tools. Lunch was a buffet-style meal, and children were allowed free access to a range of foods. Lunch was served in the school hall where the rest of the schoolchildren were eating. Food intake at lunch was unobtrusively observed and recorded. Leftovers and food swapping were recorded, and plate waste was estimated. Lunch intakes were analyzed using a multilevel regression model for repeated measures data. The likelihood ratio statistic was used to determine whether the type of breakfast eaten had a significant effect on lunch intake after allowing for sex and weight status. The type of breakfast eaten had a statistically significant effect on mean energy intake at lunchtime: lunch intake was lower after low-GI and low-GI with added sucrose breakfasts compared with lunch intake after high-GI and habitual breakfasts (which were high-GI). Overweight and sex did not have a significant effect on lunch intake. Pairwise comparisons among the 3 types of test breakfasts and between each test breakfast and habitual breakfast were made. Lunch intake after the high-GI breakfast was significantly higher than after the low-GI breakfast and low-GI breakfast with added sucrose. The details of the pairwise comparisons were as follows: high-GI versus low-GI = 145 +/- 54 kcal; high-GI versus low-GI plus sucrose = 119 +/- 53 kcal; low-GI plus sucrose versus low-GI = 27 +/- 54 kcal. Lunch intake after the low-GI breakfast and the low-GI breakfast with added sucrose was significantly lower than after the habitual breakfast. The details of the pairwise comparisons were as follows: low-GI versus habitual = -109 +/- 75 kcal; low-GI plus sucrose versus habitual = -83 +/- 75 kcal; high-GI versus habitual = 36 +/- 75 kcal. There were no significant differences between the test breakfasts in immediate satiation. The high-GI breakfasts were rated to be more palatable than the low-GI breakfasts. At lunchtime, hunger ratings were greater after the high-GI breakfast compared with the other 2 test breakfasts on 2 of the 3 experimental days. Prelunch satiety scales were inversely related to subsequent food intake. These results suggest that low-GI foods eaten at breakfast have a significant impact on food intake at lunch. This is the first study to observe such an effect in a group of normal and overweight children and adds to the growing body of evidence that low-GI foods may have an important role in weight control and obesity management. The potentially confounding effect of differences in the macronutrient and dietary fiber content of the test breakfasts warrants additional study. In addition, the impact of GI on food intake and body weight regulation in the long term needs to be investigated.

Appetite and Gut Hormones Response to a Putative α-Glucosidase Inhibitor, Salacia Chinensis, in Overweight/Obese Adults: A Double Blind Randomized Controlled Trial.

PubMed

Hao, Lihong; Schlussel, Yvette; Fieselmann, Krista; Schneider, Stephen H; Shapses, Sue A

2017-08-12

Animal studies indicate Salacia reduces body weight, possibly due to its α-glucosidase inhibitor (α-GI) properties, but this has not been examined previously. In this study, a randomized, placebo-controlled, three-way cross-over design was used to evaluate whether Salacia Chinensis (SC) reduces appetite in healthy overweight/obese individuals (body mass index 28.8 ±3.6 kg/m²; 32 ± 12 years). Forty-eight participants were fasted overnight and consumed a dose of SC (300 or 500 mg) or placebo with a fixed breakfast meal at each visit. Appetite sensations, glycemic indices and gastrointestinal peptides were measured. Results indicated that SC had no effect on postprandial appetite. However, in women, hunger was reduced by SC compared to placebo at multiple time points (300 mg; p < 0.05), but not in men. Area under the curve (AUC) for serum glucose, insulin and amylin was attenuated with SC compared to placebo ( p < 0.05). Glucagon like peptide-1 had two peaks after the meal, but the AUC did not differ between groups. The AUC of peak areas for peptide YY and ghrelin were greater for SC than placebo ( p < 0.05). These findings indicate that Salacia decreases glycemic indices supporting its role as an α-GI, and affects certain gastrointestinal peptides suggesting it may be an appetite modulator.

Impact of High-Carbohydrate Diet on Metabolic Parameters in Patients with Type 2 Diabetes

PubMed Central

Jung, Chan-Hee; Choi, Kyung Mook

2017-01-01

In patients with type 2 diabetes mellitus (T2DM), whether dietary carbohydrates have beneficial or detrimental effects on cardiometabolic risk factors has drawn attention. Although a high-carbohydrate (HC) diet and a low-carbohydrate (LC) diet have gained popularity for several decades, there is scarce review focusing on the effects of HC diet on glucose, lipids and body weight in patients with T2DM. In this review, we examined recently-published literature on the effects of HC diets on metabolic parameters in T2DM. HC diets are at least as effective as LC diets, leading to significant weight loss and a reduction in plasma glucose, HbA1c and low density lipoprotein-cholesterol (LDL-C) levels. The major concern is that HC diets may raise serum triglyceride levels and reduce high density lipoprotein-cholesterol (HDL-C) levels, increasing the risk of cardiovascular disease. However, these untoward effects were not a persistent consequence and may be ameliorated with the consumption of a low glycemic index (GI)/low glycemic load (GL) and high fiber. Carbohydrate intake should be individualized, and low caloric intake remains a crucial factor to improve insulin sensitivity and reduce body weight; however, an HC diet, rich in fiber and with a low GI/GL, may be recommendable in patients with T2DM. PMID:28338608

Impact of High-Carbohydrate Diet on Metabolic Parameters in Patients with Type 2 Diabetes.

PubMed

Jung, Chan-Hee; Choi, Kyung Mook

2017-03-24

In patients with type 2 diabetes mellitus (T2DM), whether dietary carbohydrates have beneficial or detrimental effects on cardiometabolic risk factors has drawn attention. Although a high-carbohydrate (HC) diet and a low-carbohydrate (LC) diet have gained popularity for several decades, there is scarce review focusing on the effects of HC diet on glucose, lipids and body weight in patients with T2DM. In this review, we examined recently-published literature on the effects of HC diets on metabolic parameters in T2DM. HC diets are at least as effective as LC diets, leading to significant weight loss and a reduction in plasma glucose, HbA1c and low density lipoprotein-cholesterol (LDL-C) levels. The major concern is that HC diets may raise serum triglyceride levels and reduce high density lipoprotein-cholesterol (HDL-C) levels, increasing the risk of cardiovascular disease. However, these untoward effects were not a persistent consequence and may be ameliorated with the consumption of a low glycemic index (GI)/low glycemic load (GL) and high fiber. Carbohydrate intake should be individualized, and low caloric intake remains a crucial factor to improve insulin sensitivity and reduce body weight; however, an HC diet, rich in fiber and with a low GI/GL, may be recommendable in patients with T2DM.

Assessment of glycemic load and intake of carbohydrates in the diet of Wroclaw Medical University students (Poland).

PubMed

Różańska, Dorota; Kawicka, Anna; Konikowska, Klaudia; Salomon, Agnieszka; Zatońska, Katarzyna; Szuba, Andrzej; Regulska-Ilow, Bożena

Glycemic Load (GL) is one of the indicators that can be used to assess the nutritional value of the diet. The results of numerous studies have shown that high glycemic index and/or high GL diets were associated with increased risk for type 2 diabetes, cardiovascular disease and cancer. The aim of the study was to evaluate dietary GL, intake of food products which are source of carbohydrates and contribution of particular carbohydrates in students' diets. The study group consisted of 140 female students from Wroclaw (Poland) aged 21±1.6 years. The dietary assessment was performed using food frequency-questionnaire. The GL of daily food ration (DFR) was considered low for values <80 g, medium for values between 80-120 g and high for values >120 g. The mean GL of the diets was 120.7±42 g. DFR of 12.1% of the students had low GL, 46.6% - medium, and 39.3% - high. Diets in the 4th quartile of GL were characterized by the highest energy value, total carbohydrate, sucrose, starch and fiber content and energy contribution from carbohydrates when compared with lower quartiles. Higher percentage of energy from protein and fats in the diets was related with lower dietary GL. The highest correlation coefficient between GL and weight of the consumed food was observed for sweets (r=0.67), cereal products (r=0.52), juices and sweetened beverages (r=0.50), vegetables (r=0.45) and fruits (r=0.44). In the study, cereal products, fruits, sweets, vegetables and juices and sweetened beverages consumed by the female subjects constituted respectively 26.6%, 12.8%, 11.4%, 9.1% and 8.8% of the total dietary GL. Lower dietary GL in the female students participating in the study can be achieved by limiting the intake of sweets and sweet beverages as well as consuming cereal products with a low GI. glycemic index, glycemic load, carbohydrates, students, diet.

The role of sugar-sweetened beverage consumption in adolescent obesity: a review of the literature.

PubMed

Harrington, Susan

2008-02-01

Soft drink consumption has increased by 300% in the past 20 years, and 56-85% of children in school consume at least one soft drink daily. The odds ratio of becoming obese among children increases 1.6 times for each additional can or glass of sugar-sweetened drink consumed beyond their usual daily intake of the beverage. Soft drinks currently constitute the leading source of added sugars in the diet and exceed the U.S. Department of Agriculture's recommended total sugar consumption for adolescents. With the increase in adolescent obesity and the concurrent increase in consumption of sugar-sweetened beverages (SSB), the assumption infers a relationship between the two variables. SSB, classified as high-glycemic index (GI) liquids, increase postprandial blood glucose levels and decrease insulin sensitivity. Additionally, high-GI drinks submit to a decreased satiety level and subsequent overeating. Low-GI beverages stimulate a delayed return of hunger, thereby prompting an increased flexibility in amounts and frequencies of servings. Single intervention manipulation, elimination, or marked reduction of SSB consumption may serve to decrease caloric intake, increase satiety levels, decrease tendencies towards insulin resistance, and simplify the process of weight management in this population.

Polyunsaturated fats, carbohydrates and carotid disease: The Atherosclerosis Risk in Communities (ARIC) Carotid MRI study

PubMed Central

Dearborn, Jennifer L.; Qiao, Ye; Guallar, Eliseo; Steffen, Lyn M.; Gottesman, Rebecca F.; Zhang, Yiyi; Wasserman, Bruce A.

2016-01-01

Background and aims Carbohydrates and fat intake have both been linked to development of atherosclerosis. We examined associations between glycemic index GI and fat intake with carotid atherosclerosis. Methods The Atherosclerosis Risk in Communities (ARIC) cohort enrolled participants during the period 1987–1989 and the Carotid MRI sub-study occurred between 2004 and 2006 (1,672 participants attending both visits). Measures of carbohydrate quality (usual GI), fat intake (total, polyunsaturated and saturated) and overall dietary quality index (DASH Diet Score) were derived from a 66-item food frequency questionnaire administered at baseline. Trained readers measured lipid core presence and maximum wall thickness. Using multivariate logistic regression, we determined the odds of lipid core presence by quintile (Q) of energy-adjusted dietary components. Restricted cubic spline models were used to examine non-linear associations between dietary components and maximum wall thickness. Results Mean daily polyunsaturated fat intake was 5 g (SD 1.4). GI and polyunsaturated fat intake had a nonlinear relationship with maximum wall thickness. Low (1–4 g) and high (6–12 g) polyunsaturated fat intake were associated with a statistically significant decreased odds of lipid core presence compared to intake in a majority of participants (OR Q5 vs. Q2–4: 0.64, 95% CI 0.42 to 0.98; OR Q1 vs. Q2–4: 0.64, 95% CI 0.42, 0.96), however, the association with lipid core was attenuated by adjustment for maximum wall thickness, hypertension, hyperlipidemia, and diabetes. Conclusions GI and polyunsaturated fat intake were not associated with high-risk plaque features, such as lipid core presence, independent of traditional vascular risk factors. PMID:27234460

Polyunsaturated fats, carbohydrates and carotid disease: The Atherosclerosis Risk in Communities (ARIC) Carotid MRI study.

PubMed

Dearborn, Jennifer L; Qiao, Ye; Guallar, Eliseo; Steffen, Lyn M; Gottesman, Rebecca F; Zhang, Yiyi; Wasserman, Bruce A

2016-08-01

Carbohydrates and fat intake have both been linked to development of atherosclerosis. We examined associations between glycemic index (GI) and fat intake with carotid atherosclerosis. The Atherosclerosis Risk in Communities (ARIC) cohort enrolled participants during the period 1987-1989 and the Carotid MRI sub-study occurred between 2004 and 2006 (1672 participants attending both visits). Measures of carbohydrate quality (usual GI), fat intake (total, polyunsaturated and saturated) and overall dietary quality index (DASH Diet Score) were derived from a 66-item food frequency questionnaire administered at baseline. Trained readers measured lipid core presence and maximum wall thickness. Using multivariate logistic regression, we determined the odds of lipid core presence by quintile (Q) of energy-adjusted dietary components. Restricted cubic spline models were used to examine non-linear associations between dietary components and maximum wall thickness. Mean daily polyunsaturated fat intake was 5 g (SD 1.4). GI and polyunsaturated fat intake had a nonlinear relationship with maximum wall thickness. Low (1-4 g) and high (6-12 g) polyunsaturated fat intake were associated with a statistically significant decreased odds of lipid core presence compared to intake in a majority of participants (OR Q5 vs. Q2-4: 0.64, 95% CI 0.42 to 0.98; OR Q1 vs. Q2-4: 0.64, 95% CI 0.42, 0.96), however, the association with lipid core was attenuated by adjustment for maximum wall thickness, hypertension, hyperlipidemia, and diabetes. GI and polyunsaturated fat intake were not associated with high-risk plaque features, such as lipid core presence, independent of traditional vascular risk factors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Consumption of a high glycemic load but not a high glycemic index diet is marginally associated with oxidative stress in young women.

PubMed

Arikawa, Andrea Y; Jakits, Holly E; Flood, Andrew; Thomas, William; Gross, Myron; Schmitz, Kathryn H; Kurzer, Mindy S

2015-01-01

Research studies have suggested that chronic consumption of high glycemic index foods may lead to chronically high oxidative stress. This is important because oxidative stress is suspected to be an early event in the etiology of many disease processes. We hypothesized that dietary glycemic index and glycemic load were positively associated with oxidative stress assessed by plasma F2-isoprostanes in healthy, premenopausal women (body mass index [BMI] = 24.7 ± 4.8 kg/m(2) and age 25.3 ± 3.5 years, mean ± SD). We measured plasma F2-isoprostanes in 306 healthy premenopausal women at the baseline visit for the Women In Steady Exercise Research study, using gas chromatography-mass spectrometry. Dietary glycemic index and load were calculated from the National Cancer Institute Diet History Questionnaire, and participants were divided into quartiles of dietary glycemic index and of glycemic load. Plasma F2-isoprostanes were compared across quartile groups of dietary glycemic index and glycemic load using linear regression models. Plasma F2-isoprostanes (pg/mL) increased with quartile of glycemic load (test for linear trend, P = .033), and also increased with quartile of glycemic index in participants with BMI ≥ 25 (P = .035) but not in those with BMI <25 (P = .924). After adjustment for BMI, alcohol consumption and total energy intake, both these positive trends remained marginally significant (P = .123 for quartiles of glycemic index and P = .065 for quartiles of glycemic load). Copyright © 2015 Elsevier Inc. All rights reserved.

Carbohydrate nutrition and inflammatory disease mortality in older adults.

PubMed

Buyken, Anette E; Flood, Victoria; Empson, Marianne; Rochtchina, Elena; Barclay, Alan W; Brand-Miller, Jennie; Mitchell, Paul

2010-09-01

Several studies suggest that carbohydrate nutrition is related to oxidative stress and inflammatory markers. We examined whether dietary glycemic index (GI), dietary fiber, and carbohydrate-containing food groups were associated with the mortality attributable to noncardiovascular, noncancer inflammatory disease in an older Australian cohort. Analysis included 1490 postmenopausal women and 1245 men aged ge 49 y at baseline (1992-1994) from a population-based cohort who completed a validated food-frequency questionnaire. Cox proportional hazards ratios were calculated both for death from diseases in which inflammation or oxidative stress was a predominant contributor and for cardiovascular mortality. Over a 13-y period, 84 women and 86 men died of inflammatory diseases. Women in the highest GI tertile had a 2.9-fold increased risk of inflammatory death compared with women in the lowest GI tertile [multivariate hazard ratio in energy-adjusted tertile 3 (tertile 1 as reference): 2.89; 95% CI: 1.52, 5.51; P for trend: 0.0006, adjusted for age, smoking, diabetes, and alcohol and fiber consumption]. Increasing intakes of foods high in refined sugars or refined starches (P = 0.04) and decreasing intakes of bread and cereals (P = 0.008) or vegetables other than potatoes (P = 0.007) also independently predicted a greater risk, with subjects' GI partly explaining these associations. In men, only an increased consumption of fruit fiber (P = 0.005) and fruit (P = 0.04) conferred an independent decrease in risk of inflammatory death. No associations were observed with cardiovascular mortality. These data provide new epidemiologic evidence of a potentially important link between GI and inflammatory disease mortality among older women.

Magnesium Intake, Quality of Carbohydrates, and Risk of Type 2 Diabetes: Results From Three U.S. Cohorts.

PubMed

Hruby, Adela; Guasch-Ferré, Marta; Bhupathiraju, Shilpa N; Manson, JoAnn E; Willett, Walter C; McKeown, Nicola M; Hu, Frank B

2017-12-01

Magnesium intake is inversely associated with risk of type 2 diabetes in many observational studies, but few have assessed this association in the context of the carbohydrate quality of the diet. We hypothesized that higher magnesium intake is associated with lower risk of type 2 diabetes, especially in the context of a poor carbohydrate-quality diet characterized by low cereal fiber or high glycemic index (GI) or glycemic load (GL). In the Nurses' Health Study (NHS; 1984-2012, n = 69,176), NHS2 (1991-2013, n = 91,471), and the Health Professionals' Follow-Up Study (1986-2012, n = 42,096), dietary intake was assessed from food frequency questionnaires every 4 years. Type 2 diabetes was ascertained by biennial and supplementary questionnaires. We calculated multivariate hazard ratios (HRs) of magnesium intake and incident diabetes, adjusted for age, BMI, family history of diabetes, physical activity, smoking, hypertension, hypercholesterolemia, GL, energy intake, alcohol, cereal fiber, polyunsaturated fats, trans fatty acids, and processed meat, and we considered the joint associations of magnesium and carbohydrate quality on diabetes risk. We documented 17,130 incident cases of type 2 diabetes over 28 years of follow-up. In pooled analyses across the three cohorts, those with the highest magnesium intake had 15% lower risk of type 2 diabetes compared with those with the lowest intake (pooled multivariate HR in quintile 5 vs. 1: 0.85 [95% CI 0.80-0.91], P < 0.0001). Higher magnesium intake was more strongly associated with lower risk of type 2 diabetes among participants with high GI or low cereal fiber than among those with low GI or high cereal fiber (both P interaction <0.001). Higher magnesium intake is associated with lower risk of type 2 diabetes, especially in the context of lower carbohydrate-quality diets. © 2017 by the American Diabetes Association.

Breakfast staple types affect brain gray matter volume and cognitive function in healthy children.

PubMed

Taki, Yasuyuki; Hashizume, Hiroshi; Sassa, Yuko; Takeuchi, Hikaru; Asano, Michiko; Asano, Kohei; Kawashima, Ryuta

2010-12-08

Childhood diet is important for brain development. Furthermore, the quality of breakfast is thought to affect the cognitive functioning of well-nourished children. To analyze the relationship among breakfast staple type, gray matter volume, and intelligence quotient (IQ) in 290 healthy children, we used magnetic resonance images and applied voxel-based morphometry. We divided subjects into rice, bread, and both groups according to their breakfast staple. We showed that the rice group had a significantly larger gray matter ratio (gray matter volume percentage divided by intracranial volume) and significantly larger regional gray matter volumes of several regions, including the left superior temporal gyrus. The bread group had significantly larger regional gray and white matter volumes of several regions, including the right frontoparietal region. The perceptual organization index (POI; IQ subcomponent) of the rice group was significantly higher than that of the bread group. All analyses were adjusted for age, gender, intracranial volume, socioeconomic status, average weekly frequency of having breakfast, and number of side dishes eaten for breakfast. Although several factors may have affected the results, one possible mechanism underlying the difference between the bread and the rice groups may be the difference in the glycemic index (GI) of these two substances; foods with a low GI are associated with less blood-glucose fluctuation than are those with a high GI. Our study suggests that breakfast staple type affects brain gray and white matter volumes and cognitive function in healthy children; therefore, a diet of optimal nutrition is important for brain maturation during childhood and adolescence.

Assay for hypoglycemic functional food of cocoyam (Xanthosoma sagittifolium (L.) Schott.) tuber

NASA Astrophysics Data System (ADS)

Handajani, N. S.; Harini, M.; Yuliningsih, R.; Afianatuzzahra, S.; Hasanah, U.; Widiyani, T.

2018-03-01

Diabetes Mellitus (DM) type II is a degenerative disease that is a major killer in many countries. It is characterized by an increase of the blood glucose level above normal. It is important to choose an appropriate food sources using glycemic index (GI) concept in order to prevent blood glucose increase. One of Indonesian traditional carbohydrate source is cocoyam (Xanthosoma sagittifolium (L.) Schott.) tuber. The tuber is assumed having a higher carbohydrate content with lower GI. The research aims to measure GI of cocoyam tuber (CT) and determine glucose and glycogen level in animal model after CT fed. Experimental research was carried out by using completely randomized design. We used twenty four male rats as animal models. They were grouped in to 4 different treatments. Group I was treated with standard feed, group II was treated with standard feed and glucose, group III was treated with steamed CT, and group IV was treated hypoglicemic agent standard, glibencamide. The research results that GI of steamed CT was low. It was 54. Blood glucose of diabetic rats after fed by CT decreased significantly (p<0.05), similar to diabetic rats after treated by glibencamide. Whereas glycogen level in diabetic rats after fed by CT was higher than in diabetic rats after fed by standard feed. Cocoyam tuber increased glycogen level in diabetic rats significantly (p<0,05). Glycogen level in diabetic rats fed by CT was as high as in healthy rats. Therefore CT is potential consumed for DM type II patients.

Effects of hypocaloric diets with different glycemic indexes on endothelial function and glycemic variability in overweight and in obese adult patients at increased cardiovascular risk.

PubMed

Buscemi, Silvio; Cosentino, Loretta; Rosafio, Giuseppe; Morgana, Manuela; Mattina, Alessandro; Sprini, Delia; Verga, Salvatore; Rini, Giovam Battista

2013-06-01

The role of glycemic index of the diet in glucose control and cardiovascular prevention is still not clear. The aim of this study was to determine the effects of hypocaloric diets with different glycemic indexes and glycemic loads on endothelial function and glycemic variability in nondiabetic participants at increased cardiovascular risk. Forty nondiabetic obese participants were randomly assigned to a three-month treatment with either a low glycemic index (LGI; n=19) or high glycemic index (HGI; n=21) hypocaloric diet with similar macronutrient and fiber content. Endothelial function was measured as flow-mediated dilatation (FMD) of the brachial artery before and after dieting. In addition, 48-h continuous subcutaneous glucose monitoring was done before and after dieting in a subgroup of 24 participants. The amount of weight loss after dieting was similar in both groups. The glycemic index of the diet significantly influenced the FMD (P<0.005). In particular, the change of FMD was 2.3±2.6% following the LGI diet, and -0.9±3.6% after the HGI diet (P<0.005). The mean 48-h glycemia decreased significantly after dietary treatment (P<0.05), but no significant effect of the glycemic index of the diet on results was observed. The glycemic index of the diet significantly influenced the 48-h glycemic variability measured as coefficient of variability (CV%; P<0.001). The CV% decreased after the LGI diet (from 23.5 to 20.0%) and increased after the HGI diet (from 23.6 to 26.6%). The change in percentage of FMD was inversely correlated with the change in the 48-h glycemic CV% (r=-0.45; P<0.05). Endothelial function and glycemic variability ameliorate in association with the adherence to an LGI hypocaloric diet in nondiabetic obese persons. ISRCTN56834511. Copyright © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Low glycemic index diet, exercise and vitamin D to reduce breast cancer recurrence (DEDiCa): design of a clinical trial.

PubMed

Augustin, Livia S A; Libra, Massimo; Crispo, Anna; Grimaldi, Maria; De Laurentiis, Michele; Rinaldo, Massimo; D'Aiuto, Massimiliano; Catalano, Francesca; Banna, Giuseppe; Ferrau', Francesco; Rossello, Rosalba; Serraino, Diego; Bidoli, Ettore; Massarut, Samuele; Thomas, Guglielmo; Gatti, Davide; Cavalcanti, Ernesta; Pinto, Monica; Riccardi, Gabriele; Vidgen, Edward; Kendall, Cyril W C; Jenkins, David J A; Ciliberto, Gennaro; Montella, Maurizio

2017-01-23

Mechanisms influencing breast cancer (BC) development and recurrence include hyperglycemia, hyperinsulinemia, high insulin-like growth factor-1, high circulating estrogen, inflammation and impaired cellular differentiation/apoptosis. A lifestyle program that targets all the above mechanisms may be warranted. Low glycemic index (GI) foods produce lower post-prandial glucose and insulin responses and have been associated with lower BC risk. Moderate physical activity post-diagnosis reduces BC recurrence and mortality, partly explained by reduced insulin and estrogen levels. Vitamin D increases cell differentiation/apoptosis and high serum vitamin D levels improve BC survival. Yet no trial has evaluated the combined effect of a low GI diet, moderate physical activity and vitamin D supplementation on BC recurrence in the context of a Mediterranean lifestyle setting. Women (30-74 yr) who had undergone surgery for primary histologically confirmed BC (stages I-III) within the previous 12 months, in cancer centres in Italy, will be randomized to follow, for a maximum of 33 months, either a high intensity treatment (HIT) composed of low GI diet + exercise + vitamin D (60 ng/mL serum concentration) or a lower intensity treatment (LITE) with general advice to follow a healthy diet and exercise pattern + vitamin D to avoid insufficiency. Both interventions are on a background of a Mediterranean diet. Considering a 20% recurrence rate within 3 years for BC cases and a predicted rate of 10% in the HIT group, with power of 80% and two-sided alpha of 0.05, the subject number required will be 506 (n = 253 in each arm). Clinic visits will be scheduled every 3 months. Dietary and exercise counselling and vitamin D supplements will be given at each clinic visit when blood samples, anthropometric measures and 7-day food records will be collected. DEDiCa study aims to reduce BC recurrence in women with BC using a lifestyle approach with additional vitamin D and to investigate possible cardio-metabolic benefits as well as epigenetic modifications according to lifestyle changes. Given the supporting evidence and safety of the components of our intervention we believe it is feasible and urgent to test it in cancer patients. May 11, 2016; NCT02786875 . 2015-005147-14.

Glycemic Index Biscuits Formulation of Pedada Flour (Sonneratia caseolaris) with Tubers Starch

NASA Astrophysics Data System (ADS)

Jariyah; Susiloningsih, E. K. B.; Nilasari, K.

2018-01-01

The glycemic index of food is the level of food according to its effect on blood glucose levels. Foods with low glycemic index have been shown to improve glucose and fat levels in people with diabetes mellitus and improve insulin resistance. Pedada Fruits (Sonneratia caseolaris) is the one of mangrove fruits has a high fiber content, so it can be used as a raw material in biscuits production. The aim of this research to evaluate the glycemic index on the formula biscuit from the pedada flour and starch from white sweet potato, arrowroot, taro, potato and cassava mixed. This research used completely randomized design in factorial patern with one factor and five levels on formulation biscuit of pedada flour with tubers starch (20% : 80%). The biscuits product were measured of the proximate, crude fiber, glycemic index and glycemic load on wistar rats. The best treatment was 20% of pedada flour with 80% of taro starch which produced biscuit with 76.24% of yield, 2.58% of protein, 15.55% of fat, 2.72% of crude fiber, 48.83 of glycemic index and 7.39 of glycemic load.

Relation of Dietary Glycemic Index and Glycemic Load to Coronary Artery Calcium in Asymptomatic Korean Adults.

PubMed

Choi, Yuni; Chang, Yoosoo; Ryu, Seungho; Cho, Juhee; Kim, Mi Kyung; Ahn, Younjhin; Lee, Jung Eun; Sung, Eunju; Kim, Boyoung; Ahn, Jiin; Kim, Chan-Won; Rampal, Sanjay; Zhao, Di; Zhang, Yiyi; Pastor-Barriuso, Roberto; Lima, Joao A C; Chung, Eun Chul; Shin, Hocheol; Guallar, Eliseo

2015-08-15

The relation between glycemic index, glycemic load, and subclinical coronary atherosclerosis is unknown. The aim of the study was to evaluate the associations between energy-adjusted glycemic index, glycemic load, and coronary artery calcium (CAC). This study was cross-sectional analysis of 28,429 asymptomatic Korean men and women (mean age 41.4 years) without a history of diabetes or cardiovascular disease. All participants underwent a health screening examination between March 2011 and April 2013, and dietary intake over the preceding year was estimated using a validated food frequency questionnaire. Cardiac computed tomography was used for CAC scoring. The prevalence of detectable CAC (CAC score >0) was 12.4%. In multivariable-adjusted models, the CAC score ratios (95% confidence intervals) comparing the highest to the lowest quintile of glycemic index and glycemic load were 1.74 (1.08 to 2.81; p trend = 0.03) and 3.04 (1.43 to 6.46; p trend = 0.005), respectively. These associations did not differ by clinical subgroups, including the participants at low cardiovascular risk. In conclusion, these findings suggest that high dietary glycemic index and glycemic load were associated with a greater prevalence and degree of CAC, with glycemic load having a stronger association. Copyright © 2015 Elsevier Inc. All rights reserved.

Nutritional composition, glycemic index, glycemic load, and organoleptical quality of glucomannan-enriched soy milk ice cream

NASA Astrophysics Data System (ADS)

Sa'adah, S.; Candra, O. M.; Nugrahani, G.; Pramono, A.; Afifah, D. N.

2018-01-01

Over the past decades, the number of childhood obesity cases has increased significantly, which led to an increase in the number of adults suffering from degenerative diseases such as diabetes mellitus (DM). Glucomannan-Enriched Soy Milk Ice Cream (GSMIC) may prevent obesity in children. The aim of the study was to test the level of carbohydrates, protein, fat, dietary fiber, glycemic index, glycemic load, and organoleptic quality of GSMIC. This experiment used a completely randomized design to test three formulations of glucomannan flour and soy milk (0.5%, 1.5%, and 2.5%). The products were tested for nutritional composition, and evaluated on glycemic index, glycemic load, and organoleptic quality. GSMIC 2.5% had higher levels of dietary fiber and high carbohydrate, protein, and fat content compared to ice cream (3.99%, 30.7%, 1.50%, 1.33%, respectively). The glycemic index of ice cream and 2.5% GSMIC were 75.83 (75%) and 51.48 (51%), respectively, while the glycemic load of ice cream and 2.5% GSMIC were 9.04 and 11.61, respectively. Based on the organoleptic analysis, formulation preferred by the panellists was 2.5% glucomannan flour. Glucomannan flour affected the level of carbohydrates, protein, fat, dietary fiber, glycemic index, glycemic load, and organoleptic quality in soy milk ice cream.

Effects of High vs Low Glycemic Index of Dietary Carbohydrate on Cardiovascular Disease Risk Factors and Insulin Sensitivity

PubMed Central

Sacks, Frank M.; Carey, Vincent J.; Anderson, Cheryl A. M.; Miller, Edgar R.; Copeland, Trisha; Charleston, Jeanne; Harshfield, Benjamin J.; Laranjo, Nancy; McCarron, Phyllis; Swain, Janis; White, Karen; Yee, Karen; Appel, Lawrence J.

2015-01-01

IMPORTANCE Foods that have similar carbohydrate content can differ in the amount they raise blood glucose. The effects of this property, called the glycemic index, on risk factors for cardiovascular disease and diabetes are not well understood. OBJECTIVE To determine the effect of glycemic index and amount of total dietary carbohydrate on risk factors for cardiovascular disease and diabetes. DESIGN, SETTING, AND PARTICIPANTS Randomized crossover-controlled feeding trial conducted in research units in academic medical centers, in which 163 overweight adults (systolic blood pressure, 120–159 mm Hg) were given 4 complete diets that contained all of their meals, snacks, and calorie-containing beverages, each for 5 weeks, and completed at least 2 study diets. The first participant was enrolled April 1, 2008; the last participant finished December 22, 2010. For any pair of the 4 diets, there were 135 to 150 participants contributing at least 1 primary outcome measure. INTERVENTIONS (1) A high–glycemic index (65% on the glucose scale), high-carbohydrate diet (58% energy); (2) a low–glycemic index (40%), high-carbohydrate diet; (3) a high–glycemic index, low-carbohydrate diet (40% energy); and (4) a low–glycemic index, low-carbohydrate diet. Each diet was based on a healthful DASH-type diet. MAIN OUTCOMES AND MEASURES The 5 primary outcomes were insulin sensitivity, determined from the areas under the curves of glucose and insulin levels during an oral glucose tolerance test; levels of low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides; and systolic blood pressure. RESULTS At high dietary carbohydrate content, the low– compared with high–glycemic index level decreased insulin sensitivity from 8.9 to 7.1 units (−20%, P = .002); increased LDL cholesterol from 139 to 147 mg/dL (6%, P ≤ .001); and did not affect levels of HDL cholesterol, triglycerides, or blood pressure. At low carbohydrate content, the low– compared with high–glycemic index level did not affect the outcomes except for decreasing triglycerides from 91 to 86 mg/dL (−5%, P = .02). In the primary diet contrast, the low–glycemic index, low-carbohydrate diet, compared with the high–glycemic index, high-carbohydrate diet, did not affect insulin sensitivity, systolic blood pressure, LDL cholesterol, or HDL cholesterol but did lower triglycerides from 111 to 86 mg/dL (−23%, P ≤ .001). CONCLUSIONS AND RELEVANCE In this 5-week controlled feeding study, diets with low glycemic index of dietary carbohydrate, compared with high glycemic index of dietary carbohydrate, did not result in improvements in insulin sensitivity, lipid levels, or systolic blood pressure. In the context of an overall DASH-type diet, using glycemic index to select specific foods may not improve cardiovascular risk factors or insulin resistance. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00608049 PMID:25514303

Carbohydrate nutrition differs by diabetes status and is associated with dyslipidemia in Boston Puerto Rican adults without diabetes.

PubMed

Van Rompay, Maria I; McKeown, Nicola M; Castaneda-Sceppa, Carmen; Ordovás, José M; Tucker, Katherine L

2013-02-01

Puerto Rican adults have a greater prevalence of type 2 diabetes (T2D) and lower HDL-cholesterol (HDL-C) than the general U.S. population. Carbohydrate nutrition may play a role in this disparity. Cross-sectional analyses included data from 1219 Puerto Ricans aged 45-75 y enrolled in the Boston Puerto Rican Health Study. Using the Pearson chi-square test and ANCOVA, lifestyle characteristics and dietary intake, as assessed by semiquantitative FFQ, were compared by T2D status based on fasting plasma glucose concentration and medication use. Food source rankings for carbohydrate, dietary glycemic load (GL), and fiber were obtained using the SAS procedure PROC RANK. Geometric mean plasma HDL-C and TG concentrations were compared across quintiles of dietary carbohydrate, glycemic index (GI), GL, and fiber by using ANCOVA and tests for linear trend. In multivariable analyses, individuals with T2D (39.5%) had lower dietary carbohydrate, GL, and total sugar intake from lower intake of sugar, fruit drinks, and soda compared with those without T2D. In individuals without T2D, dietary carbohydrate and GL were inversely associated with HDL-C (P < 0.0001). Associations between dietary fiber and HDL-C were confounded by carbohydrate intake, apparently from concurrent consumption of legumes with white rice, a refined carbohydrate food. No associations were observed between carbohydrate, dietary GI, GL, or fiber and TG. In conclusion, individuals with T2D showed evidence of dietary modification. Among those without diabetes, a high intake of refined carbohydrates was associated with decreased HDL-C. Longitudinal research on carbohydrate nutrition in relation to diabetes risk factors and blood lipids in Puerto Ricans is warranted.

Carbohydrates, glycemic index, glycemic load, and breast cancer risk: a systematic review and dose-response meta-analysis of prospective studies.

PubMed

Schlesinger, Sabrina; Chan, Doris S M; Vingeliene, Snieguole; Vieira, Ana R; Abar, Leila; Polemiti, Elli; Stevens, Christophe A T; Greenwood, Darren C; Aune, Dagfinn; Norat, Teresa

2017-06-01

The investigation of dose-response associations between carbohydrate intake, glycemic index, glycemic load, and risk of breast cancer stratified by menopausal status, hormone receptor status, and body mass index (BMI) remains inconclusive. A systematic review and dose-response meta-analyses was conducted to investigate these associations. As part of the World Cancer Research Fund/American Institute for Cancer Research Continuous Update Project, PubMed was searched up to May 2015 for relevant studies on these associations. Prospective studies reporting associations between carbohydrate intake, glycemic index, or glycemic load and breast cancer risk were included. Two investigators independently extracted data from included studies. Random-effects models were used to summarize relative risks (RRs) and 95%CIs. Heterogeneity between subgroups, including menopausal status, hormone receptor status, and BMI was explored using meta-regression. Nineteen publications were included. The summary RRs (95%CIs) for breast cancer were 1.04 (1.00-1.07) per 10 units/d for glycemic index, 1.01 (0.98-1.04) per 50 units/d for glycemic load, and 1.00 (0.96-1.05) per 50 g/d for carbohydrate intake. For glycemic index, the association appeared slightly stronger among postmenopausal women (summary RR per 10 units/d, 1.06; 95%CI, 1.02-1.10) than among premenopausal women, though the difference was not statistically significant (Pheterogeneity = 0.15). Glycemic load and carbohydrate intake were positively associated with breast cancer among postmenopausal women with estrogen-negative tumors (summary RR for glycemic load, 1.28; 95%CI, 1.08-1.52; and summary RR for carbohydrates, 1.13; 95%CI, 1.02-1.25). No differences in BMI were detected. Menopausal and hormone receptor status, but not BMI, might be potential influencing factors for the associations between carbohydrate intake, glycemic index, glycemic load, and breast cancer. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Diets with High or Low Protein Content and Glycemic Index for Weight-Loss Maintenance

PubMed Central

Larsen, Thomas Meinert; Dalskov, Stine-Mathilde; van Baak, Marleen; Jebb, Susan A.; Papadaki, Angeliki; Pfeiffer, Andreas F.H.; Martinez, J. Alfredo; Handjieva-Darlenska, Teodora; Kunešová, Marie; Pihlsgård, Mats; Stender, Steen; Holst, Claus; Saris, Wim H.M.; Astrup, Arne

2012-01-01

Background Studies of weight-control diets that are high in protein or low in glycemic index have reached varied conclusions, probably owing to the fact that the studies had insufficient power. Methods We enrolled overweight adults from eight European countries who had lost at least 8% of their initial body weight with a 3.3-MJ (800-kcal) low-calorie diet. Participants were randomly assigned, in a two-by-two factorial design, to one of five ad libitum diets to prevent weight regain over a 26-week period: a low-protein and low-glycemic-index diet, a low-protein and high-glycemic-index diet, a high-protein and low-glycemic-index diet, a high-protein and high-glycemic-index diet, or a control diet. Results A total of 1209 adults were screened (mean age, 41 years; body-mass index [the weight in kilograms divided by the square of the height in meters], 34), of whom 938 entered the low-calorie-diet phase of the study. A total of 773 participants who completed that phase were randomly assigned to one of the five maintenance diets; 548 completed the intervention (71%). Fewer participants in the high-protein and the low-glycemic-index groups than in the low-protein–high-glycemic-index group dropped out of the study (26.4% and 25.6%, respectively, vs. 37.4%; P = 0.02 and P = 0.01 for the respective comparisons). The mean initial weight loss with the low-calorie diet was 11.0 kg. In the analysis of participants who completed the study, only the low-protein–high-glycemic-index diet was associated with subsequent significant weight regain (1.67 kg; 95% confidence interval [CI], 0.48 to 2.87). In an intention-to-treat analysis, the weight regain was 0.93 kg less (95% CI, 0.31 to 1.55) in the groups assigned to a high-protein diet than in those assigned to a low-protein diet (P = 0.003) and 0.95 kg less (95% CI, 0.33 to 1.57) in the groups assigned to a low-glycemic-index diet than in those assigned to a high-glycemic-index diet (P = 0.003). The analysis involving participants who completed the intervention produced similar results. The groups did not differ significantly with respect to diet-related adverse events. Conclusions In this large European study, a modest increase in protein content and a modest reduction in the glycemic index led to an improvement in study completion and maintenance of weight loss. (Funded by the European Commission; ClinicalTrials.gov number, NCT00390637.) PMID:21105792

Glycemia and peak incremental indices of six popular fruits in Taiwan: healthy and Type 2 diabetes subjects compared

PubMed Central

Chen, Ya-Yen; Wu, Pin-Ching; Weng, Shuen-Fu; Liu, Jen-Fang

2011-01-01

The aim of this study was to evaluate the glycemic index and peak incremental indices of six popular fruits in Taiwan, comparing healthy subjects (n = 20) and patients with Type 2 diabetes (n = 17). The six kinds of fruits tested were grapes, Asian pears, guavas, golden kiwifruit, lychees and bananas. Glycemic index values were tested according to the standard glycemic index testing protocol. The glycemic index and peak incremental indices were calculated according to published formulas. In Type 2 diabetes subjects, the glycemic index values of grapes, Asian pears, guavas, golden kiwifruit, lychees and bananas were 49.0 ± 4.5, 25.9 ± 2.9, 32.8 ± 5.2, 47.0 ± 6.5, 60.0 ± 8.0 and 41.3 ± 3.5. In healthy subjects, the glycemic index values were 49.1 ± 7.3, 18.0 ± 5.4, 31.1 ± 5.1, 47.3 ± 12.1, 47.9 ± 6.8 and 35.1 ± 5.6. There was no significant difference in glycemic index values between healthy and Type 2 diabetes subjects. There was also no significant difference in PII when comparing healthy subjects and subjects with Type 2 diabetes. In conclusion, glycemic index and peak incremental indices in healthy subjects can be approximately the same for Type 2 diabetes. PMID:22128219

Dietary glycemic factors, insulin resistance, and adiponectin levels in acne vulgaris.

PubMed

Çerman, Aslı Aksu; Aktaş, Ezgi; Altunay, İlknur Kıvanç; Arıcı, Janset Erkul; Tulunay, Aysın; Ozturk, Feyza Yener

2016-07-01

There is increasing evidence to support the relationship between acne vulgaris and diet. The aim of this study was to investigate possible associations among dietary glycemic index, glycemic load, milk consumption, insulin resistance, and adiponectin levels in the pathogenesis of acne vulgaris. The dietary glycemic index, glycemic load, milk consumption, fasting glucose, insulin, insulin-like growth factor)-1, insulin-like growth factor binding protein-3, adiponectin, and homeostasis model assessment of insulin resistance values of 50 patients with acne vulgaris and 36 healthy control subjects were measured. Glycemic index and glycemic load levels were significantly higher (P = .022 and P = .001, respectively) and serum adiponectin levels were significantly lower (P = .015) in patients with acne than in the control subjects. There was an inverse correlation between serum adiponectin concentration and glycemic index (P = .049, r = -0.212). This study used a cross-sectional design and the study population was limited to young, nonobese adults. A high-glycemic-index/-load diet was positively associated with acne vulgaris. Adiponectin may be a pathogenetic cofactor contributing to the development of the disease. Further research on adiponectin levels in patients with acne in terms of development of insulin resistance might be important in this possible relationship. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Altering source or amount of dietary carbohydrate has acute and chronic effects on postprandial glucose and triglycerides in type 2 diabetes: Canadian trial of Carbohydrates in Diabetes (CCD).

PubMed

Wolever, T M S; Gibbs, A L; Chiasson, J-L; Connelly, P W; Josse, R G; Leiter, L A; Maheux, P; Rabasa-Lhoret, R; Rodger, N W; Ryan, E A

2013-03-01

Nutrition recommendations for type 2 diabetes (T2DM) are partly guided by the postprandial responses elicited by diets varying in carbohydrate (CHO). We aimed to explore whether long-term changes in postprandial responses on low-glycemic-index (GI) or low-CHO diets were due to acute or chronic effects in T2DM. Subjects with diet-alone-treated T2DM were randomly assigned to high-CHO/high-GI (H), high-CHO/low-GI (L), or low-CHO/high-monounsaturated-fat (M) diets for 12-months. At week-0 (Baseline) postprandial responses after H-meals (55% CHO, GI = 61) were measured from 0800 h to 1600 h. After 12 mo subjects were randomly assigned to H-meals or study diet meals (L, 57% CHO, GI = 50; M, 44% CHO, GI = 61). This yielded 5 groups: H diet with H-meals (HH, n = 34); L diet with H- (LH, n = 17) or L-meals (LL, n = 16); and M diet with H- (MH, n = 18) or M meals (MM, n = 19). Postprandial glucose fluctuations were lower in LL than all other groups (p < 0.001). Changes in postprandial-triglycerides differed among groups (p < 0.001). After 12 mo in HH and MM both fasting- and postprandial-triglycerides were similar to Baseline while in MH postprandial-triglycerides were significantly higher than at Baseline (p = 0.028). In LH, triglycerides were consistently (0.18-0.34 mmol/L) higher than Baseline throughout the day, while in LL the difference from Baseline varied across the day from 0.04 to 0.36 mmol/L (p < 0.001). Low-GI and low-CHO diets have both acute and chronic effects on postprandial glucose and triglycerides in T2DM subjects. Thus, the composition of the acute test-meal and the habitual diet should be considered when interpreting the nutritional implications of different postprandial responses. Copyright © 2012 Elsevier B.V. All rights reserved.

Dietary Glycemic Load, Glycemic Index, and Carbohydrate Intake on the Risk of Lung Cancer among Men and Women in Shanghai.

PubMed

Sun, Jiang-Wei; Zheng, Wei; Li, Hong-Lan; Gao, Jing; Yang, Gong; Gao, Yu-Tang; Rothman, Nat; Lan, Qing; Shu, Xiao-Ou; Xiang, Yong-Bing

2018-01-01

To investigate the potential influence of dietary glycemic index, glycemic load, or carbohydrate intake and lung cancer risk in Shanghai. We prospectively investigated the associations among 130,858 participants in the Shanghai Women's and Men's Health Studies. Diet was assessed using validated food-frequency questionnaires. Lung cancer cases were ascertained through annual record linkage and every 2-3 years in-home visits. Cox proportional hazard regression model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). After excluding the first 2 years of observation, 1312 participants (including 649 women and 663 men) developed lung cancer during an average follow-up of 14.8 (SD: 2.0) years for SWHS and 9.3 (SD: 1.6) years for SMHS. In multivariable analysis, no statistically significant associations were observed between glycemic index, glycemic load, and carbohydrate intake and lung cancer risk for either men or women. Similar results were observed among never smokers, and participants without history of lung disease, diabetes, or hypertension. Stratification by body mass index or menopause status also did not alter the findings. Our studies, conducted in populations who habitually have high-carbohydrate diets, provide no evidence that dietary glycemic index, glycemic load, or carbohydrate intake is associated with lung cancer risk.

Glycemic index and disease.

PubMed

Pi-Sunyer, F Xavier

2002-07-01

It has been suggested that foods with a high glycemic index are detrimental to health and that healthy people should be told to avoid these foods. This paper takes the position that not enough valid scientific data are available to launch a public health campaign to disseminate such a recommendation. This paper explores the glycemic index and its validity and discusses the effect of postprandial glucose and insulin responses on food intake, obesity, type 1 diabetes, and cardiovascular disease. Presented herein are the reasons why it is premature to recommend that the general population avoid foods with a high glycemic index.

Physicochemical properties and in vitro digestibility of starch from naturally air-dried chestnut.

PubMed

Zhao, Jinkai; Zhang, Yuyang; Wu, Yanwen; Liu, Lingling; Ouyang, Jie

2018-06-08

Naturally air-dried chestnut is a type of traditionally processed chestnut in North China which has a pleasant flavor. After air drying at room temperature and low-air humidity for two wk, the moisture, total starch content and starch relative crystallinity decreased, while the content of water-soluble sugar and amylose increased because of the dehydration and the hydrolysis of endogenous amylase. The Fourier transform infrared (FTIR) spectroscopy ratio of 1047/1022 cm -1 and the relative area of the Raman spectrum peak at 480/865 cm -1 of air-dried chestnut starch decreased in the first two wk and then increased, while the full width at half-maximum height (FWHH) of the Raman spectrum peak at 480 cm -1 showed the opposite tendency. Crystallinity had a positive correlation with the springiness and chewiness, and was negatively correlated with the estimated glycemic index (eGI). The eGI of air-dried starch was lower than those of roasted or boiled starch, which indicated that naturally air-dried chestnut with low digestibility is a good alternative to thermally processed chestnut. Copyright © 2017. Published by Elsevier B.V.

Dietary glycemic index, glycemic load and incidence of type 2 diabetes in Japanese men and women: the Japan Public Health Center-based Prospective Study.

PubMed

Oba, Shino; Nanri, Akiko; Kurotani, Kayo; Goto, Atsushi; Kato, Masayuki; Mizoue, Tetsuya; Noda, Mitsuhiko; Inoue, Manami; Tsugane, Shoichiro

2013-12-27

Japanese diets contain a relatively high amount of carbohydrates, and its high dietary glycemic index and glycemic load may raise the risk of diabetes in the Japanese population. The current study evaluated the associations between the dietary glycemic index, glycemic load, and the risk of type 2 diabetes in a population based cohort in Japan. We observed 27,769 men and 36,864 women (45-75 y) who participated in the second survey of the Japan Public Health Center-based Prospective Study. The dietary glycemic index and glycemic load were estimated using a food-frequency questionnaire. The development of diabetes was reported in a questionnaire administered five years later, and the associations were analyzed using logistic regression after controlling for age, area, total energy intake, smoking status, family history of diabetes, physical activity, hypertension, BMI, alcohol intake, magnesium, calcium, dietary fiber and coffee intake, and occupation. The dietary glycemic load was positively associated with the risk of diabetes among women: the multivariable-adjusted odds ratio comparing the highest vs. the lowest quartile was 1.52 (95% CI, 1.13-2.04; P-trend = 0.01). The association was implied to be stronger among women with BMI < 25 than the women with BMI ≥ 25. The dietary glycemic index was positively associated with the risk of diabetes among men with a high intake of total fat: the multivariable-adjusted odds ratio comparing the highest vs. the lowest quartile was 1.46 (95% CI, 0.94-2.28; P-trend = 0.04). Among women with a high total fat intake, those in the first and second quartiles of the dietary glycemic index had a significant reduced risk of diabetes, compared with those in the first quartile who had a lower total fat level (multivariable-adjusted odds ratio = 0.59 with 95% CI, 0.37-0.94, and odds ratio = 0.63 with 95% CI, 0.40-0.998 respectively). The population-based cohort study in Japan indicated that diets with a high dietary glycemic load increase the risk of type 2 diabetes among women. Total fat intake may modify the association between the dietary glycemic index and the risk of type 2 diabetes among men and women.

The impact of eating methods on eating rate and glycemic response in healthy adults.

PubMed

Sun, Lijuan; Ranawana, Dinesh Viren; Tan, Wei Jie Kevin; Quek, Yu Chin Rina; Henry, Christiani Jeyakumar

2015-02-01

Singapore is an island state that is composed of three major ethnic groups, namely Chinese, Malay and Indian. Its inhabitants consume food either using chopsticks (Chinese), fingers (Malay and Indian) or spoon (Chinese, Malay and Indian). Previous work by our group showed that the degree of mastication significantly influenced the glycemic response. The degree of mastication in turn may depend on the eating method as the amount of food taken per mouthful and chewing time differs between eating methods. Eleven healthy volunteers came in on six non-consecutive days to the laboratory and evaluated three methods of eating white rice (spoon, chopsticks and fingers) once and the reference food (glucose solution) three times in a random order. Their glycemic response (GR) was measured for the subsequent 120 min. Mastication parameters were determined using surface electrode electromyography. The GR to white rice eating with chopsticks was significantly lower than spoon. The GI of eating rice with chopsticks was 68 which is significantly lower than eating with spoon (GI=81). However there were no differences between fingers and spoon, and between fingers and chopsticks either in GR 120 min or GI. The inter-individual number of mouthful, number of chews per mouthful, chewing time per mouthful and the total time taken to consume the whole portion of rice were significantly different between spoon and chopsticks groups. Significant correlations between the number of mouthful to take the entire portion of rice and amount of rice per mouthful during mastication and the GR were observed for eating rice with spoon and chopsticks, but not for fingers. The results suggest that individual differences in number of mouthful and amount of rice per mouthful may be two of the causes for inter-individual differences in the GR between spoon and chopsticks. The present study suggests that eating rice with different feeding tools has different chewing times and amount of food taken per mouthful and then alters the GI of the rice. Copyright © 2014 Elsevier Inc. All rights reserved.

Metabolic responses to prolonged consumption of glucose- and fructose-sweetened beverages are not associated with postprandial or 24-h glucose and insulin excursions123

PubMed Central

Stanhope, Kimber L; Griffen, Steven C; Bremer, Andrew A; Vink, Roel G; Schaefer, Ernst J; Nakajima, Katsuyuki; Schwarz, Jean-Marc; Beysen, Carine; Berglund, Lars; Keim, Nancy L; Havel, Peter J

2011-01-01

Background: Consumption of sugar-sweetened beverages has been shown to be associated with dyslipidemia, insulin resistance, fatty liver, diabetes, and cardiovascular disease. It has been proposed that adverse metabolic effects of chronic consumption of sugar-sweetened beverages are a consequence of increased circulating glucose and insulin excursions, ie, dietary glycemic index (GI). Objective: We determined whether the greater adverse effects of fructose than of glucose consumption were associated with glucose and insulin exposures. Design: The subjects were studied in a metabolic facility and consumed energy-balanced diets containing 55% of energy as complex carbohydrate for 2 wk (GI = 64). The subjects then consumed 25% of energy requirements as fructose- or glucose-sweetened beverages along with their usual ad libitum diets for 8 wk at home and then as part of energy-balanced diets for 2 wk at the metabolic facility (fructose GI = 38, glucose GI = 83). The 24-h glucose and insulin profiles and fasting plasma glycated albumin and fructosamine concentrations were measured 0, 2, 8, and 10 wk after beverage consumption. Results: Consumption of fructose-sweetened beverages lowered glucose and insulin postmeal peaks and the 23-h area under the curve compared with the baseline diet and with the consumption of glucose-sweetened beverages (all P < 0.001, effect of sugar). Plasma glycated albumin concentrations were lower 10 wk after fructose than after glucose consumption (P < 0.01, effect of sugar), whereas fructosamine concentrations did not differ between groups. Conclusion: The results suggest that the specific effects of fructose, but not of glucose and insulin excursions, contribute to the adverse effects of consuming sugar-sweetened beverages on lipids and insulin sensitivity. This study is registered at clinicaltrials.gov as NCT01165853. PMID:21613559

[The glycemic index of some foods common in Mexico].

PubMed

Frati-Munari, A C; Roca-Vides, R A; López-Pérez, R J; de Vivero, I; Ruiz-Velazco, M

1991-01-01

To investigate the increase of glycemia due to the ingestion of usual food in Mexico, portions with 50 g of carbohydrate form white corn tortilla, yellow corn tortilla, spaghetti, rice, potatoes, beans brown and black, nopal (prickle pear cactus) and peanuts, compared with white bread, were given to 21 healthy and 27 non-insulin-dependent diabetic subjects. Serum glucose and insulin were measured every 30 min for 180 min long. Glycemic index was obtained as: (area under curve of glucose with test food/area under curve of glucose with white bread) X 100. A corrected index was calculated subtracting the area corresponding to initial values. Insulin index was obtained similarly. Each sample was studied 14-18 times. Glycemic and insulin indexes of white and yellow corn tortilla, spaghetti, rice and potatoes were not different from bread (P greater than 0.05). Corrected glycemic indexes of brown beans (54 +/- 15, +/- SE) and black beans (43 +/- 17) were low (p less than 0.05), as well as corrected insulin indexes (69 +/- 11 and 64 +/- 10 respectively, (P less than 0.02). Peanuts had low glycemic (33 +/- 17, P less than 0.01), but normal insulin index. Nopal had very low glycemic and insulin indexes (10 +/- 17 and 10 +/- 16, P less than 0.0001). These data might be useful in prescribing diets for diabetic subjects.

Effects of consumption of sucromalt, a slowly digestible carbohydrate, on mental and physical energy questionnaire responses.

PubMed

Dammann, Kristen W; Bell, Margie; Kanter, Mitch; Berger, Alvin

2013-03-01

To evaluate whether consumption of the low-glycemic index (GI) carbohydrate sucromalt improves healthy adults' perceptions of mental and physical energy and fatigue compared to dextrose (glucose), a high GI control. In this double-blind, randomized, cross-over study, subjects (n = 44 healthy adults) consumed a standardized dinner, and following an overnight fast, ingested 75 g of either sucromalt or glucose in solution at 7:30 AM the next day. Subjects completed validated questionnaires that assessed mental and physical energy, and fatigue, hunger, and sleepiness at baseline and hourly until 12:30 PM for a total of five post-consumption time points. Within-subject differences adjusted for baseline for individual questions and composite scores (Mental Energy State, Mental Fatigue State, Physical Energy State, and Physical Fatigue State) were analyzed using repeated measures analysis of variance. Mental Energy State, Physical Energy State, and Physical Fatigue State results favored sucromalt compared to glucose, with significant differences emerging particularly after 4-5 hours (P < 0.050). A trend toward a delay in Mental Fatigue State was also observed with sucromalt compared to glucose (P < 0.100). Minimal differences in ratings of hunger and sleepiness were observed between the beverages. Sucromalt may help attenuate the perceived decline in mental and physical energy and rise in mental and physical fatigue that can occur 4-5 hours after ingestion of a high GI beverage. Trials examining effects of sucromalt on cognitive and physical performance are of future interest.

In vitro starch digestibility and expected glycemic index of pound cakes baked in two-cycle microwave-toaster and conventional oven.

PubMed

García-zaragoza, Francisco J; Sánchez-Pardo, María E; Ortiz-Moreno, Alicia; Bello-Pérez, Luis A

2010-11-01

Bread baking technology has an important effect on starch digestibility measured as its predicted glycemic index tested in vitro. The aim of this work was to evaluate the changes in predicted glycemic index of pound cake baked in a two-cycle microwave toaster and a conventional oven. The glycemic index was calculated from hydrolysis index values by the Granfeldt method. Non-significant differences (P > 0.05) were found in hydrolysis index (60.67 ± 3.96 for the product baked in microwave oven and 65.94 ± 4.09 for the product baked in conventional oven) and predicted glycemic index content (60.5 for product baked in microwave oven and 65 for the product baked in conventional oven) in freshly-baked samples. Results clearly demonstrate that the baking pound cake conventional process could be replicated using a two-cycle multifunction microwave oven, reducing the traditional baking time. Further research is required in order to achieve pound cake crumb uniformity.

Carbohydrate, glycemic index, and glycemic load and colorectal adenomas in the Prostate, Lung, Colorectal, and Ovarian Screening Study.

PubMed

Flood, Andrew; Peters, Ulrike; Jenkins, David J A; Chatterjee, Nilanjan; Subar, Amy F; Church, Timothy R; Bresalier, Robert; Weissfeld, Joel L; Hayes, Richard B; Schatzkin, Arthur

2006-11-01

It is possible that high-glycemic-load diets, through their hyperinsulinemic effects, can increase the risk of colorectal cancer. We analyzed data from a cancer screening study to determine whether persons with high-glycemic-load diets would be at an increased risk of distal adenomas. We included subjects with no prior adenoma or cancer from the Prostate, Lung, Colorectal, and Ovarian screening trial and whose results from flexible sigmoidoscopy exams indicated either no lesions (n = 34 817) or >/=1 distal adenoma (n = 3696). We used a 137-item food-frequency questionnaire to assess usual dietary intake over the preceding 12 mo. Using logistic regression analysis, we calculated, separately for men and women, prevalence odds ratios (ORs) and 95% CIs of sigmoidoscopy-detected, distal adenomas for quintiles of energy-adjusted dietary carbohydrate, glycemic index, and glycemic load. ORs decreased with increasing intakes of carbohydrate for both the men and the women in unadjusted models, but these associations were attenuated in multivariate-adjusted models. Among the men, the association remained significant after adjustment (OR: 0.71; 95% CI 0.60, 0.84; P for trend < 0.0001), but in the women it did not (OR: 0.89; 95% CI: 0.73, 1.10; P for trend = 0.30). The results for glycemic index showed no associations in either men or women. Results for glycemic load closely mirrored those for carbohydrate. Despite expectations that increasing glycemic load and glycemic index would increase the risk of adenoma, we observed no association in women and even an inverse association in men.

[Safety assessment of stevia rebaudiana bertoni grown in southeastern Mexico as food sweetener].

PubMed

Aranda-González, Irma; Barbosa-Martín, Enrique; Toraya-Avilés, Rocío; Segura-Campos, Maira; Moguel-Ordoñez, Yolanda; Betancur-Ancona, David

2014-09-01

Stevia rebaudiana leaves and their glycosides have been recently and significantly used so important as sweeteners. However, it has been reported an antihyperglycemic effect of the extract and a glycoside. The aim of this study was to quantify S. rebaudiana glycosides, assess cytotoxicity of the extract and its acute and chronic effect on blood glucose in animal models and in human. The glycosides of the Morita II and Criolla extract were quantified by HPLC, using a C18 column (250 mm x 4.6 mm and particle size of 5 uM) with UV detection at 210 nm, mobile phase of acetonitrile/sodium phosphate buffer 10 mmol/L, pH 2.6 (32:68 v/v). Cytotoxicity study was performed in Vero cells, whereas an intraperitoneal glucose tolerance test (IPGTT) and a chronic consumption assay (4 weeks) were executed in an animal model of diabetes; finally the glycemic index (G.I.) was determined in healthy individuals. The glycoside content is higher in the Morita variety II although both had a CC50 >300 g/mL. The areas under the curve of the IPGTT and fasting glucose of the animals were not significantly different (p> 0.05) and the I.G. extract was 11.11 %, which classifies the extract as low I.G. The extract of S. rebaudiana Morita II has a low glycemic index and, in the doses tested, is not cytotoxic nor has acute or chronic effect on blood sugar, which makes it a safe sweetener. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Inhibitory activity of phenolic-rich pistachio green hull extract-enriched pasta on key type 2 diabetes relevant enzymes and glycemic index.

PubMed

Lalegani, Sajjad; Ahmadi Gavlighi, Hassan; Azizi, Mohammad Hossein; Amini Sarteshnizi, Roghayeh

2018-03-01

Phenolic compounds as agro-industrial by-products have been associated with health benefits since they exhibit high antioxidant activity and anti-diabetic properties. In this study, polyphenol-rich extract from pistachio green hull (PGH) was evaluated for antioxidant activity and its ability to inhibit α-amylase and α-glucosidase activity in vitro. The effect of PGH extract powder on in vitro starch digestibility was also evaluated. The results showed that PGH had stronger antioxidant activity than Trolox. The inhibitory effect of PGH extract against α-amylase from porcine pancreas was dose dependent and the IC 50 value was ~174μgGAE/mL. The crude PGH extract was eight times more potent on baker yeast α-glucosidase activity (IC 50 ~6μgGAE/mL) when compared to acarbose, whereas the IC 50 value of PGH extract against rat intestinal maltase activity obtained ~2.6mgGAE/mL. The non-tannin fraction of PGH extract was more effective against α-glucosidase than tannin fraction whereas the α-amylase inhibitor was concentrated in the tannin fraction. In vitro starch digestibility and glycemic index (GI) of pasta sample supplemented with PGH extract powder (1.5%) was significantly lower than the control pasta. The IC 50 value of PGH extract obtained from cooked pasta against α-amylase and α-glucosidase was increased. These results have important implications for the processing of PGH for food industry application and therefore could comply with glucose control diets. Copyright © 2017 Elsevier Ltd. All rights reserved.

Finger millet (Ragi, Eleusine coracana L.): a review of its nutritional properties, processing, and plausible health benefits.

PubMed

Shobana, S; Krishnaswamy, K; Sudha, V; Malleshi, N G; Anjana, R M; Palaniappan, L; Mohan, V

2013-01-01

Finger millet or ragi is one of the ancient millets in India (2300 BC), and this review focuses on its antiquity, consumption, nutrient composition, processing, and health benefits. Of all the cereals and millets, finger millet has the highest amount of calcium (344mg%) and potassium (408mg%). It has higher dietary fiber, minerals, and sulfur containing amino acids compared to white rice, the current major staple in India. Despite finger millet's rich nutrient profile, recent studies indicate lower consumption of millets in general by urban Indians. Finger millet is processed by milling, malting, fermentation, popping, and decortication. Noodles, vermicilli, pasta, Indian sweet (halwa) mixes, papads, soups, and bakery products from finger millet are also emerging. In vitro and in vivo (animal) studies indicated the blood glucose lowering, cholesterol lowering, antiulcerative, wound healing properties, etc., of finger millet. However, appropriate intervention or randomized clinical trials are lacking on these health effects. Glycemic index (GI) studies on finger millet preparations indicate low to high values, but most of the studies were conducted with outdated methodology. Hence, appropriate GI testing of finger millet preparations and short- and long-term human intervention trials may be helpful to establish evidence-based health benefits. Copyright © 2013 Elsevier Inc. All rights reserved.

Nutrition During Pregnancy and the Effect of Carbohydrates on the Offspring's Metabolic Profile: In Search of the "Perfect Maternal Diet".

PubMed

Tzanetakou, Irene P; Mikhailidis, Dimitri P; Perrea, Despina N

2011-01-01

Fetal growth and development is primarily dependent upon the nutritional, hormonal and metabolic environment provided by the mother. A wartime famine study in Holland first showed that a low food intake reduces the glucose offered to the fetus and thus produces smaller size infants at birth. Maternal glucose regulation is however affected by numerous factors including physiological changes of pregnancy (e.g. insulin resistance [IR]), pathological conditions (e.g. gestational diabetes mellitus) and maternal nutrition. Maternal glucose is substantially influenced by the type of carbohydrates in the diet through its direct effect on glycemia. The rate at which each carbohydrate raises blood glucose levels after ingestion, can be measured via the dietary glycemic index (GI). Carbohydrate type and the GI of the diet enhance or inhibit abnormal hyperglycemia during pregnancy caused by either pathological conditions or the inability of the mother to cope with the physiological IR of pregnancy. In turn, maternal gestational hyperglycemia may be involved in the pathogenesis of IR, impaired glucose tolerance, type 2 diabetes mellitus, the Metabolic Syndrome and subsequent cardiovascular diseases in adult offspring. A low GI maternal diet has been associated with measurable benefits to the offspring. These include a positive effect on altering maternal blood glucose production, insulinemia and reduced adiposity as well as fetal and placental insulin and glucose regulation, fetal growth, birth weight and offspring adiposity. We review the possible links between dietary carbohydrate in health during pregnancy and the effect of maternal carbohydrate ingestion on programming the offspring's metabolic profile.

A systematic review on the relations between pasta consumption and cardio-metabolic risk factors.

PubMed

Huang, M; Li, J; Ha, M-A; Riccardi, G; Liu, S

2017-11-01

The traditional Italian dish pasta is a major food source of starch with low glycemic index (GI) and an important low-GI component of the Mediterranean diet. This systematic review aimed at assessing comprehensively and in-depth the potential benefit of pasta on cardio-metabolic disease risk factors. Following a standard protocol, we conducted a systematic literature search of PubMed, CINAHL, and Cochrane Central Register of Controlled Trials for prospective cohort studies and randomized controlled dietary intervention trials that examined pasta and pasta-related fiber and grain intake in relation to cardio-metabolic risk factors of interest. Studies comparing postprandial glucose response to pasta with that to bread or potato were quantitatively summarized using meta-analysis of standardized mean difference. Evidence from studies with pasta as part of low-GI dietary intervention and studies investigating different types of pasta were qualitatively summarized. Pasta meals have significantly lower postprandial glucose response than bread or potato meals, but evidence was lacking in terms of how the intake of pasta can influence cardio-metabolic disease risk. More long-term randomized controlled trials are needed where investigators directly contrast the cardio-metabolic effects of pasta and bread or potato. Long-term prospective cohort studies with required data available should also be analyzed regarding the effect of pasta intake on disease endpoints. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Influence of temperate, subtropical, and tropical fruit consumption on risk of type 2 diabetes in an Asian population123

PubMed Central

Butler, Lesley M; Koh, Woon-Puay; Yuan, Jian-Min; van Dam, Rob M

2017-01-01

Background: Findings on the relation between fruit consumption and the risk of type 2 diabetes mellitus (T2DM) have been inconsistent. Objectives: We examined whether the consumption of total, temperate, subtropical, and tropical fruit is associated with T2DM risk and whether differences in the carbohydrate quality of fruit influence T2DM risk in Asians. Design: We included 45,411 participants in the Singapore Chinese Health Study who were 45–74 y old and had no diabetes, cancer, or cardiovascular disease at recruitment (1993–1998). Fruit intake was assessed with the use of a validated food-frequency questionnaire. Physician-diagnosed incident T2DM cases were reported at follow-up 1 (1999–2004) and follow-up 2 (2006–2010) interviews. Cox proportional hazards regression was used to estimate HRs and 95% CIs of diabetes risk. Results: In 494,741 person-years of follow-up, 5207 participants developed T2DM. After adjustment for lifestyle and dietary risk factors, high total fruit consumption was not consistently associated with lower T2DM risk [men: HR of 1.33 (95% CI: 1.04, 1.71) for ≥3 servings/d compared with <1 serving/wk (P-trend = 0.17); women: HR of 0.88 (95% CI: 0.71, 1.11) (P-trend = 0.008); P-interaction = 0.003]. The direct association in men was observed for higher–glycemic index (GI) fruit [HR: 1.51 (95% CI: 1.22, 1.86) for ≥1 serving/d compared with rarely consumed; P-trend = 0.001] but not for lower or moderate GI fruit. In women, the consumption of temperate fruit, but not of subtropical or tropical fruit, was associated with lower T2DM risk [HR: 0.79 (95% CI: 0.67, 0.92) for ≥1 serving/d compared with rarely; P-trend = 0.006]. Conclusions: The consumption of temperate fruit, such as apples, was associated with a lower risk of T2DM in women, whereas the consumption of higher-GI fruit, such as bananas, was associated with higher risk in men. The impact of fruit consumption on the risk of diabetes may differ by the type of fruit, which may reflect differences in the glycemic impact or phytochemical content. PMID:28179225

The effects of potatoes and other carbohydrate side dishes consumed with meat on food intake, glycemia and satiety response in children

PubMed Central

Akilen, R; Deljoomanesh, N; Hunschede, S; Smith, C E; Arshad, M U; Kubant, R; Anderson, G H

2016-01-01

Background: The effect of carbohydrate (CHO) foods on blood glucose (BG) is ranked by their glycemic index (GI). Boiled and mashed potatoes (BMPs) are ranked as high GI foods, whereas pasta and rice have moderate GI rankings. The objective of this study was to compare ad libitum consumption of common CHO dishes consumed with meat on meal-time food intake and post-meal satiety, BG, insulin and gut hormones in 11- to 13-year-old normal weight children. Methods: Two randomized crossover studies were conducted. At weekly intervals, children (experiment 1: 12 males (M), 8 females (F); experiment 2: 6M, 6 F) received in random order 1 of 5 CHO side dishes of rice, pasta, BMP, fried French fries (FFF) or baked French fries (BFF) eaten freely together with a fixed amount of lean beef (100 g). In experiment-1, food intake over 30 min and subjective appetite were measured for 120 min. In experiment-2, the same outcomes were measured along with BG, plasma insulin and gut hormones. Results: The results for boys and girls were pooled as sex was not a factor. In both experiments, children consumed 30–40% less calories at meals with BMP (P<0.0001) compared with all other treatments, which were similar. BMP increased satiety, expressed as a change in appetite per kilocalorie, more than all other treatments (P<0.0001). FFF resulted in the lowest (P<0.0001) glucose and insulin at meal end and post-meal and peptide YY (PYY) post-meal. Blood measures were similar among all other treatments. Conclusions: The physiological functions of CHO foods consumed ad libitum at meal time on food intake, appetite, BG, insulin and gut hormone responses in children is not predicted by the GI. PMID:26878318

The effects of potatoes and other carbohydrate side dishes consumed with meat on food intake, glycemia and satiety response in children.

PubMed

Akilen, R; Deljoomanesh, N; Hunschede, S; Smith, C E; Arshad, M U; Kubant, R; Anderson, G H

2016-02-15

The effect of carbohydrate (CHO) foods on blood glucose (BG) is ranked by their glycemic index (GI). Boiled and mashed potatoes (BMPs) are ranked as high GI foods, whereas pasta and rice have moderate GI rankings. The objective of this study was to compare ad libitum consumption of common CHO dishes consumed with meat on meal-time food intake and post-meal satiety, BG, insulin and gut hormones in 11- to 13-year-old normal weight children. Two randomized crossover studies were conducted. At weekly intervals, children (experiment 1: 12 males (M), 8 females (F); experiment 2: 6M, 6 F) received in random order 1 of 5 CHO side dishes of rice, pasta, BMP, fried French fries (FFF) or baked French fries (BFF) eaten freely together with a fixed amount of lean beef (100 g). In experiment-1, food intake over 30 min and subjective appetite were measured for 120 min. In experiment-2, the same outcomes were measured along with BG, plasma insulin and gut hormones. The results for boys and girls were pooled as sex was not a factor. In both experiments, children consumed 30-40% less calories at meals with BMP (P<0.0001) compared with all other treatments, which were similar. BMP increased satiety, expressed as a change in appetite per kilocalorie, more than all other treatments (P<0.0001). FFF resulted in the lowest (P<0.0001) glucose and insulin at meal end and post-meal and peptide YY (PYY) post-meal. Blood measures were similar among all other treatments. The physiological functions of CHO foods consumed ad libitum at meal time on food intake, appetite, BG, insulin and gut hormone responses in children is not predicted by the GI.

Higher protein diets consumed ad libitum improve cardiovascular risk markers in children of overweight parents from eight European countries.

PubMed

Damsgaard, Camilla T; Papadaki, Angeliki; Jensen, Signe M; Ritz, Christian; Dalskov, Stine-Mathilde; Hlavaty, Petr; Saris, Wim H M; Martinez, J Alfredo; Handjieva-Darlenska, Teodora; Andersen, Malene R; Stender, Steen; Larsen, Thomas M; Astrup, Arne; Mølgaard, Christian; Michaelsen, Kim F

2013-06-01

Dietary strategies to improve early cardiovascular markers in overweight children are needed. We investigated the effect of dietary protein and glycemic index (GI) on cardiovascular markers and metabolic syndrome (MetS) scores in 5- to 18-y-old children of overweight/obese parents from 8 European centers. Families were randomized to 1 of 5 diets consumed ad libitum: high protein (HP) or low protein (LP) combined with high GI (HGI) or low GI (LGI), or a control diet. At 6 centers, families received dietary instruction (instruction centers); at 2 centers, free foods were also provided (supermarket centers). Diet, anthropometry, blood pressure, and serum cardiovascular markers (lipid profile, glucose regulation, and inflammation) were measured in 253 children at baseline, 1 mo, and/or 6 mo. Protein intake was higher in the HP groups (19.9 ± 1.3% energy) than in the LP groups at 6 mo (16.8 ± 1.2% energy) (P = 0.001). The GI was 4.0 points lower (95% CI: 2.1, 6.1) in the LGI compared with the HGI groups (P < 0.001). In the supermarket centers, the HP and LP groups differed more in protein intake than did the groups in the instruction centers (P = 0.009), indicating better compliance. The HP diets evoked a 2.7-cm (95% CI: 0.9, 5.1) smaller waist circumference and a 0.25-mmol/L (95% CI: 0.09, 0.41) lower serum LDL cholesterol compared with the LP diets at 6 mo (P < 0.007). In a separate supermarket center analysis, the HP compared with LP diets reduced waist circumference (P = 0.004), blood pressure (P < 0.01), serum insulin (P = 0.013), and homeostasis model of assessment-insulin resistance (P = 0.016). In the instruction centers, the HP compared with the LP diets reduced LDL cholesterol (P = 0.004). No consistent effect of GI was seen and the MetS scores were not affected. In conclusion, increased protein intake improved cardiovascular markers in high-risk children, particularly in those undergoing most intensive intervention.

Fortification of seaweed (Eucheuma cottonii) flour on nutrition, iodine, and glycemic index of pasta

NASA Astrophysics Data System (ADS)

Firdaus, Muhamad; Yahya; Raditya Hardany Nugraha, Galih; Dwi Utari, Dyah

2017-10-01

Pasta is a nutritious and energy product which produced from the dough of wheat flour and water. It contains less of iodine and high of glycemic index. Euchema cottonii belongs of red seaweed is food substance that contains much of iodine and dietary fiber. The objective of this study was to know the fortification effect of E. cottonii flour on the nutrition, iodine, and glycemic index of pasta. E. cottonii was collected from the culture farm of E. cottonii on the Wongsorejo beach, District of Banyuwangi, East Java on April-June 2015. Wheat flour and pasta ingredients were obtained locally at shops of Pasar Besar, Malang. Pasta was produced by weighing of components, mixing, dough, milling, steaming and drying. E. cottonii flour was added on mixing process at 0; 7; 14 and 21 % of ingredients. The parameter of this study was the level of water, lipid, protein, ash, and carbohydrate (by difference), iodine, crude fiber, the total of dietary fiber, soluble fiber, insoluble fiber, and glycemic index, respectively. Data were analyzed by variance and the least square difference used to determine the difference between treatments. The highest concentration group showed more nutritious than other treatments. The characters of its product were water 6.70%, lipid 2.26%, protein 23.09%, ash 14.11%, carbohydrate 53.84%, iodine 3.71 ppm, crude fiber 8.02%, the total of dietary fiber 20.88%, soluble fiber 11.69%, insoluble fiber 9.19%, and glycemic index 44.45, respectively. In conclusion, the fortification of E. cottonii flour enhances the nutrition value, iodine content, and glycemic index of pasta.

The development of low glycemic index cookie bars from foxtail millet (Setaria italica), arrowroot (Maranta arundinacea) flour, and kidney beans (Phaseolus vulgaris).

PubMed

Lestari, Lily Arsanti; Huriyati, Emy; Marsono, Yustinus

2017-05-01

Wholegrain foods are becoming increasingly popular as a high fiber dietary supplement recommended for people with diabetes. In Indonesia, the incidence of diabetes mellitus has almost doubled recently and poses a significant health risk with the high prevalence of obesity and cardiovascular diseases. The present research aimed to develop cookie bars from foxtail millet, arrowroot flour, and kidney beans. The physical, chemical, and sensory properties were evaluated by selecting the best formula to test the glycemic index. Three formulae of cookie bars, which had different percentages of foxtail millet, kidney beans, and arrowroot flour were evaluated. The results showed that the three formulae (F1, F2, F3) had °Hue values of 53.77, 58.46, and 58.31, and breaking force of 8.37, 10.12, and 5.87 N, respectively. While all other nutritional content were significantly different between formulae, the total crude fat was not. The F2 cookie bar was selected and evaluated for the glycemic index because it has the best sensory properties, lowest total sugar and available carbohydrate content. F2 cookie bars that contain 15% foxtail millet, 15% arrowroot flour, and 30% of kidney beans have a glycemic index of 37.6 hence it could be classified as a low glycemic index cookie bar. In conclusion, our findings indicated that F2 cookie bars can be further developed as a suitable diabetic food since it has the best physico-chemical properties, sensory properties, and low glycemic index.

ILSI Brazil International Workshop on Functional Foods: a narrative review of the scientific evidence in the area of carbohydrates, microbiome, and health

PubMed Central

Meheust, Agnès; Augustin, Livia; Benton, David; Berčík, Přemysl; Birkett, Anne; Eldridge, Alison L.; Faintuch, Joel; Hoffmann, Christian; Jones, Julie Miller; Kendall, Cyril; Lajolo, Franco; Perdigon, Gabriela; Prieto, Pedro Antonio; Rastall, Robert A.; Sievenpiper, John L.; Slavin, Joanne; de Menezes, Elizabete Wenzel

2013-01-01

To stimulate discussion around the topic of ‘carbohydrates’ and health, the Brazilian branch of the International Life Sciences Institute held the 11th International Functional Foods Workshop (1–2 December 2011) in which consolidated knowledge and recent scientific advances specific to the relationship between carbohydrates and health were presented. As part of this meeting, several key points related to dietary fiber, glycemic response, fructose, and impacts on satiety, cognition, mood, and gut microbiota were realized: 1) there is a need for global harmonization of a science-based fiber definition; 2) low-glycemic index foods can be used to modulate the postprandial glycemic response and may affect diabetes and cardiovascular outcomes; 3) carbohydrate type may influence satiety and satiation; glycemic load and glycemic index show links to memory, mood, and concentration; 4) validated biomarkers are needed to demonstrate the known prebiotic effect of carbohydrates; 5) negative effects of fructose are not evident when human data are systematically reviewed; 6) new research indicates that diet strongly influences the microbiome; and 7) there is mounting evidence that the intestinal microbiota has the ability to impact the gut–brain axis. Overall, there is much promise for development of functional foods that impact the microbiome and other factors relevant to health, including glycemic response (glycemic index/glycemic load), satiety, mood, cognition, and weight management. PMID:23399638

On the Problem of Patient-Specific Endogenous Glucose Production in Neonates on Stochastic Targeted Glycemic Control

PubMed Central

Dickson, Jennifer L.; Hewett, James N.; Gunn, Cameron A.; Lynn, Adrienne; Shaw, Geoffrey M.; Chase, Geoffrey

2013-01-01

Background: Both stress and prematurity can induce hyperglycemia in the neonatal intensive care unit, which, in turn, is associated with worsened outcomes. Endogenous glucose production (EGP) is the formation of glucose by the body from substrates and contributes to blood glucose (BG) levels. Due to the inherent fragility of the extremely low birth weight (ELBW) neonates, true fasting EGP cannot be explicitly determined, introducing uncertainty into glycemic models that rely on quantifying glucose sources. Stochastic targeting, or STAR, is one such glycemic control framework. Methods: A literature review was carried out to gather metabolic and EGP values on preterm infants with a gestational age (GA) <32 weeks and a birth weight (BW) <2 kg. The data were analyzed for EGP trends with BW, GA, BG, plasma insulin, and glucose infusion (GI) rates. Trends were modeled and compared with a literature-derived range of population constant EGP models using clinically validated virtual trials on retrospective clinical data. Results: No clear relationship was found for EGP and BW, GA, or plasma insulin. Some evidence of suppression of EGP with increasing GI or BG was seen. Virtual trial results showed that population-constant EGP models fit clinical data best and gave tighter control performance to a target band in virtual trials. Conclusions: Variation in EGP cannot easily be quantified, and EGP is sufficiently modeled as a population constant in the neonatal intensive care insulin–nutrition–glucose model. Analysis of the clinical data and fitting error suggests that ELBW hyperglycemic preterm neonates have unsuppressed EGP in the higher range than that seen in literature. PMID:23911173

Genetic Polymorphisms in the Hypothalamic Pathway in Relation to Subsequent Weight Change – The DiOGenes Study

PubMed Central

Ängquist, Lars; Hansen, Rikke D.; van der A, Daphne L.; Holst, Claus; Tjønneland, Anne; Overvad, Kim; Jakobsen, Marianne Uhre; Boeing, Heiner; Meidtner, Karina; Palli, Domenico; Masala, Giovanna; Bouatia-Naji, Nabila; Saris, Wim H. M.; Feskens, Edith J. M.; J.Wareham, Nicolas; Sørensen, Thorkild I. A.; Loos, Ruth J. F.

2011-01-01

Background Single nucleotide polymorphisms (SNPs) in genes encoding the components involved in the hypothalamic pathway may influence weight gain and dietary factors may modify their effects. Aim We conducted a case-cohort study to investigate the associations of SNPs in candidate genes with weight change during an average of 6.8 years of follow-up and to examine the potential effect modification by glycemic index (GI) and protein intake. Methods and Findings Participants, aged 20–60 years at baseline, came from five European countries. Cases (‘weight gainers’) were selected from the total eligible cohort (n = 50,293) as those with the greatest unexplained annual weight gain (n = 5,584). A random subcohort (n = 6,566) was drawn with the intention to obtain an equal number of cases and noncases (n = 5,507). We genotyped 134 SNPs that captured all common genetic variation across the 15 candidate genes; 123 met the quality control criteria. Each SNP was tested for association with the risk of being a ‘weight gainer’ (logistic regression models) in the case-noncase data and with weight gain (linear regression models) in the random subcohort data. After accounting for multiple testing, none of the SNPs was significantly associated with weight change. Furthermore, we observed no significant effect modification by dietary factors, except for SNP rs7180849 in the neuromedin β gene (NMB). Carriers of the minor allele had a more pronounced weight gain at a higher GI (P = 2×10−7). Conclusions We found no evidence of association between SNPs in the studied hypothalamic genes with weight change. The interaction between GI and NMB SNP rs7180849 needs further confirmation. PMID:21390334

Effects of Curcuma longa (turmeric) on postprandial plasma glucose and insulin in healthy subjects.

PubMed

Wickenberg, Jennie; Ingemansson, Sandra Lindstedt; Hlebowicz, Joanna

2010-10-12

Previous animal studies have shown that Curcuma (C.) longa lowers plasma glucose. C. longa may thus be a promising ingredient in functional foods aimed at preventing type 2 diabetes. The purpose of the study is to study the effect of C. longa on postprandial plasma glucose, insulin levels and glycemic index (GI) in healthy subjects. Fourteen healthy subjects were assessed in a crossover trial. A standard 75 g oral glucose tolerance test (OGTT) was administered together with capsules containing a placebo or C. longa. Finger-prick capillary and venous blood samples were collected before, and 15, 30, 45, 60, 90, and 120 min after the start of the OGTT to measure the glucose and insulin levels, respectively. The ingestion of 6 g C. longa had no significant effect on the glucose response. The change in insulin was significantly higher 30 min (P = 0.03) and 60 min (P = 0.041) after the OGTT including C. longa. The insulin AUCs were also significantly higher after the ingestion of C. longa, 15 (P = 0.048), 30 (P = 0.035), 90 (P = 0.03), and 120 (P = 0.02) minutes after the OGTT. The ingestion of 6 g C. longa increased postprandial serum insulin levels, but did not seem to affect plasma glucose levels or GI, in healthy subjects. The results indicate that C. longa may have an effect on insulin secretion.

Plasma adiponectin concentrations are associated with dietary glycemic index in Malaysian patients with type 2 diabetes.

PubMed

Loh, Beng-In; Sathyasuryan, Daniel Robert; Mohamed, Hamid Jan Jan

2013-01-01

Adiponectin, an adipocyte-derived hormone has been implicated in the control of blood glucose and chronic inflammation in type 2 diabetes. However, limited studies have evaluated dietary factors on plasma adiponectin levels, especially among type 2 diabetic patients in Malaysia. The aim of this study was to investigate the influence of dietary glycemic index on plasma adiponectin concentrations in patients with type 2 diabetes. A cross-sectional study was conducted in 305 type 2 diabetic patients aged 19-75 years from the Penang General Hospital, Malaysia. Socio-demographic information was collected using a standard questionnaire while dietary details were determined by using a pre-validated semi-quantitative food frequency questionnaire. Anthropometry measurement included weight, height, BMI and waist circumference. Plasma adiponectin concentrations were measured using a commercial ELISA kit. Data were analyzed using multiple linear regression. After multivariate adjustment, dietary glycemic index was inversely associated with plasma adiponectin concentrations (β =-0.272, 95% CI -0.262, - 0.094; p<0.001). It was found that in individuals who consumed 1 unit of foods containing high dietary glycemic index that plasma adiponectin level reduced by 0.3 μg/mL. Thirty two percent (31.9%) of the variation in adiponectin concentrations was explained by age, sex, race, smoking status, BMI, waist circumference, HDL-C, triglycerides, magnesium, fiber and dietary glycemic index according to the multiple linear regression model (R2=0.319). These results support the hypothesis that dietary glycemic index influences plasma adiponectin concentrations in patients with type 2 diabetes. Controlled clinical trials are required to confirm our findings and to elucidate the underlying mechanism.

[Moderate exercise and intake of either high or low glycemic index carbohydrates in sedentary women].

PubMed

Ortiz-Rodríguez, Briseidy; De León, Lidia G; Esparza-Romero, Julián; Carrasco-Legleu, Claudia E; Candia-Luján, Ramón

2018-05-25

To analyze changes in blood glucose, insulin and triglyceride concentrations in relation to a moderate aerobic exercise in sedentary women of different body weight, exposed to either a high or low glycemic index carbohydrates diet. DISEñO: Cross-over type. SITE: Research was performed in the Exercise Physiology Laboratory at Facultad de Ciencias de la Cultura Física, Universidad Autónoma de Chihuahua, México. Twenty-six young sedentary women who did not exercise in the last year participated in the study. Four of adequate weight (AW) and 2 with obesity (OB) were excluded for not consuming the suggested carbohydrates (1gr/kg of weight) nor completed the programed exercise. There were n=10 in each group (AW/OB). Two treatments of 55minutes of aerobic exercise each were applied one day after consuming either high or low glycemic index carbohydrates. Plasmatic glucose, insulin, and triglycerides were determined before and after the scheduled exercise. Glucose, insulin, and triglycerides were higher in OB than in AW at baseline. Glucose was normalized in OB from 5.8±0.35 to 5.3±0.23 mmol/L (P=.001), only by eating foods with low glycemic index; triglycerides increased from 139.5±66.0 to 150.8±67.2mg/dl (P=.004) at the end of the exercise, after consumption of low glycemic index carbohydrates. Elevation of triglycerides secondary to exercise after consumption of low glycemic index seems to indicate an increase of lipid oxidation in OB. Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

The Roles of Glycated Albumin as Intermediate Glycation Index and Pathogenic Protein

PubMed Central

Kim, Kwang Joon

2012-01-01

The conventional glycemic indices used in management of diabetic patients includes A1c, fructosamine, 1,5-anhydroglucitol, and glycated albumin (GA). Among these indices, A1c is currently used as the gold standard. However, A1c cannot reflect the glycemic change over a relatively short period of time, and its accuracy is known to decrease when abnormalities in hemoglobin metabolism, such as anemia, coexist. When considering these weaknesses, there have been needs for finding a novel glycemic index for diagnosing and managing diabetes, as well as for predicting diabetic complications properly. Recently, several studies have suggested the potential of GA as an intermediate-term glycation index in covering the short-term effect of treatment. Furthermore, its role as a pathogenic protein affecting the worsening of diabetes and occurrence of diabetic complications is receiving attention as well. Therefore, in this article, we wanted to review the recent status of GA as a glycemic index and as a pathogenic protein. PMID:22540045

Comparison of glycemic control and variability in patients with type 2 and posttransplantation diabetes mellitus.

PubMed

Werzowa, Johannes; Pacini, Giovanni; Hecking, Manfred; Fidler, Catharina; Haidinger, Michael; Brath, Helmut; Thomas, Andreas; Säemann, Marcus D; Tura, Andrea

2015-01-01

Posttransplantation diabetes mellitus (PTDM) is a common complication after renal transplantation leading to increased cardiovascular morbidity and mortality. In subjects with type 2 diabetes (T2DM) increased glycemic variability and poor glycemic control have been associated with cardiovascular complications. We therefore aimed at determining glycemic variability and glycemic control in subjects with PTDM in comparison to T2DM subjects. In this observational study we analyzed 10 transplanted subjects without diabetes (Control), 10 transplanted subjects with PTDM, and 8 non-transplanted T2DM subjects using Continuous Glucose Monitoring (CGM). Several indices of glycemic control quality and variability were computed. Many indices of both glycemic control quality and variability were different between control and PTDM subjects, with worse values in PTDM. The indices of glycemic control, such as glucose mean, GRADE and M-value, were similar in PTDM and T2DM, but some indices of glycemic variability, that is CONGA, lability index and shape index, showed a markedly higher (i.e., worse) value in T2DM than in PTDM (P value range: 0.001-0.035). Although PTDM and T2DM subjects showed similar glycemic control quality, glycemic variability was significantly higher in T2DM. These data underscore potential important pathophysiological differences between T2DM and PTDM indicating that increased glycemic variability may not be a key factor for the excess cardiovascular mortality in patients with PTDM. Copyright © 2015 Elsevier Inc. All rights reserved.

The EIT-based global inhomogeneity index is highly correlated with regional lung opening in patients with acute respiratory distress syndrome.

PubMed

Zhao, Zhanqi; Pulletz, Sven; Frerichs, Inéz; Müller-Lisse, Ullrich; Möller, Knut

2014-02-06

The electrical impedance tomography (EIT)-based global inhomogeneity (GI) index was introduced to quantify tidal volume distribution within the lung. Up to now, the GI index was evaluated for plausibility but the analysis of how it is influenced by various physiological factors is still missing. The aim of our study was to evaluate the influence of proportion of open lung regions measured by EIT on the GI index. A constant low-flow inflation maneuver was performed in 18 acute respiratory distress syndrome (ARDS) patients (58 ± 14 years, mean age ± SD) and 8 lung-healthy patients (41 ± 12 years) under controlled mechanical ventilation. EIT raw data were acquired at 25 scans/s and reconstructed offline. Recruited lung regions were identified as those image pixels of the lung regions within the EIT scans where local impedance amplitudes exceeded 10% of the maximum amplitude during the maneuver. A series of GI indices was calculated during mechanical lung inflation, based on the differential images obtained between different time points. Respiratory system elastance (Ers) values were calculated at 10 lung volume levels during low-flow maneuver. The GI index decreased during low-flow inflation, while the percentage of open lung regions increased. The values correlated highly in both ARDS (r2 = 0.88 ± 0.08, p < 0.01) and lung-healthy patients (r2 = 0.92 ± 0.05, p < 0.01). Ers and GI index were also significantly correlated in 16 out of 18 ARDS (r2 = 0.84 ± 0.13, p < 0.01) and in 6 out of 8 lung-healthy patients (r2 = 0.84 ± 0.07, p < 0.01). Significant differences were found in GI values between two groups (0.52 ± 0.21 for ARDS and 0.41 ± 0.04 for lung-healthy patients, p < 0.05) as well in Ers values (0.017 ± 0.008 cmH2O/ml for ARDS and 0.009 ± 0.001 cmH2O/ml for lung-healthy patients, p < 0.01). We conclude that the GI index is a reliable measure of ventilation heterogeneity highly correlated with lung recruitability measured with EIT. The GI index may prove to be a useful EIT-based index to guide ventilation therapy.

Effect of carob (Ceratonia siliqua L.) flour on the antioxidant potential, nutritional quality, and sensory characteristics of fortified durum wheat pasta.

PubMed

Sęczyk, Łukasz; Świeca, Michał; Gawlik-Dziki, Urszula

2016-03-01

This paper presents a study on the effect of carob flour addition from 1% to 5% (w/w) on phenolics content, antioxidant activity, nutritional quality, and sensory attributes of wheat pasta. An increase of about 2-folds, 18-folds and 3-folds in phenolics content, antiradical activity and reducing power for pasta fortified with 5% of carob flour was observed, respectively, compared to the control. Expected glycemic index (eGI) was increased proportionally to the substitution level and ranged between 72.2 and 83.9 for 1-5% of supplement, respectively. Furthermore, pasta fortification affected the in vitro bioaccessibility of nutrients. In case of 5% supplemented pasta, the digestibility of starch and protein decreased by about 9% compared to the control. The replacement of semolina with carob flour from 1% to 5% had no significant effect on pasta sensory attributes. In conclusion, carob flour seems to be a promising functional ingredient for pasta fortification. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sterilization in a liquid of a specific starch makes it slowly digestible in vitro and low glycemic in rats.

PubMed

Severijnen, Chantal; Abrahamse, Evan; van der Beek, Eline M; Buco, Amra; van de Heijning, Bert J M; van Laere, Katrien; Bouritius, Hetty

2007-10-01

Diabetics are recommended to eat a balanced diet containing normal amounts of carbohydrates, preferably those with a low glycemic index. For solid foods, this can be achieved by choosing whole-grain, fiber-rich products. For (sterilized) liquid products, such as meal replacers, the choices for carbohydrate sources are restricted due to technological limitations. Starches usually have a high glycemic index after sterilization in liquids, whereas low glycemic sugars and sugar replacers can only be used in limited amounts. Using an in vitro digestion assay, we identified a resistant starch (RS) source [modified high amylose starch (mHAS)] that might enable the production of a sterilized liquid product with a low glycemic index. Heating mHAS for 4-5 min in liquid increased the slowly digestible starch (SDS) fraction at the expense of the RS portion. The effect was temperature dependent and reached its maximum above 120 degrees C. Heating at 130 degrees C significantly reduced the RS fraction from 49 to 22%. The product remained stable for at least several months when stored at 4 degrees C. To investigate whether a higher SDS fraction would result in a lower postprandial glycemic response, the sterilized mHAS solution was compared with rapidly digestible maltodextrin. Male Wistar rats received an i.g. bolus of 2.0 g available carbohydrate/kg body weight. Ingestion of heat-treated mHAS resulted in a significant attenuation of the postprandial plasma glucose and insulin responses compared with maltodextrin. mHAS appears to be a starch source which, after sterilization in a liquid product, acquires slow-release properties. The long-term stability of mHAS solutions indicates that this may provide a suitable carbohydrate source for low glycemic index liquid products for inclusion in a diabetes-specific diet.

Perceived Barriers to Application of Glycaemic Index: Valid Concerns or Lost in Translation?

PubMed Central

Grant, Shannan M.; Wolever, Thomas M. S.

2011-01-01

The term glycaemic-index (GI) originally appeared in the literature in the early 1980s. GI categorizes carbohydrate according to glycaemic effect postprandially. Since its inception, GI has obtained and maintained interest of academics and clinicians globally. Upon review of GI literature, it becomes clear that the clinical utility of GI is a source of controversy. Can and should GI be applied clinically? There are academics and clinicians on both sides of the argument. Certainly, this controversy has been a stimulus for the evolution of GI methodology and application research, but may also negatively impact clinicians’ perception of GI if misunderstood. This article reviews two assessments of GI that are often listed as barriers to application; the GI concept is (1) too complex and (2) too difficult for clients to apply. The literature reviewed does not support the majority of purported barriers, but does indicate that there is a call from clinicians for more and improved GI education tools and clinician GI education. The literature indicates that the Registered Dietitian (RD) can play a key role in GI knowledge translation; from research to application. Research is warranted to assess GI education tool and knowledge needs of clinicians and the clients they serve. PMID:22254100

Evaluation of resistant starch, glycemic index and fortificants content of premix rice coated with various concentrations and types of edible coating materials

NASA Astrophysics Data System (ADS)

Yulianto, W. A.; Susiati, A. M.; Adhini, H. A. N.

2018-01-01

The incidence of diabetes in Indonesia has been increasing year by year. Diets with a low glycemic index and high resistant starch foods can assist diabetics in controlling their blood glucose levels. Diabetics are known to have micro-nutrient deficiencies of chromium, magnesium and vitamin D that can be overcome by consuming parboiled rice fortified by use of a coating method. The fortification of parboiled rice (premix rice) can be achieved by coating with HPMC (hydroxypropyl methyl cellulose), MC (methyl cellulose), CMC (carboxyl methyl cellulose), gum arabic and rice starch. This research aimed to evaluate the levels of resistant starch, glycemic index and fortificants of premix rice coated with different concentrations and types of edible coating materials. This research used completely randomized design, with treatments to the concentrations and the types of edible coating (HPMC, CMC, MC, gum arabic and rice starch). The concentrations of edible coating were 0.15%, 0.2% and 0.25% for cellulose derivative coatings; 25%, 30%, 35% for gum arabic and 2%, 3.5% and 5% for rice starch. This research shows that fortified premix rice coated with various concentrations and types of edible coating materials is high in resistant starch and has a low glycemic index. The coating treatment affects the levels of magnesium and vitamin D, but does not affect the levels of chromium in parboiled rice. The premix rice with a low glycemic index and high nutrient content (chromium, magnesium and vitamin D) was premix rice coated by CMC 0.25% and HPMC 0.25% with glycemic indeces of 39.34 and 38.50, respectively.

Greater diet quality is associated with more optimal glycemic control in a longitudinal study of youth with type 1 diabetes.

PubMed

Nansel, Tonja R; Lipsky, Leah M; Liu, Aiyi

2016-07-01

Despite the centrality of nutrition in the management of type 1 diabetes, the association of diet quality and macronutrient distribution with glycemic control is ambiguous. This study examined longitudinally the association of dietary intake with multiple indicators of glycemic control in youth with type 1 diabetes participating in a behavioral nutrition intervention study. Participants in a randomized clinical trial of a behavioral nutrition intervention [n = 136; mean ± SD age: 12.8 ± 2.6 y; glycated hemoglobin (HbA1c): 8.1% ± 1.0%; 69.1% using an insulin pump] completed 3-d diet records at baseline and months 3, 6, 9, 12, and 18; masked continuous glucose monitoring (CGM) data were obtained concurrently with the use of the Medtronic iPro CGM system. HbA1c was obtained every 3 mo; 1,5-anhydroglucitol was obtained every 6 mo. Linear mixed-effects regression models estimated associations of time-varying dietary intake variables with time-varying glycemic control indicators, controlling for age, height, weight, sex, Tanner stage, diabetes duration, regimen, frequency of blood glucose monitoring, physical activity, and treatment assignment. HbA1c was associated inversely with carbohydrate and natural sugar, and positively with protein and unsaturated fat. 1,5-Anhydroglucitol was associated positively with fiber intake and natural sugar. Greater glycemic control as indicated by ≥1 CGM variable was associated with higher Healthy Eating Index-2005, whole plant food density, fiber, carbohydrate, and natural sugar and lower glycemic index and unsaturated fat. Both overall diet quality and macronutrient distribution were associated with more optimal glycemic control. Associations were more consistent for CGM variables obtained concurrently with dietary intake than for biomarkers of longer-term glycemic control. These findings suggest that glycemic control may be improved by increasing intake of high-fiber, low glycemic-index, carbohydrate-containing foods. This trial was registered at clinicaltrials.gov as NCT00999375. © 2016 American Society for Nutrition.

Determination of glycaemic index; some methodological aspects related to the analysis of carbohydrate load and characteristics of the previous evening meal.

PubMed

Granfeldt, Y; Wu, X; Björck, I

2006-01-01

To determine the possible differences in glycaemic index (GI) depending on (1) the analytical method used to calculate the 'available carbohydrate' load, that is, using carbohydrates by difference (total carbohydrate by difference, minus dietary fibre (DF)) as available carbohydrates vs available starch basis (total starch minus resistant starch (RS)) of a food rich in intrinsic RS and (2) the effect of GI characteristics and/or the content of indigestible carbohydrates (RS and DF) of the evening meal prior to GI testing the following morning. Blood glucose and serum insulin responses were studied after subjects consuming (1) two levels of barley kernels rich in intrinsic RS (15.2%, total starch basis) and (2) after a standard breakfast following three different evening meals varying in GI and/or indigestible carbohydrates: pasta, barley kernels and white wheat bread, respectively. Healthy adults with normal body mass index. (1) Increasing the portion size of barley kernels from 79.6 g (50 g 'available carbohydrates') to 93.9 g (50 g available starch) to adjust for its RS content did not significantly affect the GI or insulin index (11). (2) The low GI barley evening meal, as opposed to white wheat bread and pasta evening meals, reduced the postprandial glycaemic and insulinaemic (23 and 29%, respectively, P < 0.05) areas under the curve at a standardized white bread breakfast fed the following morning. (1) Increasing portion size to compensate for the considerable portion of RS in a low GI barley product had no significant impact on GI or II. However, for GI testing, it is recommended to base carbohydrate load on specific analyses of the available carbohydrate content. (2) A low GI barley evening meal containing high levels of indigestible carbohydrates (RS and DF) substantially reduced the GI and II of white wheat bread determined at a subsequent breakfast meal.

Determination of Factors Effected Dietary Glycemic Index in Turkish University Students

ERIC Educational Resources Information Center

Gumus, Huseyin; Akdevelioglu, Yasemin; Bulduk, Sidika

2014-01-01

We aimed to determine how factors such as smoking, regular activity, etc. affected dietary glycemic index in university students. Methods: This study was carried out at Gazi University, Ankara, Turkey. The participants were 577 randomly selected Turkish healthy female university students aged 17-32 years. The survey included a questionnaire that…

The EIT-based global inhomogeneity index is highly correlated with regional lung opening in patients with acute respiratory distress syndrome

PubMed Central

2014-01-01

Background The electrical impedance tomography (EIT)-based global inhomogeneity (GI) index was introduced to quantify tidal volume distribution within the lung. Up to now, the GI index was evaluated for plausibility but the analysis of how it is influenced by various physiological factors is still missing. The aim of our study was to evaluate the influence of proportion of open lung regions measured by EIT on the GI index. Methods A constant low-flow inflation maneuver was performed in 18 acute respiratory distress syndrome (ARDS) patients (58 ± 14 years, mean age ± SD) and 8 lung-healthy patients (41 ± 12 years) under controlled mechanical ventilation. EIT raw data were acquired at 25 scans/s and reconstructed offline. Recruited lung regions were identified as those image pixels of the lung regions within the EIT scans where local impedance amplitudes exceeded 10% of the maximum amplitude during the maneuver. A series of GI indices was calculated during mechanical lung inflation, based on the differential images obtained between different time points. Respiratory system elastance (Ers) values were calculated at 10 lung volume levels during low-flow maneuver. Results The GI index decreased during low-flow inflation, while the percentage of open lung regions increased. The values correlated highly in both ARDS (r2 = 0.88 ± 0.08, p < 0.01) and lung-healthy patients (r2 = 0.92 ± 0.05, p < 0.01). Ers and GI index were also significantly correlated in 16 out of 18 ARDS (r2 = 0.84 ± 0.13, p < 0.01) and in 6 out of 8 lung-healthy patients (r2 = 0.84 ± 0.07, p < 0.01). Significant differences were found in GI values between two groups (0.52 ± 0.21 for ARDS and 0.41 ± 0.04 for lung-healthy patients, p < 0.05) as well in Ers values (0.017 ± 0.008 cmH2O/ml for ARDS and 0.009 ± 0.001 cmH2O/ml for lung-healthy patients, p < 0.01). Conclusions We conclude that the GI index is a reliable measure of ventilation heterogeneity highly correlated with lung recruitability measured with EIT. The GI index may prove to be a useful EIT-based index to guide ventilation therapy. PMID:24502320

Association of hemoglobin A1c and glycated albumin with carotid atherosclerosis in community-dwelling Japanese subjects: the Hisayama Study.

PubMed

Mukai, Naoko; Ninomiya, Toshiharu; Hata, Jun; Hirakawa, Yoichiro; Ikeda, Fumie; Fukuhara, Masayo; Hotta, Taeko; Koga, Masafumi; Nakamura, Udai; Kang, Dongchon; Kitazono, Takanari; Kiyohara, Yutaka

2015-06-24

It is not clear which glucose measure is more useful in the assessment of atherosclerosis. We investigated the associations of hemoglobin A1c (HbA1c), glycated albumin (GA), 1,5-anhydroglucitol (1,5-AG), fasting plasma glucose (FPG), and 2-hour postload glucose (PG) with carotid intima-media thickness (IMT) in community-dwelling Japanese subjects. A total of 2702 subjects aged 40-79 years underwent a 75-g oral glucose tolerance test and measurements of HbA1c, GA, 1,5-AG, and carotid IMT by ultrasonography in 2007-2008. Carotid wall thickening was defined as a maximum IMT of >1.0 mm. The crude and multivariable-adjusted linear and logistic regression models were used to analyze cross-sectional associations between levels of glycemic measures and carotid IMT. The crude average of the maximum IMT increased significantly with rising quartiles of HbA1c, GA, FPG, and 2-hour PG levels in subjects with and without glucose intolerance (GI), while no clear association was observed for 1,5-AG. After adjustment for other confounding factors, positive trends for HbA1c, GA, and FPG (all p for trend < 0.05), but not 2-hour PG (p = 0.07) remained robust in subjects with GI, but no such associations were found in those without GI. When estimating multivariable-adjusted β values for the associations of 1 SD change in glycemic measures with the maximum IMT in subjects with GI, the magnitude of the influence of HbA1c (β = 0.021), GA (β = 0.024), and FPG (β = 0.024) was larger than that of 2-hour PG (β = 0.014) and 1,5-AG (β = 0.003). The multivariable-adjusted odds ratios for the presence of carotid wall thickening increased significantly with elevating HbA1c, GA, and FPG levels only in subjects with GI (all p for trend < 0.001). Among subjects with GI, the area under the receiver operating characteristic curve significantly increased by adding HbA1c (p = 0.04) or GA (p = 0.04), but not 1,5-AG, FPG, or 2-hour PG, to the model including other cardiovascular risk factors. In community-dwelling Japanese subjects with GI, elevated HbA1c, GA, and FPG levels were significantly associated with increased carotid IMT, and HbA1c and GA provided superior discrimination for carotid wall thickening compared to 1,5-AG, FPG, and 2-hour PG, suggesting that HbA1c and GA are useful for assessing carotid atherosclerosis.

Associations between Rice, Noodle, and Bread Intake and Sleep Quality in Japanese Men and Women

PubMed Central

Yoneyama, Satoko; Sakurai, Masaru; Nakamura, Koshi; Morikawa, Yuko; Miura, Katsuyuki; Nakashima, Motoko; Yoshita, Katsushi; Ishizaki, Masao; Kido, Teruhiko; Naruse, Yuchi; Nogawa, Kazuhiro; Suwazono, Yasushi; Sasaki, Satoshi; Nakagawa, Hideaki

2014-01-01

Background Previous studies have shown that a diet with a high-glycemic index is associated with good sleep quality. Therefore, we investigated the association of sleep quality with the intake of 3 common starchy foods with different glycemic indexes–rice, bread, and noodles–as well as the dietary glycemic index in a Japanese population. Methods The participants were 1,848 men and women between 20 and 60 years of age. Rice, bread, and noodle consumption was evaluated using a self-administered diet history questionnaire. Sleep quality was evaluated by using the Japanese version of the Pittsburgh Sleep Quality Index, and a global score >5.5 was considered to indicate poor sleep. Results Multivariate-adjusted odds ratios (95% confidence intervals) for poor sleep across the quintiles of rice consumption were 1.00 (reference), 0.68 (0.49–0.93), 0.61 (0.43–0.85), 0.59 (0.42–0.85), and 0.54 (0.37–0.81) (p for trend = 0.015); those for the quintiles of noodle consumption were 1.00 (reference), 1.25 (0.90–1.74), 1.05 (0.75–1.47), 1.31 (0.94–1.82), and 1.82 (1.31–2.51) (p for trend = 0.002). Bread intake was not associated with sleep quality. A higher dietary glycemic index was significantly associated with a lower risk of poor sleep (p for trend = 0.020). Conclusion A high dietary glycemic index and high rice consumption are significantly associated with good sleep in Japanese men and women, whereas bread intake is not associated with sleep quality and noodle consumption is associated with poor sleep. The different associations of these starchy foods with sleep quality might be attributable to the different glycemic index of each food. PMID:25127476

Effects of weight loss and long-term weight maintenance with diets varying in protein and glycemic index on cardiovascular risk factors: the diet, obesity, and genes (DiOGenes) study: a randomized, controlled trial.

PubMed

Gögebakan, Ozlem; Kohl, Angela; Osterhoff, Martin A; van Baak, Marleen A; Jebb, Susan A; Papadaki, Angeliki; Martinez, J Alfredo; Handjieva-Darlenska, Teodora; Hlavaty, Petr; Weickert, Martin O; Holst, Claus; Saris, Wim H M; Astrup, Arne; Pfeiffer, Andreas F H

2011-12-20

We sought to separately examine the effects of either weight loss or diets varying in protein content and glycemic index without further changes in body weight on cardiovascular risk factors within the Diet, Obesity, and Genes study (DiOGenes). DiOGenes is a pan-European controlled dietary intervention study in 932 overweight adults who first lost body weight on an 8-week low-calorie diet and were then randomized to 1 of 5 ad libitum diets for 26 weeks. The diets were either high or low protein or high or low glycemic index in 4 combinations or control. Weight loss (-11.23 kg; 95% confidence interval, -11.54 to -10.92; P<0.001) reduced high-sensitivity C-reactive protein (-1.15 mg/L; 95% confidence interval, -1.30 to -0.41; P<0.001), low- and high-density lipoprotein cholesterol, triglycerides, and blood pressure. During the 26-week weight maintenance period in the intention-to-treat analysis, the further decrease of high-sensitivity C-reactive protein blood levels was -0.46 mg/L greater (95% confidence interval, -0.79 to -0.13) in the groups assigned to low-glycemic-index diets than in those on high-glycemic-index diets (P<0.001). Groups on low-protein diets achieved a -0.25 mg/L greater reduction in high-sensitivity C-reactive protein (95% confidence interval, -0.59 to -0.17) than those on high-protein diets (P<0.001), whereas lipid profiles and blood pressure were not differently affected. This large-scale intervention study clearly separates weight loss from dietary composition-related effects. Low-glycemic-index carbohydrates and, to a lesser extent, low-protein intake may specifically reduce low-grade inflammation and associated comorbidities in overweight/obese adults. http://www.clinicaltrials.gov. Unique identifier: NCT00390637.

[Glycemic variability and oxidative stress in children, with type 1 diabetes attending a summer camp].

PubMed

Colomo, N; Tapia, M J; Vallejo, M R; García-Torres, F; Rubio-Martín, E; Caballero, F F; Jiménez, J M; Pelaez, M J; Gómez, A M; Sánchez, I; López-Siguero, J P; Soriguer, F; Ruiz de Adana, M S

2014-09-01

To assess glycemic variability, oxidative stress and their relationship in children and adolescents with type 1 diabetes (T1DM) attending a summer camp. Cross-sectional study that included 54 children and adolescents with T1DM aged 7-16, attending a 7 day summer camp. Sociodemographic information, clinical data, and blood glucose values measured using an Accu-Chek Nano® glucose meter were recorded. Glucose variability markers (standard deviation [SD], low blood glucose index [LBGI], high blood glucose index [HBGI], mean amplitude of glycemic excursions [MAGE] and mean of daily differences [MODD]) were calculated. Oxidative stress was assessed by the measurement of 8-iso-prostaglandin F2 alpha (PGF2α) in a 24-hour urine sample collected at the end of the camp in 14 children. The Median SD, MAGE and MODD indexes were in the high range (61, 131 and 58 mg/dl, respectively), LBGI in the moderate range (3.3), and HBGI in the low range (4.5). The mean HbA1c was 7.6% and the median urinary excretion rate of 8-iso-PGF2α was 864.39 pg/mg creatinine. The Spearman correlation coefficients between markers of glycemic variability (SD, HBGI, MAGE, MODD) were significant. Non-significant correlations were found between markers of glycemic variability and urinary 8-iso-PGF2α. High glycemic variability was observed in children and adolescents attending a summer camp. However, no correlations were found between markers of glycemic variability and oxidative stress measured by urinary 8-iso-PGF2α. Further studies are needed to address the relationship between oxidative stress and glycemic variability in children with T1DM. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Impact of carbohydrates on weight regain.

PubMed

Bosy-Westphal, Anja; Müller, Manfred J

2015-07-01

Research on obesity treatment has shifted its focus from weight loss to weight-loss maintenance strategies. The conventional approach of a low-fat diet is challenged by insights from glycemic effects of carbohydrates on body weight regulation. Metabolic and endocrine adaptations to weight loss that contribute to weight regain involve reduced energy expenditure, increased insulin sensitivity, and enhanced orexigenic signals. This review summarizes the impact of carbohydrates on energetic efficiency, partitioning of weight regain as fat and lean mass, and appetite control. Both the amount and frequency of postprandial glycemia add to body weight regulation after weight loss and strengthen the concept of glycemic index and glycemic load. In addition, dietary fiber and slowly or poorly absorbable functional sugars modify gastrointestinal peptides involved in appetite and metabolic regulation and exert prebiotic effects. Current evidence suggests that a low-glycemic load diet with a preference for low-glycemic index foods and integration of slowly digestible, poorly absorbable carbohydrates may improve weight-loss maintenance. Future studies should investigate the health benefits of low glycemic functional sweeteners (e.g., isomaltulose and tagatose).

Polymer optical waveguide with multiple graded-index cores for on-board interconnects fabricated using soft-lithography.

PubMed

Ishigure, Takaaki; Nitta, Yosuke

2010-06-21

We successfully fabricate a polymer optical waveguide with multiple graded-index (GI) cores directly on a substrate utilizing the soft-lithography method. A UV-curable polymer (TPIR-202) supplied from Tokyo Ohka Kogyo Co., Ltd. is used, and the GI cores are formed during the curing process of the core region, which is similar to the preform process we previously reported. We experimentally confirm that near parabolic refractive index profiles are formed in the parallel cores (more than 50 channels) with 40 microm x 40 microm size at 250-microm pitch. Although the loss is still as high as 0.1 approximately 0.3 dB/cm at 850 nm, which is mainly due to scattering loss inherent to the polymer matrix, the scattering loss attributed to the waveguide's structural irregularity could be sufficiently reduced by a graded refractive index profile. For comparison, we fabricate step-index (SI)-core waveguides with the same materials by means of the same process. Then, we evaluate the inter-channel crosstalk in the SI- and GI-core waveguides under almost the same conditions. It is noteworthy that remarkable crosstalk reduction (5 dB and beyond) is confirmed in the GI-core waveguides, since the propagating modes in GI-cores are tightly confined near the core center and less optical power is found near the core cladding boundary. This significant improvement in the inter-channel crosstalk allows the GI-core waveguides to be utilized for extra high-density on-board optical interconnections.

Adding glycaemic index and glycaemic load functionality to DietPLUS, a Malaysian food composition database and diet intake calculator.

PubMed

Shyam, Sangeetha; Wai, Tony Ng Kock; Arshad, Fatimah

2012-01-01

This paper outlines the methodology to add glycaemic index (GI) and glycaemic load (GL) functionality to food DietPLUS, a Microsoft Excel-based Malaysian food composition database and diet intake calculator. Locally determined GI values and published international GI databases were used as the source of GI values. Previously published methodology for GI value assignment was modified to add GI and GL calculators to the database. Two popular local low GI foods were added to the DietPLUS database, bringing up the total number of foods in the database to 838 foods. Overall, in relation to the 539 major carbohydrate foods in the Malaysian Food Composition Database, 243 (45%) food items had local Malaysian values or were directly matched to International GI database and another 180 (33%) of the foods were linked to closely-related foods in the GI databases used. The mean ± SD dietary GI and GL of the dietary intake of 63 women with previous gestational diabetes mellitus, calculated using DietPLUS version3 were, 62 ± 6 and 142 ± 45, respectively. These values were comparable to those reported from other local studies. DietPLUS version3, a simple Microsoft Excel-based programme aids calculation of diet GI and GL for Malaysian diets based on food records.

Effects of Changing the Amount and Source of Dietary Carbohydrates on Symptoms and Dietary Satisfaction Over a 1-Year Period in Subjects with Type 2 Diabetes: Canadian Trial of Carbohydrates in Diabetes (CCD).

PubMed

Wolever, Thomas M S; Chiasson, Jean-Louis; Josse, Robert G; Leiter, Lawrence A; Maheux, Pierre; Rabasa-Lhoret, Rémi; Rodger, N Wilson; Ryan, Edmond A

2017-04-01

To determine the long-term effects of changing the amount or source of dietary carbohydrate on quality of life (QOL), symptoms and dietary satisfaction in people with type 2 diabetes. Subjects with diabetes treated by diet alone (n=162) were randomly assigned to high-carbohydrate/high-glycemic-index (HGI) diets; high-carbohydrate/low-glycemic-index (LGI) diets; or lower-carbohydrate/high-monounsaturated-fat (LC) diets for 1 year. We measured QOL at baseline and at study's end, and we measured symptoms and dietary satisfaction quarterly. The HGI, LGI and LC diets contained, respectively, 47±1, 52±1 and 40±1% energy carbohydrate; 30±1, 27±1 and 40±1% fat with GI 64±0.4, 55±0.4 and 59±0.4. Significantly more participants reported increased flatulence on LGI than on LC and HGI diets at 3 months (41%, 19%, 14%; p<0.05), but not at 12 months (29%, 17%, 17%; ns). Abdominal distension was more severe (46% vs. 14%, 19%; p<0.05), and headache less severe (8% vs. 22%, 23%; p<0.05) on LGI than on both other diets. Increased appetite was more severe on LC (33%) than on HGI diets (14%, p<0.05). Joint/limb pains were less severe on LGI (16%) than HGI (28%) diets. LC elicited more severe gloomy thoughts (23%) than LGI (4%; p<0.05) but greater dietary-satisfaction (70%; p<0.05) than LGI (40%) and HGI (48%) diets. For all diets, glycated hemoglobin (A1C) levels increased less in those who gained less weight, had less increased appetite and were more satisfied with the enjoyment obtained from eating. Each diet elicited increased severity of 1 or more symptoms than the other diets. Although overall dietary satisfaction was greater on the 40% carbohydrate diet than on the 50% carbohydrate diet, the LGI diet was no less satisfying than the HGI diet. Changes in appetite and dietary satisfaction may influence body weight and glycemic control, or vice-versa. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Effects of added PGX®, a novel functional fibre, on the glycaemic index of starchy foods.

PubMed

Brand-Miller, Jennie C; Atkinson, Fiona S; Gahler, Roland J; Kacinik, Veronica; Lyon, Michael R; Wood, Simon

2012-07-01

The development of lower-glycaemic index (GI) foods requires simple, palatable and healthy strategies. The objective of the present study was to determine the most effective dose of a novel viscous fibre supplement (PGX®) to be added to starchy foods to reduce their GI. Healthy subjects (n 10) consumed glucose sugar (50 g in water × 3) and six starchy foods with a range of GI values (52-72) along with 0 (inert fibre), 2.5 or 5 g granular PGX® dissolved in 250 ml water. GI testing according to ISO Standard 26,642-2010 was used to determine the reduction in GI. PGX® significantly reduced the GI of all six foods (P < 0.001), with an average reduction of 19 % for the 2.5 g dose and 30 % for the 5 g dose, equivalent to a reducing the GI by 7 and 15 units, respectively. Consuming small quantities of the novel functional fibre PGX®, mixed with water at the start of a meal, is an effective strategy to reduce the GI of common foods.

Satiety following intake of potatoes and other carbohydrate test meals.

PubMed

Geliebter, Allan; Lee, Michelle I-Ching; Abdillahi, Mariane; Jones, James

2013-01-01

The study investigated satiation and satiety following intake of starch-rich side dishes representing a range of glycemic indices (GIs). Twelve normal-weight (BMI = 22.4 ± SD 2.0) participants (6 male, 6 female, 22-30 years) received one of four side dishes or white bread (GI reference) in randomized order on five mornings, followed by an ad libitum lunch. Blood draws prior to test meal and during the 2 h before lunch measured plasma glucose and insulin concentrations. GI was calculated from glucose incremental area under the curve (AUC). Hunger, fullness, desire to eat and prospective consumption were rated just before blood draws. No significant difference was found in hunger or fullness AUCs between test meals. Both potato meals yielded lower desire to eat compared to pasta throughout the 2-hour period (p = 0.002). Total lunch energy intake did not differ. No significant correlations were found between test meal GI and ratings of hunger, fullness or energy intake at lunch meal. GI of energy-equivalent test meals did not predict satiety or lunch meal intake. There was evidence of reduced appetite following both potato meals relative to the other carbohydrate side dishes but no differences in subsequent intake. Copyright © 2012 S. Karger AG, Basel.

Is the omega-3 index a valid marker of intestinal membrane phospholipid EPA+DHA content?

PubMed Central

Gurzell, Eric A.; Wiesinger, Jason; Morkam, Christina; Hemmrich, Sophia; Harris, William S.; Fenton, Jenifer I.

2014-01-01

Despite numerous studies investigating n-3 long chain polyunsaturated fatty acid (LCPUFA) supplementation and inflammatory bowel diseases (IBD), the extent to which dietary n-3 LCPUFAs incorporate in gastrointestinal (GI) tissues and correlate to the omega-3 index is unknown. In this study, mice were fed three diets with increasing percent of energy (%en) derived from eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA). Dietary levels reflected recommended intakes of fish/fish oil by the American Heart Association. We analyzed the FA composition of phospholipids extracted from red blood cells (RBCs), plasma, and GI tissues. We observed that the 0.1%en EPA+DHA diet was sufficient to significantly increase the omega-3 index (RBC EPA+DHA) after 5 week feeding. The baseline EPA levels were 0.2 – 0.6% across all tissues increasing to 1.6 – 4.3% in the highest EPA+DHA diet; these changes resulted in absolute increases of 1.4 – 3.9% EPA across tissues. The baseline DHA levels were 2.2 – 5.9% across all tissues increasing to 5.8 – 10.5% in the highest EPA+DHA diet; these changes resulted in absolute increases of 3.2 – 5.7% DHA across tissues. These increases in EPA and DHA across all tissues resulted in strong (r > 0.91) and significant (p < 0.001) linear correlations between the omega-3 index and plasma/GI tissue EPA+DHA content, suggesting that the omega-3 index reflects the relative amounts of EPA+DHA in GI tissues. These data demonstrate that the GI tissues are highly responsive to dietary LCPUFA supplementation and that the omega-3 index can serve as a valid biomarker for assessing dietary EPA+DHA incorporation into GI tissues. PMID:24913088

Effect of blood sampling schedule and method of calculating the area under the curve on validity and precision of glycaemic index values.

PubMed

Wolever, Thomas M S

2004-02-01

To evaluate the suitability for glycaemic index (GI) calculations of using blood sampling schedules and methods of calculating area under the curve (AUC) different from those recommended, the GI values of five foods were determined by recommended methods (capillary blood glucose measured seven times over 2.0 h) in forty-seven normal subjects and different calculations performed on the same data set. The AUC was calculated in four ways: incremental AUC (iAUC; recommended method), iAUC above the minimum blood glucose value (AUCmin), net AUC (netAUC) and iAUC including area only before the glycaemic response curve cuts the baseline (AUCcut). In addition, iAUC was calculated using four different sets of less than seven blood samples. GI values were derived using each AUC calculation. The mean GI values of the foods varied significantly according to the method of calculating GI. The standard deviation of GI values calculating using iAUC (20.4), was lower than six of the seven other methods, and significantly less (P<0.05) than that using netAUC (24.0). To be a valid index of food glycaemic response independent of subject characteristics, GI values in subjects should not be related to their AUC after oral glucose. However, calculating GI using AUCmin or less than seven blood samples resulted in significant (P<0.05) relationships between GI and mean AUC. It is concluded that, in subjects without diabetes, the recommended blood sampling schedule and method of AUC calculation yields more valid and/or more precise GI values than the seven other methods tested here. The only method whose results agreed reasonably well with the recommended method (ie. within +/-5 %) was AUCcut.

Nutritional status and nutritional habits of men with benign prostatic hyperplasia or prostate cancer - preliminary investigation.

PubMed

Goluch-Koniuszy, Zuzanna; Rygielska, Magda; Nowacka, Ilona

2013-01-01

The ageing in men, the most frequent pathologic lesions affecting the prostatic gland in this period are benign prostatic hyperplasia (BPH) and prostate cancer (PC), the course of which may be influenced by the improper nutritional status of patients and their nutritional habits. The aim of this study was, therefore, to evaluate the nutritional status and eating habits of men diagnosed and treated for one of the above diseases. MATERIAL AND METODS: The nutritional status of 30 male patients with clinically confirmed and treated disease of the prostatic gland, including 15 men (aged 51-75 years) with BPH and 15 men (aged 51-73 years) with PC, was evaluated based on their BMI, WC, WHR, and WHtR parameters. In turn, the energy and nutritive value of 90 daily food rations (DFRs) was evaluated. Finally, calculations were made for the Key's index of diet atherogenicity, resultant Glycemic Index (GI) and Glycemic Load (GL). Higher values of the BMI, WC, WHR and WHtR parameters were noted in the men with PC, they were also characterized by a higher incidence of peripheral subcutaneous obesity and visceral obesity. The DFRs of the men were characterized by a low energy value and by a low intake of available carbohydrates, dietary fi ber, K, Ca, Mg, vitamins D and C, and fl uids at a simultaneously high intake of total and animal protein, cholesterol, Na, P, Fe, Cu as well as vitamins B2 and PP. The contribution of energy derived from the basic nutrients diverged from the recommended values. In addition, the DFRs were characterized by high values of Key's index and 24-h GL. Differences in meeting the RDA for selected nutrients between the analysed groups of men were statistically significant. The improper nutritional status of the men may result from their incorrect nutritional habits which fail to improve their health status, and even predispose them to the development of some diet-dependent diseases. In view of that, both correction of diets of the surveyed men, as well as their health-promoting nutritional education in the aspect of prostate diseases seem necessary.

Lowering dietary glycaemic index through nutrition education among Malaysian women with a history of gestational diabetes mellitus.

PubMed

Sangeetha-Shyam; Fatimah, A; Rohana, A G; Norasyikin, A W; Karuthan, C; Nik, Shanita S; Mohd, Yusof B N; Nor, Azmi K

2013-04-01

Gestational diabetes mellitus (GDM) increases risks for type 2 diabetes and cardiovascular diseases. Low glycaemic index (GI) diets improve cardio-metabolic outcomes in insulin-resistant individuals. We examined the feasibility of lowering GI through GI-based-education among Asian post-GDM women. A 3-month investigation was carried out on 60 Malaysian women with a mean age of 31.0 +/- 4.5 years and a history of GDM. Subjects were randomised into two groups: LGIE and CHDR. The CHDR group received conventional healthy dietary recommendations only. The LGIE group received GI based-education in addition to conventional healthy dietary recommendations. At baseline and after 3-months, dietary intake of energy and macronutrient intakes including GI diet and glycaemic load was assessed using 3-day food records. Diabetes-Diet and GI-concept scores and physical activity levels were assessed using a questionnaire. Adherence to dietary instructions was measured at the end of 3 months. At the end of 3 months, the LGIE group had significant reductions in energy intake (241.7 +/- 522.4Kcal, P = 0.037, ES=0.463), total carbohydrate (48.7 +/- 83.5g, P = 0.010, ES = 0.583), GI (3.9 +/- 7.1, P = 0.017, ES = 0.549) and GL (39.0 +/- 55.3, P = 0.003, ES = 0.705) and significant increases in protein (3.7 +/- 5.4g, 0.003, ES = 0.685) and diet fibre (4.6 +/- 7.3g, P = 0.06). The CHDR group had a significant reduction in fat only (5.7 +/- 9.4g, P = 0.006, ES = 0.606). There was a 30% increase in GI-concept scores in the LGIE group (p < 0.001). Changes in GI-concept scores correlated significantly to the reduction in dietary GI (r = -0.642, P = 0.045). Dietary adherence was comparable in both groups. GI-education improves GI-concept knowledge and helps lower dietary glycaemic index among women with a history of GDM.

[Integral indices of peripheral blood leukogram in the estimation of non-specific immunological reactivity in patients with ischemic heart disease].

PubMed

Zhukhorov, L S; Voronaia, Iu L

2002-12-01

With the help of differential blood count analysis and velocity of erythrocyte sedimentation (VES), 30 healthy persons (donors), 30 patients with chronic ischemic hearty disease (IHD) and 34 patients with acute myocardial infarction (AMI) underwent the procedure of calculation for leukocyte index (LI), leukocyte intoxication index (LII), leukocyte shift index (LSI), leukocyte and VES ratio (LVESR), leukocytic and granulocytic index (LGI), general index (GI), neurophil-lymphocyte ratio (NLR), neurophil-monocyte ratio (NMR), lymphocyte-monocyte ratio (LMR) and lymphocyte-eosinophil ratio (LER). Unlike healthy people, patients with chronic IHD had higher indices of LVESR, GI and LER while patients with AMI had increasing indices of LII, LSI, NLR, LER and decreasing indices of LI, LGI, GI, LMI. In case of AMI compared with chronic IHD, average indices of LII, LSI, NLR were higher and indices of LI, LGI, LVESR, GI, LMR were lower. The obtained results show expansion of possibilities to get information about the state of non-specific immunologic reactivity in patients with various IHD forms with the help of integral indices in blood leukogram.

Low glycaemic index diet and disposition index in type 2 diabetes (the Canadian trial of carbohydrates in diabetes): a randomised controlled trial.

PubMed

Wolever, T M S; Mehling, C; Chiasson, J-L; Josse, R G; Leiter, L A; Maheux, P; Rabasa-Lhoret, R; Rodger, N W; Ryan, E A

2008-09-01

We recently found that oral glucose tolerance over 1 year in type 2 diabetic patients declined to a significantly lesser degree on a low-glycaemic-index than on a reduced-carbohydrate diet. Here, we examined whether that finding was associated with an improvement in disposition index, an index of beta cell function defined as the product of insulin sensitivity and insulin secretion. Since this is a report of secondary analysis on a previously published trial, the results should be considered as hypothesis-generating. Type 2 diabetic patients treated by diet alone (n = 162) were randomised by computer to high-carbohydrate/high-glycaemic index (High-GI, n = 52), high-carbohydrate/low-glycaemic index (Low-GI, n = 56) or low-carbohydrate/high-monounsaturated-fat (Low-CHO, n = 54) diets for 1 year in a multi-centre, parallel-design clinical trial conducted at University teaching hospitals. At baseline and at 3, 6 and 12 months participants underwent 75 g OGTTs; 27 participants dropped out or were excluded. Indices of insulin sensitivity, insulin secretion and disposition index, derived from the OGTT, were compared among diets. Those assessing the outcomes were blinded to group assignment. Neither muscle insulin sensitivity index nor insulinogenic index differed significantly among diets. However, a significant time x diet interaction existed for disposition index (muscle insulin sensitivity index x insulinogenic index) (p = 0.036). After 3 months, disposition index tended to be higher on Low-CHO than on Low-GI diets, namely by 0.07 h(-1) (95% CI -0.04, 0.18). However, by 12 months this reversed and disposition index became higher on Low-GI than on Low-CHO, namely by 0.12 h(-1) (0.01, 0.23; p < 0.05, baseline disposition index 0.23 h(-1)). There were no important adverse effects associated with the treatments. These results suggest that, in patients with type 2 diabetes on diet alone, a Low-GI diet for 1 year increases disposition index, an index of beta cell function, compared with a Low-CHO diet.

Estimation of glycaemic index of peach palm (Bactris gasipaes) cooked fruits and chips, and pitahaya (Hylocereus spp.) pulp.

PubMed

Jiménez, Gin; Gómez, Georgina; Pérez, Ana M; Blanco-Metzler, Adriana

2012-09-01

The glycaemic index (GI) is a physiological measure of a food's potential to increase postprandial blood glucose, as compared to the effect produced by food taken as reference, such as glucose or white bread. Currently researchers and consumers are interested in low GI foods, since their consumption is associated with better weight control and reduced risk of incidence of chronic diseases, like diabetes. In the present study, the GI value for peach palm cooked fruit, peach palm chips and pitahaya pulp was estimated. The methodology established by the FAO/WHO for determining the GI of food was used. A total of 12 healthy, non-smoking volunteers were selected and they ingested the fore mentioned foods on different occasions, in 25 g portions of available carbohydrates, after 12-14 h overnight fast. Blood glucose levels were measured in 30 min intervals up to 120 min after ingestion. Average GI value was 48 +/- 11 for the pitahaya pulp and 35 +/- 6 for the peach palm cooked fruit, which may be classified as low glyceamic index foods. The GI of peach palm chips was 60 +/- 7, corresponding to a food with a moderate GI. The processing for producing the chips caused an increase in the GI value when compared to the cooked fruit, probably because the stages of miIling, moulding and baking promote availability of starch during hydrolysis by the digestive enzymes.

Evaluating compliance to a low glycaemic index (GI) diet in women with polycystic ovary syndrome (PCOS).

PubMed

Egan, Nicola; Read, Anna; Riley, Paddy; Atiomo, William

2011-03-08

A low Glycaemic Index (GI) diet may decrease some long-term health risks in Polycystic Ovary Syndrome (PCOS) such as endometrial cancer. This study was performed to assess compliance to a low GI diet in women with PCOS. Food diaries prospectively collected over 6 months from women on a low GI diet or healthy eating diet were analysed retrospectively. The women were recruited for a pilot randomised control trial investigating whether a low GI diet decreased the risk of Endometrial Cancer. Nine women with PCOS completed 33 food diaries (17 from women on a low GI diet and 16 from women on a healthy eating diet) recording 3023 food items (low GI group:n = 1457; healthy eating group:n = 1566). Data was analysed using Foster-Powell international values inserted into an SPSS database as no scientifically valid established nutrition software was found. The main outcome measures were mean item GI and Glyacemic Load (GL), mean meal GL, percentage high GI foods and mean weight loss. Women allocated the low GI diet had a statistically significant lower GI of food items (33.67 vs 36.91, p < 0.05), lower percentage of high GI foods (4.3% vs 12.1%, p < 0.05) and lower GL of food items and meals. Women with PCOS on a low GI diet consumed food items with a significantly lower mean GI and GL compared to the healthy eating diet group. Longer term compliance needs evaluation in subsequent studies to ascertain that this translates to reduced long term health risks. ISRCTN: ISRCTN86420258.

The Association of Bread and Rice with Metabolic Factors in Type 2 Diabetic Patients.

PubMed

Akhoundan, Mahdieh; Shadman, Zhaleh; Jandaghi, Parisa; Aboeerad, Maryam; Larijani, Bagher; Jamshidi, Zahra; Ardalani, Hamidreza; Khoshniat Nikoo, Mohsen

2016-01-01

Carbohydrates are shown to have an important role in blood glucose control, type 2 diabetes and cardiovascular diseases risk. This is even more challenging when considering populations consuming refined grains diets. Bread and rice are staple foods which supply main proportion of Iranian calorie intake. This study was designed to investigate the effect of bread and rice intake on blood glucose control, lipid profile and anthropometric measurements in Iranian type 2 diabetic patients. 426 patients with type 2 diabetes were included in this study. Anthropometric measurements were done using standard methods. Dietary information was assessed by a valid and reliable food frequency questionnaire (FFQ). Fasting blood glucose (FBG), glycated hemoglobin (HbA1c), serum triglycride (TG), total cholesterol (TC), low density lipoprotein (LDL) and high density lipoprotein (HDL) cholesterol were examined after 12-hour fasting. The results represented that people in the highest tertile compared to the lowest tertile of calorie adjusted total bread intake have higher FBG. FBG in the highest tertile of calorie adjusted total bread-rice intake was also significantly higher than the lowest. The association remained significant after adjusting for potential confounders. Rice intake showed no association with cardio-metabolic risk factors. We founded that higher total bread intake and total bread-rice intake were associated with FBG in type 2 diabetic patients whereas rice intake was not associated with glucose and lipid profile. This result should be confirmed in prospective studies, considering varieties, glycemic index (GI), glycemic load (GL) and cooking method of bread and rice.

Association between Carbohydrate Intake and Serum Lipids

PubMed Central

Ma, Yunsheng; Chiriboga, David E.; Olendzki, Barbara C.; Li, Wenjun; Leung, Katherine; Hafner, Andrea R.; Li, Youfu; Ockene, Ira S.; Hebert, James R.

2006-01-01

Background The effect of dietary carbohydrate on blood lipids has received considerable attention in light of the current trend in lowering carbohydrate intake for weight loss. Objectives To evaluate the association between carbohydrate intake and serum lipids. Methods Blood samples and 24-hour dietary and physical activity recall interviews were obtained from each subject at quarterly intervals for five consecutive quarters between 1994 and 1998 from 574 healthy adults in Central Massachusetts. Relationships between serum lipids and dietary carbohydrate factors were assessed using linear mixed models and adjusting for other risk factors known to be related to blood lipids. Both cross-sectional and longitudinal results were reported. Results Cross-sectional analysis results from this study suggest that higher total carbohydrate intake, percentage of calories from carbohydrate, glycemic index (GI) and/or glycemic load (GL) are related to lower high-density lipoprotein cholesterol (HDL-C) and higher serum triacylglycerol levels, while higher total carbohydrate intake and/or GL are related to lower total and low-density lipoprotein cholesterol (LDL-C) levels. In a one-year longitudinal analysis, GL was positively associated with total and LDL-C levels, and there was an inverse association between percentage of calories from carbohydrate and HDL-C levels. Conclusions Results suggest that there is a complex and predominantly unfavorable effect of increased intake of highly processed carbohydrate on lipid profile, which may have implications for metabolic syndrome, diabetes, and coronary heart disease. Further studies in the form of randomized controlled trials are required to investigate these associations and determine the implications for lipid management. PMID:16582033

Glycaemic index of four commercially available breads in Malaysia.

PubMed

Yusof, Barakatun Nisak Mohd; Abd Talib, Ruzita; Karim, Norimah A; Kamarudin, Nor Azmi; Arshad, Fatimah

2009-09-01

This study was carried out to determine the blood glucose response and glycaemic index (GI) values of four types of commercially available breads in Malaysia. Twelve healthy volunteers (six men, six women; body mass index, 21.9±1.6 kg/m(2); age, 22.9±1.7 years) participated in this study. The breads tested were multi-grains bread (M-Grains), wholemeal bread (WM), wholemeal bread with oatmeal (WM-Oat) and white bread (WB). The subjects were studied on seven different occasions (four tests for the tested breads and three repeated tests of the reference food) after an overnight fast. Capillary blood samples were taken immediately before (0 min) and 15, 30, 45, 60, 90 and 120 min after consumption of the test foods. The blood glucose response was obtained by calculating the incremental area under the curve. The GI values were determined according to the standardized methodology. Our results showed that the M-Grains and WM-Oat could be categorized as intermediate GI while the WM and WB breads were high GI foods, respectively. The GI of M-Grains (56±6.2) and WM-Oat (67±6.9) were significantly lower than the reference food (glucose; GI = 100) (P < 0.05). No significant difference in GI value was seen between the reference food and the GI of WM (85±5.9) and WB (82±6.5) (P > 0.05). Among the tested breads, the GI values of M-Grains and WM-Oat were significantly lower (P < 0.05) than those of WM and WB. There was no relationship between the dietary fibre content of the bread with the incremental area under the curve (r = 0.15, P = 0.15) or their GI values (r = 0.17, P = 0.12), indicating that the GI value of the test breads were unaffected by the fibre content of the breads. The result of this study will provide useful nutritional information for dieticians and the public alike who may prefer low-GI over high-GI foods.

Counting Carbs? Understanding Glycemic Index and Glycemic Load

MedlinePlus

... seems to support the concept that the more complex carbohydrates will lead to better blood sugar control than ... everybody, not only diabetics, to eat the more complex carbohydrates because they will be more gradually absorbed, and ...

Effect of fiber sources on fatty acids profile, glycemic index, and phenolic compound content of in vitro digested fortified wheat bread.

PubMed

Kurek, Marcin Andrzej; Wyrwisz, Jarosław; Karp, Sabina; Wierzbicka, Agnieszka

2018-05-01

In this study, some dietary fiber (DF) sources were investigated as fortifiers of wheat bread: oat (OB), flax (FB), and apple (AB). Adding oat and flax fibers to bread significantly changed the fatty acid profiles. OB was highest in oleic acid (33.83% of lipids) and linoleic acid (24.31% of lipids). Only in FB, γ-linolenic fatty acid was present in a significant amount-18.32%. The bioaccessibility trails revealed that the DF slow down the intake of saturated fatty acids. PUFA were least bioaccessible from all fatty acids groups in the range of (72% in OB to 87% in FB). The control bread had the greatest value (80.5) and was significantly higher than values for OB, FB, and AB in terms of glycemic index. OB, FB and AB addition led to obtain low glycemic index. AB had a significant highest value of total phenolic (897.2 mg/kg) with the lowest values in FB (541.2 mg/kg). The only significant lowering of caloric values in this study was observed in AB. The study could address the gap in the area of research about taking into consideration glycemic index, fatty acid profile and phenolic content in parallel in terms of DF application in breads.

Optimal timing of vitamin K antagonist resumption after upper gastrointestinal bleeding. A risk modelling analysis.

PubMed

Majeed, Ammar; Wallvik, Niklas; Eriksson, Joakim; Höijer, Jonas; Bottai, Matteo; Holmström, Margareta; Schulman, Sam

2017-02-28

The optimal timing of vitamin K antagonists (VKAs) resumption after an upper gastrointestinal (GI) bleeding, in patients with continued indication for oral anticoagulation, is uncertain. We included consecutive cases of VKA-associated upper GI bleeding from three hospitals retrospectively. Data on the bleeding location, timing of VKA resumption, recurrent GI bleeding and thromboembolic events were collected. A model was constructed to evaluate the 'total risk', based on the sum of the cumulative rates of recurrent GI bleeding and thromboembolic events, depending on the timing of VKA resumption. A total of 121 (58 %) of 207 patients with VKA-associated upper GI bleeding were restarted on anticoagulation after a median (interquartile range) of one (0.2-3.4) week after the index bleeding. Restarting VKAs was associated with a reduced risk of thromboembolism (HR 0.19; 95 % CI, 0.07-0.55) and death (HR 0.61; 95 % CI, 0.39-0.94), but with an increased risk of recurrent GI bleeding (HR 2.5; 95 % CI, 1.4-4.5). The composite risk obtained from the combined statistical model of recurrent GI bleeding, and thromboembolism decreased if VKAs were resumed after three weeks and reached a nadir at six weeks after the index GI bleeding. On this background we will discuss how the disutility of the outcomes may influence the decision regarding timing of resumption. In conclusion, the optimal timing of VKA resumption after VKA-associated upper GI bleeding appears to be between 3-6 weeks after the index bleeding event but has to take into account the degree of thromboembolic risk, patient values and preferences.

Effects of long-term intervention with low- and high-glycaemic-index breakfasts on food intake in children aged 8-11 years.

PubMed

Henry, C Jeya K; Lightowler, Helen J; Strik, Caroline M

2007-09-01

The aim of the present study was to investigate the effects of long-term intervention of low-glycaemic-index (GI) v. high-GI breakfasts on energy and macronutrient intakes in children aged 8-11 years. Preadolescent children were assigned to one of two groups in a random cross-over design. Each group was given low-GI and high-GI breakfasts on two non-consecutive days per week for 10 weeks per breakfast type. Each breakfast provided approximately 1273 kJ (300 kcal) and was closely matched for macronutrient and dietary fibre content. Subsequent food intake at an ad libitum buffet lunch was recorded and daily energy and macronutrient intakes were measured by 24 h recall and 3 d food diaries. There was a tendency towards a reduced energy intake at lunch following the low-GI breakfast compared with the high-GI breakfast, although the mean difference of 75 kJ (18 kcal) was not significant (P = 0.406). In particular, there was a trend towards a reduced energy intake in the low-GI arm compared with the high-GI arm among boys. In addition, data from the 3 d food diaries showed that there was a tendency towards a reduced energy intake during the low-GI compared with the high-GI study period. In conclusion, although the difference in energy intake following the low-GI and high-GI breakfasts was not statistically significant, the reduced energy intake following the low-GI breakfast is encouraging. Both dietary fibre and carbohydrate type may affect GI, thus their potential and relative modulating effect on appetite requires further investigation.

Is the omega-3 index a valid marker of intestinal membrane phospholipid EPA+DHA content?

PubMed

Gurzell, Eric A; Wiesinger, Jason A; Morkam, Christina; Hemmrich, Sophia; Harris, William S; Fenton, Jenifer I

2014-09-01

Despite numerous studies investigating n-3 long chain polyunsaturated fatty acid (LCPUFA) supplementation and inflammatory bowel diseases (IBD), the extent to which dietary n-3 LCPUFAs incorporate in gastrointestinal (GI) tissues and correlate with red blood cell (RBC) n-3 LCPUFA content is unknown. In this study, mice were fed three diets with increasing percent of energy (%en) derived from eicosapentaenoic acid (EPA)+docosahexaenoic acid (DHA). Dietary levels reflected recommended intakes of fish/fish oil by the American Heart Association. We analyzed the FA composition of phospholipids extracted from RBCs, plasma, and GI tissues. We observed that the 0.1%en EPA+DHA diet was sufficient to significantly increase the omega-3 index (RBC EPA+DHA) after 5 week feeding. The baseline EPA levels were 0.2-0.6% across all tissues increasing to 1.6-4.3% in the highest EPA+DHA diet; these changes resulted in absolute increases of 1.4-3.9% EPA across tissues. The baseline DHA levels were 2.2-5.9% across all tissues increasing to 5.8-10.5% in the highest EPA+DHA diet; these changes resulted in absolute increases of 3.2-5.7% DHA across tissues. These increases in EPA and DHA across all tissues resulted in strong (r>0.91) and significant (P<0.001) linear correlations between the omega-3 index and plasma/GI tissue EPA+DHA content, suggesting that the omega-3 index reflects the relative amounts of EPA+DHA in GI tissues. These data demonstrate that the GI tissues are highly responsive to dietary LCPUFA supplementation and that the omega-3 index can serve as a valid biomarker for assessing dietary EPA+DHA incorporation into GI tissues. Copyright © 2014 Elsevier Ltd. All rights reserved.

A Low Glycaemic Index Diet Incorporating Isomaltulose Is Associated with Lower Glycaemic Response and Variability, and Promotes Fat Oxidation in Asians.

PubMed

Henry, Christiani Jeyakumar; Kaur, Bhupinder; Quek, Rina Yu Chin; Camps, Stefan Gerardus

2017-05-09

Low glycaemic index (GI) foods minimize large blood glucose fluctuations and have been advocated to enhance fat oxidation and may contribute to weight management. We determined whether the inclusion of isomaltulose compared to sucrose in a low/high GI meal sequence can modulate the glycaemic response and substrate oxidation in an Asian population. Twenty Chinese men (body mass index (BMI): 17-28 kg/m²) followed a 24 h low GI (isomaltulose, Palatinose TM ) or high GI (sucrose) diet in a randomized double-blind, controlled cross-over design. Treatment meals included dinner (day 1), breakfast, lunch, and snack (day 2). Continuous glucose monitoring provided incremental area under the curve (iAUC) and mean amplitude of glycaemic excursion (MAGE) and 10 h indirect calorimetry (whole body calorimeter) (day 2) provided energy expenditure and substrate oxidation. Our results demonstrated that the low GI diet resulted in lower 24 h glucose iAUC (502.5 ± 231.4 vs. 872.6 ± 493.1 mmol/L; p = 0.002) and lower 24 h glycaemic variability (MAGE: 1.67 ± 0.53 vs. 2.68 ± 1.13 mmol/L; p < 0.001). Simultaneously, 10 h respiratory quotient increased more during high GI ( p = 0.014) and fat oxidation was higher after low GI breakfast ( p = 0.026), lunch ( p < 0.001) and snack ( p = 0.013). This indicates that lower GI mixed meals incorporating isomaltulose are able to acutely reduce the glycaemic response and variability and promote fat oxidation.

A Low Glycaemic Index Diet Incorporating Isomaltulose Is Associated with Lower Glycaemic Response and Variability, and Promotes Fat Oxidation in Asians

PubMed Central

Henry, Christiani Jeyakumar; Kaur, Bhupinder; Quek, Rina Yu Chin; Camps, Stefan Gerardus

2017-01-01

Low glycaemic index (GI) foods minimize large blood glucose fluctuations and have been advocated to enhance fat oxidation and may contribute to weight management. We determined whether the inclusion of isomaltulose compared to sucrose in a low/high GI meal sequence can modulate the glycaemic response and substrate oxidation in an Asian population. Twenty Chinese men (body mass index (BMI): 17–28 kg/m2) followed a 24 h low GI (isomaltulose, PalatinoseTM) or high GI (sucrose) diet in a randomized double-blind, controlled cross-over design. Treatment meals included dinner (day 1), breakfast, lunch, and snack (day 2). Continuous glucose monitoring provided incremental area under the curve (iAUC) and mean amplitude of glycaemic excursion (MAGE) and 10 h indirect calorimetry (whole body calorimeter) (day 2) provided energy expenditure and substrate oxidation. Our results demonstrated that the low GI diet resulted in lower 24 h glucose iAUC (502.5 ± 231.4 vs. 872.6 ± 493.1 mmol/L; p = 0.002) and lower 24 h glycaemic variability (MAGE: 1.67 ± 0.53 vs. 2.68 ± 1.13 mmol/L; p < 0.001). Simultaneously, 10 h respiratory quotient increased more during high GI (p = 0.014) and fat oxidation was higher after low GI breakfast (p = 0.026), lunch (p < 0.001) and snack (p = 0.013). This indicates that lower GI mixed meals incorporating isomaltulose are able to acutely reduce the glycaemic response and variability and promote fat oxidation. PMID:28486426

Evaluation of Glycemic Control, Lifestyle and Clinical Characteristics in Patients with Type 2 Diabetes Treated at King Abdullah University Hospital in Jordan.

PubMed

Al-Eitan, Laith N; Nassar, Ahmad M; Saadeh, Nesreen A; Almomani, Basima A

2016-12-01

The study aimed to assess glycemic control in a Jordanian population with type 2 diabetes and to explore the sociodemographic, clinical and medication-related factors as well as the anthropometric indexes and laboratory values associated with and possibly contributing to unsatisfactory glycemic control. We included 237 patients previously diagnosed as having type 2 diabetes. Data were collected through direct interviews. Sociodemographic and clinical details were collected using a questionnaire designed for the purpose of the study, anthropometric measurements were obtained at the time of the interviews, and laboratory data were extracted from the medical records of King Abdullah University Hospital. Of the participants, 60.8% were found to have unsatisfactory glycemic control (glycated hemoglobin levels ≥7%). Unsatisfactory glycemic control was associated with younger ages at diabetes diagnosis, higher mean weights and higher prevalences of diabetic neuropathy. No relationships were found among glycemic control and body mass index, waist circumference or central obesity. Patients with adequate control were more likely to have health insurance and to have hypothyroidism as a comorbidity. Insulin use and medication plans containing insulin were associated with unsatisfactory control. Patients with unsatisfactory control had higher mean levels of low-density lipoproteins and triglycerides and lower mean levels of high-density lipoproteins. Moreover, elevated triglycerides (≥150 mg/dL) and dyslipidemia were associated with unsatisfactory glycemic control. More than half of the participants had unsatisfactory glycemic control, highlighting the need for a change in the approach and strategies used for patients with diabetes in Jordan. Factors associated with glycemic control that were found in this study should be further studied and used in the prevention and management of diabetes. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

SU-F-T-613: Multi-Lesion Cranial SRS VMAT Plan Quality

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ballangrud, A; Kuo, L; Happersett, L

Purpose: Cranial SRS VMAT plans must have steep dose gradient around each target to reduce dose to normal brain. This study reports on the correlation between gradient index (GI=V50%/V100%), target size and target dose heterogeneity index (HI=PTV Dmax/prescription dose) for multi-lesion cranial SRS VMAT plans. Methods: VMAT plans for 10 cranial cases with 3 to 6 lesions (total 39 lesions) generated in Varian Eclipse V11.0.47 with a fine-tuned AAA beam model and 0.125 cm dose grid were analyzed. One or two iso centers were used depending on the spatial distribution of lesions. Two to nine coplanar and non-coplanar arcs weremore » used per isocenter. Conformity index (CI= V100%/VPTV), HI, and GI were determined for each lesion. Dose to critical structures were recorded. Results: Lesion size ranged from 0.05–11.00 cm3. HI ranged from 1.2–1.4, CI ranged from 1.0–2.8 and GI from 3.1–8.4. Maximum dose to brainstem, chiasm, lenses, optic nerves and eyes ranged from 120–1946 cGy, 47–463 cGy, 9–121 cGy, 14–512 cGy, and 17–294 cGy, respectively. Brain minus PTV (Brain-PTV) V7Gy was in the range 1.1–6.5%, and Brain-PTV Dmean was in the range 94–324 cGy. Conclusion: This work shows that a GI < 5 can be achieved for lesions > 0.4cc. For smaller lesions, GI increases rapidly. GI is lower when HI is increased. Based on this study, recommend HI is 1.4, and recommended GI is for volumes <0.1cc GI<9, 0.1–0.4cc GI<6, 0.4–0.1.0cc GI<5, and for volumes >1.0cc GI<4. CI is < 1.3 for all lesions except for targets < 0.1cc. Cranial SRS VMAT plans must be optimized to lower the GI to reduce the dose to normal brain tissue.« less

Effects of vitamin D-fortified low fat yogurt on glycemic status, anthropometric indexes, inflammation, and bone turnover in diabetic postmenopausal women: A randomised controlled clinical trial.

PubMed

Jafari, Tina; Faghihimani, Elham; Feizi, Awat; Iraj, Bijan; Javanmard, Shaghayegh Haghjooy; Esmaillzadeh, Ahmad; Fallah, Aziz A; Askari, Gholamreza

2016-02-01

Low levels of serum 25-hydroxy vitamin D (25(OH)D) are common in type 2 diabetic patients and cause several complications particularly, in postmenopausal women due to their senile and physiological conditions. This study aimed to assess the effects of vitamin D-fortified low fat yogurt on glycemic status, anthropometric indexes, inflammation, and bone turnover in diabetic postmenopausal women. In a randomized, placebo-controlled, double-blind parallel-group clinical trial, 59 postmenopausal women with type 2 diabetes received fortified yogurt (FY; 2000 IU vitamin D in 100 g/day) or plain yogurt (PY) for 12 weeks. Glycemic markers, anthropometric indexes, inflammatory, and bone turnover markers were assessed at baseline and after 12 weeks. After intervention, in FY group (vs PY group), were observed: significant increase in serum 25(OH)D and decrease of PTH (stable values in PY); significant improvement in serum fasting insulin, HOMA-IR, HOMA-B, QUICKI, and no changes in serum fasting glucose and HbA1c (significant worsening of all indexes in PY); significant improvement in WC, WHR, FM, and no change in weight and BMI (stable values in PY); significant increase of omentin (stable in PY) and decrease of sNTX (significant increase in PY). Final values of glycemic markers (except HbA1c), omentin, and bone turnover markers significantly improved in FY group compared to PY group. Regarding final values of serum 25(OH)D in FY group, subjects were classified in insufficient and sufficient categories. Glycemic status improved more significantly in the insufficient rather than sufficient category; whereas the other parameters had more amelioration in the sufficient category. Daily consumption of 2000 IU vitamin D-fortified yogurt for 12 weeks improved glycemic markers (except HbA1c), anthropometric indexes, inflammation, and bone turnover markers in postmenopausal women with type 2 diabetes. www.irct.ir (IRCT2013110515294N1). Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

The glycaemic index: importance of dietary fibre and other food properties.

PubMed

Björck, Inger; Elmståhl, Helena Liljeberg

2003-02-01

An increasing body of evidence suggests that a low-glycaemic-index (GI) diet has a therapeutic as well as a preventive potential in relation to the insulin resistance syndrome. The implementation of a low-GI diet, however, will require an extended list of low-GI foods to be available on the market. The tailoring of low-GI bread products offers a particular challenge due to their generally high GI and abundance in the diet. Low-GI bread products can be tailored by, for example,enclosure of cereal kernels, sour dough fermentation and/or addition of organic acids, or use of cereal genotypes with elevated contents of amylose or f-glucans. Low-GI cereal foods appear to vary in effect on 'second-meal' glucose tolerance in healthy subjects. In addition to the slow-release properties of such foods, the content of dietary fibre appears to play a role. The low glycaemia to starch in a pasta breakfast (GI 54) promoted a higher glucose tolerance and lowered triacylglycerol levels at a standardized lunch ingested 4 h later, compared with a white-wheat-bread breakfast (GI 100). The metabolic benefits of the low GI properties per se have been demonstrated also in the longer term. Thus, a reduction in dietary GI improved glucose and lipid metabolism and normalized fibrinolytic activity in type 2 diabetics, while maintaining a similar amount and composition of dietary fibre. However, the higher dietary fibre content frequently associated with low-GI foods may add to the metabolic merits of a low-GI diet. Consequently, a low-GI barley meal rich in dietary fibre (GI 53) improved glucose tolerance from evening meal to breakfast, whereas an evening meal with pasta had no effect (GI 54). The exchange of common high-GI bread for low-GI high-fibre bread, as the only dietary modification, improved insulin economy in women at risk of type 2 diabetes. These results are in accordance with epidemiological evidence of a reduced risk of type 2 diabetes with a low-GI diet rich in cereal fibre. It is concluded that low-GI cereal foods developed should preferably be rich in dietary fibre.

White vegetables: glycemia and satiety.

PubMed

Anderson, G Harvey; Soeandy, Chesarahmia Dojo; Smith, Christopher E

2013-05-01

The objective of this review is to discuss the effect of white vegetable consumption on glycemia, satiety, and food intake. White vegetables is a term used to refer to vegetables that are white or near white in color and include potatoes, cauliflowers, turnips, onions, parsnips, white corn, kohlrabi, and mushrooms (technically fungi but generally considered a vegetable). They vary greatly in their contribution to the energy and nutrient content of the diet and glycemia and satiety. As with other foods, the glycemic effect of many white vegetables has been measured. The results illustrate that interpretation of the semiquantitative comparative ratings of white vegetables as derived by the glycemic index must be context dependent. As illustrated by using the potato as an example, the glycemic index of white vegetables can be misleading if not interpreted in the context of the overall contribution that the white vegetable makes to the carbohydrate and nutrient composition of the diet and their functionality in satiety and metabolic control within usual meals. It is concluded that application of the glycemic index in isolation to judge the role of white vegetables in the diet and, specifically in the case of potato as consumed in ad libitum meals, has led to premature and possibly counterproductive dietary guidance.

Correlation between heterogeneity index (HI) and gradient index (GI) for high dose stereotactic radiotherapy/radiosurgery (SRT/SRS)

NASA Astrophysics Data System (ADS)

Tas, B.; Durmus, I. F.; Okumus, A.; Uzel, O. E.

2017-02-01

To evaluate between Heterogeneity Index (HI) and Gradient Index (GI) correlation for high dose Stereotactic radiotherapy (SRT) / Stereotactic radiosurgery (SRS) using Versa HD® lineer accelerator. Nine patients with single metastasis were used in this study. Patient's treatment planning were performed using Monaco5.1® Treatment planning system (TPS) with non-coplanar 6MV Flattening filter free (FFF) beams by partial Volumetric modulated arc therapy (VMAT) tecnique for each patient. We determined three different size of metastasis catagory which are less than 1cc, between 1cc and 5cc and larger than 5cc volume. Also, three different HI were calculated for each patients. These are 1.10, 1.20 and 1.30. Mean GI was determined 8.57±2.2 for 1.10 HI, 7.23±1.7 for 1.20 HI and 6.0±1.1 for 1.30 HI for less than 1cc metastasis. Then GI was determined 4.77±0.4 for 1.10 HI, 4.37±0.3 for 1.20 HI and 3.97±0.3 for 1.30 HI for between 1cc and 5cc metastasis. Finally, GI was determined 4.00±0.5 for 1.10 HI,3.63±0.5 for 1.20 HI and 3.27±0.4 for 1.30 HI for larger than 5cc metastasis. These results show that GI depends on significantly size and HI of metastasis especially for less than 1cc.

Effect of dietary curries on the glycaemic index.

PubMed

Pirasath, S; Thayaananthan, K; Balakumar, S; Arasaratnam, V

2010-12-01

Determination of the glycaemic index (GI) of different basic foods in combination with different curries. METHODS; Healthy volunteers (n = 20) of 21.05 (+/- 0.92) years old, 53.90 (+/- 9.36) kg in body weight, 153.92 (+/- 9.15) cm in height and 20.55 (+/- 2.22) kgm(-2) of body mass index were included. After overnight fasting, 75g of glucose and each test food containing 75g of digestible carbohydrate were administered and blood glucose level measured half hourly for two hours. The GI was calculated and analysed by randomised complete block design using SAS analytical package. The mean GI values of parboiled rice ('Mottaikarupan') either with green leaf curry (Amaranthus) or gravy (soya meat) or green leaf curry and gravy were 47.47 (+/- 11.21), 56.30 (+/- 9.31) and 54.67 (+/- 10.03) % respectively. The mean GI of 'kurakkan pittu' (Eleucine coracana) with the above curries were 57.51 (+/- 5.52), 63.25 (+/- 8.86) and 59.25 (+/- 5.49) % respectively. The mean GI of 'atta pittu' (whole wheat grain flour) with the above curries were 44.40 (+/-14.27), 50.80 (+/- 9.35) and 46.29 (+/- 8.90) % respectively. The GI of parboiled rice or 'kurakkan pittu' or 'atta pittu' with green leaf curry differed significantly (p < 0.05) from other combined foods. The GI of parboiled rice or 'kurakkan pittu' or 'atta pittu' with gravy or green leaf curry and gravy did not differ significantly (p > 0.05) among them. 'Kurakkan pittu' is inferior to 'atta pittu' and parboiled rice. Including curries to basic foods altered the GI. Therefore, when dietary advice is given to diabetic patients, not only the basic foods, but also the curries to be consumed have to be considered.

Higher dietary glycemic index and glycemic load values increase the risk of osteoporotic fracture in the PREvención con DIeta MEDiterránea (PREDIMED)-Reus trial.

PubMed

García-Gavilán, Jesús Francisco; Bulló, Mònica; Camacho-Barcia, Lucia; Rosique-Esteban, Nuria; Hernández-Alonso, Pablo; Basora, Josep; Martínez-González, Miguel Angel; Estruch, Ramón; Fitó, Montserrat; Salas-Salvadó, Jordi

2018-06-01

High glucose and insulin concentrations seem to have a negative impact on bone health. However, the relation between the dietary glycemic index (DGI) and the dietary glycemic load (DGL), which has proved to be effective at modulating blood glucose concentrations after carbohydrate consumption, has yet to be explored in relation to bone health. The aim of the study was to examine the associations between the DGI or DGL and the risk of osteoporotic-related fractures in an elderly Mediterranean population. The study was conducted in 870 subjects aged 55-80 y at high cardiovascular disease risk participating in the PREvención con DIeta MEDiterránea (PREDIMED)-Reus study. The DGI and DGL were estimated from validated food-frequency questionnaires with the use of the international glycemic index and glycemic load values, with glucose as reference. Data on osteoporotic fractures were acquired from a systematic review of medical records. We used Cox proportional hazard models to assess the risk of osteoporotic fracture according to tertiles of average DGI and DGL. A total of 114 new cases of osteoporotic-related fractures were documented after a mean follow-up of 8.9 y. Participants in the highest tertile of DGI and DGL had a significantly higher risk of osteoporotic fractures than those in the lowest tertile after adjusting for potential confounders (HR: 1.80; 95% CI: 1.03, 3.15 and HR: 3.20; 95% CI: 1.25, 8.18, respectively). A high DGI and DGL are associated with a higher risk of osteoporosis-related fractures in an elderly Mediterranean population at high cardiovascular disease risk. This trial was registered at isrctn.com as ISRCTN35739639.

[Socioeconomic, demographic, nutritional, and physical activity factors in the glycemic control of adolescents with type 1 diabetes mellitus].

PubMed

Marques, Rosana de Morais Borges; Fornés, Nélida Schmid; Stringhini, Maria Luiza Ferreira

2011-04-01

To identify the association of socioeconomic, demographic, nutritional and of physical activity factors in the glycemic control of adolescents with T1DM. Sectional study of 71 adolescents with type 1 diabetes. Socioeconomic, demographic and anthropometric data were obtained. The glycemic control was classified by the index of glycated hemoglobin (A1C). Four 24-hours recalls of food consumption and physical activity were applied. The A1C was inadequate for the majority of the adolescents. The low educational level of the caregivers influenced the inadequate glycemic control. Patients with lower insulin dose presented better glycemic control. The food consumption was high of fat and poor of carbohydrate. Most of the patients were sedentary. Factors related to education, insulin and food consumption influenced the glycemic control.

PlantGI: a database for searching gene indices in agricultural plants developed at NIAB, Korea

PubMed Central

Kim, Chang Kug; Choi, Ji Weon; Park, DongSuk; Kang, Man Jung; Seol, Young-Joo; Hyun, Do Yoon; Hahn, Jang Ho

2008-01-01

The Plant Gene Index (PlantGI) database is developed as a web-based search system with search capabilities for keywords to provide information on gene indices specifically for agricultural plants. The database contains specific Gene Index information for ten agricultural species, namely, rice, Chinese cabbage, wheat, maize, soybean, barley, mushroom, Arabidopsis, hot pepper and tomato. PlantGI differs from other Gene Index databases in being specific to agricultural plant species and thus complements services from similar other developments. The database includes options for interactive mining of EST CONTIGS and assembled EST data for user specific keyword queries. The current version of PlantGI contains a total of 34,000 EST CONTIGS data for rice (8488 records), wheat (8560 records), maize (4570 records), soybean (3726 records), barley (3417 records), Chinese cabbage (3602 records), tomato (1236 records), hot pepper (998 records), mushroom (130 records) and Arabidopsis (8 records). Availability The database is available for free at http://www.niab.go.kr/nabic/. PMID:18685722

Contributors to dietary glycaemic index and glycaemic load in the Netherlands: the role of beer.

PubMed

Sluik, Diewertje; Atkinson, Fiona S; Brand-Miller, Jennie C; Fogelholm, Mikael; Raben, Anne; Feskens, Edith J M

2016-04-14

Diets high in glycaemic index (GI) and glycaemic load (GL) have been associated with a higher diabetes risk. Beer explained a large proportion of variation in GI in a Finnish and an American study. However, few beers have been tested according to International Organization for Standardization (ISO) methodology. We tested the GI of beer and estimated its contribution to dietary GI and GL in the Netherlands. GI testing of pilsner beer (Pilsner Urquell) was conducted at The University of Sydney according to ISO international standards with glucose as the reference food. Subsequently, GI and GL values were assigned to 2556 food items in the 2011 Dutch food composition table using a six-step methodology and consulting four databases. This table was linked to dietary data from 2106 adults in the Dutch National Food Consumption Survey 2007-2010. Stepwise linear regression identified contribution to inter-individual variation in dietary GI and GL. The GI of pilsner beer was 89 (SD 5). Beer consumption contributed to 9·6 and 5·3% inter-individual variation in GI and GL, respectively. Other foods that contributed to the inter-individual variation in GI and GL included potatoes, bread, soft drinks, sugar, candy, wine, coffee and tea. The results were more pronounced in men than in women. In conclusion, beer is a high-GI food. Despite its relatively low carbohydrate content (approximately 4-5 g/100 ml), it still made a contribution to dietary GL, especially in men. Next to potatoes, bread, sugar and sugar-sweetened beverages, beer captured a considerable proportion of between-person variability in GI and GL in the Dutch diet.

Co-composting of livestock manure with rice straw: characterization and establishment of maturity evaluation system.

PubMed

Qian, Xiaoyong; Shen, Genxiang; Wang, Zhenqi; Guo, Chunxia; Liu, Yangqing; Lei, Zhongfang; Zhang, Zhenya

2014-02-01

Composting is considered to be a primary treatment method for livestock manure and rice straw, and high degree of maturity is a prerequisite for safe land application of the composting products. In this study pilot-scale experiments were carried out to characterize the co-composting process of livestock manure with rice straw, as well as to establish a maturity evaluation index system for the composts obtained. Two pilot composting piles with different feedstocks were conducted for 3 months: (1) swine manure and rice straw (SM-RS); and (2) dairy manure and rice straw (DM-RS). During the composting process, parameters including temperature, moisture, pH, total organic carbon (TOC), organic matter (OM), different forms of nitrogen (total, ammonia and nitrate), and humification index (humic acid and fulvic acid) were monitored in addition to germination index (GI), plant growth index (PGI) and Solvita maturity index. OM loss followed the first-order kinetic model in both piles, and a slightly faster OM mineralization was achieved in the SM-RS pile. Also, the SM-RS pile exhibited slightly better performance than the DM-RS according to the evolutions of temperature, OM degradation, GI and PGI. The C/N ratio, GI and PGI could be included in the maturity evaluation index system in which GI>120% and PGI>1.00 signal mature co-composts. Copyright © 2013 Elsevier Ltd. All rights reserved.

The impact of eating behavior on psychological symptoms typical of reactive hypoglycemia. A pilot study comparing women with polycystic ovary syndrome to controls.

PubMed

Barry, John A; Bouloux, Pierre; Hardiman, Paul J

2011-08-01

The idea that diet can affect mood and behavior in women with polycystic ovary syndrome (PCOS) by altering blood glucose levels has become popular in recent years. This paper describes an online survey (N=462) of 24 women with PCOS, 299 healthy control women, 47 women who possibly had undiagnosed PCOS, and 92 men. The groups were compared for symptoms of mood and behavioral symptoms typical of reactive (postprandial) hypoglycemia. The outcome measures were two questionnaires that measure states associated with hypoglycemia: the Hypoglycemia Symptom Checklist-7 (HSC-7), which measures behavioral symptoms and the Mood Adjective Checklist (MACL), which measures emotional states. Controlling for age and body mass index (BMI) using between-groups analysis of covariance (ANCOVA), the women with PCOS scored significantly higher than the other three groups (p<0.001) on the outcome measures. These differences remained statistically significant in a subset of twelve women with PCOS compared to twelve healthy control women closely matched for age, BMI, and eating behavior. The findings are suggestive of hypoglycemia-related mood and behavioral problems in PCOS. Future research should test whether blood glucose levels correlate with these symptoms in PCOS, and whether a low glycemic index ('low-GI') diet improves the symptoms. Copyright © 2011 Elsevier Ltd. All rights reserved.

Pre_GI: a global map of ontological links between horizontally transferred genomic islands in bacterial and archaeal genomes

PubMed Central

Pierneef, Rian; Cronje, Louis; Bezuidt, Oliver; Reva, Oleg N.

2015-01-01

Abstract The Predicted Genomic Islands database (Pre_GI) is a comprehensive repository of prokaryotic genomic islands (islands, GIs) freely accessible at http://pregi.bi.up.ac.za/index.php . Pre_GI, Version 2015, catalogues 26 744 islands identified in 2407 bacterial/archaeal chromosomes and plasmids. It provides an easy-to-use interface which allows users the ability to query against the database with a variety of fields, parameters and associations. Pre_GI is constructed to be a web-resource for the analysis of ontological roads between islands and cartographic analysis of the global fluxes of mobile genetic elements through bacterial and archaeal taxonomic borders. Comparison of newly identified islands against Pre_GI presents an alternative avenue to identify their ontology, origin and relative time of acquisition. Pre_GI aims to aid research on horizontal transfer events and materials through providing data and tools for holistic investigation of migration of genes through ecological niches and taxonomic boundaries. Database URL: http://pregi.bi.up.ac.za/index.php , Version 2015 PMID:26200753

Do we need a geoelectric index?

NASA Technical Reports Server (NTRS)

Holzworth, R.; Volland, H.

1986-01-01

The need for a geoelectric index (GI) measuring the global level of atmospheric electrical activity for a given time is assessed, and methods for defining a GI are compared. Current problems in atmospheric and space electrodynamics (the global circuit, solar-terrestrial coupling, lightning effects on the ionosphere/magnetosphere, and mesospheric generators), atmospheric chemistry (the stratospheric ozone cycle and atmospheric gravity waves), and meteorology (fog forecasting) are reviewed to illustrate the usefullness of a GI. Derivations of a GI from in situ electrical measurements and from ground or satellite remote sensing of source properties are described, and a system based on ground measurement of the intensity of the Schumann resonance lines (as proposed by Polk, 1982) is found to be the most practical, requiring as few as three (automatically operated) stations for global coverage.

The glycaemic index and insulinaemic index of commercially available breakfast and snack foods in an Asian population.

PubMed

Tan, Wei Shuan Kimberly; Tan, Wei Jie Kevin; Ponnalagu, Shalini D/O; Koecher, Katie; Menon, Ravi; Tan, Sze-Yen; Henry, Christiani J

2018-05-01

A low-glycaemic-index (GI) breakfast has been shown to lower blood glucose levels throughout the day. A wide variety of breakfast foods are consumed, but their GI values are largely unknown, hence limiting consumers' ability to select healthier options. This study investigated the GI values of ten common breakfast (five Asian and five Western) foods in this region using a randomised, cross-over study design. Participants arrived after an overnight fast, and fasting blood sample was taken before participants consumed test foods. Next, blood samples were taken at fixed intervals for 180 min. Glycaemic and insulinaemic responses to test foods were calculated as incremental AUC over 120 min, which were subsequently reported as glycaemic and insulinaemic indices. In all, nineteen healthy men (nine Chinese and ten Indians) aged 24·7 (sem 0·4) years with a BMI of 21·7 (sem 0·4) kg/m2 completed the study. Asian breakfast foods were of medium (white bun filled with red bean paste=58 (sem 4); Chinese steamed white bun=58 (sem 3)) to high GI (rice idli=85 (sem 4); rice dosa=76 (sem 5); upma=71 (sem 6)), whereas Western breakfast foods were all of low GI (whole-grain biscuit=54 (sem 5); whole-grain biscuit filled with peanut butter=44 (sem 3); whole-grain oat muesli=55 (sem 4); whole-grain oat protein granola=51 (sem 4); whole-grain protein cereal=49 (sem 3)). The GI of test foods negatively correlated with protein (r s -0·366), fat (r s -0·268) and dietary fibre (r s -0·422) (all P<0·001). GI values from this study contribute to the worldwide GI database, and may assist healthcare professionals in recommending low-GI breakfast to assist in lower daily glycaemia among Asians who are susceptible to type 2 diabetes mellitus.

[Effect of fragmentation and quality of carbohydrates diet on metabolic control parameters in insulin treated type 2 diabetic individuals].

PubMed

Sambra Vásquez, Verónica; Tapia Fernández, Carolina; Vega Soto, Claudia

2015-04-01

Currently there is no consensus regarding fragmentation, quantity and quality of carbohydrates (CHO) that should be followed by insulin treated type 2 diabetic individuals (ITT2D). To determine the relationship between the meal times, quality of available CHO in every meal and the metabolic control parameters in ITT2D individuals with a single or double dose of intermediate-acting insulin. 40 ITT2D individuals were evaluated, using food surveys to obtain the quantity of CHO, glycemic index (GI), glycemic load (GL) in every meal and meal times. The metabolic control was determined through lab exams (glycated hemoglobin; HbA1c, venous fasting glycaemia) and fasting (FBG), preprandial (PreG), postprandial (PostG) and bed time (BTG) capilar glycaemia using a glucometer. Statistical analysis were applied considering significant as p<0,05. Individuals recorded an average of 4,9 ± 1,1 meals a day. It was found an asociation between lunch GL and Post G (r=0,317; p<0,05) and BTG (r=0,321; p<0,05). BTG was inversely correlated with the meals' distribution (r = -0,346; p<0,05) and there was a trend to show lower values of BTG with individuals conducting ≥5 meals per day. It was observed that FBG predicts a 65%the variability of HbA1c (r =0,805; r2 =0,648; p<0,001). The meal times in ITT2D individuals with s single or doublé dose of intermédiate-acting insulin could improve BTG. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Starch digestibility and glycemic index of Paranthas supplemented with Citrus maxima (Burm.) Merr. fruit segments.

PubMed

Reshmi, S K; Sudha, M L; Shashirekha, M N

2017-12-01

The present investigation was undertaken to develop paranthas suiting diabetic population with added health benefits. Paranthas were prepared using fresh and dry segments of pomelo. The increase in the concentration of segments decreased the texture value from 1080 to 1022 g force (fresh segments) and 1005 to 870 g force (dry segments). Naringin along with other bioactive compounds were retained to a greater extent in Paranthas containing dry pomelo fruit segments. Paranthas prepared using 20% (fresh) and 5% (dry) were sensorily acceptable. The pomelo incorporated paranthas had higher levels of resistance starch fractions (12.94%) with low predicted glycemic index (49.89%) compared to control Paranthas at 5.54 and 58.64% respectively. The fortified paranthas with an considerable content of bioactive compounds and low glycemic index indicate the possibility of using it as a dietary supplement. Thus utilization of pomelo fortification helps in improving the nutritional and functional property of paranthas suiting diabetes as well as general population.

Influence of low versus moderate glycemic index of diet on substrate oxidation and energy expenditure during incremental exercise in endurance athletes: a randomized counterbalanced cross-over trial.

PubMed

Durkalec-Michalski, Krzysztof; Zawieja, Emilia Ewa; Zawieja, Bogna Ewa; Podgórski, Tomasz; Jurkowska, Dominika; Jeszka, Jan

2017-12-18

The study was aimed at assessing the influence of 3-week low glycemic index (LGI) versus moderate glycemic index (MGI) diet on substrate oxidation during incremental exercise. 17 runners completed two 3-week trials of either LGI or MGI diet in a randomised counterbalanced manner. Before and after each trial the incremental cycling test was performed. Metabolic alternations were observed only within tested diets and no significant differences in fat and carbohydrate (CHO) oxidation were found between MGI and LGI diets. Following MGI diet CHO oxidation rate increased. The AUC of fat oxidation decreased after both diets. Percent contribution of fat to energy yield declined, whereas contribution of CHO was augmented following MGI diet. This study indicates that the 3-week MGI diet increased the rate of carbohydrate oxidation during incremental cycling test and improved performance in acute intense exercise test, while both high-carbohydrate diets downregulated fat oxidation rate.

The Effect of Dietary Glycaemic Index on Glycaemia in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

PubMed

Ojo, Omorogieva; Ojo, Osarhumwese Osaretin; Adebowale, Fajemisin; Wang, Xiao-Hua

2018-03-19

The increasing prevalence of diabetes in the United Kingdom and worldwide calls for new approaches to its management, and diets with low glycaemic index have been proposed as a useful means for managing glucose response. However, there are conflicting reports and differences in the results of studies in terms of their effectiveness. Furthermore, the impact of low-glycaemic index diets and their long-term use in patients with type 2 diabetes remains unclear. The objective of this study was to conduct a systematic review and meta-analysis of the effect of low-glycaemic index diets in patients with type 2 diabetes. Search methods: Randomised controlled studies were selected from a number of databases (EBSCOHost with links to Health Research databases, PubMed, and grey literature) based on the Population, Intervention, Comparator, Outcomes and Study designs (PICOS) framework. The search terms included synonyms and Medical Subject Headings (MeSH) and involved the use of Boolean operators (AND/OR) which allowed the combination of words and search terms. As per the selection criteria, the following types of articles were selected: studies on randomised controlled trials, with year of publication between 2008 and 2018, including patients with type 2 diabetes. Thus, studies involving patients with gestational and type 1 diabetes were excluded, as were observational studies. Nine articles which met the inclusion criteria were selected for the systematic review, whereas only six articles which met the criteria were included in the meta-analysis. Studies were evaluated for quality and risk of bias. In addition, heterogeneity, meta-analysis, and sensitivity tests of the extracted data were carried out using Review Manager 5.3 (Review Manager, 2014). The findings of the systematic review showed that the low-glycaemic index (low-GI) diet resulted in a significant improvement (<0.05) in glycated haemoglobin (HbA1c) in two studies: low-GI diet Δ = -0.5% (95% CI, -0.61% to -0.39%) vs. high-cereal fibre diet Δ = -0.18% (95% CI, -0.29% to -0.07%); and low-GI legume diet Δ = -0.5% (95%, -0.6% to -0.4%) vs. high-wheat fibre diet Δ = -0.3% (95% Cl, -0.4 to -0.2%). There was a slight improvement in one study (low glycaemic response = 6.5% (6.3-7.1) vs. control = 6.6% (6.3-7.0) and no significant difference ( p > 0.05) in four studies compared with the control diet. Four studies showed improvements in fasting blood glucose in low-GI diets compared to higher-GI diets or control: low-GI diet = 150.8 ± 8.7 vs. higher-GI diet = 157.8 ± 10.4 mg/dL, mean ± SD p = 0.43; low-GI diet = 127.7 vs. high-cereal fibre diet = 136.8 mg/dL, p = 0.02; low-GI diet = 6.5 (5.6-8.4) vs. standard diabetic diet = 6.7 (6.1-7.5) mmol/L, median and interquartile range p > 0.05; and low-GI diet = 7.3 ± 0.3 vs. conventional carbohydrate exchange diet = 7.7 ± 0.4 mmol/L, mean ± SEM (Standard Error of Mean) p < 0.05. The results of the meta-analysis and sensitivity tests demonstrated significant differences ( p < 0.001 and p < 0.001, respectively) between the low-GI diet and the higher-GI diet or control diet in relation to glycated haemoglobin. Differences between the low-GI diet and higher-GI diet or control were significant ( p < 0.05) with respect to the fasting blood glucose following meta-analysis. The low-GI diet is more effective in controlling glycated haemoglobin and fasting blood glucose compared with a higher-GI diet or control in patients with type 2 diabetes.

Issues in Nutrition: Carbohydrates.

PubMed

Thompson, Margaret E; Noel, Mary Barth

2017-01-01

Carbohydrates include sugars, starches, and dietary fibers. Resistant starches resemble fiber in their behavior in the intestinal tract, and may have positive effects on blood glucose levels and the gut microbiome. Fibers are classified as soluble and insoluble, but most fiber-containing foods contain a mixture of soluble and insoluble fiber. Soluble fiber has been shown to lower low-density lipoprotein cholesterol levels. Many artificial sweeteners and other sugar substitutes are available. Most natural sources of sweeteners also are energy sources. Many artificial sweeteners contain no kilocalories in the amounts typically used. Sugar alcohols may have a laxative effect when consumed in large amounts. Glycemic index and glycemic load are measurements that help quantify serum glucose response after ingestion of particular foods. These measurements may be affected by the combination of foods consumed in a given meal, and the glycemic index may vary among individuals eating the same meal. Eating foods with a low glycemic index may help prevent development of type 2 diabetes. There is no definitive evidence to recommend low-carbohydrate diets over low-fat diets for long-term weight loss; they are equally effective. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

White Vegetables: Glycemia and Satiety12

PubMed Central

Anderson, G. Harvey; Soeandy, Chesarahmia Dojo; Smith, Christopher E.

2013-01-01

The objective of this review is to discuss the effect of white vegetable consumption on glycemia, satiety, and food intake. White vegetables is a term used to refer to vegetables that are white or near white in color and include potatoes, cauliflowers, turnips, onions, parsnips, white corn, kohlrabi, and mushrooms (technically fungi but generally considered a vegetable). They vary greatly in their contribution to the energy and nutrient content of the diet and glycemia and satiety. As with other foods, the glycemic effect of many white vegetables has been measured. The results illustrate that interpretation of the semiquantitative comparative ratings of white vegetables as derived by the glycemic index must be context dependent. As illustrated by using the potato as an example, the glycemic index of white vegetables can be misleading if not interpreted in the context of the overall contribution that the white vegetable makes to the carbohydrate and nutrient composition of the diet and their functionality in satiety and metabolic control within usual meals. It is concluded that application of the glycemic index in isolation to judge the role of white vegetables in the diet and, specifically in the case of potato as consumed in ad libitum meals, has led to premature and possibly counterproductive dietary guidance. PMID:23674805

Glycaemic Index and Load Values Tested in Normoglycemic Adults for Five Staple Foodstuffs: Pounded Yam, Pounded Cassava-Plantain, Placali, Attieke and Maize Meal Stiff Porridge

PubMed Central

Kouamé, Adam C.; Kouassi, Kouakou N.; N’dri, Yao D.; Amani, N’guessan G.

2015-01-01

There is currently an increased global interest in the published glycaemic index (GI) and glycaemic load (GL) values of foods. However, data on the GI and GL values of different varieties of foods within Côte d’Ivoire are very limited. The study therefore aimed at finding the GI and GL of the main food staples in Côte d’Ivoire. Following the International Standard Organisation’s protocol (ISO/FDI 26642:2010), a selection of five staple foodstuffs were tested for their GI and GL. Fasted healthy subjects were given 50 g of available carbohydrate servings of a glucose reference, which was tested twice, and test foods which were tested once, on separate occasions. Excepted attieke (GI 63), the majority of foods tested have a high GI (GI > 70). Attieke (agbodjama) had a high GL (GL 29) while placali (GL 17) and maize meal stiff porridge (GL 16) had medium GLs. The GLs of pounded cassava-plantain and pounded yam are 26 and 22. Consumption of attieke could minimize postprandial blood glucose spikes, in spite of high GL and potentially have benefit in the management and prevention of some chronic diseases. PMID:25690417

Pregnancy, exercise and nutrition research study with smart phone app support (Pears): Study protocol of a randomized controlled trial.

PubMed

Kennelly, Maria A; Ainscough, Kate; Lindsay, Karen; Gibney, Eileen; Mc Carthy, Mary; McAuliffe, Fionnuala M

2016-01-01

Maternal adiposity confers an increased risk of GDM in pregnancy. A low glycemic index (GI) dietary intervention has been found to improve glucose homeostasis and reduce gestational weight gain. Mobile Health (mHealth) Technology-assisted interventions are becoming commonplace as an aid to treating many chronic diseases. The aim of this study is to assess the impact of a 'healthy lifestyle package' with mHealth smart phone technology as support compared with usual care on the incidence of GDM in an overweight and obese pregnant population. We propose a randomized controlled trial of an mHealth assisted healthy lifestyle intervention package versus standard obstetric care in pregnant women with a BMI ≥25kg/m(2)-39.9kg/m(2). Patients are randomized to control or intervention group in a 1:1 ratio. The intervention arm healthy lifestyle package includes a motivational counseling session to encourage behavior change, involving targeted, low GI nutritional advice and daily physical activity prescription delivered before 18weeks gestation, as well as a smart phone app to provide ongoing healthy lifestyle advice and support throughout pregnancy. The primary outcome is the incidence of GDM at 29weeks' gestation and power analysis indicates that 253 women are required in each group to detect a difference. This will be the first clinical trial to evaluate the effectiveness of a smart phone technology-assisted targeted healthy lifestyle intervention, which is grounded in behavior change theories and techniques, to support antenatal management of an overweight and obese pregnant population in preventing GDM. Copyright © 2015 Elsevier Inc. All rights reserved.

Impact of Dietary Fiber Consumption on Insulin Resistance and the Prevention of Type 2 Diabetes.

PubMed

Weickert, Martin O; Pfeiffer, Andreas F H

2018-01-01

Large prospective cohort studies consistently show associations of a high dietary fiber intake (>25 g/d in women and >38 g/d in men) with a 20-30% reduced risk of developing type 2 diabetes (T2D), after correction for confounders. It is less well recognized that these effects appear to be mainly driven by high intakes of whole grains and insoluble cereal fibers, which typically are nonviscous and do not relevantly influence postprandial glucose responses [i.e., glycemic index (GI)] or are strongly fermented by the gut microbiota in the colon. In contrast, a dietary focus on soluble, viscous, gel-forming, more readily fermentable fiber intakes derived from fruit and certain vegetables yields mixed results and generally does not appear to reduce T2D risk. Although disentangling types of fiber-rich foods and separating these from possible effects related to the GI is an obvious challenge, the common conclusion that key metabolic effects of high-fiber intake are explained by mechanisms that should mainly apply to the soluble, viscous type can be challenged. More recently, studies in humans and animal models focused on gaining mechanistic insights into why especially high-cereal-fiber (HCF) diets appear to improve insulin resistance (IR) and diabetes risk. Although effects of HCF diets on weight loss are only moderate and comparable to other types of dietary fibers, possible novel mechanisms have emerged, which include the prevention of the absorption of dietary protein and modulation of the amino acid metabolic signature. Here we provide an update of our previous review from 2008, with a focus on mechanistic insights of how HCF diets may improve IR and the risk of developing T2D. © 2018 American Society for Nutrition. All rights reserved.

Safety, tolerability, and efficacy of metformin extended-release oral antidiabetic therapy in patients with type 2 diabetes: An observational trial in Asia

PubMed Central

Kim, Chul-Hee; Han, Kyung-Ah; Oh, Han-Jin; Tan, Kevin Eng-Kiat; Sothiratnam, Radhakrishna; Tjokroprawiro, Askandar; Klein, Marcus

2012-01-01

Background The aim of the present prospective observational study was to assess the tolerability and antihyperglycemic efficacy of metformin extended-release (MXR) in the routine treatment of patients with type 2 diabetes mellitus (T2DM) from six Asian countries. Methods Data from 3556 patients treated with once-daily MXR for 12 weeks, or until discontinuation, were analyzed. Results Treatment with MXR was well tolerated, with 97.4% of patients completing 12 weeks of treatment. Only 3.3% of patients experienced one or more gastrointestinal (GI) side-effects and only 0.7% of patients discontinued for this reason (primary endpoint). The incidence of GI side-effects and related discontinuations appeared to be considerably lower during short-term MXR therapy than during previous treatment (mean 2.71 years’ duration), most commonly with immediate-release metformin. A 12-week course of MXR therapy also reduced HbA1c and fasting glucose levels from baseline. Conclusions The present study provides new insights into the incidence of GI side-effects with MXR in Asian patients with T2DM and on the tolerability of MXR in non-Caucasian populations. Specifically, these data indicate that once-daily MXR not only improves measures of glycemic control in Asian patients with T2DM, but also has a favorable GI tolerability profile that may help promote enhanced adherence to oral antidiabetic therapy. PMID:22742083

The glycaemic index values of foods containing fructose are affected by metabolic differences between subjects.

PubMed

Wolever, T M S; Jenkins, A L; Vuksan, V; Campbell, J

2009-09-01

Glycaemic responses are influenced by carbohydrate absorption rate, type of monosaccharide absorbed and the presence of fat; the effect of some of these factors may be modulated by metabolic differences between subjects. We hypothesized that glycaemic index (GI) values are affected by the metabolic differences between subjects for foods containing fructose or fat, but not for starchy foods. The GI values of white bread (WB), fruit leather (FL) and chocolate-chip cookies (CCC) (representing starch, fructose and fat, respectively) were determined in subjects (n=77) recruited to represent all 16 possible combinations of age (< or =40, >40 years), sex (male, female), ethnicity (Caucasian, non-Caucasian) and body mass index (BMI) (< or =25, >25 kg/m2) using glucose as the reference. At screening, fasting insulin, lipids, c-reactive protein (CRP), aspartate transaminase (AST) and waist circumference (WC) were measured. There were no significant main effects of age, sex, BMI or ethnicity on GI, but there were several food x subject-factor interactions. Different factors affected each food's area under the curve (AUC) and GI. The AUC after oral glucose was related to ethnicity, age and triglycerides (r 2=0.27); after WB to ethnicity, age, triglycerides, sex and CRP (r 2=0.43); after CCC to age and weight (r 2=0.18); and after FL to age and CRP (r 2=0.12). GI of WB was related to ethnicity (r 2=0.12) and of FL to AST, insulin and WC (r 2=0.23); but there were no significant correlations for CCC. The GI values of foods containing fructose might be influenced by metabolic differences between -subjects, whereas the GI of starchy foods might be affected by ethnicity. However, the proportion of variation explained by subject factors is small.

Experimental assessment of oral hygiene achieved by children wearing rapid palatal expanders, comparing manual and electric toothbrushes.

PubMed

Mazzoleni, S; Bonaldo, G; Pontarolo, E; Zuccon, A; De Francesco, M; Stellini, E

2014-08-01

The aim was to compare the efficacy of the electric versus the manual toothbrush in terms of the oral hygiene achieved by patients wearing rapid palatal expanders (RPEs). Forty patients were randomly divided into two groups; one equipped with a manual toothbrush (Group A), the other with an electric toothbrush (Group B). Each child's plaque index (PI) and gingival index (GI) were calculated at banded molar level at times T0 (before banding), T1 (a month later), T2 (3 months later) and T3 (when the expander was removed). At each appointment, the PI and GI were recorded and the patient was remotivated. The level of oral hygiene achieved by the group using an electric toothbrush produced a greater improvement in the two indexes than in the group using the manual toothbrush that showed no statistically significant improvement (PI T0-T3: P = 0.309; GI T0-T3: P = 0.141). Both indexes dropped considerably in both groups from T0 to T2, but more so in the group B. From T2 to T3, although the electric toothbrush continued to be substantially more effective, Group B showed a statistically significant deterioration in the oral hygiene (PI +20%; GI +33%). Other assessments conducted on particular areas of the tooth showed improvements in the PI (-33%) for the vestibular region, and for the GI (-57%) in the palatal region among the patients in Group B, while there were no significant changes in these indexes in Group A. Our findings show that the electric toothbrush is statistically more efficient in performing an adequate level of oral hygiene in children wearing RPE. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Glycaemic index and glycaemic load values of cereal products and weight-management meals available in the UK.

PubMed

Henry, C Jeya K; Lightowler, Helen J; Dodwell, Lis M; Wynne, Jacqueline M

2007-07-01

There is currently an increased global interest in the published glycaemic index (GI) values of foods. The aim of the present work was to supplement a previous study on the glycaemic response of 140 foods available in the UK by studying a further forty-four foods. One hundred and twenty-two healthy subjects, with a mean age of 32.4 (sd 11.4) years and a mean BMI of 23.6 (sd 3.6) kg/m2, were recruited to the study. Subjects were served equivalent available carbohydrate amounts (50 or 30 g) of test foods (cereal products and weight-management meals) and a standard food (glucose) on separate occasions. Capillary blood glucose was measured from finger-prick samples in fasted subjects (0 min) and at 15, 30, 45, 60, 90 and 120 min after starting to eat each test food. For each test food, the GI value was determined, and the glycaemic load was calculated as the product of the GI and the amount of available carbohydrate in a reference serving size. The GI values of the foods tested ranged from 23 to 83. Of the forty-four foods tested, thirty-three were classified as low-GI, eight as medium-GI and three as high-GI foods. Most GI values of the foods tested compared well with previously published values for similar foods. In summary, this study provides reliable GI and glycaemic load values for a range of foods, further advancing our understanding of the glycaemic response of different foods. The data reported here make an important addition to published GI values.

Application and opportunities of pulses in food system: a review.

PubMed

Asif, Muhammad; Rooney, Lloyd W; Ali, Rashida; Riaz, Mian N

2013-01-01

Pulses are highly nutritious seeds of pod-bearing leguminous plants, specifically dry peas, lentils, and chickpeas. US farmers harvest about 2.6 million pounds of pulses every year but 75% of this is being exported internationally because of its increased consumption in the developing countries. In the current scenario, increasing costs of production, bad economy, and fluctuating food commodity prices have made a strong case for US producers to seek opportunities to increase domestic consumption of pulses through value-added products. Pulses are the richest sources of plant proteins and provide approximately 10% of the total dietary requirements of the proteins world over. Pulses are also high in dietary fibers and complex carbohydrates leading to low GI (glycemic index) foods. Pulses help to lower cholesterol and triglycerides as leguminous fibers are hypoglycosuria because of consisting more amylose than amylopectin. Pulses provide tremendous opportunities to be utilized in the processed foods such as bakery products, bread, pasta, snack foods, soups, cereal bar filing, tortillas, meat, etc. These show excellent opportunities in frozen dough foods either as added flour or as fillings. Pulses in view of their nutrient profile, seem to be ideal for inclusion in designing snack foods, baby, and sports foods.

Early postoperative and late metabolic morbidity after pancreatic resections: An old and new challenge for surgeons - A review.

PubMed

Beger, Hans G; Mayer, Benjamin

2018-02-16

The metrics for measuring early postoperative morbidity after resection of pancreatic neoplastic tumors are overall morbidity, severe surgery-related morbidity, frequency of reoperation and reintervention, in-hospital, 30-day and 90-day mortality and length of hospital stay. Thirty-day readmission after discharge is additionally an indispensable criterion to assess quality of surgery. The metrics for surgery-associated long-term results after pancreatic resections are survival times, new onset of diabetes (DM), impaired glucose tolerance, exocrine pancreatic insufficiency, body mass index and GI motility dysfunctions. Following pancreaticoduodenectomy (PD) performed on pancreatic normo-glycemic patients for malignant and benign tumors, 4-30% develop postoperative new onset of diabetes. Long-term persistence of diabetes mellitus is observed after surgery for benign tumors in 14% and in 15.5% of patients after cancer resection. Pancreatic exocrine insufficiency after PD is observed in the early postoperative period in 23-80% of patients. Persistence of exocrine dysfunctions exists in 25% and 49% of patients. Following left-sided pancreatic resection, new onset DM is observed in 14% of cases; an exocrine insufficiency persisting in the long-term outcome is observed in 16-28% of patients. Copyright © 2018 Elsevier Inc. All rights reserved.

Regulation of Endogenous (Male) Rodent GLP-1 Secretion and Human Islet Insulin Secretion by Antagonism of Somatostatin Receptor 5.

PubMed

Farb, Thomas B; Adeva, Marta; Beauchamp, Thomas J; Cabrera, Over; Coates, David A; Meredith, Tamika DeShea; Droz, Brian A; Efanov, Alexander; Ficorilli, James V; Gackenheimer, Susan L; Martinez-Grau, Maria A; Molero, Victoriano; Ruano, Gema; Statnick, Michael A; Suter, Todd M; Syed, Samreen K; Toledo, Miguel A; Willard, Francis S; Zhou, Xin; Bokvist, Krister B; Barrett, David G

2017-11-01

Incretin and insulin responses to nutrient loads are suppressed in persons with diabetes, resulting in decreased glycemic control. Agents including sulfonylureas and dipeptidyl peptidase-4 inhibitors (DPP4i) partially reverse these effects and provide therapeutic benefit; however, their modes of action limit efficacy. Because somatostatin (SST) has been shown to suppress insulin and glucagonlike peptide-1 (GLP-1) secretion through the Gi-coupled SST receptor 5 (SSTR5) isoform in vitro, antagonism of SSTR5 may improve glycemic control via intervention in both pathways. Here, we show that a potent and selective SSTR5 antagonist reverses the blunting effects of SST on insulin secretion from isolated human islets, and demonstrate that SSTR5 antagonism affords increased levels of systemic GLP-1 in vivo. Knocking out Sstr5 in mice provided a similar increase in systemic GLP-1 levels, which were not increased further by treatment with the antagonist. Treatment of mice with the SSTR5 antagonist in combination with a DPP4i resulted in increases in systemic GLP-1 levels that were more than additive and resulted in greater glycemic control compared with either agent alone. In isolated human islets, the SSTR5 antagonist completely reversed the inhibitory effect of exogenous SST-14 on insulin secretion. Taken together, these data suggest that SSTR5 antagonism should increase circulating GLP-1 levels and stimulate insulin secretion (directly and via GLP-1) in humans, improving glycemic control in patients with diabetes. Copyright © 2017 Endocrine Society.

Dietary glycaemic index and glycaemic load among Australian children and adolescents: results from the 2011-2012 Australian Health Survey.

PubMed

Jones, Molly; Barclay, Alan W; Brand-Miller, Jennie C; Louie, Jimmy Chun Yu

2016-07-01

This study aimed to examine the dietary glycaemic index (GI) and glycaemic load (GL) of Australian children and adolescents, as well as the major food groups contributing to GL, in the recent 2011-2012 Australian Health Survey. Plausible food intake data from 1876 children and adolescents (51 % boys), collected using a multiple-pass 24-h recall, were analysed. The GI of foods was assigned based on a step-wise published method using values from common GI databases. Descriptive statistics were calculated for dietary GI, GL and contribution to GL by food groups, stratified by age group and sex. Linear regression was used to test for trends across age groups for BMI, dietary GI and GL, and intakes of energy, nutrients and food groups. Pearson's χ 2 test was used to test for differences between age groups for categorical subject characteristic variables. Mean dietary GI and GL of participants were 55·5 (sd 5·3) and 137·4 (sd 50·8), respectively. The main contributors to dietary GL were starchy foods: breads, cereal-based dishes, breakfast cereals, flours, grains and potatoes accounted for 41 % of total GL. Sweetened beverages, fruit and vegetable juices/drinks, cake-type desserts and sweet biscuits contributed 15 %. No significant difference (at P<0·001) was observed between sexes. In conclusion, Australian children and adolescents appear to consume diets with a lower GI than European children. Exchanging high-GI foods for low-GI alternatives within core and non-core foods may improve diet quality of Australian children and adolescents.

Diet compounds, glycemic index and obesity-related cardiac effects.

PubMed

Diniz, Yeda S; Burneiko, Regina M; Seiva, Fabio R F; Almeida, Flávia Q A; Galhardi, Cristiano Machado; Filho, José Luiz V B Novelli; Mani, Fernanda; Novelli, Ethel L B

2008-02-20

Diet compounds may influence obesity-related cardiac oxidative stress and metabolic sifting. Carbohydrate-rich diet may be disadvantageous from fat-rich diet to cardiac tissue and glycemic index rather than lipid profile may predict the obesity-related cardiac effects. Male Wistar rats were divided into three groups (n=8/group): (C) receiving standard chow (3.0 kcal/g); (CRD) receiving carbohydrate-rich diet (4.0 kcal/g), and (FRD) receiving fat-rich diet (4.0 kcal/g). Rats were sacrificed after the oral glucose tolerance test (OGTT) at 60 days of dietary treatments. Lipid profile and oxidative stress parameters were determined in serum. Myocardial samples were used to determine oxidative stress, metabolic enzymes, glycogen and triacylglycerol. FRD rats showed higher final body weight and body mass index than CRD and C. Serum cholesterol and low-density lipoprotein were higher in FRD than in CRD, while triacylglycerol and oxidized low-density lipoprotein cholesterol were higher in CRD than in FRD. CRD rats had the highest myocardial lipid hydroperoxide and diminished superoxide dismutase and catalase activities. Myocardial glycogen was lower and triacylglycerol was higher in CRD than in C and FRD rats. Although FRD rats had depressed myocardial-reducing power, no significant changes were observed in myocardial energy metabolism. Myocardial beta-hydroxyacyl coenzyme-A dehydrogenase and citrate synthase, as well as the enhanced lactate dehydrogenase/citrate synthase ratio indicated that fatty acid degradation was decreased in CRD rats. Glycemic index was positively correlated with obesity-related cardiac effects. Isoenergetic carbohydrate-rich and fat-rich diets induced different degree of obesity and differently affected lipid profile. Carbohydrate-rich diet was deleterious relative to fat-rich diet in the heart enhancing lipoperoxidation and shifting the metabolic pathway for energy production. Glycemic index rather than dyslipidemic profile may predict the obesity effects on cardiac tissue.

Relationships of self-reported dietary factors and perceived acne severity in a cohort of New York young adults.

PubMed

Burris, Jennifer; Rietkerk, William; Woolf, Kathleen

2014-03-01

Recent observational and experimental evidence suggests that diet may contribute to acne prevalence. To examine the differences in select dietary factors (glycemic index [GI], total sugar, added sugar, fruit/fruit juice, fruit/vegetables, vegetables, saturated fat, trans fat, and number of milk and fish servings per day) between groups of self-reported acne severity. Secondary objectives were to investigate the differences in food-aggravated acne beliefs and acne-specific quality-of-life between groups of self-reported acne severity. This study utilized a cross-sectional design. A total of 248 (115 male, 133 female) participants, age 18 to 25 years, completed questionnaires designed to measure self-reported acne severity, select dietary factors, food-aggravated acne beliefs, acne-specific quality-of-life, and anthropometric and demographic characteristics. The Block fat/sugar/fruit/vegetable food frequency questionnaire assessed usual dietary intake. Data were collected in New York City between January and May 2012. One-way between groups analysis of variance examined differences in dietary factors, anthropometric characteristics, and acne-specific quality-of-life between groups of self-reported acne. χ² tests compared food-aggravated acne beliefs and demographic characteristics between groups of self-reported acne. Compared with participants with no or mild acne, participants with moderate to severe acne reported greater dietary GI (P<0.001), added sugar (P<0.001), total sugar (P<0.001), number of milk servings per day (P<0.001), saturated fat (P<0.001), and trans-fatty acids (P<0.001), and fewer servings of fish per day (P=0.002). Among all participants, 58.1% perceived diet to aggravate or influence acne. This study suggests that diet, particularly dietary GI, saturated fat, trans fat, milk, and fish may influence or aggravate acne development. Future research is necessary to elucidate the proposed mechanisms linking diet and acne and determine the impact of medical nutrition therapy on acne development. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Glycaemic index and glycaemic load values of a selection of popular foods consumed in Hong Kong.

PubMed

Lok, Kris Y; Chan, Ruth; Chan, Dicken; Li, Liz; Leung, Grace; Woo, Jean; Lightowler, Helen J; Henry, C Jeya K

2010-02-01

The objective of the present paper is to provide glycaemic index (GI) and glycaemic load (GL) values for a variety of foods that are commonly consumed in Hong Kong and expand on the international GI table of Chinese foods. Fasted healthy subjects were given 50 g of available carbohydrate servings of a glucose reference, which was tested twice, and test foods of various brands of noodles (n 5), instant cereals (n 3) and breads (n 2), which were tested once, on separate occasions. For each test food, tests were repeated in ten healthy subjects. Capillary blood glucose was measured via finger-prick samples in fasting subjects ( - 5, 0 min) and at 15, 30, 45, 60, 90 and 120 min after the consumption of each test food. The GI of each test food was calculated geometrically by expressing the incremental area under the blood glucose response curve (IAUC) of each test food as a percentage of each subject's average IAUC for the reference food. GL was calculated as the product of the test food's GI and the amount of available carbohydrate in a reference serving size. The majority of GI values of foods tested were medium (a GI value of 56-69) to high (a GI value of 70 or more) and compared well with previously published values. More importantly, our dataset provides GI values of ten foods previously untested and presents values for foods commonly consumed in Hong Kong.

Effects of a beverage containing an enzymatically induced-viscosity dietary fiber, with or without fructose, on the postprandial glycemic response to a high glycemic index food in humans.

PubMed

Wolf, B W; Wolever, T M S; Lai, C S; Bolognesi, C; Radmard, R; Maharry, K S; Garleb, K A; Hertzler, S R; Firkins, J L

2003-09-01

Dietary supplementation with guar gum or fructose has been reported to reduce the postprandial glycemic response to an oral glucose challenge. As a result of the poor palatability of most foods containing guar gum, a novel low-viscosity beverage with guar gum was developed that becomes viscous in vivo through an enzymatic induction. The primary study objective was to determine the effect of an amylase-induced viscosity (I-V) product, with or without supplemental fructose, on the postprandial glycemic response to a high glycemic index test meal in healthy nondiabetic subjects. The study was a four-treatment, placebo-controlled, double-blind, randomized block protocol. The study was performed at Glycaemic Index Testing, Inc., Toronto, Ontario, Canada. A total of 30 healthy nondiabetic volunteers (13 male, 17 female, mean+/-s.e.m. age of 51+/-3 y and body mass index of 24.2+/-0.4 kg/m(2)) participated in the study. In the morning after an overnight fast, subjects participated in four 3-h meal glucose tolerance tests on separate occasions. The test meals contained 50 g of available carbohydrate from maltodextrin and white bread (control) or the same meal with either 5 g of guar gum (3.6 g galactomannan), 5 g of fructose, or 5 g of guar gum +5 g of fructose. Treatments containing guar gum had a reduced (P<0.01) baseline-adjusted peak glucose response and incremental area under the glucose curve. In contrast to previous studies, fructose increased (P<0.05) the baseline-adjusted peak glucose concentration. Guar gum incorporated into an amylase I-V product provided a means to stabilize blood glucose levels by reducing the early phase excursion and then by appropriately maintaining the later phase excursion in healthy nondiabetic humans.

Macronutrient Composition and Food Form Affect Glucose and Insulin Responses in Humans

PubMed Central

Shafaeizadeh, Shila; Muhardi, Leilani; van de Heijning, Bert J. M.; van der Beek, Eline M.

2018-01-01

Glycaemic index (GI) is used as an indicator to guide consumers in making healthier food choices. We compared the GI, insulin index (II), and the area under the curve for blood glucose and insulin as glucose (GR) and insulin responses (IR) of a newly developed liquid nutritional formula with one commercially available liquid product with different types of carbohydrates. We then evaluated the glucose and insulin responses of two test foods with comparable energy density and protein percentage but presented in different food forms (liquid vs. solid). Fourteen healthy women participated in the study. GI, II, GR, and IR were assessed after (independent) consumption of two liquid products and a solid breakfast meal. The two liquid foods showed comparable GI, whilst the liquid form appeared to produce lower median GI (25 vs. 54), and II (52 vs. 98) values compared to the solid breakfast (p < 0.02). The median GR and IR for solid breakfast were respectively 44% and 45% higher compared to the liquid product (p < 0.02). Liquid formulas with different carbohydrate qualities produced comparable glucose responses, while foods with comparable energy density and protein percentage but different food form elicited differential effects on GI, II, GR, and IR. Nutrient quality and food form need to be taken into consideration when developing low GI products to manage glycaemic responses. PMID:29419785

Effect of an intensive nutrition intervention of a high protein and low glycemic-index diet on weight of kidney transplant recipients: study protocol for a randomized clinical trial.

PubMed

Pedrollo, Elis Forcellini; Nicoletto, Bruna Bellincanta; Carpes, Larissa Salomoni; de Freitas, Júlia de Melo Cardoso; Buboltz, Julia Roberta; Forte, Cristina Carra; Bauer, Andrea Carla; Manfro, Roberto Ceratti; Souza, Gabriela Corrêa; Leitão, Cristiane Bauermann

2017-09-06

Excessive weight gain is commonly observed within the first year after kidney transplantation and is associated with negative outcomes, such as graft loss and cardiovascular events. The purpose of this study is to evaluate the effect of a high protein and low glycemic-index diet on preventing weight gain after kidney transplantation. We designed a prospective, single-center, open-label, randomized controlled study to compare the efficacy of a high protein (1.3-1.4 g/kg/day) and low-glycemic index diet versus a conventional diet (0.8-1.0 g/kg/day of protein) on preventing weight gain after kidney transplantation. A total of 120 eligible patients 2 months after transplantation will be recruited. Patients with an estimated glomerular filtration rate through the modification of diet of renal disease (MDRD) formula < 30 mL/min/1.73 m 2 or urinary albumin excretion > 300 mg/24 h will be excluded. Patients' diets will be allocated through simple sequential randomization. Patients will be followed-up for 12 months with nine clinic appointments with a dietitian and the evaluations will include nutritional assessment (anthropometrics, body composition, and resting metabolic rate) and laboratory tests. The primary outcome is weight maintenance or body weight gain under 5% after 12 months. Secondary outcomes include body composition, resting metabolic rate, satiety sensation, kidney function, and other metabolic parameters. Diets with higher protein content and lower glycemic index may lead to weight loss because of higher satiety sensation. However, there is a concern about the association of high protein intake and kidney damage. Nevertheless, there is little evidence on the impact of high protein intake on long-term kidney function outcome. Therefore, we designed a study to test if a high protein diet with low-glycemic index will be an effective and safe nutritional intervention to prevent weight gain in kidney transplant patients. ClinicalTrials.gov identifier, NCT02883777 . Registered on 3 August 2016.

Postprandial effects of breakfast glycaemic index on cognitive performance among young, healthy adults: A crossover clinical trial.

PubMed

Sanchez-Aguadero, Natalia; Recio-Rodriguez, Jose I; Patino-Alonso, Maria C; Mora-Simon, Sara; Alonso-Dominguez, Rosario; Sanchez-Salgado, Benigna; Gomez-Marcos, Manuel A; Garcia-Ortiz, Luis

2018-04-12

To evaluate the postprandial effects of high and low glycaemic index (GI) breakfasts on cognitive performance in young, healthy adults. A crossover clinical trial including 40 young, healthy adults (aged 20-40 years, 50% females) recruited from primary healthcare centres in Salamanca, Spain. Verbal memory, phonological fluency, attention, and executive functions were examined 0, 60, and 120 minutes after consuming a low GI (LGI), high GI (HGI), or water breakfast. Every subject tried each breakfast variant, in a randomized order, separated by a washout period of 7 days, for a total of 3 weeks. A significant interaction between the type of breakfast consumed and immediate verbal memory was identified (P<.05). We observed a trend towards better performance in verbal memory (delayed and immediate), attention, and phonological fluency following an LGI breakfast. Cognitive performance during the postprandial phase in young, healthy adults was minimally affected by the GI of breakfast. The potential for breakfast's GI modulation to improve short- and long-term cognitive functioning requires further research.

The use of dry Jerusalem artichoke as a functional nutrient in developing extruded food with low glycaemic index.

PubMed

Radovanovic, Ana; Stojceska, Valentina; Plunkett, Andrew; Jankovic, Slobodan; Milovanovic, Dragan; Cupara, Snezana

2015-06-15

This study considers the use of dry Jerusalem artichoke (JA) as a functional nutrient in developing food products with enhanced nutritional characteristics and low glycaemic index (GI). Three different formulations based on buckwheat and JA were developed and processed using extrusion technology. Nutritional properties including the levels of total dietary fibre (TDF), protein, inulin, total carbohydrates and lipids were analysed. A clinical study was performed on ten healthy volunteers (aged between 21 and 56) to determine the level of GI and glycaemic load (GL). The results revealed that JA significantly (P<0.05) increased the levels of TDF and inulin whilst decreasing carbohydrates, lipids and proteins. The resulting products had a significant (P<0.05) effect on IAUC between reference food and extruded products, GI and GL. Samples containing 80% of Jerusalem artichoke were considered as a low GI food whilst samples containing 30% and 60% of Jerusalem artichoke as a medium GI food. A similar trend was seen in terms of GL. Copyright © 2015. Published by Elsevier Ltd.

A Simple Composite Metric for the Assessment of Glycemic Status from Continuous Glucose Monitoring Data: Implications for Clinical Practice and the Artificial Pancreas.

PubMed

Hirsch, Irl B; Balo, Andrew K; Sayer, Kevin; Garcia, Arturo; Buckingham, Bruce A; Peyser, Thomas A

2017-06-01

The potential clinical benefits of continuous glucose monitoring (CGM) have been recognized for many years, but CGM is used by a small fraction of patients with diabetes. One obstacle to greater use of the technology is the lack of simplified tools for assessing glycemic control from CGM data without complicated visual displays of data. We developed a simple new metric, the personal glycemic state (PGS), to assess glycemic control solely from continuous glucose monitoring data. PGS is a composite index that assesses four domains of glycemic control: mean glucose, glycemic variability, time in range and frequency and severity of hypoglycemia. The metric was applied to data from six clinical studies for the G4 Platinum continuous glucose monitoring system (Dexcom, San Diego, CA). The PGS was also applied to data from a study of artificial pancreas comparing results from open loop and closed loop in adolescents and in adults. The new metric for glycemic control, PGS, was able to characterize the quality of glycemic control in a wide range of study subjects with various mean glucose, minimal, moderate, and excessive glycemic variability and subjects on open loop versus closed loop control. A new composite metric for the assessment of glycemic control based on CGM data has been defined for use in assessing glycemic control in clinical practice and research settings. The new metric may help rapidly identify problems in glycemic control and may assist with optimizing diabetes therapy during time-constrained physician office visits.

Glycaemic index of different coconut (Cocos nucifera)-flour products in normal and diabetic subjects.

PubMed

Trinidad, Trinidad P; Valdez, Divinagracia H; Loyola, Anacleta S; Mallillin, Aida C; Askali, Faridah C; Castillo, Joan C; Masa, Dina B

2003-09-01

The glycaemic index (GI) of commonly consumed bakery products supplemented with increasing levels of coconut (Cocos nucifera) flour was determined in ten normal and ten diabetic subjects. Using a randomized crossover design, the control and test foods were fed in random order on separate occasions after an overnight fast. Blood samples were collected through finger prick before and after feeding and were analysed for glucose levels using a clinical chemistry analyser. The significantly low-GI (<60) foods investigated were: macaroons (GI 45.7 (sem 3.0)) and carrot cake (GI 51.8 (sem 3.3)), with 200-250 g coconut flour/kg (P<0.05). The test foods with 150 g coconut flour/kg had GI ranging from 61.3 to 71.4. Among the test foods, pan de sal (GI 87.2 (sem 5.5)) and multigrain loaf (GI 85.2 (sem 6.8)) gave significantly higher GI with 50 and 100 g coconut flour/kg respectively (P<0.05). On the other hand, granola bar and cinnamon bread with 50 and 100 g coconut flour/kg respectively gave a GI ranging from 62.7 to 71.6 and did not differ significantly from the test foods with 150 g coconut flour/kg (P<0.05). A very strong negative correlation (r -0.85, n 11, P<0.005) was observed between the GI and dietary fibre content of the test foods supplemented with coconut flour. In conclusion, the GI of coconut flour-supplemented foods decreased with increasing levels of coconut flour and this may be due to its high dietary fibre content. The results of the present study may form a scientific basis for the development of coconut flour as a functional food. However, the fat content of coconut flour-supplemented food should always be considered to optimize the functionality of coconut fibre in the proper control and management of diabetes mellitus.

Nixtamalization Process Affects Resistant Starch Formation and Glycemic Index of Tamales.

PubMed

Mariscal-Moreno, Rosa María; de Dios Figueroa Cárdenas, Juan; Santiago-Ramos, David; Rayas-Duarte, Patricia; Veles-Medina, José Juan; Martínez-Flores, Héctor Eduardo

2017-05-01

Tamales were prepared with 3 nixtamalization processes (traditional, ecological, and classic) and evaluated for chemical composition, starch properties, and glycemic index. Resistant starch (RS) in tamales increased 1.6 to 3.7 times compared to raw maize. This increment was due to the starch retrogradation (RS3) and amylose-lipid complexes (RS5) formation. Tamales elaborated with classic and ecological nixtamalization processes exhibited the highest total, soluble and insoluble dietary fiber content, and the highest RS content and lower in vivo glycemic index compared to tamales elaborated with traditional nixtamalization process. Thermal properties of tamales showed 3 endotherms: amylopectin retrogradation (42.7 to 66.6 °C), melting of amylose lipid complex type I (78.8 to 105.4), and melting of amylose-lipid complex type II (110.7 to 129.7). Raw maize exhibited X-ray diffraction pattern type A, after nixtamalization and cooking of tamales it changed to V-type polymorph structure, due to amylose-lipid complexes formation. Tamales from ecological nixtamalization processes could represent potential health benefits associated with the reduction on blood glucose response after consumption. © 2017 Institute of Food Technologists®.

Impact of Timely Treatment Intensification on Glycemic Goal Achievement in Patients With Type 2 Diabetes Failing Metformin Monotherapy.

PubMed

Mahabaleshwarkar, Rohan; Templin, Megan; Gohs, Frank; Mulder, Holly; DeSantis, Andrea; Ejzykowicz, Flavia; Rajpathak, Swapnil; Wilkins, Nick

2017-10-01

Purpose The purpose of the study was to examine the association between timely treatment intensification (TTI) and glycemic goal achievement in patients with type 2 diabetes (T2D) failing metformin monotherapy (MM). Methods This study was set at a large integrated health care system in the United States. The study cohort included T2D patients aged 18 to 85 years who were on MM between January 2009 and September 2013 and had an uncontrolled glycated hemoglobin (A1C) reading (≥8%) after at least 3 months of MM (corresponding date was index date). Secondary analyses were performed using A1C <7% as T2D control. TTI was defined as receipt of an add-on therapy within 180 days after the index date. Impact of TTI on glycemic goal achievement was determined using multivariate Cox proportional hazards regression. Patients were censored at their last A1C reading or health care visit during 2 years after the index date. Results The study cohort consisted of 996 patients, ~58% male and ~59% Caucasian, with a mean age of ~54 (±12) years. TTI was observed in 50.2% of the patients. The rate of glycemic goal achievement was higher in patients with TTI compared with patients without TTI (hazards ratio = 1.632, 95% confidence interval = 1.328-2.006). The results for the secondary analyses were largely consistent with the primary findings. Conclusions TTI positively affected glycemic goal achievement among T2D patients failing MM and could be a useful strategy to increase the currently low proportion of patients with their T2D controlled in the United States.

Lower glycemic load meals reduce diurnal glycemic oscillations in women with risk factors for gestational diabetes

PubMed Central

Kizirian, Nathalie V; Goletzke, Janina; Brodie, Shannon; Atkinson, Fiona S; Markovic, Tania P; Ross, Glynis P; Buyken, Anette; Brand-Miller, Jennie C

2017-01-01

Objective Maternal glycemia plays a key role in fetal growth. We hypothesized that lower glycemic load (GL) meals (lower glycemic index, modestly lower carbohydrate) would substantially reduce day-long glucose variability in women at risk of gestational diabetes mellitus (GDM). Research design and methods A crossover study of 17 women (mean±SD age 34.8±4 years; gestational weeks 29.3±1.3; body mass index 23.8±4.7 kg/m2) who consumed a low GL or a high GL diet in random order, 1-day each, over 2 consecutive days. Diets were energy-matched and fiber-matched with 5 meals per 24 hours. All food was provided. Continuous glucose monitoring was used to assess diurnal glycemia. Results Maternal glucose levels were 51% lower on the low GL day with lower incremental area under the curve (iAUC±SEM 549±109 vs 1120±198 mmol/L min, p=0.015). Glycemic variability was significantly lower on the low GL day, as demonstrated by a lower average SD (0.7±0.1 vs 0.9±0.1, p<0.001) and lower mean amplitude of glycemic excursions (2.1±0.2 vs 2.7±0.2 mmol/L, p<0.001). Conclusions A lower GL meal plan in pregnancy acutely halves day-long maternal glucose levels and reduces glucose variability, providing further evidence to support the utility of a low GL diet in pregnancy. PMID:28405345

Glycaemic and insulin responses, glycaemic index and insulinaemic index values of rice between three Asian ethnic groups.

PubMed

Tan, V M H; Wu, T; Henry, C J; Lee, Y S

2015-04-28

Asians exhibit larger glycaemic response (GR) and insulin response (IR) than Caucasians, predisposing to an increased risk of type 2 diabetes mellitus (T2DM). We aimed to determine the GR and IR as well as the glycaemic index (GI) and insulinaemic index (II) of two rice varieties among three ethnic groups in Singapore. A total of seventy-five healthy males (twenty-five Chinese, twenty-five Malay and twenty-five Asian-Indians) were served the available equivalent carbohydrate amounts (50 g) of test foods (Jasmine rice and Basmati rice) and a reference food (glucose) on separate occasions. Postprandial blood glucose and plasma insulin concentrations were measured at fasting ( -5 and 0 min) and at 15, 30, 45, 60, 90 and 120 min after food consumption. Using the trapezoidal rule, GR, IR, GI and II values were determined. The GR did not differ between ethnic groups for Jasmine rice and Basmati rice. The IR was consistently higher for Jasmine rice (P=0·002) and Basmati rice (P=0·002) among Asian-Indians, probably due to compensatory hyperinsulinaemia to maintain normoglycaemia. The GI and II of both rice varieties did not differ significantly between ethnicities. The overall mean GI for Jasmine rice and Basmati rice were 91 (sd 21) and 59 (sd 15), respectively. The overall mean II for Jasmine rice was 76 (sd 26) and for Basmati rice was 57 (sd 24). We conclude that the GI values presented for Jasmine rice and Basmati rice were applicable to all three ethnic groups in Singapore. Future studies should include deriving the II for greater clinical utility in the prevention and management of T2DM.

Severity and prevalence of plaque-induced gingivitis in the Chinese population.

PubMed

Zhang, Jincai; Xuan, Dongying; Fan, Weihua; Zhang, Xiong; Dibart, Serge; De Vizio, William; Panagakos, Foti; Zhang, Yun-Po

2010-10-01

This study investigated the prevalence and severity of gingivitis and plaque in a representative Chinese population of adults. Using the Loe-Silness gingivitis index (GI) and the modified Quigley-Hein plaque index (PULI), researchers examined 1143 patients from Guangzhou, Shenyang, and Nanjing for the presence of gingivitis and plaque. A two-tailed t-test was used to determine significant differences in the GI and PLI scores between gender and urban/rural areas. The data pertaining to study sites and age groups were compared using the Kruskal-Wallis one-way analysis of variances (ANOVA) by ranks. The correlation between GI/PLI and age was examined using the Pearson correlation coefficient. Age differences among three sites were analyzed with the one-way ANOVA. The age and urban/rural compositions (mean age 42.2 years) paralleled the 2008 China census. The overall average and standard deviation of GI and PLI were 1.101 +/- 0.239 and 3.394 +/- 0.578, respectively. Age significantly correlated with GI and PLI (P < .0001). The PLI in males was significantly higher (P < .0001) than in females; however, no significant difference was noted between GI in males compared to females. Patients in rural areas showed a significantly higher GI and PLI (t = 7.723, P < .0001; t = 7.072, P < .0001) than those in urban ones. Clinical trials evaluating a product's antigingivitis efficacy should recruit participants from a population that represents accurately the intended product users. Variables should include gender, race, age, and geography.

Short-term effects of non-surgical periodontal therapy on clinical measures of impaired glucose tolerance in people with prediabetes and chronic periodontitis.

PubMed

Giblin, Lori J; Boyd, Linda D; Rainchuso, Lori; Chadbourne, Dianne

2014-01-01

Diabetes and periodontal disease are conditions considered to be biologically linked. Prediabetes is a condition in which individuals have blood glucose levels, impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) or glycated hemoglobin (A1C) levels higher than normal but not high enough to be classified as diabetes. Few human studies address the relationship between periodontitis and prediabetes or clarify an association between periodontitis and prediabetes. The purpose of this pilot study was to examine the impact of non-surgical periodontal therapy (NSPT) on clinical measures of glycemic control in prediabetes. Prediabetes measures of IFG, IGT, A1C and periodontal measures of pocket depth (PD), clinical attachment level (CAL), plaque index (PI) and gingival index (GI) were taken at baseline and 3 months in 12 subjects with prediabetes and chronic slight to moderate periodontitis. Blood samples were taken from each subject following an 8 hour fast. This study controlled for changes in medications, body-mass index, physical activity and diet. Comparison of mean prediabetes and periodontal measures from baseline and post-treatment at 3 months demonstrated clinical improvement for both periodontal and prediabetes measures. A mean reduction in PD of 0.27 (p=0.003), CAL of 0.32 (p=0.050) and A1C of 0.19 (p=0.015) reached statistical significance. This pilot study suggests NSPT improves A1C and periodontal measures at 3 months. The robustness of measures is limited due to the small sample size and lack of a control group. Further larger scale studies using a randomized control design would be informative. Copyright © 2014 The American Dental Hygienists’ Association.

Dental Health Status and Hygiene in Children and Adolescents with Type 1 Diabetes Mellitus.

PubMed

Rafatjou, Rezvan; Razavi, Zahra; Tayebi, Soudeh; Khalili, Maryam; Farhadian, Maryam

2016-01-01

There is disagreement on the effect of diabetes on oral hygiene. The purpose of this study was to assess the oral health and hygiene status of type 1 diabetic patient. In this case control study, periodontal health and hygiene of 80 children and adolescents (5-18 yr of age) with type 1 diabetes mellitus referred to Pediatric Endocrine Clinic of Besat Hospital Hamadan Iran 2013 - 2014 and 80 non diabetic control subjects were clinically assessed. The required data such as sex, age, duration of the diabetes, type and number of insulin injections per day were obtained from self-administered questionnaire and the patient's medical records. Participants in both groups were examined for Decay-missing- filled teeth (DMFT); dmft (for primary teeth), oral hygiene using O'Leary plaque index (PI) and gingivitis index (GI). P<0.05 was considered significant. The mean age of the study and the control group was 12.5±4.05 and 12.08±3.47 yr, respectively. There were no significant difference between two groups in terms of DMFT (P=0.158) and PI indices (P=0.373). The GI index difference was statistically significant in diabetic group (P=0.001). Interestingly, a higher dmft index was observed in the control group (P=0.008). In diabetic groups, GI and DMFT index increased significantly with duration of diabetes. Apart from higher scores of GI index, frequency of oral and periodontal disease was not different in diabetic patients compared with healthy subjects. Findings of present study are insufficient to support a significant effect of diabetes on increasing the risk of oral and periodontal diseases. However, diabetic children and adolescents should receive oral hygiene instruction.

Adipocytes and intestinal epithelium dysfunctions linking obesity to inflammation induced by high glycemic index pellet-diet in Wistar rats.

PubMed

Luz, Anna Beatriz Santana; Dos Santos Figueredo, Júlia Braga; Salviano, Bianca Damásio Pereira Dantas; Aguiar, Ana Júlia Felipe Camelo; Pinheiro, Luiza Gabriella Soares Dantas; Krause, Matheus Felipe Dantas; da Silva Camillo, Christina; Ladd, Fernando Vagner Lobo; Bortolin, Raul Hernandes; Silbiger, Vivian Nogueira; Maciel, Bruna Leal Lima; de Araújo Morais, Ana Heloneida

2018-06-29

We investigated the inflammatory effect of a pellet-diet with high glycemic index and load (HGLI) on the histological organization of adipocytes, intestinal epithelium, and fat in liver and pancreas in adult male Wistar rats. Two groups ( n =10) received for 17 weeks: (1) HGLI diet or (2) Standard diet (Labina®). Histological analyses of adipose tissue, jejunum, liver, and pancreas were performed. Stereology analysis, visceral adiposity index, gene expression, and immunohistochemistry of tumor necrosis factor-α (TNF-α) in visceral adipose tissue and plasma TNF-α were also assessed. The HGLI diet-induced hypertrophy of adipocytes with adipocyte volume density equal to 97.0%, cross-sectional area of adipocytes equivalent to 1387 µm² and a total volume of adipocytes of 6.97 cm³ an elevation of 8%, 25%, and 58%, respectively. Furthermore, the HGLI diet increased liver and pancreatic fat deposition, altered and inflamed the intestinal epithelia, and increased TNF-α gene expression ( P =0.014) with a positive immunostaining in visceral adipose tissue and high plasma TNF-α in comparison with standard diet. The results suggest that this diet was able to generate changes commonly caused to solid diets with high fat or fructose-rich beverages. To the best of our knowledge, this is the first report in the literature concerning the properties of low-cost, sucrose-rich pellet-diet presenting high glycemic index and high glycemic load efficient on the development of obesity complications in Wistar rats that were subjected to diet-induced obesity. Therefore, the HGLI pellet-diet may be considered an effective tool to be used by the scientific community in experimental research. © 2018 The Author(s).

No mediating effects of glycemic control and inflammation on the association between vitamin D and lung function in the general population.

PubMed

Kaul, Anne; Gläser, Sven; Hannemann, Anke; Stubbe, Beate; Felix, Stefan B; Nauck, Matthias; Ewert, Ralf; Friedrich, Nele

2017-04-01

Vitamin D deficiency is discussed to be associated with lung health. While former studies focused on subjects suffering from pulmonary diseases, we aimed to investigate the association of 25-hydroxy vitamin D [25(OH)D] with lung function in the general population and examined whether mediating effects of inflammation, glycemic control or renal function exist. 1404 participants from the Study of Health in Pomerania with pulmonary function testing assessed by expiratory volume in 1 s (FEV 1 ), forced vital capacity (FVC), total lung capacity and Krogh index were used. Adjusted analysis of variance, linear regression models and mediation analyses were performed. Significant positive associations between 25(OH)D levels and FEV 1 , FVC and Krogh index were found. Mediator analyses revealed no mediating effect of inflammation (fibrinogen), glycemic control (HbA1c) or renal function (eGFR) on associations with FEV 1 or FVC. With respect to Krogh-Index, the association to 25(OH)D was slightly mediated by fibrinogen with a proportion mediated of 9.7%. Significant positive associations of 25(OH)D with lung function were revealed in a general population. The proposed mediating effects of inflammation, glycemic control and renal function on these relations were not confirmed. Further studies examining the causality of the association between 25(OH)D and lung function are necessary. Copyright © 2017 Elsevier Ltd. All rights reserved.

Associations between lower urinary tract dysfunction and glycemic control in women with type 2 diabetes: A cross-sectional study.

PubMed

Tai, Huai-Ching; Tai, Tong-Yuan; Yang, Wei-Shiung; Wang, Shin-Wei; Yu, Hong-Jeng

2016-04-01

Patients with diabetes are predisposed to develop a variety of complications, including lower urinary tract (LUT) dysfunction. We aimed to examine the associations between glycemic control and LUT dysfunction in women with type 2 diabetes (T2D). We included 400 women with T2D (age range, 48-75 years) in this cross-sectional analysis. The participants were divided into tertiles according to glycosylated hemoglobin (HbA1c) measurements. The mean HbA1c levels for tertiles 1, 2, and 3 were 6.2% (N=132), 7.1% (N=132), and 8.4% (N=136), respectively. We evaluated LUT dysfunction with the American Urological Association Symptom Index (AUA-SI) questionnaire, uroflowmetry (UFM), and post-void residual (PVR). No significant differences were found among HbA1c tertiles regarding storage, voiding and total AUA-SI scores, and prevalence of LUT symptoms. However, women in tertile 3 had higher prevalences of severe LUT symptoms (AUA-SI≥20) and clinically significant PVR (≥100mL) compared to women in the other tertiles. Multivariate analysis revealed that diabetic neuropathy, but not HbA1c, significantly predicted LUT symptoms in women with T2D after adjustment for age, body mass index (BMI) and hypertension. However, HbA1c was associated with an increased risk of developing clinically significant PVR. Our findings do not support significant associations between glycemic control and LUT symptoms in women with T2D. However, women with poor glycemic control are more likely to develop urinary retention than women with proper glycemic control. Clinicians should, therefore, be aware of and educate patients about the association between urinary retention and glycemic control. Copyright © 2016 Elsevier Inc. All rights reserved.

Maize and resistant starch enriched breads reduce postprandial glycemic responses in rats.

PubMed

Brites, Carla M; Trigo, Maria J; Carrapiço, Belmira; Alviña, Marcela; Bessa, Rui J

2011-04-01

White wheat bread is a poor source of dietary fiber, typically containing less than 2%. A demand exists for the development of breads with starch that is slowly digestible or partially resistant to the digestive process. The utilization of maize flour and resistant starch is expected to reduce the release and absorption of glucose and, hence, lower the glycemic index of bread. This study was undertaken to investigate the hypothesis that a diet of maize bread, as produced and consumed in Portugal, would have beneficial metabolic effects on rats compared to white wheat bread. We also hypothesized that the effect of resistant starch on glycemic response could be altered by the use of different formulations and breadmaking processes for wheat and maize breads. Resistant starch (RS) was incorporated into formulations of breads at 20% of the inclusion rate of wheat and maize flours. Assays were conducted with male Wistar rats (n = 36), divided into four groups and fed either wheat bread, RS-wheat bread, maize bread, and RS-maize bread to evaluate feed intake, body weight gain, fecal pH, and postprandial blood glucose response (glycemic response). Blood triglycerides, total cholesterol concentrations, and liver weights were also determined. The maize bread group presented higher body weight gain and cholesterol level, lower fecal pH, and postprandial blood glucose response than the wheat bread group. The RS-wheat bread group showed significant reductions in feed intake, fecal pH, postprandial blood glucose response, and total cholesterol. The RS-maize group displayed significant reductions of body weight gain, fecal pH, and total cholesterol levels; however, for the glycemic response, only a reduction in fasting level was observed. These results suggest that maize bread has a lower glycemic index than wheat bread, and the magnitude of the effect of RS on glycemic response depends of type of bread. Copyright © 2011 Elsevier Inc. All rights reserved.

Early development of osteoporosis in male smokers with hypoandrogenism due to fascioliasis with or without schistosomiasis added by life style.

PubMed

Kilany, Yasser Fouad; Abou Holw, Sahar A; Abouel-Nour, Mohamed Fathy; Morsy, Ayman T A

2009-12-01

The multifactor outcome of hypoandrogenemia with the impact of oxidative stress induced by glucose intolerance, fascioliasis with or without schistosomiasis and cumulative smoking influence on bone remodeling and the early development of osteoporotic manifestations were studied. The effect on vascular endothelium immune mediated mechanisms and antioxidant capacity were monitored in cases of youth aged selected male smokers involving 20 with hypoandrogenemia who were either subjected to sedentary life style, glucose intolerance fascioliasis hepatic fibrosis (FHF) (G1) or without (G2) and GI after following 6 months therapy (G3). Monitoring of clinical picture and biochemical assessments of osteoporotic indices (osteocolcin, bone alkaline phosphatase, parathyroid hormone, urinary cyclic AMP), hypoandrogenism (dehydroepiandrosterane sulphate or DHEAS & testosterone) glycemic determinant (insulin) immuno-inflammatory response (interleukein-6, tumor necrosis factor alpha, E-selectin, ceruloplasmin) smoking index (serum cotinine), total antioxidant capacity (AOC) and lipid peroxidation (malonedialdehyde) was done before and after 6 months therapeutic program involving supplement of DHEAS, mirazid, chromium picolinate, and megavit zinc alongside smoking cessation and physical exercise daily for at least 30 minutes. Treatment with Mirazid supplied as 10 mg/kg for 6 successive days resulted in 100% cure of fascioliasis whether single or combined with schistosomiasis.

The salivary β-HEX A% index as an excellent marker of periodontitis in smoking alcohol-dependent persons.

PubMed

Waszkiewicz, Napoleon; Zalewska-Szajda, Beata; Chojnowska, Sylwia; Szajda, Sławomir Dariusz; Zalewska, Anna; Konarzewska, Beata; Szulc, Agata; Wojtulewska-Supron, Aleksandra; Kępka, Alina; Knaś, Małgorzata; Ładny, Jerzy Robert; Milewski, Robert; Zwierz, Krzysztof

2013-01-01

Severe periodontitis leading to tooth loss is found in 5-15% of most populations worldwide. The applicability of salivary β -hexosaminidase (β-HEX A%, percentage of β-HEX A isoenzyme to total β-HEX) and β-HEX B% (β-HEX B/β-HEX) indexes was investigated as a possible marker of periodontitis. Thirty three alcohol-dependent smokers (AS) and 32 healthy controls (C) were enrolled in the study. The activity of β-HEX was measured spectrophotometrically. β-HEX A% was significantly higher and β-HEX B% was lower in AS than in C group. We found a significant correlation between β-HEX A% and gingival index (GI) and an inverse correlation between β-HEX A% and salivary flow (SF), in all groups. Salivary β-HEX A% index in smoking alcoholics at 0.23 had excellent sensitivity (96%) and specificity (91%); the AUC for β-HEX A% was high (0.937). There were no correlations between amount/duration-time of alcohol drinking/smoking and β-HEX A% or β-HEX B%. We found significant correlations between the time period of denture wearing and GI, papilla bleeding index (PBI), and decayed missing filled teeth index (DMFT) and between GI and the amount of smoked cigarettes per day. Bad periodontal state was most likely due to the nicotine dependence. Salivary β-HEX A% is a promising excellent marker for the diagnosis of periodontitis.

[ASSOCIATION BETWEEN DIETARY GLYCEMIC INDEX AND GLYCEMIC LOAD AND INTIMA MEDIA THICKNESS IN A POPULATION AT HIGH CARDIOVASCULAR RISK: A SUBGROUP ANALYSIS IN THE PREDIMED TRIAL].

PubMed

Goñi Ruiz, Nuria; Martínez González, Miguel Ángel; Salas Salvadó, Jordi; Buil Cosiales, Pilar; Diez Espino, Javier; Martinez Vila, Eduardo; Irimia Sierra, Pablo; Ros Rahola, Emilio; Toledo Atucha, Estefania

2015-11-01

increased carotid íntima-media thickness (IMT) is a marker of atherosclerosis and a predictor of future cardiovascular events. Although a beneficial effect of Mediterranean diets, in particular, enhanced with virgin olive oil and nuts, on longitudinal changes in IMT has been reported, the association between carbohydrates and the development of atherosclerosis is still unclear. to assess the association between glycemic index (IG) and glycemic load (CG) of the diet and intima media thickness (GIMC) in a population at high cardiovascular risk with no clinical symptoms. one hundred eighty seven participants of the PREDIMED-NAVARRA center (PREDIMED means in Spanish "PREvención con DIeta MEDiterránea") were randomly selected to undergo baseline and 1-year measurement of GIMC. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire. Participants were categorized into four groups of energy-adjusted IG and CG intake. Multivariate analysis models (ANCOVA) were used to study the association between dietary IG and CG and GIMC and its changes. in our study we found no significant association between IG or CG and GIMC at baseline or after one year. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Does the ingestion of a 24 hour low glycaemic index Asian mixed meal diet improve glycaemic response and promote fat oxidation? A controlled, randomized cross-over study.

PubMed

Camps, Stefan Gerardus; Kaur, Bhupinder; Quek, Rina Yu Chin; Henry, Christiani Jeyakumar

2017-07-12

The health benefits of consuming a low glycaemic index (GI) diet to reduce the risk of type 2 Diabetes are well recognized. In recent years the GI values of various foods have been determined. Their efficacy in constructing and consuming a low GI diet over 24 h in modulating glycaemic response has not been fully documented. The translation of using single-point GI values of foods to develop a 24 h mixed meal diet can provide valuable information to consumers, researchers and dietitians to optimize food choice for glycaemic control. By using GI values of foods to develop mixed meals, our study is the first to determine how both blood glucose and substrate oxidation may be modulated over 24 h. The study included 11 Asian men with a BMI between 17-24 kg/m 2 who followed both a 1-day low GI and 1-day high GI diet in a randomized, controlled cross-over design. Test meals included breakfast, lunch, snack and dinner. Glycaemic response was measured continuously for over 24 h and postprandial substrate oxidation for 10 h inside a whole body calorimeter. The low GI diet resulted in lower 24 h glucose iAUC (860 ± 440 vs 1329 ± 614 mmol/L.min; p = 0.014) with lower postprandial glucose iAUC after breakfast (p < 0.001), lunch (p = 0.009), snack (p = 0.012) and dinner (p = 0.003). Moreover, 24 h mean amplitude of glycaemic excursion was lower during the low GI vs high GI diet (1.44 ± 0.63 vs 2.33 ± 0.82 mmol/L; p < 0.001). Simultaneously, decrease in 10 h fat oxidation was less during the low vs high GI diet (-0.033 ± 0.021 vs -0.050 ± 0.017 g/min; p < 0.001), specifically after breakfast (p < 0.001) and lunch (p < 0.001). Our study corroborates that using low GI local foods to construct a 24 h low GI diet, is able to reduce glycaemic response and variability as recorded by continuous glucose monitoring. Our observations also confirm that a low GI diet promotes fat oxidation over carbohydrate oxidation when compared to a high GI diet. These observations provide public health support for the encouragement of healthier nutrition choices by consuming low GI foods. NCT 02631083 (Clinicaltrials.gov).

Maternal Nutrition and Glycaemic Index during Pregnancy Impacts on Offspring Adiposity at 6 Months of Age--Analysis from the ROLO Randomised Controlled Trial.

PubMed

Horan, Mary K; McGowan, Ciara A; Gibney, Eileen R; Byrne, Jacinta; Donnelly, Jean M; McAuliffe, Fionnuala M

2016-01-04

Childhood obesity is associated with increased risk of adult obesity and metabolic disease. Diet and lifestyle in pregnancy influence fetal programming; however the influence of specific dietary components, including low glycaemic index (GI), remains complex. We examined the effect of a maternal low GI dietary intervention on offspring adiposity at 6 months and explored the association between diet and lifestyle factors in pregnancy and infant body composition at 6 months. 280 6-month old infant and mother pairs from the control (n = 142) and intervention group (n = 138), who received low GI dietary advice in pregnancy, in the ROLO study were analysed. Questionnaires (food diaries and lifestyle) were completed during pregnancy, followed by maternal lifestyle and infant feeding questionnaires at 6 months postpartum. Maternal anthropometry was measured throughout pregnancy and at 6 months post-delivery, along with infant anthropometry. No difference was found in 6 months infant adiposity between control and intervention groups. Maternal trimester three GI, trimester two saturated fats and trimester one and three sodium intake were positively associated with offspring adiposity, while trimester two and three vitamin C intake was negatively associated. In conclusion associations were observed between maternal dietary intake and GI during pregnancy and offspring adiposity at 6 months of age.

Maternal Nutrition and Glycaemic Index during Pregnancy Impacts on Offspring Adiposity at 6 Months of Age—Analysis from the ROLO Randomised Controlled Trial

PubMed Central

Horan, Mary K.; McGowan, Ciara A.; Gibney, Eileen R.; Byrne, Jacinta; Donnelly, Jean M.; McAuliffe, Fionnuala M.

2016-01-01

Childhood obesity is associated with increased risk of adult obesity and metabolic disease. Diet and lifestyle in pregnancy influence fetal programming; however the influence of specific dietary components, including low glycaemic index (GI), remains complex. We examined the effect of a maternal low GI dietary intervention on offspring adiposity at 6 months and explored the association between diet and lifestyle factors in pregnancy and infant body composition at 6 months. 280 6-month old infant and mother pairs from the control (n = 142) and intervention group (n = 138), who received low GI dietary advice in pregnancy, in the ROLO study were analysed. Questionnaires (food diaries and lifestyle) were completed during pregnancy, followed by maternal lifestyle and infant feeding questionnaires at 6 months postpartum. Maternal anthropometry was measured throughout pregnancy and at 6 months post-delivery, along with infant anthropometry. No difference was found in 6 months infant adiposity between control and intervention groups. Maternal trimester three GI, trimester two saturated fats and trimester one and three sodium intake were positively associated with offspring adiposity, while trimester two and three vitamin C intake was negatively associated. In conclusion associations were observed between maternal dietary intake and GI during pregnancy and offspring adiposity at 6 months of age. PMID:26742066

Effects of barley β-glucan-enriched flour fractions on the glycaemic index of bread.

PubMed

Finocchiaro, Franca; Ferrari, Barbara; Gianinetti, Alberto; Scazzina, Francesca; Pellegrini, Nicoletta; Caramanico, Rosita; Salati, Claudia; Shirvanian, Vigen; Stanca, Antonio Michele

2012-02-01

The aim of this research was to evaluate β-glucan-enriched flours, obtained from barleys with either normal or waxy starch, for their effects on the glycaemic index (GI) and the quality of bread. Rheological results confirmed that when barley flour was included in the dough the overall quality of bread slightly worsened. However, positive consequences on glycaemia were obtained with the normal starch barley: the GI of all-wheat bread (82.8 ± 7.2) was significantly reduced (57.2 ± 7.9) when 40% of wheat flour was substituted with β-glucan-enriched barley flour (6.0% ± 0.1 β-glucan in the final flour blend). In contrast, this positive effect was significantly reduced (GI: 70.1 ± 9.1) when 40% of wheat flour was substituted with the β-glucan-enriched flour of a waxy barley (CDC Alamo; 6.6 ± 0.2 β-glucan in the final flour blend), suggesting that the ability of β-glucans to lower the GI was affected by the barley starch-type.

Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study.

PubMed

Jönsson, Tommy; Granfeldt, Yvonne; Ahrén, Bo; Branell, Ulla-Carin; Pålsson, Gunvor; Hansson, Anita; Söderström, Margareta; Lindeberg, Staffan

2009-07-16

Our aim was to compare the effects of a Paleolithic ('Old Stone Age') diet and a diabetes diet as generally recommended on risk factors for cardiovascular disease in patients with type 2 diabetes not treated with insulin. In a randomized cross-over study, 13 patients with type 2 diabetes, 3 women and 10 men, were instructed to eat a Paleolithic diet based on lean meat, fish, fruits, vegetables, root vegetables, eggs and nuts; and a Diabetes diet designed in accordance with dietary guidelines during two consecutive 3-month periods. Outcome variables included changes in weight, waist circumference, serum lipids, C-reactive protein, blood pressure, glycated haemoglobin (HbA1c), and areas under the curve for plasma glucose and plasma insulin in the 75 g oral glucose tolerance test. Dietary intake was evaluated by use of 4-day weighed food records. Study participants had on average a diabetes duration of 9 years, a mean HbA1c of 6,6% units by Mono-S standard and were usually treated with metformin alone (3 subjects) or metformin in combination with a sulfonylurea (3 subjects) or a thiazolidinedione (3 subjects). Mean average dose of metformin was 1031 mg per day. Compared to the diabetes diet, the Paleolithic diet resulted in lower mean values of HbA1c (-0.4% units, p = 0.01), triacylglycerol (-0.4 mmol/L, p = 0.003), diastolic blood pressure (-4 mmHg, p = 0.03), weight (-3 kg, p = 0.01), BMI (-1 kg/m2, p = 0.04) and waist circumference (-4 cm, p = 0.02), and higher mean values of high density lipoprotein cholesterol (+0.08 mmol/L, p = 0.03). The Paleolithic diet was mainly lower in cereals and dairy products, and higher in fruits, vegetables, meat and eggs, as compared with the Diabetes diet. Further, the Paleolithic diet was lower in total energy, energy density, carbohydrate, dietary glycemic load, saturated fatty acids and calcium, and higher in unsaturated fatty acids, dietary cholesterol and several vitamins. Dietary GI was slightly lower in the Paleolithic diet (GI = 50) than in the Diabetic diet (GI = 55). Over a 3-month study period, a Paleolithic diet improved glycemic control and several cardiovascular risk factors compared to a Diabetes diet in patients with type 2 diabetes.

Exploitation of Common Bean Flours with Low Antinutrient Content for Making Nutritionally Enhanced Biscuits.

PubMed

Sparvoli, Francesca; Laureati, Monica; Pilu, Roberto; Pagliarini, Ella; Toschi, Ivan; Giuberti, Gianluca; Fortunati, Paola; Daminati, Maria G; Cominelli, Eleonora; Bollini, Roberto

2016-01-01

Consumption of legumes is associated with a number of physiological and health benefits. Legume proteins complement very well those of cereals and are often used to produce gluten-free products. However, legume seeds often contain antinutritional compounds, such as phytate, galactooligosaccharides, phenolic compounds, lectins, enzyme inhibitors, whose presence could affect their nutritional value. Screening natural and induced biodiversity for useful traits, followed by breeding, is a way to remove undesirable components. We used the common bean cv. Lady Joy and the lpa1 mutant line, having different seed composition for absence/presence of lectins,α-amylase inhibitor, (α-AI) and phytic acid, to verify the advantage of their use to make biscuits with improved nutritional properties. We showed that use of unprocessed flour from normal beans (Taylor's Horticulture and Billò) must be avoided, since lectin activity is still present after baking, and demonstrated the advantage of using the cv. Lady Joy, lacking active lectins and having active α-AI. To assess the contribution of bean flour to biscuit quality traits, different formulations of composite flours (B12, B14, B22, B24, B29) were used in combinations with wheat (B14), maize (gluten-free B22 and B29), or with both (B12 and B24). These biscuits were nutritionally better than the control, having a better amino acid score, higher fiber amount, lower predicted glycemic index (pGI) and starch content. Replacement of cv. Lady Joy bean flour with that of lpa1, having a 90% reduction of phytic acid and devoid of α-AI, contributed to about a 50% reduction of phytic acid content. We also showed that baking did not fully inactivate α-AI, further contributing to lowering the pGI of the biscuits. Finally, data from a blind taste test using consumers indicated that the B14 biscuit was accepted by consumers and comparable in terms of liking to the control biscuit, although the acceptability of these products decreased with the increase of bean content. The B22 gluten-free biscuits, although received liking scores that were just above the middle point of the hedonic scale, might represent a good compromise between health benefits (absence of gluten and lower pGI), expectations of celiac consumers and likeness.

Exploitation of Common Bean Flours with Low Antinutrient Content for Making Nutritionally Enhanced Biscuits

PubMed Central

Sparvoli, Francesca; Laureati, Monica; Pilu, Roberto; Pagliarini, Ella; Toschi, Ivan; Giuberti, Gianluca; Fortunati, Paola; Daminati, Maria G.; Cominelli, Eleonora; Bollini, Roberto

2016-01-01

Consumption of legumes is associated with a number of physiological and health benefits. Legume proteins complement very well those of cereals and are often used to produce gluten-free products. However, legume seeds often contain antinutritional compounds, such as phytate, galactooligosaccharides, phenolic compounds, lectins, enzyme inhibitors, whose presence could affect their nutritional value. Screening natural and induced biodiversity for useful traits, followed by breeding, is a way to remove undesirable components. We used the common bean cv. Lady Joy and the lpa1 mutant line, having different seed composition for absence/presence of lectins,α-amylase inhibitor, (α-AI) and phytic acid, to verify the advantage of their use to make biscuits with improved nutritional properties. We showed that use of unprocessed flour from normal beans (Taylor's Horticulture and Billò) must be avoided, since lectin activity is still present after baking, and demonstrated the advantage of using the cv. Lady Joy, lacking active lectins and having active α-AI. To assess the contribution of bean flour to biscuit quality traits, different formulations of composite flours (B12, B14, B22, B24, B29) were used in combinations with wheat (B14), maize (gluten-free B22 and B29), or with both (B12 and B24). These biscuits were nutritionally better than the control, having a better amino acid score, higher fiber amount, lower predicted glycemic index (pGI) and starch content. Replacement of cv. Lady Joy bean flour with that of lpa1, having a 90% reduction of phytic acid and devoid of α-AI, contributed to about a 50% reduction of phytic acid content. We also showed that baking did not fully inactivate α-AI, further contributing to lowering the pGI of the biscuits. Finally, data from a blind taste test using consumers indicated that the B14 biscuit was accepted by consumers and comparable in terms of liking to the control biscuit, although the acceptability of these products decreased with the increase of bean content. The B22 gluten-free biscuits, although received liking scores that were just above the middle point of the hedonic scale, might represent a good compromise between health benefits (absence of gluten and lower pGI), expectations of celiac consumers and likeness. PMID:27446157

The influence of the utilization time of brush heads from different types of power toothbrushes on oral hygiene assessed over a 6-month observation period: A randomized clinical trial.

PubMed

Schmickler, Jan; Wurbs, Sabine; Wurbs, Susanne; Kramer, Katharina; Rinke, Sven; Hornecker, Else; Mausberg, Rainer F; Ziebolz, Dirk

2016-12-01

This randomized clinical trial investigated the influence of the utilization time of brush heads from different types of power toothbrushes [oscillating rotating (OR) and sonic action (SA)93; on oral hygiene (plaque accumulation and gingival inflammation) over a 6-month observation period. 49 participants were randomly allocated into two groups: use of the same brush head over 6 months (NR: non-replacement) or replacement of brush head every 4 weeks over 6 months (R: replacement). Each group was subdivided into two subgroups according to kind of toothbrush (TB) used (OR and SA). Modified Quigley-Hein plaque index (QHI), papilla bleeding index (PBI), and gingival index (GI) were recorded at baseline and 2, 8, 12, 16, and 24 weeks after baseline. After 24 weeks, participants of both groups (R and NR) received a new brush head. At week 26, final QHI, PBI, and GI were recorded. QHI decreased between baseline and follow-up visits in R groups (P< 0.05), with the exception of week 12 (P= 0.26). In NR groups, no significant decrease was detected (P> 0.05). There was no significant effect of time on PBI or GI in any of R subgroups (P> 0.05). In NR oscillating/rotating TB: significant increase in PBI and GI was detected 24 weeks after baseline (PBI: P= 0.02, GI: P= 0.03); sonic action TBs showed significant decrease in PBI at every follow-up visit (P< 0.05), except at 24 weeks after baseline (P= 0.73). GI was significantly decreased at 2 weeks after baseline only (P< 0.01). Six-month use of the same brush head reduced effectiveness in removing plaque, and gingival inflammation appeared to increase after a utilization time of over 4 months. Replacing brush heads is advised after 4 months.

Effect of local diets with added sucrose on glycemic profiles of healthy and diabetic Brazilian subjects.

PubMed

Marchini, J S; Fáccio, J R; Rodrigues, M M; Unamuno, M R; Foss, M C; Dutra-de-Oliveira, J E

1994-12-01

We set out to determine the daily glycemic profile of healthy and non-insulin-dependent diabetes mellitus (NIDDM) persons and to test the hypothesis that small amounts of sucrose added to NIDDM meals would not change their responses. Thirteen NIDDM and six healthy volunteers participated in the study. They initially consumed a diet similar to their home diet and later a diabetic hospital dietary regimen, with and without 30 g/day sugar replacing equivalent food energy. The hospital diet included their usual foods: bread, milk, rice, beans, meat, vegetables and fruits at breakfast, lunch and dinner. To follow their glycemic profile we drew several blood samples during a 22-hour period. The day-long plasma glucose profile of the NIDDM and healthy subjects showed similar patterns, increasing after the meals and returning later to baseline levels. The extra amount of sucrose consumed did not change the daily glycemic profile or the calculated glycemic area under the 22-hour glycemic curves. These results call attention to the importance of the 22-hour glycemic profile compared to other shorter glycemic indexes. The 22-hour profile has obvious advantage for planning day-long diabetic diets, taking in consideration local daily foods and usual eating habits. Maintenance of a small and traditional amount of food, e.g., sucrose, without harmful effects to the subjects, is another advantage of this proposition. It improves patient compliance as well as social daily life.

Effect of changing the amount and type of fat and carbohydrate on insulin sensitivity and cardiovascular risk: the RISCK (Reading, Imperial, Surrey, Cambridge, and Kings) trial1234

PubMed Central

Jebb, Susan A; Lovegrove, Julie A; Griffin, Bruce A; Frost, Gary S; Moore, Carmel S; Chatfield, Mark D; Bluck, Les J; Williams, Christine M; Sanders, Thomas AB

2010-01-01

Background: Insulin sensitivity (Si) is improved by weight loss and exercise, but the effects of the replacement of saturated fatty acids (SFAs) with monounsaturated fatty acids (MUFAs) or carbohydrates of high glycemic index (HGI) or low glycemic index (LGI) are uncertain. Objective: We conducted a dietary intervention trial to study these effects in participants at risk of developing metabolic syndrome. Design: We conducted a 5-center, parallel design, randomized controlled trial [RISCK (Reading, Imperial, Surrey, Cambridge, and Kings)]. The primary and secondary outcomes were changes in Si (measured by using an intravenous glucose tolerance test) and cardiovascular risk factors. Measurements were made after 4 wk of a high-SFA and HGI (HS/HGI) diet and after a 24-wk intervention with HS/HGI (reference), high-MUFA and HGI (HM/HGI), HM and LGI (HM/LGI), low-fat and HGI (LF/HGI), and LF and LGI (LF/LGI) diets. Results: We analyzed data for 548 of 720 participants who were randomly assigned to treatment. The median Si was 2.7 × 10−4 mL · μU−1 · min−1 (interquartile range: 2.0, 4.2 × 10−4 mL · μU−1 · min−1), and unadjusted mean percentage changes (95% CIs) after 24 wk treatment (P = 0.13) were as follows: for the HS/HGI group, −4% (−12.7%, 5.3%); for the HM/HGI group, 2.1% (−5.8%, 10.7%); for the HM/LGI group, −3.5% (−10.6%, 4.3%); for the LF/HGI group, −8.6% (−15.4%, −1.1%); and for the LF/LGI group, 9.9% (2.4%, 18.0%). Total cholesterol (TC), LDL cholesterol, and apolipoprotein B concentrations decreased with SFA reduction. Decreases in TC and LDL-cholesterol concentrations were greater with LGI. Fat reduction lowered HDL cholesterol and apolipoprotein A1 and B concentrations. Conclusions: This study did not support the hypothesis that isoenergetic replacement of SFAs with MUFAs or carbohydrates has a favorable effect on Si. Lowering GI enhanced reductions in TC and LDL-cholesterol concentrations in subjects, with tentative evidence of improvements in Si in the LF-treatment group. This trial was registered at clinicaltrials.gov as ISRCTN29111298. PMID:20739418

Glycaemic index and glycaemic load of selected popular foods consumed in Southeast Asia.

PubMed

Sun, Lijuan; Lee, Davina Elizabeth Mei; Tan, Wei Jie Kevin; Ranawana, Dinesh Viren; Quek, Yu Chin Rina; Goh, Hui Jen; Henry, Christiani Jeyakumar

2015-03-14

The objective of the present study was to determine the glycaemic index (GI) and glycaemic load (GL) values of standard portion sizes of Southeast Asian traditional foods. A total of fifteen popular Southeast Asian foods were evaluated. Of these foods, three were soft drinks, while the other twelve were solid foods commonly consumed in this region. In total, forty-seven healthy participants (eighteen males and twenty-nine females) volunteered to consume either glucose at least twice or one of the fifteen test foods after a 10-12 h overnight fast. Blood glucose concentrations were analysed before consumption of the test food, and 15, 30, 45, 60, 90 and 120 min after food consumption, using capillary blood samples. The GI value of each test food was calculated by expressing the incremental area under the blood glucose response curve (IAUC) value of the test food as a percentage of each participant's average IAUC value, with glucose as the reference food. Among the fifteen foods tested, six belonged to low-GI foods (Ice Green Tea, Beehoon, Pandan Waffle, Curry Puff, Youtiao and Kaya Butter Toast), three belonged to medium-GI foods (Barley Drink, Char Siew Pau and Nasi Lemak), and the other six belonged to high-GI foods (Ice Lemon Tea, Chinese Carrot Cake, Chinese Yam Cake, Chee Cheong Fun, Lo Mai Gai and Pink Rice Cake). The GI and GL values of these traditional foods provide valuable information to consumers, researchers and dietitians on the optimal food choice for glycaemic control. Moreover, our dataset provides GI values of fifteen foods that were not previously tested extensively, and it presents values of foods commonly consumed in Southeast Asia.

Clinicopathological and Prognostic Analysis of Primary Gastrointestinal Stromal Tumor Presenting with Gastrointestinal Bleeding: a 10-Year Retrospective Study.

PubMed

Yin, Zhijie; Gao, Jinbo; Liu, Weizhen; Huang, Cheng; Shuai, Xiaoming; Wang, Guobin; Tao, Kaixiong; Zhang, Peng

2017-05-01

The objectives of this paper were to investigate the clinicopathological characteristics and prognostic factors of GI-bleeding GIST patients and explore whether GI bleeding is a risk factor for GIST relapse. Primary GIST patients with initial symptoms of GI bleeding or no GI bleeding were retrospectively studied. Up to 178 GI-bleeding GIST patients including 108 (60.7%) males and 70 (39.3%) females were evaluated for the clinicopathological characteristics. The stomach, small bowel, and colorectum were the tumor sites in 82 (46.1%), 85 (47.8%), and 11 (6.2%) patients. Of the 178 patients, 163 GI-bleeding patients had follow-up while another 363 patients from the total population presented without GI bleeding were followed up. Up to 526 patients who received postoperative follow-up were included in the survival analysis. Compared with the 363 non-GI-bleeding patients, GI-bleeding patients developed smaller tumors (P = 0.015) and had a longer relapse-free survival (RFS; P = 0.014). For the 163 GI-bleeding patients, a Cox regression analysis showed that the mitotic count and the platelet-lymphocyte ratio before surgery were independent prognostic predictors for poor outcome regarding RFS. For all 526 patients, a Cox regression analysis indicated that tumor location, mitotic index, platelet-lymphocyte ratio, and GI bleeding were independent prognosis predictors. Compared to non-GI-bleeding GIST patients, patients with GI bleeding were more likely to be male and to have more small intestine GISTs, smaller tumors, and a longer RFS. For GI-bleeding patients, mitotic count and platelet-lymphocyte ratio were independent prognostic indicators. GI bleeding served as a surrogate for smaller GIST and was a protective factor for GIST recurrence.

The effect of nopal (Opuntia ficus indica) on postprandial blood glucose, incretins, and antioxidant activity in Mexican patients with type 2 diabetes after consumption of two different composition breakfasts.

PubMed

López-Romero, Patricia; Pichardo-Ontiveros, Edgar; Avila-Nava, Azalia; Vázquez-Manjarrez, Natalia; Tovar, Armando R; Pedraza-Chaverri, José; Torres, Nimbe

2014-11-01

Nopal is a plant used in traditional Mexican medicine to treat diabetes. However, there is insufficient scientific evidence to demonstrate whether nopal can regulate postprandial glucose. The purpose for conducting this study was to evaluate the glycemic index, insulinemic index, glucose-dependent insulinotropic peptide (GIP) index, and the glucagon-like peptide 1 (GLP-1) index, and the effect of nopal on patients with type 2 diabetes after consumption of a high-carbohydrate breakfast (HCB) or high-soy-protein breakfast (HSPB) on the postprandial response of glucose, insulin, GIP, GLP-1, and antioxidant activity. In study 1, the glycemic index, insulinemic index, GIP index, and GLP-1 index were calculated for seven healthy participants who consumed 50 g of available carbohydrates from glucose or dehydrated nopal. In study 2, 14 patients with type 2 diabetes consumed nopal in HCB or HSPB with or without 300 g steamed nopal. The glycemic index of nopal was 32.5±4, insulinemic index was 36.1±6, GIP index was 6.5±3.0, and GLP-1 index was 25.9±18. For those patients with type 2 diabetes who consumed the HCB+nopal, there was significantly lower area under the curve for glucose (287±30) than for those who consumed the HCB only (443±49), and lower incremental area under the curve for insulin (5,952±833 vs 7,313±1,090), and those patients with type 2 diabetes who consumed the HSPB avoided postprandial blood glucose peaks. Consumption of the HSPB+nopal significantly reduced the postprandial peaks of GIP concentration at 30 and 45 minutes and increased the antioxidant activity after 2 hours measured by the 2,2-diphenyl-1-picrilhidracyl method. These findings suggest that nopal could reduce postprandial blood glucose, serum insulin, and plasma GIP peaks, as well as increase antioxidant activity in healthy people and patients with type 2 diabetes. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Carbohydrate-rich foods: glycaemic indices and the effect of constituent macronutrients.

PubMed

Widanagamage, Rahal D; Ekanayake, Sagarika; Welihinda, Jayantha

2009-01-01

The glycaemic index (GI) ranks foods according to their acute glycaemic impact and is used in planning meals for patients invoking glycaemic control through diet. Kurakkan (Eleusine coracana) flour roti, rice flour roti, atta flour roti, boiled breadfruit (Artocarpus altilis/Artocarpus communis) and boiled legumes (mungbean, cowpea and chickpea) were categorized as low-GI foods (relative to white bread; Prima Crust Top), and the corresponding GI (+/- standard error of the mean) values were 70+/-8, 69+/-7, 67+/-9, 64+/-7, 57+/-6, 49+/-8 and 29+/-5, respectively. Kurakkan flour pittu and wheat flour roti were classified as medium-GI foods with GI values of 85+/-6 and 72+/-6. Hoppers, rice flour pittu, wheat flour pittu and Olu-milk rice (seeds of Nymphaea lotus) were categorized as high-GI foods, and the corresponding GI (+/- standard error of the mean) values were 120+/-8, 103+/-7, 101+/-8 and 91+/-8, respectively. The GI values significantly (P<0.01) and negatively correlated with the insoluble dietary fibre (rho = - 0.780), soluble dietary fibre (rho = - 0.712) and protein (rho = - 0.738) contents in grams per 100 g digestible starch containing foods.

The association of gastrointestinal symptoms with weight, diet, and exercise in weight-loss program participants.

PubMed

Levy, Rona L; Linde, Jennifer A; Feld, Kayla A; Crowell, Michael D; Jeffery, Robert W

2005-10-01

Studies on the relationship between gastrointestinal (GI) symptoms and obesity are limited. Research on the relationship between GI symptoms (including irritable bowel syndrome [IBS]), weight, and weight-related behaviors are rare. This study assessed rates of GI symptoms in a sample of obese patients in a weight-loss program and explored relationships among GI symptoms and obesity, binge eating, dieting (fat and fruit/fiber consumption), and physical activity. A total of 983 participants (70% women) had a mean body mass index (BMI) of 33.2+/-5.7 kg/m2 (range, 25.1-60.8 kg/m2) and a mean age of 52.7+/-12.4 years (range, 20.4-89.8 y). Participants completed a questionnaire about diet and physical activity and a standardized self-report Rome II questionnaire assessing IBS status and GI symptoms. In bivariate analyses BMI was associated positively with abdominal pain and diarrhea whereas healthier diet (lower fat and higher fruit/fiber intake) and higher physical activity were associated with fewer GI symptoms. In multivariate models BMI was not associated with GI symptoms; physical activity remained a protective factor. Although physiologic mechanisms still need to be explored, associations between GI symptoms and diet and exercise behaviors may have implications for the treatment of both obesity and GI symptoms.

Sri Lankan rice mixed meals: effect on glycaemic index and contribution to daily dietary fibre requirement.

PubMed

Hettiaratchi, U P K; Ekanayake, S; Welihinda, J

2011-04-01

The glycaemic index (GI) concept ranks starchy foods according to the blood glucose responses following ingestion. When considering commonly consumed Sri Lankan meals, only a few can be categorised as low GI. However, a significant negative correlation between the GI of Sri Lankan meals and fibre content has been observed indicating the potential to reduce the GI of meals by incorporating naturally occurring sources of fibre. Thus, the objective of this study was to study the effect of increased edible quantities of fibre on the GI of rice meals consumed in Sri Lanka. Meal 1 consisted of rice with several meal accompaniments (lentil curry, boiled egg, coconut gravy and Centella asiatica (gotukola) leaves salad). Meal 2 contained similar constituents as meal 1 and a Lasia spinosa (kohila) rhizome salad. The composition of meal 3 was similar to meal 2 but contained Trichosanthes cucumerina (snake gourd) salad instead of Lasia spinosa salad. Meal 3 contained similar fibre contents as meal 1 and similar meal size as meal 2. The glycaemic indices of the three meals were determined with healthy individuals (n=10, age=20-30 yrs, BMI=24 +/- 3 kg/m2) using bread as the standard. Meals 1 and 3 contained total dietary fibre (TDF) contents of 15.2g. Meal 2 contained 16.3g TDF. The GI values of the three meals were 63 +/- 5, 57 +/- 5, 61 +/- 5 respectively and were not significantly different from one another (p>0.05). The GI of the rice mixed meal 2 was reduced by 9% when total edible dietary fibre content of the actual meal was increased by 7.2%. The study results show that the GI of rice mixed meals may be reduced by including naturally occurring sources of fibre with starchy staples while fulfilling daily dietary fibre requirement of an adult at low cost.

Pomegranate juice, but not an extract, confers a lower glycemic response on a high-glycemic index food: randomized, crossover, controlled trials in healthy subjects.

PubMed

Kerimi, Asimina; Nyambe-Silavwe, Hilda; Gauer, Julia S; Tomás-Barberán, Francisco A; Williamson, Gary

2017-12-01

Background: Low-glycemic index diets have demonstrated health benefits associated with a reduced risk of developing type 2 diabetes. Objectives: We tested whether pomegranate polyphenols could lower the glycemic response of a high-glycemic index food when consumed together and the mechanism by which this might occur. Design: We compared the acute effect of a pomegranate juice and a polyphenol-rich extract from pomegranate (supplement) on the bread-derived postprandial blood glucose concentration in 2 randomized, crossover, controlled studies (double-blinded for the supplements), each on 16 healthy volunteers. An additional randomized, crossover, controlled study on 16 volunteers consuming constituent fruit acids in a pH-balanced solution (same pH as pomegranate) and bread was conducted to determine any contributions to postprandial responses caused by acidic beverages. Results: As primary outcome, the incremental area under the curve for bread-derived blood glucose (-33.1% ± 18.1%, P = 0.000005) and peak blood glucose (25.4% ± 19.3%, P = 0.0004) were attenuated by pomegranate juice, compared with a control solution containing the equivalent amount of sugars. In contrast, the pomegranate supplement, or a solution containing the malic and citric acid components of the juice, was ineffective. The pomegranate polyphenol punicalagin was a very effective inhibitor of human α-amylase in vitro, comparable to the drug acarbose. Neither the pomegranate extract nor the individual component polyphenols inhibited 14 C-D-glucose transport across differentiated Caco-2/TC7 cell monolayers, but they inhibited uptake of 14 C-glucose into Xenopus oocytes expressing the human glucose transporter type 2. Further, some of the predicted pomegranate gut microbiota metabolites modulated 14 C-D-glucose and 14 C-deoxy-D-glucose uptake into hepatic HepG2 cells. Conclusions: These data indicate that pomegranate polyphenols, when present in a beverage but not in a supplement, can reduce the postprandial glycemic response of bread, whereas microbial metabolites from pomegranate polyphenols exhibit the potential to further modulate sugar metabolism much later in the postprandial period. This trial was registered at clinicaltrials.gov as NCT02486978, NCT02624609, and NCT03242876. © 2017 American Society for Nutrition.

The Salivary β-HEX A% Index as an Excellent Marker of Periodontitis in Smoking Alcohol-Dependent Persons

PubMed Central

Waszkiewicz, Napoleon; Zalewska-Szajda, Beata; Chojnowska, Sylwia; Szajda, Sławomir Dariusz; Zalewska, Anna; Konarzewska, Beata; Szulc, Agata; Wojtulewska-Supron, Aleksandra; Kępka, Alina; Knaś, Małgorzata; Ładny, Jerzy Robert; Milewski, Robert; Zwierz, Krzysztof

2013-01-01

Background. Severe periodontitis leading to tooth loss is found in 5–15% of most populations worldwide. Aim. The applicability of salivary β-hexosaminidase (β-HEX A%, percentage of β-HEX A isoenzyme to total β-HEX) and β-HEX B% (β-HEX B/β-HEX) indexes was investigated as a possible marker of periodontitis. Methods. Thirty three alcohol-dependent smokers (AS) and 32 healthy controls (C) were enrolled in the study. The activity of β-HEX was measured spectrophotometrically. Results. β-HEX A% was significantly higher and β-HEX B% was lower in AS than in C group. We found a significant correlation between β-HEX A% and gingival index (GI) and an inverse correlation between β-HEX A% and salivary flow (SF), in all groups. Salivary β-HEX A% index in smoking alcoholics at 0.23 had excellent sensitivity (96%) and specificity (91%); the AUC for β-HEX A% was high (0.937). There were no correlations between amount/duration-time of alcohol drinking/smoking and β-HEX A% or β-HEX B%. We found significant correlations between the time period of denture wearing and GI, papilla bleeding index (PBI), and decayed missing filled teeth index (DMFT) and between GI and the amount of smoked cigarettes per day. Conclusion. Bad periodontal state was most likely due to the nicotine dependence. Salivary β-HEX A% is a promising excellent marker for the diagnosis of periodontitis. PMID:24288426

Comparative study on resistant starch, amilose content and glycaemic index after precooked process in white rice

NASA Astrophysics Data System (ADS)

Pratiwi, V. N.

2018-03-01

Rice is a staple food and regarded as a useful carbohydrate source. In general rice is high in glycaemic index (GI) and low colonic fermentation. People are aware of the alterations in blood glucose levels or glycaemic index after consuming rice. Resistant starch (RS) and amylose content play an important role in controlling GI. GI and RS content have been established as important indicators of starch digestibility. The aim of this study was to determine the precooked process with hydrothermal (boiling at 80°C, 10 minutes) and cooling process with low temperature (4°C, 1 h) to increase potential content of RS and decrease of glycaemic index of white rice. There were two stages of this research, 1) preparation of white rice with precooked process; 2) analysis of precooked white rice characteristics (resistant starch, amylose content, and estimated glycaemic index). The result of analysis on precooked white rice showed an increased RS content (1.11%) and white rice (0.99%), but the difference was not statistically significant. The amylose content increased significantly after precooked process in white rice (24.70%) compared with white rice (20.89%). Estimated glycaemic index (EGI) decreased after precooked proses (65.63%) but not significant as compared to white rice (66.47%). From the present study it was concluded that precooked process had no significant impact on increasing RS and decreasing EGI of white rice. This may be due to the relatively short cooling time (1hour) in 4°C.

Cross-sectional and longitudinal relationships of body mass index with glycemic control in children and adolescents with type 1 diabetes mellitus.

PubMed

Nansel, T R; Lipsky, L M; Iannotti, R J

2013-04-01

Weight gain is an oft-cited outcome of improved glycemic control in adults with type 1 diabetes, though few studies have investigated this in youth. The purpose of this paper was to examine cross-sectional and longitudinal associations of body mass index (BMI, kg/m(2)) with glycemic control in youth with type 1 diabetes (n=340, 12.5 ± 1.7 year, 49% female, duration ≥ 1 year) participating in a 2-year multi-center intervention study targeting family diabetes management. BMI was calculated from height and weight measured at clinic visits. Glycohemoglobin (HbA1c) at each visit was assayed centrally. Cross-sectional associations of baseline BMI with glycemic control, and of change in BMI and HbA1c with baseline values, were examined. Longitudinal associations of time-varying BMI and HbA1c were examined using a multilevel linear mixed effects model controlling for time-varying time (months), insulin dose (units/kg/day), regimen, Tanner stage, and time invariant baseline diabetes duration, BMI, treatment group and sociodemographic characteristics. Baseline HbA1c was unrelated to baseline BMI, but was related positively to subsequent BMI change (p=0.04) and inversely to HbA1c change (p=0.002). Baseline BMI was inversely related to BMI change (p=0.01) and unrelated to HbA1c change. In multilevel regression, BMI was related inversely to HbA1c (%) (β ± SE=-0.11 ± 0.02, p<0.001) and positively to insulin dose (0.23 ± 0.07, p=0.001). In the treatment group only, BMI was positively related to pump regimen (0.18 ± 0.08, p=0.02). Increased insulin administered to improve glycemic control may contribute to increased BMI in youth with type 1 diabetes, indicating the importance of determining ways to minimize weight gain while optimizing glycemic control. Published by Elsevier Ireland Ltd.

Serum bilirubin levels are positively associated with glycemic variability in women with type 2 diabetes.

PubMed

Kim, Lee Kyung; Roh, Eun; Kim, Min Joo; Kim, Min Kyeong; Park, Kyeong Seon; Kwak, Soo Heon; Cho, Young Min; Park, Kyong Soo; Jang, Hak Chul; Jung, Hye Seung

2016-11-01

Glycemic variability is known to induce oxidative stress. We investigated the relationships between glycemic variability and serum bilirubin levels, an endogenous anti-oxidant, in patients with diabetes. A cross-sectional study was carried out with 77 patients with type 2 diabetes who had been recruited to two clinical studies from 2008 to 2014. There were no participants with diseases of the pancreas, liver, biliary tract and chronic renal insufficiency. Glycemic variation was calculated by a continuous glucose monitoring system, and correlation analyses were carried out to evaluate their association with bilirubin levels. Multiple linear regression was carried out to identify independent factors influencing bilirubin levels and glycemic variation. Among the participants, 42.3% were men. The mean (standard deviation) age was 61.5 years (10.4 years), body mass index was 24.2 kg/m 2 (2.8 kg/m 2 ), diabetes duration was 17.7 years (9.5 years), hemoglobin A 1c was 60.7 mmol/mol (7.1 mmol/mol; 7.7 [0.7]%) and bilirubin was 11.8 μmol/L (4.10 μmol/L). Serum bilirubin levels were not different according to age, body mass index and hemoglobin A 1c . However, the mean amplitude of glucose excursion was positively associated with bilirubin levels in women (r = 0.588, P < 0.001). After adjustment with duration of diabetes, serum albumin, liver enzymes, and mean glucose, the correlation between bilirubin and mean amplitude of glucose excursion remained significant (r = 0.566, P < 0.001). Multiple linear regression analyses showed that bilirubin was an independent determinant for the mean amplitude of glucose excursion in women. 1,5-Anhydroglucitol was also associated with bilirubin levels in women. Bilirubin level within the physiological range might be an independent predictor for glycemic variability in women with type 2 diabetes. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

Dietary Fiber, Carbohydrate Quality and Quantity, and Mortality Risk of Individuals with Diabetes Mellitus

PubMed Central

Burger, Koert N. J.; Beulens, Joline W. J.; van der Schouw, Yvonne T.; Sluijs, Ivonne; Spijkerman, Annemieke M. W.; Sluik, Diewertje; Boeing, Heiner; Kaaks, Rudolf; Teucher, Birgit; Dethlefsen, Claus; Overvad, Kim; Tjønneland, Anne; Kyrø, Cecilie; Barricarte, Aurelio; Bendinelli, Benedetta; Krogh, Vittorio; Tumino, Rosario; Sacerdote, Carlotta; Mattiello, Amalia; Nilsson, Peter M.; Orho-Melander, Marju; Rolandsson, Olov; Huerta, José María; Crowe, Francesca; Allen, Naomi; Nöthlings, Ute

2012-01-01

Background Dietary fiber, carbohydrate quality and quantity are associated with mortality risk in the general population. Whether this is also the case among diabetes patients is unknown. Objective To assess the associations of dietary fiber, glycemic load, glycemic index, carbohydrate, sugar, and starch intake with mortality risk in individuals with diabetes. Methods This study was a prospective cohort study among 6,192 individuals with confirmed diabetes mellitus (mean age of 57.4 years, and median diabetes duration of 4.4 years at baseline) from the European Prospective Investigation into Cancer and Nutrition (EPIC). Dietary intake was assessed at baseline (1992–2000) with validated dietary questionnaires. Cox proportional hazards analysis was performed to estimate hazard ratios (HRs) for all-cause and cardiovascular mortality, while adjusting for CVD-related, diabetes-related, and nutritional factors. Results During a median follow-up of 9.2 y, 791 deaths were recorded, 306 due to CVD. Dietary fiber was inversely associated with all-cause mortality risk (adjusted HR per SD increase, 0.83 [95% CI, 0.75–0.91]) and CVD mortality risk (0.76[0.64–0.89]). No significant associations were observed for glycemic load, glycemic index, carbohydrate, sugar, or starch. Glycemic load (1.42[1.07–1.88]), carbohydrate (1.67[1.18–2.37]) and sugar intake (1.53[1.12–2.09]) were associated with an increased total mortality risk among normal weight individuals (BMI≤25 kg/m2; 22% of study population) but not among overweight individuals (P interaction≤0.04). These associations became stronger after exclusion of energy misreporters. Conclusions High fiber intake was associated with a decreased mortality risk. High glycemic load, carbohydrate and sugar intake were associated with an increased mortality risk in normal weight individuals with diabetes. PMID:22927948

Effect of an educational Inpatient Diabetes Management Program on medical resident knowledge and measures of glycemic control: a randomized controlled trial.

PubMed

Desimone, Marisa E; Blank, Gary E; Virji, Mohamed; Donihi, Amy; DiNardo, Monica; Simak, Deborah M; Buranosky, Raquel; Korytkowski, Mary T

2012-01-01

To investigate the effectiveness of an Inpatient Diabetes Management Program (IDMP) on physician knowledge and inpatient glycemic control. Residents assigned to General Internal Medicine inpatient services were randomized to receive the IDMP (IDMP group) or usual education only (non-IDMP group). Both groups received an overview of inpatient diabetes management in conjunction with reminders of existing order sets on the hospital Web site. The IDMP group received print copies of the program and access to an electronic version for a personal digital assistant (PDA). A Diabetes Knowledge Test (DKT) was administered at baseline and at the end of the 1-month rotation. The frequency of hyperglycemia among patients under surveillance by each group was compared by using capillary blood glucose values and a dispersion index of glycemic variability. IDMP users completed a questionnaire related to the program. Twenty-two residents participated (11 in the IDMP group and 11 in the non-IDMP group). Overall Diabetes Knowledge Test scores improved in both groups (IDMP: 69% ± 1.7% versus 83% ± 2.1%, P = .003; non-IDMP: 76% ± 1.2% versus 84% ± 1.4%, P = .02). The percentage of correct responses for management of corticosteroid-associated hyperglycemia (P = .004) and preoperative glycemic management (P = .006) improved in only the IDMP group. The frequency of hyperglycemia (blood glucose level >180 mg/dL) and the dispersion index (5.3 ± 7.6 versus 3.7 ± 5.6; P = .2) were similar between the 2 groups. An IDMP was effective at improving physician knowledge for managing hyperglycemia in hospitalized patients treated with corticosteroids or in preparation for surgical procedures. Educational programs directed at improving overall health care provider knowledge for inpatient glycemic management may be beneficial; however, improvements in knowledge do not necessarily result in improved glycemic outcomes.

Dental, periodontal and salivary conditions in diabetic children associated with metabolic control variables and nutritional plan adherence.

PubMed

Díaz Rosas, C Y; Cárdenas Vargas, E; Castañeda-Delgado, J E; Aguilera-Galaviz, L A; Aceves Medina, M C

2018-06-01

Diabetes mellitus is a chronic disease that has manifestations other than alterations in endocrine regulation or in metabolic pathways. Several diseases of the oral cavity have been associated with diabetes mellitus type 1 and 2 in young people according to their evolution. Scarce information exists regarding the role of diabetes and its association with the oral health status in paediatric diabetic patients. The aims of the study were to assess the quality of saliva, saliva acidogenicity, dental caries experience, fluorosis and periodontal status in diabetic patients and to evaluate their relationship with metabolic control variables and nutritional plan adherence. The study population consisted of 60 paediatric patients with both types of diabetes mellitus. Saliva testing included stimulated flow, pH (using pH indicator strips), buffer capacity and Snyder's Test. DMFT/dmft and dental caries experience were determined on the basis of ICDAS II codes. The periodontal status was assessed by PI and GI and fluorosis by FI. Nutritional plan adherence was established from the subscale "Dietary Control" of the Diabetes Self-Management Profile questionnaire. Medical Data was retrieved from the clinical registers in the Diabetic Clinic. We describe the main characteristics of the oral cavity related variables of our population that might guide the clinical practice in similar settings; we found a dmft/DMFT of 1.71 ± 1.74 and 0.64 ± 1.03, PI of 1.91 ± 0.75, GI of 0.50 ± 0.56 and a fluorosis prevalence of 61%. We identified several correlated variables, which indicate strong associations between the nutritional habits of the patients and co-occurrence of oral cavity physiopathological alterations. Several correlations were found between acidogenic activity of the saliva (Snyder Test) and the percentage of adherence to the nutritional plan and to the dmft index. Furthermore, a significant correlation between the buffering capacity of the saliva and the glycemic control of the participants was found. Neither an association nor a difference among means was found between treatment regime and the plaque index. The results of the present study concluded that there was a significant relationship between diabetes mellitus and an increased prevalence of oral cavity related diseases in the paediatric population. These are also associated with a poor adherence to the nutritional plan.

Enrichment of pasta with faba bean does not impact glycemic or insulin response but can enhance satiety feeling and digestive comfort when dried at very high temperature.

PubMed

Greffeuille, Valérie; Marsset-Baglieri, Agnès; Molinari, Nicolas; Cassan, Denis; Sutra, Thibault; Avignon, Antoine; Micard, Valérie

2015-09-01

Enrichment of durum wheat pasta with legume flour enhances their protein and essential amino acid content, especially lysine content. However, despite its nutritional potential, the addition of a legume alters the rheological properties of pasta. High temperature drying of pasta reduces this negative effect by strengthening its protein network. The aim of our study was to determine if these changes in the pasta structure alter its in vitro carbohydrate digestibility, in vivo glycemic, insulin and satiety responses. We also investigated if high temperature drying of pasta can reduce the well-known digestive discomfort associated with the consumption of legume grains. Fifteen healthy volunteers consumed three test meals: durum wheat pasta dried at a low temperature (control), and pasta enriched with 35% faba bean dried at a low and at a very high temperature. When enriched with 35% legume flour, pasta maintained its nutritionally valuable low glycemic and insulin index, despite its weaker protein network. Drying 35% faba bean pasta at a high temperature strengthened its protein network, and decreased its in vitro carbohydrate digestion with no further decrease in its in vivo glycemic or insulin index. Drying pasta at a very high temperature reduced digestive discomfort and enhanced self-reported satiety, and was not associated with a modification of energy intake in the following meal.

Oral health education and therapy reduces gingivitis during pregnancy.

PubMed

Geisinger, Maria L; Geurs, Nicolaas C; Bain, Jennifer L; Kaur, Maninder; Vassilopoulos, Philip J; Cliver, Suzanne P; Hauth, John C; Reddy, Michael S

2014-02-01

Pregnant women demonstrate increases in gingivitis despite similar plaque levels to non-pregnant counterparts. To evaluate an intensive protocol aimed at reducing gingivitis in pregnant women and provide pilot data for large-scale randomized controlled trials investigating oral hygiene measures to reduce pregnancy gingivitis and alter maternity outcomes. One hundred and twenty participants between 16 and 24 weeks gestation with Gingival Index (GI) scores ≥2 at ≥50% of tooth sites were enrolled. Plaque index (PI), gingival inflammation (GI), probing depth (PD), and clinical attachment levels (CAL) were recorded at baseline and 8 weeks. Dental prophylaxis was performed at baseline and oral hygiene instructions at baseline, 4 and 8 weeks. Pregnancy outcomes were recorded at parturition. Mixed-model analysis of variance was used to compare clinical measurements at baseline and 8 weeks. Statistically significant reductions in PI, GI, PD, and CAL occurred over the study period. Mean whole mouth PI and GI scores decreased approximately 50% and the percentage of sites with PI and GI ≥2 decreased from 40% to 17% and 53% to 21.8%, respectively. Mean decreases in whole mouth PD and CAL of 0.45 and 0.24 mm, respectively, were seen. Intensive oral hygiene regimen decreased gingivitis in pregnant patients. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effect of coffee and tea on the glycaemic index of foods: no effect on mean but reduced variability.

PubMed

Aldughpassi, Ahmed; Wolever, Thomas M S

2009-05-01

Coffee and tea may influence glycaemic responses but it is not clear whether they affect the glycaemic index (GI) value of foods. Therefore, to see if coffee and tea affected the mean and SEM of GI values, the GI of fruit leather (FL) and cheese puffs (CP) were determined twice in ten subjects using the FAO/WHO protocol with white bread as the reference food. In one series subjects chose to drink 250 ml of either coffee or tea with all test meals, while in the other series they drank 250 ml water. The tests for both series were conducted as a single experiment with the order of all tests being randomised. Coffee and tea increased the overall mean peak blood glucose increment compared with water by 0.25 (SEM 0.09) mmol/l (P=0.02), but did not significantly affect the incremental area under the glucose response curve. Mean GI values were not affected by coffee or tea but the SEM was reduced by about 30% (FL: 31 (SEM 4) v. 35 (SEM 7) and CP: 76 (SEM 6) v. 75 (SEM 8) for coffee or tea v. water, respectively). The error mean square term from the ANOVA of the GI values was significantly smaller for coffee or tea v. water (F(18, 18) = 2.31; P=0.04). We conclude that drinking coffee or tea with test meals does not affect the mean GI value obtained, but may reduce variability and, hence, improve precision.

Glycaemic index and glycaemic load values of commonly consumed foods in the United Arab Emirates.

PubMed

Al Dhaheri, Ayesha S; Henry, C Jeyakumar K; Mohamad, Maysm N; Ohuma, Eric O; Ismail, Leila Cheikh; Al Meqbaali, Fatima T; Jarrar, Amjad H

2017-04-01

Glycaemic index (GI) and glycaemic load (GL) values of some commonly consumed foods in the United Arab Emirates were determined with an aim of adding these values to the existing international table of GI and GL values. In all, eighteen test foods categorised into breads (n 5), entrée dishes (n 3), main dishes (n 5) and sweet dishes (n 5) were tested. For each test food, at least fifteen healthy participants consumed 25 or 50 g available carbohydrate portions of a reference food (glucose), which was tested three times, and a test food after an overnight fast, was tested once, on separate occasions. Capillary blood samples were obtained by finger-prick and blood glucose was measured using clinical chemistry analyser. A fasting blood sample was obtained at baseline and before consumption of test foods. Additional blood samples were obtained at 15, 30, 45, 60, 90 and 120 min after the consumption of each test food. The GI value of each test food was calculated as the percentage of the incremental area under the blood glucose curve (IAUC) for the test food of each participant divided by the average IAUC for the reference food of the same participant. The GI values of tested foods ranged from low (55 or less) to high (70 or more). The GI values of various breads and rice-containing dishes were comparable with previously published values. This study provides GI and GL values of previously untested traditional Emirati foods which could provide a useful guide on dietary recommendations for the Emirati population.

Elevated levels of faecal calprotectin in primary Sjögren's syndrome is common and associated with concomitant organic gastrointestinal disease.

PubMed

Andréasson, Kristofer; Ohlsson, Bodil; Mandl, Thomas

2016-01-12

Primary Sjögren's syndrome (pSS) is a systemic rheumatic disease in which gastrointestinal (GI) symptoms are common. Faecal calprotectin (FC) is a non-invasive biomarker that has been suggested to discriminate organic intestinal disease from functional disorders. The purpose of this study was to explore the usefulness of FC testing in patients with pSS. In total, 56 consecutive patients with pSS and 29 healthy control subjects were included in this cross-sectional study. FC was measured with a commercially available enzyme-linked immunosorbent assay kit. GI symptoms were evaluated with the Rome III questionnaire and the Visual Analogue Scale for Irritable Bowel Syndrome. In patients with pSS, disease activity was estimated using the European League Against Rheumatism (EULAR) Sjögren's Syndrome Disease Activity Index (ESSDAI), and patient-reported outcomes were evaluated with the EULAR Sjögren's Syndrome Patient-Reported Index. Patients with pSS had higher levels of FC than healthy control subjects (median 54 μg/g, interquartile range [IQR 20-128]; vs. 20 μg/g [20-43]; p = 0.002). Concomitant organic GI disease was found in 14 patients with pSS and included inflammatory bowel disease (n = 3), colonic adenoma (n = 2) and GI lymphoma (n = 1). Patients with organic GI disease had higher FC levels than the other patients with pSS (median 274 μg/g [IQR 61-363] vs. median 34 μg/g [IQR 20-76]; p < 0.001). Although patients with pSS reported abdominal discomfort more frequently than healthy control subjects did, such symptoms were not associated with organic GI disease or elevated FC levels. FC correlated moderately with ESSDAI. Excluding patients with organic GI disease, we did not identify any significant association between ESSDAI and FC levels. GI symptoms are frequent in pSS. Contrary to patient-reported outcomes, elevated FC levels in pSS indicate possible organic GI disease that warrants further investigation.

Continuous glucose monitoring reveals different glycemic responses of moderate- vs high-carbohydrate lunch meals in people with type 2 diabetes.

PubMed

Powers, Margaret A; Cuddihy, Robert M; Wesley, David; Morgan, Blaine

2010-12-01

This single-center, meal-intervention, crossover study was conducted to determine the glycemic response to fixed meals with varying carbohydrate content. Continuous glucose monitoring was used to document the glycemic response. Participants were 14 people with type 2 diabetes on metformin only. On 4 consecutive days in March or July 2008, study participants consumed a fixed breakfast and one of two test meals (lunch) provided in random order. The two lunch types varied only in carbohydrate content; the protein, fat, fiber, and glycemic index were similar. They consumed no caloric food or beverages for 4 hours after each meal. Consuming double the carbohydrate content did not double the glycemic response variables, yet most were substantially different in glucose value (mg/dL) or minutes. General linear model analyses revealed substantial differences for peak glucose, change from baseline glucose to peak, time to return to preprandial glucose, 4-hour glucose area under the curve, and 4-hour mean glucose. Continuous glucose monitoring data provided a robust description of the glycemic response to the two meals. Such data can help improve postprandial glucose levels through more informed nutrition recommendations and synchronization of food intake, diabetes medication, and/or physical activity. Copyright © 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Postprandial blood glucose control in type 1 diabetes for carbohydrates with varying glycemic index foods.

PubMed

Hashimoto, Shogo; Noguchi, Claudia Cecilia Yamamoto; Furutani, Eiko

2014-01-01

Treatment of type 1 diabetes consists of maintaining postprandial normoglycemia using the correct prandial insulin dose according to food intake. Nonetheless, it is hardly achieved in practice, which results in several diabetes-related complications. In this study we present a feedforward plus feedback blood glucose control system that considers the glycemic index of foods. It consists of a preprandial insulin bolus whose optimal bolus dose and timing are stated as a minimization problem, which is followed by a postprandial closed-loop control based on model predictive control. Simulation results show that, for a representative carbohydrate intake of 50 g, the present control system is able to maintain postprandial glycemia below 140 mg/dL while preventing postprandial hypoglycemia as well.

Study of Glycemic Variability Through Time Series Analyses (Detrended Fluctuation Analysis and Poincaré Plot) in Children and Adolescents with Type 1 Diabetes.

PubMed

García Maset, Leonor; González, Lidia Blasco; Furquet, Gonzalo Llop; Suay, Francisco Montes; Marco, Roberto Hernández

2016-11-01

Time series analysis provides information on blood glucose dynamics that is unattainable with conventional glycemic variability (GV) indices. To date, no studies have been published on these parameters in pediatric patients with type 1 diabetes. Our aim is to evaluate the relationship between time series analysis and conventional GV indices, and glycosylated hemoglobin (HbA1c) levels. This is a transversal study of 41 children and adolescents with type 1 diabetes. Glucose monitoring was carried out continuously for 72 h to study the following GV indices: standard deviation (SD) of glucose levels (mg/dL), coefficient of variation (%), interquartile range (IQR; mg/dL), mean amplitude of the largest glycemic excursions (MAGE), and continuous overlapping net glycemic action (CONGA). The time series analysis was conducted by means of detrended fluctuation analysis (DFA) and Poincaré plot. Time series parameters (DFA alpha coefficient and elements of the ellipse of the Poincaré plot) correlated well with the more conventional GV indices. Patients were grouped according to the terciles of these indices, to the terciles of eccentricity (1: 12.56-16.98, 2: 16.99-21.91, 3: 21.92-41.03), and to the value of the DFA alpha coefficient (> or ≤1.5). No differences were observed in the HbA1c of patients grouped by GV index criteria; however, significant differences were found in patients grouped by alpha coefficient and eccentricity, not only in terms of HbA1c, but also in SD glucose, IQR, and CONGA index. The loss of complexity in glycemic homeostasis is accompanied by an increase in variability.

Use of a germination bioassay to test compost maturity in Tekelan Village

NASA Astrophysics Data System (ADS)

Oktiawan, Wiharyanto; Zaman, Badrus; Purwono

2018-02-01

Livestock waste from cattle farms in Tekelan village, Getasan Subdistrict, Semarang Regency can be grouped into three types, namely solid waste, slurry and waste water. Solid waste (cow dung) was processed into compost, while slurry and waste water were used to make liquid fertilizer. This compost was used as a component of planting media in horticultural crops and potted plants production. We evaluated the toxicity (phytochemical and ecotoxicological) test of compost by using germination index (GI). Vigna radiata seeds are sown on filter paper dampened with compost extract for different times. GI was calculated by relative germination (G) and relative radical length (L). The germination index (GI) = G / G0 x L / L0 x 100, where G0 and L0 are values obtained by distilled water as a control. The results showed that germination bioassay and radical length using aquades and groundwater in Tekelan village did not affect the radical length of Vigna radiata . Technically, groundwater in Tekelan village can be used as a germination bioassay control. The cow dung compost substrate appears to have a major influence on compost toxicity. Mature compost was produced on day 14 with a GI of 104.03.

Dietary composition in the treatment of polycystic ovary syndrome: a systematic review to inform evidence-based guidelines.

PubMed

Moran, Lisa J; Ko, Henry; Misso, Marie; Marsh, Kate; Noakes, Manny; Talbot, Mac; Frearson, Meredith; Thondan, Mala; Stepto, Nigel; Teede, Helena J

2013-04-01

While lifestyle management is recommended as first-line treatment of polycystic ovary syndrome (PCOS), the optimal dietary composition is unclear. The aim of this study was to compare the effect of different diet compositions on anthropometric, reproductive, metabolic, and psychological outcomes in PCOS. A literature search was conducted (Australasian Medical Index, CINAHL, EMBASE, Medline, PsycInfo, and EBM reviews; most recent search was performed January 19, 2012). Inclusion criteria were women with PCOS not taking anti-obesity medications and all weight-loss or maintenance diets comparing different dietary compositions. Studies were assessed for risk of bias. A total of 4,154 articles were retrieved and six articles from five studies met the a priori selection criteria, with 137 women included. A meta-analysis was not performed due to clinical heterogeneity for factors including participants, dietary intervention composition, duration, and outcomes. There were subtle differences between diets, with greater weight loss for a monounsaturated fat-enriched diet; improved menstrual regularity for a low-glycemic index diet; increased free androgen index for a high-carbohydrate diet; greater reductions in insulin resistance, fibrinogen, total, and high-density lipoprotein cholesterol for a low-carbohydrate or low-glycemic index diet; improved quality of life for a low-glycemic index diet; and improved depression and self-esteem for a high-protein diet. Weight loss improved the presentation of PCOS regardless of dietary composition in the majority of studies. Weight loss should be targeted in all overweight women with PCOS through reducing caloric intake in the setting of adequate nutritional intake and healthy food choices irrespective of diet composition. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Growth Index: A Powerful Tool for School Improvement

ERIC Educational Resources Information Center

Wiseman, Perry; Thomas, Kimberly

2011-01-01

This article outlines a formula called Growth Index (GI), which is designed to measure student growth within all proficiency levels year after year, and track classroom or schoolwide growth. This growth should be considered as one of several dimensions that constitute principal and teacher effectiveness. Unlike Academic Performance Index (API) and…

Effect of pasta in the context of low-glycaemic index dietary patterns on body weight and markers of adiposity: a systematic review and meta-analysis of randomised controlled trials in adults

PubMed Central

Chiavaroli, Laura; Kendall, Cyril W C; Braunstein, Catherine R; Blanco Mejia, Sonia; Leiter, Lawrence A; Jenkins, David J A; Sievenpiper, John L

2018-01-01

Objective Carbohydrate staples such as pasta have been implicated in the obesity epidemic. It is unclear whether pasta contributes to weight gain or like other low-glycaemic index (GI) foods contributes to weight loss. We synthesised the evidence of the effect of pasta on measures of adiposity. Design Systematic review and meta-analysis using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Data sources MEDLINE, Embase, CINAHL and the Cochrane Library were searched through 7 February 2017. Eligibility criteria for selecting studies We included randomised controlled trials ≥3 weeks assessing the effect of pasta alone or in the context of low-GI dietary patterns on measures of global (body weight, body mass index (BMI), body fat) and regional (waist circumference (WC), waist-to-hip ratio (WHR), sagittal abdominal diameter (SAD)) adiposity in adults. Data extraction and synthesis Two independent reviewers extracted data and assessed risk of bias. Data were pooled using the generic inverse-variance method and expressed as mean differences (MDs) with 95% CIs. Heterogeneity was assessed (Cochran Q statistic) and quantified (I2 statistic). GRADE assessed the certainty of the evidence. Results We identified no trial comparisons of the effect of pasta alone and 32 trial comparisons (n=2448 participants) of the effect of pasta in the context of low-GI dietary patterns. Pasta in the context of low-GI dietary patterns significantly reduced body weight (MD=−0.63 kg; 95% CI −0.84 to –0.42 kg) and BMI (MD=−0.26 kg/m2; 95% CI −0.36 to –0.16 kg/m2) compared with higher-GI dietary patterns. There was no effect on other measures of adiposity. The certainty of the evidence was graded as moderate for body weight, BMI, WHR and SAD and low for WC and body fat. Conclusions Pasta in the context of low-GI dietary patterns does not adversely affect adiposity and even reduces body weight and BMI compared with higher-GI dietary patterns. Future trials should assess the effect of pasta in the context of other ‘healthy’ dietary patterns. Trial registration number NCT02961088; Results. PMID:29615407

Effect of pasta in the context of low-glycaemic index dietary patterns on body weight and markers of adiposity: a systematic review and meta-analysis of randomised controlled trials in adults.

PubMed

Chiavaroli, Laura; Kendall, Cyril W C; Braunstein, Catherine R; Blanco Mejia, Sonia; Leiter, Lawrence A; Jenkins, David J A; Sievenpiper, John L

2018-04-02

Carbohydrate staples such as pasta have been implicated in the obesity epidemic. It is unclear whether pasta contributes to weight gain or like other low-glycaemic index (GI) foods contributes to weight loss. We synthesised the evidence of the effect of pasta on measures of adiposity. Systematic review and meta-analysis using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. MEDLINE, Embase, CINAHL and the Cochrane Library were searched through 7 February 2017. We included randomised controlled trials ≥3 weeks assessing the effect of pasta alone or in the context of low-GI dietary patterns on measures of global (body weight, body mass index (BMI), body fat) and regional (waist circumference (WC), waist-to-hip ratio (WHR), sagittal abdominal diameter (SAD)) adiposity in adults. Two independent reviewers extracted data and assessed risk of bias. Data were pooled using the generic inverse-variance method and expressed as mean differences (MDs) with 95% CIs. Heterogeneity was assessed (Cochran Q statistic) and quantified (I 2 statistic). GRADE assessed the certainty of the evidence. We identified no trial comparisons of the effect of pasta alone and 32 trial comparisons (n=2448 participants) of the effect of pasta in the context of low-GI dietary patterns. Pasta in the context of low-GI dietary patterns significantly reduced body weight (MD=-0.63 kg; 95% CI -0.84 to -0.42 kg) and BMI (MD=-0.26 kg/m 2 ; 95% CI -0.36 to -0.16 kg/m 2 ) compared with higher-GI dietary patterns. There was no effect on other measures of adiposity. The certainty of the evidence was graded as moderate for body weight, BMI, WHR and SAD and low for WC and body fat. Pasta in the context of low-GI dietary patterns does not adversely affect adiposity and even reduces body weight and BMI compared with higher-GI dietary patterns. Future trials should assess the effect of pasta in the context of other 'healthy' dietary patterns. NCT02961088; Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Glucooxidative stress and spontaneous abortion in pregnant women with diabetes mellitus type 1].

PubMed

Todorova, K; Ivanov, S; Mazneĭkova, V; Genova, M

2005-01-01

The pregnancies in women with Diabetes mellitus are in condition of increased glucooxidative stress, which could be toxic for the developing embryo. END-POINTS: To evaluate the levels of selenium and glutation peroxidase in pregnant women with Diabetes mellitus type 1 in the first trimester of pregnancy and to establish whether there is a correlation between the diabetic glycemic control and occurrence of spontaneous abortions. Prospective study of 75 women for 1 year period. he pregnant women were divided in 3 groups as follows: 1st group--30 pregnant women with Diabetes mellitus type 1 with normal outcome; 2nd group--16 pregnant women with Diabetes mellitus type 1 with spontaneous abortion; 3rd group--29 healthy pregnant controls. The activity of GI-Px in red blood cells was measured in hemolysat of EDTA plasma in Germany. The levels of glucosylated haemoglobin were also evaluated. 1. In all pregnant women the levels of selenium were lower without significant difference between them 1st group--0.12 +/- 0.6 mmol/l, 2ndd group 0.13 +/- 0.1 mmol/l, 3rd group 0.13 +/- 0.7 mmol/l (P > 0.05). 2. There is an increase in the activity of GI-Px, which is statistically significant in the healthy pregnant women 47.8 +/- 13.3 U/g Hb and diabetic pregnant women with normal outcome 48. 6 +/- 8.4 U/g Hb. There is no statistically significant difference in the activity of GI-Px in diabetic pregnant women with spontaneous abortions and the healthy controls (P > 0. 05). 3. Negative correlation between the levels of selenium and the activity of GI-Px was proved in healthy pregnant women (r = - 0.4; P < 0.05). No correlation was found between the level of the selenium and the activity of GI-Px into the two groups of diabetic pregnant women. 4. There is a correlation in the levels of diabetic pregnant women with spontaneous abortions (r = -0.38; P < 0.001). The increased activity of GI-Px in diabetic pregnant women with spontaneous abortions is a result of increased antioxidative defense of the cell. Probably the ineffective antioxidant defense, leading to a spontaneous abortion is due to the low levels of selenium and high level of pre-prandial glycaemia.

Gluten-free snacks using plantain-chickpea and maize blend: chemical composition, starch digestibility, and predicted glycemic index.

PubMed

Flores-Silva, Pamela C; Rodriguez-Ambriz, Sandra L; Bello-Pérez, Luis A

2015-05-01

An increase in celiac consumers has caused an increasing interest to develop good quality gluten-free food products with high nutritional value. Snack foods are consumed worldwide and have become a normal part of the eating habits of the celiac population making them a target to improve their nutritive value. Extrusion and deep-frying of unripe plantain, chickpea, and maize flours blends produced gluten-free snacks with high dietary fiber contents (13.7-18.2 g/100 g) and low predicted glycemic index (28 to 35). The gluten-free snacks presented lower fat content (12.7 to 13.6 g/100 g) than those reported in similar commercial snacks. The snack with the highest unripe plantain flour showed higher slowly digestible starch (11.6 and 13.4 g/100 g) than its counterpart with the highest chickpea flour level (6 g/100 g). The overall acceptability of the gluten-free snacks was similar to that chili-flavored commercial snack. It was possible to develop gluten-free snacks with high dietary fiber content and low predicted glycemic index with the blend of the 3 flours, and these gluten-free snacks may also be useful as an alternative to reduce excess weight and obesity problems in the general population and celiac community. © 2015 Institute of Food Technologists®

Performance of a light fluorescence device for the detection of microbial plaque and gingival inflammation.

PubMed

Rechmann, Peter; Liou, Shasan W; Rechmann, Beate M T; Featherstone, John D B

2016-01-01

The hypothesis to be tested was that using the SOPROCARE system in fluorescence perio-mode allows scoring of microbial plaque that is comparable to the Turesky modification of the Quigley Hein plaque index (T-QH) and scoring of gingival inflammation comparable to the Silness and Löe gingival inflammation index (GI). Fifty-five subjects with various amounts of microbial plaque were recruited. The T-QH and GI index were recorded. SOPROCARE pictures were recorded in fluorescence perio-mode and in daylight mode. Finally, conventional digital photographs were taken. All pictures were assessed using the same criteria as described for the clinical indices. The average T-QH was 1.1 ± 1.2 (mean ± SD). Scoring with SOPROCARE perio-mode led to a slightly higher average than the T-QH scores. SOPROCARE daylight mode and digital photography showed the highest plaque scores. The average GI index was 0.7 ± 0.9. SOPROCARE in perio-mode scored slightly lower. Linear regression fits between the different clinical indices and SOPROCARE scores were significantly different from zero demonstrating high goodness of fit. The study demonstrated that the SOPROCARE fluorescence assessment tool in perio-mode allows reliable judgment of microbial plaque and gingival inflammation levels similar to the established Turesky-modified Quigley Hein index and the Silness and Löe gingival inflammation index. Training on plaque-free teeth will actually reduce scoring errors. The SOPROCARE fluorescence tool in perio-mode provides reliable evaluation of microbial plaque and gingival inflammation for the dental clinician.

Food processing methods influence the glycaemic indices of some commonly eaten West Indian carbohydrate-rich foods.

PubMed

Bahado-Singh, P S; Wheatley, A O; Ahmad, M H; Morrison, E Y St A; Asemota, H N

2006-09-01

Glycaemic index (GI) values for fourteen commonly eaten carbohydrate-rich foods processed by various methods were determined using ten healthy subjects. The foods studied were round leaf yellow yam (Dioscorea cayenensis), negro and lucea yams (Dioscorea rotundata), white and sweet yams (Dioscorea alata), sweet potato (Solanum tuberosum), Irish potato (Ipomoea batatas), coco yam (Xanthosoma spp.), dasheen (Colocasia esculenta), pumpkin (Cucurbita moschata), breadfruit (Artocarpus altilis), green banana (Musa sapientum), and green and ripe plantain (Musa paradisiaca). The foods were processed by boiling, frying, baking and roasting where applicable. Pure glucose was used as the standard with a GI value of 100. The results revealed marked differences in GI among the different foods studied ranging from 35 (se 3) to 94 (se 8). The area under the glucose response curve and GI value of some of the roasted and baked foods were significantly higher than foods boiled or fried (P<0.05). The results indicate that foods processed by roasting or baking may result in higher GI. Conversely, boiling of foods may contribute to a lower GI diet.

A systematic review of interventions for Hispanic women with or at risk of Gestational diabetes mellitus (GDM).

PubMed

Carolan-Olah, Mary; Duarte-Gardea, Maria; Lechuga, Julia

2017-10-01

Gestational Diabetes Mellitus (GDM) is a serious health concern for pregnant women, with Hispanic women at particular risk for developing the condition. The aim of this review was to critically examine GDM intervention programs for Hispanic women, in the United States of America (US). English and Spanish electronic databases were searched for relevant studies published between 1995 and 2015. Eligible study designs included randomized controlled trial, pre/post-test and quasi experimental methods. Findings indicated that there was a dearth of literature reporting on GDM interventions for Hispanic women and just seven papers met inclusion criteria. These seven studies were included in the review and they reported on interventions for: (1) pregnant women at high risk of developing GDM; (2) pregnant women with GDM. Results suggest that a combination of intensive counselling over a prolonged period of time, together with a low calorie, possibly low glycemic index diet, produces best results. The review found that intensive nutritional counselling approaches which promote low calorie/low GI diets appear to be most effective in BGL management in this population. Interventions that are delivered in Spanish and culturally tailored may be more acceptable to participants. More research is needed to develop suitable interventions to improve GDM management among Hispanic women. Copyright © 2017 Elsevier B.V. All rights reserved.

Effect of different milling methods on glycaemic response of foods made with finger millet (Eucenea coracana) flour.

PubMed

Jayasinghe, M A; Ekanayake, S; Nugegoda, D B

2013-12-01

Compare glycaemic response of foods prepared with finger millet flour, using traditional stone grinding and industrial milling. Crossover study. Healthy volunteers (n=11) consisting of five males and six females), aged between 20 and 30 years, with a body mass index of 18.5-23.5 Kgm-2. Blood glucose concentration was measured at fasting and 30, 45, 60, 90, 120 minutes after ingestion of roti and pittu made with stone ground or industrially milled finger millet flour, containing 50 g of available carbohydrates. Glycaemic Index (GI) values were expressed as the average value of the 11 subjects. Significant differences (p<0.05) in GI between similar food types made of flour milled using different methods were observed. GI for roti made of stone ground flour was 44±5 and that of roti made of industrially milled flour was 59±7. Pittu made of stone ground flour had a GI of 67±5 and GI of pittu made of industrially milled flour was 79±5. Microscopic analysis of flour samples and a sieving process using different sieve sizes showed larger particle size distribution in stone ground flour compared to industrially milled flour. Larger particle sizes in the stone ground flour compared with industrially milled flour was established as the only factor affecting the difference in GI of same type of food prepared with flour milled using different methods. There were no significant differences (p>0.05) in proximate compositions of the different foods or raw flours. Foods prepared with finger millet (kurakkan) flour with a larger particle size distribution resulted in a lower glycaemic response.

Maternal diet and weight at 3 months postpartum following a pregnancy intervention with a low glycaemic index diet: results from the ROLO randomised control trial.

PubMed

Horan, Mary K; McGowan, Ciara A; Gibney, Eileen R; Donnelly, Jean M; McAuliffe, Fionnuala M

2014-07-23

Pregnancy increases the risk of being overweight at a later time period, particularly when there is excessive gestational weight gain. There remains a paucity of data into the effect of low glycaemic index (GI) pregnancy interventions postpartum. To examine the impact of a low glycaemic index diet during pregnancy on maternal diet 3 months postpartum. This analysis examined the diet, weight and lifestyle of 460 participants of the ROLO study 3 months postpartum. Questionnaires on weight, physical activity, breastfeeding, supplement use, food label reading and dietary habits were completed. The intervention group had significantly greater weight loss from pre-pregnancy to 3 months postpartum than the control group (1.3 vs. 0.1 kg, p = 0.022). The intervention group reported greater numbers following a low glycaemic index diet (p < 0.001) and reading food labels (p = 0.032) and had a lower glycaemic load (GL) (128 vs. 145, p = 0.014) but not GI (55 vs. 55, p = 0.809) than controls. Low GI dietary interventions in pregnancy result in improved health-behaviours and continued reported compliance at 3 months postpartum possibly through lower dietary GL as a result of portion control. Greater levels of weight loss from pre-pregnancy to 3 months postpartum in the intervention group may have important positive implications for overweight and obesity.

Effect of banana pulp and peel flour on physicochemical properties and in vitro starch digestibility of yellow alkaline noodles.

PubMed

Ramli, Saifullah; Alkarkhi, Abbas F M; Shin Yong, Yeoh; Min-Tze, Liong; Easa, Azhar Mat

2009-01-01

The present study describes the utilization of banana--Cavendish (Musa acuminata L., cv cavendshii) and Dream (Musa acuminata colla. AAA, cv 'Berangan')--pulp and peel flours as functional ingredients in yellow alkaline noodles. Noodles were prepared by partial substitution of wheat flour with ripe banana pulp or peel flours. In most cases, the starch hydrolysis index, predicted glycaemic index (pGI) and physicochemical properties of cooked noodles were affected by banana flour addition. In general, the pGI values of cooked noodles were in the order; banana peel noodles < banana pulp noodles < control noodles. Since the peel flour was higher in total dietary fibre but lower in resistant starch contents than the pulp flour, the low pGI of banana peel noodles was mainly due to its high dietary fibre content. In conclusion, banana pulp and peel flour could be useful for controlling starch hydrolysis of yellow noodles, even though some physicochemical properties of the noodles were altered.

A study of glycemic response to Corinthian raisins in healthy subjects and in type 2 diabetes mellitus patients.

PubMed

Kanellos, Panagiotis T; Kaliora, Andriana C; Liaskos, Christos; Tentolouris, Nikolaos K; Perrea, Despina; Karathanos, Vaios T

2013-06-01

This study was designed to evaluate the metabolic response to Corinthian raisins in healthy and in patients with type 2 diabetes mellitus. Healthy subjects (n = 15) and diabetic patients (n = 15) received 74 g raisins or 50 g glucose as reference food. Blood samples were collected at time 0 (before the consumption) and 30, 60, 90, 120, 150 and 180 min after raisin or glucose consumption. There was no significant difference in baseline glucose and insulin between raisins and reference in both groups. The difference at glucose peaks between raisins and reference was significant in healthy and in diabetics. Glycemic and insulinemic responses were decreased after raisin consumption compared to reference. An estimate of the glycemic index would be 66.3 ± 3.4.

Interaction of sleep quality and sleep duration on glycemic control in patients with type 2 diabetes mellitus.

PubMed

Tang, Yunzhao; Meng, Lingling; Li, Daiqing; Yang, Min; Zhu, Yanjuan; Li, Chenguang; Jiang, Zhenhuan; Yu, Ping; Li, Zhu; Song, Hongna; Ni, Changlin

2014-01-01

Copious evidence from epidemiological and laboratory studies has revealed that sleep status is associated with glucose intolerance, insulin resistance, thus increasing the risk of developing type 2 diabetes. The aim of this study was to reveal the interaction of sleep quality and sleep quantity on glycemic control in patients with type 2 diabetes mellitus. From May 2013 to May 2014, a total of 551 type 2 diabetes patients in Tianjin Metabolic Diseases Hospital were enrolled. Blood samples were taken to measure glycosylated hemoglobin (HbA1c), and all the patients completed the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) questionnaire to evaluate their sleep status. "Good sleep quality" was defined as PQSI <5, "average sleep quality" was defined as PQSI 6-8, and "poor sleep quality" was defined as PQSI >8. Poor glycemic control was defined as HbA1c ≥7%. Sleep quantity was categorized as <6, 6-8, and >8 hours/night. Short sleep time was defined as sleep duration <6 hours/night. In the poor glycemic control group, the rate of patients who had insufficient sleep was much higher than that in the other group (χ(2) = 11.16, P = 0.037). The rate of poor sleep quality in poor glycemic control group was much greater than that in the average control group (χ(2) = 9.79, P = 0.007). After adjusted by gender, age, body mass index, and disease duration, the adjusted PSQI score's OR was 1.048 (95% CI 1.007-1.092, P = 0.023) for HbA1c level. The sleep duration's OR was 0.464 (95% CI 0.236-0.912, P = 0.026) for HbA1c level. One-way analysis of variance showed that the poor sleep quality group had the highest homeostasis model assessment-insulin resistance (P < 0.01). Inadequate sleep, in both quality and quantity, should be regarded as a plausible risk factor for glycemic control in type 2 diabetes. Poor sleep might bring much more serious insulin resistance and could be the reason for bad glycemic control. A good night's sleep should be seen as a critical health component tool in the prevention and treatment of type 2 diabetes. It is important for clinicians to target the root causes of short sleep duration and/or poor sleep quality.

Distinct lipid profiles predict improved glycemic control in obese, nondiabetic patients after a low-caloric diet intervention: the Diet, Obesity and Genes randomized trial.

PubMed

Valsesia, Armand; Saris, Wim Hm; Astrup, Arne; Hager, Jörg; Masoodi, Mojgan

2016-09-01

An aim of weight loss is to reduce the risk of type 2 diabetes (T2D) in obese subjects. However, the relation with long-term glycemic improvement remains unknown. We evaluated the changes in lipid composition during weight loss and their association with long-term glycemic improvement. We investigated the plasma lipidome of 383 obese, nondiabetic patients within a randomized, controlled dietary intervention in 8 European countries at baseline, after an 8-wk low-caloric diet (LCD) (800-1000 kcal/d), and after 6 mo of weight maintenance. After weight loss, a lipid signature identified 2 groups of patients who were comparable at baseline but who differed in their capacities to lose weight and improve glycemic control. Six months after the LCD, one group had significant glycemic improvement [homeostasis model assessment of insulin resistance (HOMA-IR) mean change: -0.92; 95% CI: -1.17, -0.67)]. The other group showed no improvement in glycemic control (HOMA-IR mean change: -0.26; 95% CI: -0.64, 0.13). These differences were sustained for ≥1 y after the LCD. The same conclusions were obtained with other endpoints (Matsuda index and fasting insulin and glucose concentrations). Significant differences between the 2 groups were shown in leptin gene expression in adipose tissue biopsies. Significant differences were also observed in weight-related endpoints (body mass index, weight, and fat mass). The lipid signature allowed prediction of which subjects would be considered to be insulin resistant after 6 mo of weight maintenance [validation's receiver operating characteristic (ROC) area under the curve (AUC): 71%; 95% CI: 62%, 81%]. This model outperformed a clinical data-only model (validation's ROC AUC: 61%; 95% CI: 50%, 71%; P = 0.01). In this study, we report a lipid signature of LCD success (for weight and glycemic outcome) in obese, nondiabetic patients. Lipid changes during an 8-wk LCD allowed us to predict insulin-resistant patients after 6 mo of weight maintenance. The determination of the lipid composition during an LCD enables the identification of nonresponders and may help clinicians manage metabolic outcomes with further intervention, thereby improving the long-term outcome and preventing T2D. This trial was registered at clinicaltrials.gov as NCT00390637. © 2016 American Society for Nutrition.

Reproductive Cycle of Hard Clam, Meretrix lyrata Sowerby, 1851 (Bivalvia: Veneridae) from Sarawak, Malaysia.

PubMed

Hamli, Hadi; Idris, Mohd Hanafi; Rajaee, Amy Halimah; Kamal, Abu Hena Mustafa

2015-12-01

A study of the reproductive cycle of the hard clam, Meretrix lyrata, was documented based on histological observation and Gonad Index (GI). Samples were taken from estuarine waters of the Buntal River in Sarawak, Malaysia. The gonad of M. lyrata started to develop in September 2013. Gametogenesis continued to develop until the maturation and spawning stage from February to April 2014. The GI pattern for a one-year cycle showed a significant correlation with chlorophyll a. The corresponding GI with chlorophyll a suggested that the development of the reproductive cycle of M. lyrata required a high amount of food to increase gametogenesis.

Reproductive Cycle of Hard Clam, Meretrix lyrata Sowerby, 1851 (Bivalvia: Veneridae) from Sarawak, Malaysia

PubMed Central

Hamli, Hadi; Idris, Mohd Hanafi; Rajaee, Amy Halimah; Kamal, Abu Hena Mustafa

2015-01-01

A study of the reproductive cycle of the hard clam, Meretrix lyrata, was documented based on histological observation and Gonad Index (GI). Samples were taken from estuarine waters of the Buntal River in Sarawak, Malaysia. The gonad of M. lyrata started to develop in September 2013. Gametogenesis continued to develop until the maturation and spawning stage from February to April 2014. The GI pattern for a one-year cycle showed a significant correlation with chlorophyll a. The corresponding GI with chlorophyll a suggested that the development of the reproductive cycle of M. lyrata required a high amount of food to increase gametogenesis. PMID:26868710

Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study

PubMed Central

Jönsson, Tommy; Granfeldt, Yvonne; Ahrén, Bo; Branell, Ulla-Carin; Pålsson, Gunvor; Hansson, Anita; Söderström, Margareta; Lindeberg, Staffan

2009-01-01

Background Our aim was to compare the effects of a Paleolithic ('Old Stone Age') diet and a diabetes diet as generally recommended on risk factors for cardiovascular disease in patients with type 2 diabetes not treated with insulin. Methods In a randomized cross-over study, 13 patients with type 2 diabetes, 3 women and 10 men, were instructed to eat a Paleolithic diet based on lean meat, fish, fruits, vegetables, root vegetables, eggs and nuts; and a Diabetes diet designed in accordance with dietary guidelines during two consecutive 3-month periods. Outcome variables included changes in weight, waist circumference, serum lipids, C-reactive protein, blood pressure, glycated haemoglobin (HbA1c), and areas under the curve for plasma glucose and plasma insulin in the 75 g oral glucose tolerance test. Dietary intake was evaluated by use of 4-day weighed food records. Results Study participants had on average a diabetes duration of 9 years, a mean HbA1c of 6,6% units by Mono-S standard and were usually treated with metformin alone (3 subjects) or metformin in combination with a sulfonylurea (3 subjects) or a thiazolidinedione (3 subjects). Mean average dose of metformin was 1031 mg per day. Compared to the diabetes diet, the Paleolithic diet resulted in lower mean values of HbA1c (-0.4% units, p = 0.01), triacylglycerol (-0.4 mmol/L, p = 0.003), diastolic blood pressure (-4 mmHg, p = 0.03), weight (-3 kg, p = 0.01), BMI (-1 kg/m2, p = 0.04) and waist circumference (-4 cm, p = 0.02), and higher mean values of high density lipoprotein cholesterol (+0.08 mmol/L, p = 0.03). The Paleolithic diet was mainly lower in cereals and dairy products, and higher in fruits, vegetables, meat and eggs, as compared with the Diabetes diet. Further, the Paleolithic diet was lower in total energy, energy density, carbohydrate, dietary glycemic load, saturated fatty acids and calcium, and higher in unsaturated fatty acids, dietary cholesterol and several vitamins. Dietary GI was slightly lower in the Paleolithic diet (GI = 50) than in the Diabetic diet (GI = 55). Conclusion Over a 3-month study period, a Paleolithic diet improved glycemic control and several cardiovascular risk factors compared to a Diabetes diet in patients with type 2 diabetes. Trial registration ClinicalTrials.gov NCT00435240. PMID:19604407

Glycemic Response to Black Beans and Chickpeas as Part of a Rice Meal: A Randomized Cross-Over Trial.

PubMed

Winham, Donna M; Hutchins, Andrea M; Thompson, Sharon V

2017-10-04

Legumes, such as black beans ( Phaseolus vulgaris L.) and chickpeas ( Cicer arietinum L.), have a low glycemic index, and may reduce the glycemic load of meals in which they are included. Although the low glycemic response of beans consumed alone has been documented, few studies have examined the glycemic response to traditional food combinations such as black beans and rice or chickpeas and rice. This randomized cross-over study examined the glycemic and insulinemic impact of 50 grams of available carbohydrate from three test meals: plain white rice (control), black beans with rice, and chickpeas with rice among healthy adult women ( n = 12, 18-65 years). Treatments were consumed on different mornings, a minimum of 7 days apart. Blood samples were collected at time 0 (fasting), and at 30, 60, 90, and 120 min postprandial, and were subsequently analyzed for glucose and insulin concentrations. Glucose response based on the incremental area under the curve showed a significant difference by treatment ( p = 0.027). Changes in blood glucose concentrations were significantly different for the black bean meal and the chickpea meal in comparison to rice alone at 60 min ( p = 0.026 and p = 0.024), 90 min ( p = 0.001 and p = 0.012) and 120 min post prandial ( p = 0.024; black bean meal). Findings indicate that combinations of black beans and chickpeas with white rice improve glycemic response, providing evidence that has promising implications for dietary guidance to reduce postprandial glucose and related health risks through traditional food patterns.

Glycemic Index and Diabetes

MedlinePlus

... Oatmeal (rolled or steel-cut), oat bran, muesli Pasta, converted rice, barley, bulgar Sweet potato, corn, yam, ... bran flakes, instant oatmeal Shortgrain white rice, rice pasta, macaroni and cheese from mix Russet potato, pumpkin ...

Integration of FTTH and GI-POF in-house networks based on injection locking and direct-detection techniques.

PubMed

Peng, Hsiao-Chun; Lu, Hai-Han; Li, Chung-Yi; Su, Heng-Sheng; Hsu, Chin-Tai

2011-03-28

An integration of fiber-to-the-home (FTTH) and graded-index plastic optical fiber (GI-POF) in-house networks based on injection-locked vertical cavity surface emitting lasers (VCSELs) and direct-detection technique is proposed and experimentally demonstrated. Sufficient low bit error rate (BER) values were obtained over a combination of 20-km single-mode fiber (SMF) and 50-m GI-POF links. Signal qualities satisfy the worldwide interoperability for microwave access (WiMAX) requirement with data signals of 20 Mbps/5.8 GHz and 70 Mbps/10 GHz, respectively. Since our proposed network does not use sophisticated and expensive RF devices in premises, it reveals a prominent one with simpler and more economic advantages. Our proposed architecture is suitable for the SMF-based primary and GI-POF-based in-house networks.

Effects of management in gestational diabetes mellitus with normal prepregnancy body mass index on pregnancy outcomes and placental ultrastructures: a prospective cohort study.

PubMed

Han, Yun; Zheng, Yan-Li; Wu, Ai-Min; Liu, Hong-Bin; Su, Jian-Bin; Lu, Xiao-Yan; Han, Yu-Wen; Ji, Jin-Long; Ji, Ju-Hua; Shi, Yue

2016-12-01

A great quantity of gestational diabetes mellitus with normal prepregnancy body mass index have emerged with the new criteria of gestational diabetes mellitus in China based on the International Diabetes in Pregnancy Consensus group criteria, and understanding placental changes and how they affect outcomes are necessary in order to develop effective management approach. The aim of this study was to prospectively explore the effect of active management starting from the late second trimester in gestational diabetes mellitus women with normal prepregnancy body mass index on pregnancy outcomes and placental ultrastructures, and to provide scientific evidences for optimizing the management of gestational diabetes mellitus in China. Gestational diabetes mellitus women with normal prepregnancy body mass index in the same period of this prospective cohort study were divided into intervention group (n = 51) and control group (n = 55). The intervention group was managed rigorously, while the control group received conventional prenatal cares. The glucose profile, gestational weight gain and pregnancy outcomes were followed up and placental ultrastructures were observed and recorded by transmission electron microscopy. The blood glucose level and gestational weight gain in intervention group were significantly better controlled than those in control group (P < 0.01). The incidences of fetal distress, cesarean section and large for gestational age were significantly lower in intervention group than in control group (P < 0.05). There was a significant reduction in the incidence of abnormal placental ultrastructure in the intervention group (P < 0.01). After adjustment for confounding factors, the undesirable glycemic control and conventional management were related to abnormal placental ultrastructure (P < 0.05). Meanwhile, the undesirable glycemic control, abnormal placental ultrastructure and conventional management made sense in the incidence of fetal distress (P < 0.05), and the target glycemic control, recommend weight gain and active management were associated with reductions in the prevalence of cesarean delivery and large for gestational age (P < 0.05). The active management of gestational diabetes mellitus women with normal prepregnancy body mass index can improve pregnancy outcomes and placental ultrastructures, and the abnormal placental ultrastructure might be closely associated with the undesirable glycemic control and adverse pregnancy outcomes.

Gastrointestinal events in at-risk patients starting non-steroidal anti-inflammatory drugs (NSAIDs) for rheumatic diseases: the EVIDENCE study of European routine practice.

PubMed

Lanas, Angel; Boers, Maarten; Nuevo, Javier

2015-04-01

Data concerning rates of gastrointestinal (GI) events in non-steroidal anti-inflammatory drug (NSAID) users derive mainly from clinical trials. The EVIDENCE study quantified the incidence of symptomatic uncomplicated and/or complicated GI events in at-risk European patients treated with NSAIDs in real-life practice. This non-interventional study assessed 4144 adults with at least one GI risk factor who recently initiated NSAID therapy for osteoarthritis (85%), rheumatoid arthritis (11%), ankylosing spondylitis (3%) or a combination (1%). Patient characteristics and medical history were collected from medical records. GI events (upper and lower) were recorded at in-clinic visits during 6 months' follow-up. Mean time on index NSAID at enrolment was 33 days. The incidence (per 100 person-years) was 18.5 per 100 person-years for uncomplicated GI events and 0.7 per 100 person-years for complicated GI events. Upper GI events were far more common (12%) than lower GI events (1%) during study follow-up (median 182 days (range 61-320)). Other reported rates for cardiovascular, anaemia or non-GI events were much less frequent. A minority (28%) of patients had ongoing proton pump inhibitor use at enrolment, with strong variation by practice and country. EVIDENCE is the largest prospective study of the real-life management of European patients treated with NSAIDs for rheumatic diseases and at increased GI risk. It shows that GI events from the upper GI tract are far more common than those from the lower GI tract. It also shows adherence to guidelines for gastroprotection is generally low. NCT01176682. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The Relative Associations of β-Cell Function and Insulin Sensitivity with Glycemic Status and Incident Glycemic Progression in Migrant Asian Indians in the United States: the MASALA study

PubMed Central

Gujral, UP; Narayan, KMV; Kahn, SE; Kanaya, AM

2013-01-01

AIMS We assessed the relative associations of β-cell dysfunction and insulin sensitivity with baseline glycemic status and incident glycemic progression among Asian Indians in the United States. METHODS A 5-sample oral glucose tolerance test was obtained at baseline. Normoglycemia, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes (T2DM) were defined by ADA criteria. The Matsuda Index (ISIM) estimated insulin sensitivity, and the Disposition Index (DIo) estimated β-cell function. Visceral fat was measured by abdominal CT. After 2.5 years, participants underwent a 2-sample oral glucose tolerance test. Standardized polytomous logistic regression was used to examine associations with prevalent and incident glycemia. RESULTS Mean age was 57±8 years and BMI 26.1±4.6 kg/m2. Log ISIM and log DIo were associated with prediabetes and T2DM after adjusting for age, sex, BMI, family history of diabetes, hypertension, and smoking. After adjusting for visceral fat, only DIo remained associated with prediabetes (OR per SD 0.17, 95% CI: 0.70, 0.41) and T2DM (OR 0.003, 95% CI: 0.0001, 0.03). Incidence rates (per 1,000 person-year) were: normoglycemia to IGT: 82.0, 95% CI (40, 150); to IFG: 8.4, 95% CI (0, 41); to T2DM: 8.6, 95% CI (0, 42); IGT to T2DM: 55.0, 95% CI (17, 132); IFG to T2DM: 64.0, 95% CI (3, 316). The interaction between sex and the change in waist circumference (OR 1.8, per SD 95% CI: 1.22, 2.70) and the change in log HOMA-β(OR 0.37, per SD 95% CI: 0.17, 0.81) were associated with glycemic progression. CONCLUSIONS The association of DIo with baseline glycemia after accounting for visceral fat as well as the association of the change in log HOMA-β with incident glycemic progression implies innate β-cell susceptibility in Asian Indians for glucose intolerance or dysglycemia. PMID:24211090

Investigation of the effects of the level of glycemic control on erectile function and pathophysiological mechanisms in diabetic rats.

PubMed

Cho, Sung Yong; Chai, Ji Sun; Lee, Sun Hee; Park, Kwanjin; Paick, Jae-Seung; Kim, Soo Woong

2012-06-01

Poor glycemic control is associated with erectile dysfunction (ED); however, differences in ED according to the level of glycemic control have been poorly investigated. The aim of this paper is to investigate the change in erectile function according to the level of glycemic control and to clarify the pathophysiological mechanism of diabetes-associated ED. Streptozotocin was injected into 55 male Sprague-Dawley rats classified into four groups: control (group 1), diabetes with multiple insulin injections (group 2), diabetes with a single injection (group 3), and untreated diabetes (group 4). Daily insulin injections in groups 2 and 3 were administered for 4 weeks after 10 weeks of diabetic induction. The main outcome measures are the anova or Kruskal-Wallis tests to evaluate glycosylated hemoglobin (HbA1c), testosterone levels, the ratios of intracavernosal pressure to mean arterial pressure (ICP/MAP), area under the ICP curve to MAP (AUC/MAP), and changes in cavernous tissue and protein expression related to Rho kinase and nitric oxide pathways. HbA1c levels were different between pairs of groups. Group 4 showed the lowest erectile parameters and group 2 showed near normal level. No differences in erectile parameters were found between groups 1 and 2 or between groups 3 and 4, except the ratio of AUC to MAP for group 1 was significantly higher than that of group 2 (20 Hz stimulation). Decrease in erectile function of group 2 was related to decreased expression of nitrergic nitric oxide synthase or decreased testosterone level compared with group 1. Groups 2 and 3 showed significant differences in erectile parameters, which were associated with difference in apoptotic index. Groups 3 and 4 showed no differences in erectile parameters, although these groups had significant differences in apoptotic index, smooth muscle component, and protein expression ratios of phosphorylated to total myosin phosphatase target subunit 1, endothelial nitric oxide synthase, and Akt. Improvement in glycemic control assists recovery from diabetes-associated ED; however, only tight glycemic control can provide recovery from ED to a near normal status. © 2012 International Society for Sexual Medicine.

Meal frequency patterns and glycemic properties of maternal diet in relation to preterm delivery: Results from a large prospective cohort study

PubMed Central

Birgisdottir, Bryndis Eva; Sengpiel, Verena; Brantsæter, Anne Lise; Haugen, Margareta; Myhre, Ronny; Meltzer, Helle Margrete; Jacobsson, Bo

2017-01-01

Background Dietary habits are linked to high maternal glucose levels, associated with preterm delivery. The aim of this study was to examine the associations between meal frequency and glycemic properties of maternal diet in relation to preterm delivery. Methods This prospective cohort study included 66,000 women from the Norwegian Mother and Child Cohort Study (MoBa). Meal frequency and food intake data were obtained from a validated food frequency questionnaire during mid-pregnancy. Principal component factor analysis was used with a data-driven approach, and three meal frequency patterns were identified: “snack meal”, “main meal”, and “evening meal”. Pattern scores were ranked in quartiles. Glycemic index and glycemic load were estimated from table values. Intakes of carbohydrates, added sugar, and fiber were reported in grams per day and divided into quartiles. Gestational age was obtained from the Medical Birth Registry of Norway. Preterm delivery was defined as birth at <37 gestational weeks. A Cox regression model was used to assess associations with preterm delivery. Results After adjustments, the “main meal” pattern was associated with a reduced risk of preterm delivery, with hazard ratios (HRs) of 0.89 (95% confidence interval (CI): 0.80, 0.98) and 0.90 (95% CI: 0.81, 0.99) for the third and fourth quartiles, respectively, and p for trend of 0.028. This was mainly attributed to the group of women with BMI ≥25 kg/m2, with HRs of 0.87 (95% CI: 0.79, 0.96) and 0.89 (95% CI: 0.80, 0.98) for the third and fourth quartiles, respectively, and p for trend of 0.010. There was no association between glycemic index, glycemic load, carbohydrates, added sugar, fiber, or the remaining meal frequency patterns and preterm delivery. Conclusion Regular consumption of main meals (breakfast, lunch, dinner) was associated with a lower risk of preterm delivery. Diet should be further studied as potential contributing factors for preterm delivery. PMID:28249018

Gender Differences in Publication Productivity, Academic Rank, and Career Duration Among U.S. Academic Gastroenterology Faculty.

PubMed

Diamond, Sarah J; Thomas, Charles R; Desai, Sima; Holliday, Emma B; Jagsi, Reshma; Schmitt, Colleen; Enestvedt, Brintha K

2016-08-01

Female representation in academic medicine is increasing without proportional increases in female representation at senior ranks. The purpose of this study is to describe the gender representation in academic gastroenterology (GI) and compare publication productivity, academic rank, and career duration between male and female gastroenterologists. In 2014, the authors collected data including number of publications, career duration, h-index, and m-index for faculty members at 114 U.S. academic GI programs. Of 2,440 academic faculty, 1,859 (76%) were men and 581 (24%) were women. Half (50%) of men held senior faculty position compared with 29% of women (P < .001). Compared with female faculty, male faculty had significantly (P < .001) longer careers (20 vs. 11 years), more publications (median 24 [0-949] vs. 9 [0-438]), and higher h-indices (8 vs. 4). Higher h-index correlated with higher academic rank (P < .001). The authors detected no difference in the h-index between men and women at the same rank for professor, associate professor, and instructor, nor any difference in the m-index between men and women (0.5 vs. 0.46, respectively, P = .214). A gender gap exists in the number and proportion of women in academic GI; however, after correcting for career duration, productivity measures that consider quantity and impact are similar for male and female faculty. Women holding senior faculty positions are equally productive as their male counterparts. Early and continued career mentorship will likely lead to continued increases in the rise of women in academic rank.

Add-on therapy with anagliptin in Japanese patients with type-2 diabetes mellitus treated with metformin and miglitol can maintain higher concentrations of biologically active GLP-1/total GIP and a lower concentration of leptin.

PubMed

Osonoi, Takeshi; Saito, Miyoko; Hariya, Natsuyo; Goto, Moritaka; Mochizuki, Kazuki

2016-12-01

Metformin, α-glucosidase inhibitors (α-GIs), and dipeptidyl peptidase 4 inhibitors (DPP-4Is) reduce hyperglycemia without excessive insulin secretion, and enhance postprandial plasma concentration of glucagon-like peptide-1 (GLP-1) in type-2 diabetes mellitus (T2DM) patients. We assessed add-on therapeutic effects of DPP-4I anagliptin in Japanese T2DM patients treated with metformin, an α-GI miglitol, or both drugs on postprandial responses of GLP-1 and glucose-dependent insulinotropic polypeptide (GIP), and on plasma concentration of the appetite-suppressing hormone leptin. Forty-two Japanese T2DM patients with inadequately controlled disease (HbA1c: 6.5%-8.0%) treated with metformin (n=14), miglitol (n=14) or a combination of the two drugs (n=14) received additional treatment with anagliptin (100mg, p.o., b.i.d.) for 52 weeks. We assessed glycemic control, postprandial responses of GLP-1 and glucose-dependent insulinotropic polypeptide (GIP), and on plasma concentration of leptin in those patients. Add-on therapy with anagliptin for 52 weeks improved glycemic control and increased the area under the curve of biologically active GLP-1 concentration without altering obesity indicators. Total GIP concentration at 52 weeks was reduced by add-on therapy in groups treated with miglitol compared with those treated with metformin. Add-on therapy reduced leptin concentrations. Add-on therapy with anagliptin in Japanese T2DM patients treated with metformin and miglitol for 52 weeks improved glycemic control and enhanced postprandial concentrations of active GLP-1/total GIP, and reduce the leptin concentration. Copyright © 2016 Elsevier Inc. All rights reserved.

Diets: MedlinePlus Health Topic

MedlinePlus

... 10 Tips to Enjoying Your Meal (Department of Agriculture) - PDF Also in Spanish Glycemic Index Diet: What's ... Lung, and Blood Institute) Search Recipes (Department of Agriculture) Also in Spanish SuperTracker: My Foods. My Fitness. ...

Dietary composition of carbohydrates contributes to the development of experimental type 2 diabetes.

PubMed

Hodgson, K; Govan, B; Ketheesan, N; Morris, J

2013-04-01

Evidence has emerged supporting a link between high glycaemic index (GI) diets and type 2 diabetes (T2D). The aim of this study was to determine if dietary GI influences the development of hyperglycaemia in C57BL/6 mice to more closely reflect T2D. Male C57BL/6 mice (n=30) were randomly divided into 3 dietary groups consisting of either standard rodent chow (4.8 % fat, 20 % protein), or a high fat (HF) diet (21-23 % fat, 19 % protein) with low GI (15.4 % starch; HF-LG) or high GI (50.5 % dextrose; HF-HG) ad libitum for 10 weeks. Body weight, blood glucose, glucose tolerance, and circulating cholesterol and triglyceride levels were measured for the duration of the study. We found that increasing the GI of a moderately HF diet induces severe hyperglycaemia and insulin resistance in C57BL/6 mice, reflective of criteria for diagnosis of T2D, whilst littermates consuming an equivalent low GI diet maintain glucose homeostasis. This study demonstrates the significant contribution of both dietary carbohydrate and fat composition in the aetiopathogenesis of T2D.

Decreased complexity of glucose dynamics in diabetes: evidence from multiscale entropy analysis of continuous glucose monitoring system data.

PubMed

Chen, Jin-Long; Chen, Pin-Fan; Wang, Hung-Ming

2014-07-15

Parameters of glucose dynamics recorded by the continuous glucose monitoring system (CGMS) could help in the control of glycemic fluctuations, which is important in diabetes management. Multiscale entropy (MSE) analysis has recently been developed to measure the complexity of physical and physiological time sequences. A reduced MSE complexity index indicates the increased repetition patterns of the time sequence, and, thus, a decreased complexity in this system. No study has investigated the MSE analysis of glucose dynamics in diabetes. This study was designed to compare the complexity of glucose dynamics between the diabetic patients (n = 17) and the control subjects (n = 13), who were matched for sex, age, and body mass index via MSE analysis using the CGMS data. Compared with the control subjects, the diabetic patients revealed a significant increase (P < 0.001) in the mean (diabetic patients 166.0 ± 10.4 vs. control subjects 93.3 ± 1.5 mg/dl), the standard deviation (51.7 ± 4.3 vs. 11.1 ± 0.5 mg/dl), and the mean amplitude of glycemic excursions (127.0 ± 9.2 vs. 27.7 ± 1.3 mg/dl) of the glucose levels; and a significant decrease (P < 0.001) in the MSE complexity index (5.09 ± 0.23 vs. 7.38 ± 0.28). In conclusion, the complexity of glucose dynamics is decreased in diabetes. This finding implies the reactivity of glucoregulation is impaired in the diabetic patients. Such impairment presenting as an increased regularity of glycemic fluctuating pattern could be detected by MSE analysis. Thus, the MSE complexity index could potentially be used as a biomarker in the monitoring of diabetes.

Do Perceptions of Empowerment Affect Glycemic Control and Self-Care Among Adults with Type 2 Diabetes?

PubMed

D'Souza, Melba Sheila; Karkada, Subrahmanya Nairy; Hanrahan, Nancy P; Venkatesaperumal, Ramesh; Amirtharaj, Anandhi

2015-02-24

The Arab adult with T2DM is understudied with less known facts about the perception of empowerment and its relationship with self-care and glycemic control. The purpose of this study was to determine the extent to which perception of empowerment by Arab adults living with Type 2 Diabetes Mellitus (T2DM) was associated with better glycemic control and self-care management. A cross-sectional descriptive study was led among 300 Arab adults living in Oman with T2DM in an outpatient diabetes clinic. The Diabetes Empowerment Scale (DES), glycosylated haemaglobin (HbA1c) and Body mass index was assessed. The DES was found to be valid and reliable for the population. ANOVA, Regression analysis, and Structural equation modeling was used for analysis. The composite score and three subscales of DES were a significant and strong predictor of good glycemic control among Omani adults with T2DM (p<0.001). Age, education, duration of DM, prior DM education program and medications were significantly associated with DES. Diabetes nurse educators engaged in the care of adults with T2DM should assess self-empowerment and tailor interventions to increase empowerment for better glycemic control. Patient empowerment plays an essential role in maintaining self-care behaviours and HbA1c.

Assessment of Histological Remission in Ulcerative Colitis: Discrepancies Between Daily Practice and Expert Opinion.

PubMed

Römkens, Tessa E H; Kranenburg, Pim; Tilburg, Arjan van; Bronkhorst, Carolien; Nagtegaal, Iris D; Drenth, Joost P H; Hoentjen, Frank

2018-03-28

Histological remission [HR] is a potential treatment target in ulcerative colitis [UC]. Limited 'real world' data are available on the reliability of histological scoring when assessing minimal histological inflammation. The aim of this study was to investigate the reliability of UC histological scores in colonic biopsies showing mucosal healing [MH] and limited histological inflammation, and to compare the 'daily practice' histological assessment with expert reviews by gastrointestinal [GI] pathologists. We performed a retrospective single-centre study. Colonic biopsies from UC patients with MH [Mayo score ≤ 1] were included. All biopsies assessed in daily practice were reassessed by three blinded GI pathologists using three histological scores (Geboes score [GS], Riley score [RS], Harpaz [Gupta] Index [HGI]) and a global visual scale [GVS]. We evaluated inter- and intra-observer variation between GI pathologists and correlations between scores including the initial histological assessment using Cronbach's alpha and Spearman rho analysis. In total, 270 biopsies from 39 UC patients were included. The inter-observer concordance for all histological indexes was substantial to almost perfect [GS 0.84; HGI 0.61; GVS 0.74, RS 0.91]. Correlation between the RS and GS was almost perfect [R = 0.86], but we found no correlation between the primary histological assessment and reassessment by GI pathologists. Current UC histological scores reliably assess limited histological inflammation in UC patients. The discrepancy between the initial histological assessment and the reassessment by dedicated GI pathologists suggests a gap between daily practice and academic expertise. This issue may limit the implementation of HR as a treatment target for UC in daily practice.

Preoperative prognostic nutritional index predicts postoperative surgical site infections in gastrointestinal fistula patients undergoing bowel resections.

PubMed

Hu, Qiongyuan; Wang, Gefei; Ren, Jianan; Ren, Huajian; Li, Guanwei; Wu, Xiuwen; Gu, Guosheng; Li, Ranran; Guo, Kun; Deng, Youming; Li, Yuan; Hong, Zhiwu; Wu, Lei; Li, Jieshou

2016-07-01

Recent studies have implied a prognostic value of the prognostic nutritional index (PNI) in postoperative septic complications of elective colorectal surgeries. However, the evaluation of PNI in contaminated surgeries for gastrointestinal (GI) fistula patients is lack of investigation. The purpose of this study was to explore the predictive value of PNI in surgical site infections (SSIs) for GI fistula patients undergoing bowel resections.A retrospective review of 290 GI patients who underwent intestinal resections between November 2012 and October 2015 was performed. Univariate and multivariate analyses were conducted to identify risk factors for SSIs, and receiver operating characteristic cure was used to quantify the effectiveness of PNI.SSIs were diagnosed in 99 (34.1%) patients, with incisional infection identified in 54 patients (18.6%), deep incisional infection in 13 (4.5%), and organ/space infection in 32 (11.0%). receiver operating characteristic curve analysis defined a PNI cut-off level of 45 corresponding to postoperative SSIs (area under the curve [AUC] = 0.72, 76% sensitivity, 55% specificity). Furthermore, a multivariate analysis indicated that the PNI < 45 [odd ratio (OR): 2.24, 95% confidence interval (CI): 1.09-4.61, P = 0.029] and leukocytosis (OR: 3.70, 95% CI: 1.02-13.42, P = 0.046) were independently associated with postoperative SSIs.Preoperative PNI is a simple and useful marker to predict SSIs in GI fistula patients after enterectomies. Measurement of PNI is therefore recommended in the routine assessment of patients with GI fistula receiving surgical treatment.

A randomized controlled trial evaluating antioxidant-essential oil gel as a treatment for gingivitis in orthodontic patients.

PubMed

Martin, Benjamin J; Campbell, Phillip M; Rees, Terry D; Buschang, Peter H

2016-05-01

To evaluate the treatment effect of an antioxidant-essential oil gel on orthodontic patients with generalized gingivitis. The gel contains the essential oils menthol and thymol and the antioxidants ferulic acid and phloretin. Thirty patients from the university's orthodontic clinic were screened for gingivitis and randomly allocated into treatment and placebo-control groups. Each patient was evaluated at three orthodontic treatment visits (T1, T2, and T3). A periodontal examination, including probing depth (PD), bleeding on probing (BOP), gingival index (GI), and plaque index (PI) was performed at each visit. Between T1 and T2, patients were instructed to apply a topical gel (active or placebo) to their gingiva twice daily after brushing. From T2 to T3, patients were instructed to discontinue use of the gel. The treatment group showed statistically significant (P < .05) reductions of BOP (-13.6 percentage points) and GI (-0.14) between T1 and T2, and significant increases in BOP (13.3 percentage points) and GI (0.14) between T2 and T3. Except for an increase in the GI between T2 and T3, the control group showed no significant changes in BOP or GI over time. The only other significant changes that occurred pertained to the treatment group, which showed significant increases in PD (0.08 mm) and PI (0.18) between T2 and T3. Application of a topical antioxidant-essential oil gel is an effective means of reducing inflammation in orthodontic patients with gingivitis.

Effect of a mucoadhesive gel and dental scaling on gingivitis in dogs.

PubMed

Bonello, D; Squarzoni, P

2008-03-01

Twenty client-owned dogs diagnosed with gingivitis were studied over a 45-day period in order to investigate the effect of professional dental prophylaxis combined with the use of a topical mucoadhesive gel containing adelmidrol, an aliamide. A non-intrusive papillary-marginal-gingival index (PMGI) was measured at each assessment, while the gingivitis index (GI) was measured only at the beginning and end of the study. Compared to the control group, the treated dogs had a significant decrease (P < 0.005) in the average GI index during the course of the study. A significant reduction (P < 0.002) in the average PMGI index was observed in both groups 15-days following dental prophylaxis. However at 30 and 45-days following dental prophylaxis, the PMGI index values were significantly different (P < 0.005) from baseline only in treated dogs. These results suggest that the combined use of a mucoadhesive gel with dental scaling was able to improve the regression of gingival inflammation and lengthen the therapeutic benefits of dental scaling and polishing during a limited study period.

Fear of GI symptoms has an important impact on quality of life in patients with moderate-to-severe IBS.

PubMed

Lackner, Jeffrey M; Gudleski, Gregory D; Ma, Chang-Xing; Dewanwala, Akriti; Naliboff, Bruce

2014-11-01

Because irritable bowel syndrome (IBS) is a functional medical condition for which there is no curative therapy, treatment goals emphasize relieving gastrointestinal (GI) symptoms and optimizing the quality of life (QOL). This study sought to characterize the magnitude of the associations between QOL impairment, fear of IBS symptoms, and confounding variables. Subjects included 234 Rome III-diagnosed IBS patients (mean age, 41 years, 79%, female) without comorbid organic GI disease who were referred to two specialty care clinics of an National Institutes of Health trial for IBS. Subjects completed a testing battery that included the IBS-specific QOL (IBS-QOL), SF-12 (generic QOL), the UCLA GI Symptom Severity Scale, the Visceral Sensitivity Index, Trait Anxiety Inventory, and Brief Symptom Inventory. Multiple linear regression was used to develop a model for predicting QOL. Data supported an overall model that included sociodemographic, clinical (e.g., current severity of GI symptoms), and psychosocial (e.g., fear of GI symptoms, distress, neuroticism) variables, accounting for 48.7% of the variance in IBS-QOL (F=15.1, P <0.01). GI symptom fear was the most robust predictor of IBS-QOL (β=-0.45 P <0.01), accounting for 14.4% of the total variance. Patients' fear that GI symptoms have aversive consequences, is a predictor of QOL impairment that cannot be fully explained by the severity of their GI symptoms, overall emotional well-being, neurotic personality style, or other clinical features of IBS. An understanding of the unique impact that GI symptom fears have on QOL can inform treatment planning and help gastroenterologists to better manage more severe IBS patients seen in tertiary care clinics.

The effect of a triclosan/copolymer/fluoride 
toothpaste on plaque formation, gingivitis, and 
dentin hypersensitivity: A single-blinded 
randomized clinical study.

PubMed

Al Habashneh, Rola; Farasin, Rawan; Khader, Yousef

2017-01-01

The daily removal of supragingival dental plaque is a key factor in the prevention of gingivitis. The aim of the study was to compare the gingival health benefits of a triclosan/copolymer/fluoride toothpaste (Colgate Total, a fluoride toothpaste containing an antiseptic) to a commercially available toothpaste containing 0.243% sodium fluoride in a silica base (Colgate Herbal, a conventional fluoride toothpaste with herbal extracts). A total of 50 patients with gingivitis and at least one sensitive tooth were included. The subjects were randomly stratified into two groups: Colgate Total toothpaste, and Colgate Herbal toothpaste. After a 4-week pre-experimental phase, baseline Plaque Index (Quigley-Hein Index) (PI), Gingival Index (GI), Gingival Bleeding Index (GBI), and Visual Analog Scale (VAS) were assessed. The PI, GI, GBI, and VAS were reexamined at weeks 4, 12, and 24 after the baseline. Fifty subjects complied with the protocol and completed the study. The conventional fluoride toothpaste with herbal extracts group and the fluoride toothpaste containing an antiseptic group exhibited significant reductions in PI, GI, GBI, and VAS over time. The amount of reduction after 6 months of the treatment was higher in the Total group compared to Herbal group (1.82 vs 1.39, P = .015 for PI; 0.67 vs 0.37, P < .005 for GI; and 56.64% vs 34.26%, P < .005 for GBI). No significant difference was seen for VAS. Twice daily brushing with a toothpaste containing 0.3% triclosan and polyvinyl methyl ether and maleic acid copolymer provides a more effective level of plaque control and gingival health with no effect on decreasing dentin hypersensitivity compared to conventional fluoride toothpaste. Toothpastes containing triclosan/copolymer, in addition to fluoride, result in a higher reduction in plaque, gingival inflammation, and gingival bleeding when compared with fluoride toothpastes without triclosan/copolymer.

Gastrointestinal Bleeding Due to Gastrointestinal Tract Malignancy: Natural History, Management, and Outcomes.

PubMed

Schatz, Richard A; Rockey, Don C

2017-02-01

Gastrointestinal (GI) tumor bleeding can vary from occult bleeding to massive hemorrhage and can be the presenting sign of malignancy. Our primary aims were to: (1) characterize the natural history, treatment, and outcomes in patients with GI tumor bleeding and (2) compare and contrast bleeding in upper GI (UGI)/small bowel (SB) and lower GI malignancies. Patients with endoscopically confirmed tumor bleeding were identified through search of consecutive electronic medical records: Bleeding was determined by the presence of melena, hematochezia, hematemesis, or fecal occult blood. Comprehensive clinical and management data were abstracted. A total of 354 patients with GI tumors were identified: 71 had tumor bleeding (42 UGI/SB and 29 colonic). GI bleeding was the initial presenting symptom of malignancy in 55/71 (77%) of patients; 26/71 patients had widely metastatic disease at presentation. Further, 15 of 26 patients with metastatic disease presented with GI bleeding. Visible bleeding was present in 14/42 (33%) and 4/29 (14%) of UGI/SB and colonic tumors, respectively. Endoscopic hemostasis was attempted in 10 patients, and although initial control was successful in all, bleeding recurred in all of these patients. The most common endoscopic lesion was clean-based tumor ulceration. Overall mortality at 1 year was 57% for esophageal/gastric, 14% for SB, and 33% for colonic tumors. When patients with GI malignancy present with GI bleeding, it is often the index symptom. Initial endoscopic hemostasis is often successful, but rebleeding is typical. Esophageal and gastric tumors carry the poorest prognosis, with a high 1-year mortality rate.

Relation of Severe Coronary Artery Narrowing to Insulin or Thiazolidinedione Use in Patients With Type 2 Diabetes Mellitus (from the Bypass Angioplasty Revascularization Investigation 2 Diabetes Study)

PubMed Central

Pop-Busui, Rodica; Lombardero, Manuel; Lavis, Victor; Forker, Alan; Green, Jennifer; Korytkowski, Mary; Sobel, Burton E.; Jones, Teresa L.Z.

2009-01-01

Patients with diabetes continue to die of coronary artery disease (CAD) at rates 2 to 4 times higher than patients without diabetes, despite advances in treatment of cardiovascular disease. The role of glycemic control therapies, independent of their glucose-lowering effects, on cardiovascular disease is a recurring question. We examined the association of glycemic control therapies with extent of CAD as measured by coronary angiogram obtained at baseline in 1,803 subjects in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial who had type 2 diabetes mellitus, documented moderate to severe CAD, and no previous cardiac revascularization procedures. The association between glycemic control therapy use recorded at baseline and percent coronary artery stenosis and myocardial jeopardy index was analyzed by multiple regression models. Insulin use at study entry was associated with 23% fewer highly stenotic lesions (≥70%) (p <0.001) and a significantly lower myocardial jeopardy index compared with subjects not on insulin, despite a worse cardiac risk factor profile, more unstable angina, and increased inflammatory markers in insulin users. Subjects taking thiazolidinediones (TZDs) for ≥6 months had 17% fewer highly stenotic lesions (p = 0.02) and significantly lower C-reactive protein, fibrinogen, and plasminogen activator inhibitor-1 levels compared with those not taking TZDs. In conclusion, this cross-sectional study of patients with type 2 diabetes mellitus and CAD showed that treatment with insulin or TZDs was associated with fewer highly stenotic lesions, independent of disease duration, glycemic control, and other risk factors. PMID:19576321

Elevated α-Hydroxybutyrate and Branched-Chain Amino Acid Levels Predict Deterioration of Glycemic Control in Adolescents.

PubMed

Tricò, Domenico; Prinsen, Hetty; Giannini, Cosimo; de Graaf, Robin; Juchem, Christoph; Li, Fangyong; Caprio, Sonia; Santoro, Nicola; Herzog, Raimund I

2017-07-01

Traditional risk factors for type 2 diabetes mellitus are weak predictors of changes in glucose tolerance and insulin sensitivity in youth. To identify early metabolic features of insulin resistance (IR) in youth and whether they predict deterioration of glycemic control. A cross-sectional and longitudinal study was conducted at the Yale Pediatric Obesity Clinic. Concentrations of α-hydroxybutyrate, β-hydroxybutyrate, lactate, and branched-chain amino acids (BCAAs) were measured by nuclear magnetic resonance spectroscopy in 78 nondiabetic adolescents during an oral glucose tolerance test (OGTT). Associations between baseline metabolic alterations and longitudinal changes in glucose control were tested in 16 subjects after a mean follow-up of 2.3 years. The relationship between metabolite levels, parameters of IR, and glycemic control, and their progression over time. Elevated fasting α-hydroxybutyrate levels were observed in adolescents with reduced insulin sensitivity after adjusting for age, sex, ethnicity, Tanner stage, and body mass index z-score (P = 0.014). Plasma α-hydroxybutyrate and BCAAs were increased throughout the course of the OGTT in this group (P < 0.03). Notably, borderline IR was associated with a progressive α-hydroxybutyrate decrease from elevated baseline concentrations to normal levels (P = 0.02). Increased baseline α-hydroxybutyrate concentrations were further associated with progressive worsening of glucose tolerance and disposition index. α-Hydroxybutyrate and BCAA concentrations during an OGTT characterize insulin-resistant youth and predict worsening of glycemic control. These findings provide potential biomarkers for risk assessment of type 2 diabetes and new insights into IR pathogenesis. Copyright © 2017 Endocrine Society

Bend-insensitive distributed sensing in singlemode-multimode-singlemode optical fiber structure by using Brillouin optical time-domain analysis.

PubMed

Xu, Pengbai; Dong, Yongkang; Zhang, Juwang; Zhou, Dengwang; Jiang, Taofei; Xu, Jinlong; Zhang, Hongying; Zhu, Tao; Lu, Zhiwei; Chen, Liang; Bao, Xiaoyi

2015-08-24

We propose a bend-insensitive distributed Brillouin optical fiber sensing by using a singlemode-multimode-singlemode optical fiber structure for the first time to the best of our knowledge. The sensing fiber is a graded-index multimode fiber (GI-MMF) sandwiched by two standard single-mode fibers (SMFs) with central-alignment splicing at the interface between GI-MMF and SMF to excite the fundamental mode in GI-MMF. The sensing system can resist a minimal bend radius of 1.25mm while maintain the measurement performance, with which the measured coefficients of strain and temperature are 421.6MHz/% and 0.826MHz/°C, respectively. We also demonstrate that the higher-order modes excited in GI-MMF can be easily influenced by bending, so that exciting the fundamental mode is essential for bend-insensitive distributed sensing.

Short-term poor glycemic control and retinal microvascular changes in pediatric Type 1 Diabetes patients in Singapore: a pilot study.

PubMed

Li, Ling-Jun; Lamoureux, Ecosse; Wong, Tien Yin; Lek, Ngee

2017-06-15

Poor glycemic control in Type 1 Diabetes (T1D) patients is strongly associated with an increased risk of diabetes-related microvascular complications later in life, but it is unclear whether short period of poor glycemic control in children with T1D can cause evident microvascular morphological changes long before any pathological manifestation. Our study aimed to investigate the longitudinal association between poor glycemic control and subsequent changes in retinal microvasculature, in a pilot study of 55 pediatric T1D patients from Singapore after a one-year follow-up. This is a hospital-based, exposure-matched and retrospective longitudinal study. A total of 55 T1D patients were included from Singapore KK Women's and Children Hospital, 28 of whom had poor glycemic control (average glycated hemoglobin [HbA1c] ≥8% during the year) while the other 27 age- and gender-matched subjects had good glycemic control (HbA1c <8%). Retinal photography was taken at diabetes annual screening and images were graded by trained graders using a semi-automated computer-based program (Singapore I Vessel Assessment [SIVA], version 4.0, Singapore Eye Research Institute, Singapore) and a spectrum of retinal vascular parameters (e.g. caliber, tortuosity, branching angle and fractal dimension) were measured quantitatively from 0.5 to 2.0 disc diameters. There was no significant difference in ethnicity, duration of T1D, blood pressure, body mass index (BMI) and low-density cholesterol lipoprotein (LDL) between the two groups. Retinal imaging was obtained at the end of 1 year of glycemic control assessment. In multiple linear regression adjusting for ethnicity, BMI, LDL and duration of T1D, patients with poor glycemic control tended to have marginally wider retinal arteriolar caliber (6.0 μm, 95% CI: -0.9, 12.8) and had significantly larger retinal arteriolar branching angle (10.1 degrees, 95% CI: 1.4, 18.9) compared with their age- and gender- matched counterparts with good glycemic control. Our findings showed that abnormal retinal microvascular morphology was evident in pediatric patients with T1D after one-year's poor glycemic control. Such morphological abnormalities may lead to future development of microvascular complications among T1D pediatric patients with poor glycemic control.

Low glycaemic index, or low glycaemic load, diets for diabetes mellitus.

PubMed

Thomas, Diana; Elliott, Elizabeth J

2009-01-21

The aim of diabetes management is to normalise blood glucose levels, since improved blood glucose control is associated with reduction in development, and progression, of complications. Nutritional factors affect blood glucose levels, however there is currently no universal approach to the optimal dietary treatment for diabetes. There is controversy about how useful the glycaemic index (GI) is in diabetic meal planning. Improved glycaemic control through diet could minimise medications, lessen risk of diabetic complications, improve quality of life and increase life expectancy. To assess the effects of low glycaemic index, or low glycaemic load, diets on glycaemic control in people with diabetes. We performed electronic searches of The Cochrane Library, MEDLINE, EMBASE and CINAHL with no language restriction. We assessed randomised controlled trials of four weeks or longer that compared a low glycaemic index, or low glycaemic load, diet with a higher glycaemic index, or load, or other diet for people with either type 1 or 2 diabetes mellitus, whose diabetes was not already optimally controlled. Two reviewers independently extracted data on study population, intervention and outcomes for each included study, using standardised data extraction forms. Eleven relevant randomised controlled trials involving 402 participants were identified. There was a significant decrease in the glycated haemoglobin A1c (HbA1c) parallel group of trials, the weighted mean difference (WMD) was -0.5% with a 95% confidence interval (CI) of - 0.9 to -0.1, P = 0.02; and in the cross-over group of trials the WMD was -0.5% with a 95% CI of -1.0 to -0.1, P = 0.03. Episodes of hypoglycaemia were significantly fewer with low compared to high GI diet in one trial (difference of -0.8 episodes per patient per month, P < 0.01), and proportion of participants reporting more than 15 hyperglycaemic episodes per month was lower for low-GI diet compared to measured carbohydrate exchange diet in another study (35% versus 66%, P = 0.006). No study reported on mortality, morbidity or costs. A low-GI diet can improve glycaemic control in diabetes without compromising hypoglycaemic events.

GI-conf: A configuration tool for the GI-cat distributed catalog

NASA Astrophysics Data System (ADS)

Papeschi, F.; Boldrini, E.; Bigagli, L.; Mazzetti, P.

2009-04-01

In this work we present a configuration tool for the GI-cat. In an Service-Oriented Architecture (SOA) framework, GI-cat implements a distributed catalog service providing advanced capabilities, such as: caching, brokering and mediation functionalities. GI-cat applies a distributed approach, being able to distribute queries to the remote service providers of interest in an asynchronous style, and notifies the status of the queries to the caller implementing an incremental feedback mechanism. Today, GI-cat functionalities are made available through two standard catalog interfaces: the OGC CSW ISO and CSW Core Application Profiles. However, two other interfaces are under testing: the CIM and the EO Extension Packages of the CSW ebRIM Application Profile. GI-cat is able to interface a multiplicity of discovery and access services serving heterogeneous Earth and Space Sciences resources. They include international standards like the OGC Web Services -i.e. OGC CSW, WCS, WFS and WMS, as well as interoperability arrangements (i.e. community standards) such as: UNIDATA THREDDS/OPeNDAP, SeaDataNet CDI (Common Data Index), GBIF (Global Biodiversity Information Facility) services, and SibESS-C infrastructure services. GI-conf implements user-friendly configuration tool for GI-cat. This is a GUI application that employs a visual and very simple approach to configure both the GI-cat publishing and distribution capabilities, in a dynamic way. The tool allows to set one or more GI-cat configurations. Each configuration consists of: a) the catalog standards interfaces published by GI-cat; b) the resources (i.e. services/servers) to be accessed and mediated -i.e. federated. Simple icons are used for interfaces and resources, implementing a user-friendly visual approach. The main GI-conf functionalities are: • Interfaces and federated resources management: user can set which interfaces must be published; besides, she/he can add a new resource, update or remove an already federated resource. • Multiple configuration management: multiple GI-cat configurations can be defined; every configuration identifies a set of published interfaces and a set of federated resources. Configurations can be edited, added, removed, exported, and even imported. • HTML report creation: an HTML report can be created, showing the current active GI-cat configuration, including the resources that are being federated and the published interface endpoints. The configuration tool is shipped with GI-cat and can be used to configure the service after its installation is completed.

Gingival crevicular fluid volume and periodontal parameters alterations after use of conventional and self-ligating brackets.

PubMed

Bergamo, Ana Zn; Nelson-Filho, Paulo; Romano, Fábio L; da Silva, Raquel Ab; Saraiva, Maria Cp; da Silva, Lea Ab; Matsumoto, Mirian An

2016-12-01

The aim of this study was to evaluate the alterations on plaque index (PI), gingival index (GI), gingival bleeding index (GBI), and gingival crevicular fluid (GCF) volume after use of three different brackets types for 60 days. Setting Participants: The sample comprised 20 patients of both sexes aged 11-15 years (mean age: 13.3 years), with permanent dentition, adequate oral hygiene, and mild tooth crowding, overjet, and overbite. A conventional metallic bracket Gemini™, and two different brands of self-ligating brackets - In-Ovation ® R and SmartClip™ - were bonded to the maxillary incisors and canines. PI, GI, GBI scores, and GCF volume were measured before and 30 and 60 days after bonding of the brackets. Data were analysed statistically using non-parametric tests coefficient at a 5% significance level. There was no statistically significant correlation (P > 0.05) between tooth crowding, overjet, and overbite and the PI, GI, GBI scores, and GCF volume before bonding, indicating no influence of malocclusion on the clinical parameters. Regardless of the bracket design, no statistically significant difference (P > 0.05) was found for GI, GBI scores. PI and GCF volume showed a significant difference among the brackets in different periods. In pairwise comparisons a significant difference was observed when compared before with 60 days after bonding, for the teeth bonded with SmartClip™ self-ligating bracket, (PI P = 0.009; GCF volume P = 0.001). There was an increase in PI score and GCF volume 60 days after bonding of SmartClip™ self-ligating brackets, indicating the influence of bracket design on these clinical parameters.

Regular consumption of Lactobacillus reuteri-containing lozenges reduces pregnancy gingivitis: an RCT.

PubMed

Schlagenhauf, Ulrich; Jakob, Lena; Eigenthaler, Martin; Segerer, Sabine; Jockel-Schneider, Yvonne; Rehn, Monika

2016-11-01

This randomized controlled trial assessed the impact of Lactobacillus reuteri on pregnancy gingivitis in healthy women. Forty-five healthy women (24 test/21 placebo) with pregnancy gingivitis in the third trimester of pregnancy were enrolled. At baseline Gingival Index (GI) and Plaque Index (PlI) were assessed at the Ramfjord teeth and venous blood taken for TNF-α analysis. Subsequently participants were randomly provided with lozenges to be consumed 2 × daily until birth (approx. 7 weeks) containing ≥10 8 CFU L. reuteri ATCC PTA 5289 and ≥10 8 CFU L. reuteri DSM 17938 (test) or being devoid of L. reuteri (placebo). Within 2 days after birth recording of GI, PlI and blood sampling were repeated. At baseline, mean GI and mean PlI did not differ significantly between both groups. In the test group mean TNF-α serum level was significantly (p < 0.02) lower than in the placebo group. At reevaluation, mean GI and mean PlI of the test group were both significantly (p < 0.0001) lower than in the placebo group. Mean TNF-α serum level did no longer differ significantly between the groups. The consumption of L. reuteri lozenges may be a useful adjunct in the control of pregnancy gingivitis. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Gingival changes during pregnancy: III. Impact of clinical, microbiological, immunological and socio-demographic factors on gingival inflammation.

PubMed

Carrillo-de-Albornoz, Ana; Figuero, Elena; Herrera, David; Cuesta, Pedro; Bascones-Martínez, Antonio

2012-03-01

To identify predictor variables involved in exacerbated gingival inflammation associated with pregnancy. In this cohort study, 48 pregnant and 28 non-pregnant women without periodontitis were included. The pregnant women were evaluated in the first, second and third trimester and at 3 months postpartum, whilst the non-pregnant women were evaluated twice, with a 6-month interval. At each visit, clinical [plaque index (PlI) and gingival index (GI)], hormonal (salivary progesterone and estradiol), immunological [gingival crevicular fluid interleukin-1β, interleukin-6, tumour necrosis factor-α (TNF-α) and prostaglandin-E(2) ] and microbiological (periodontal pathogens culture) evaluations were performed. Statistical analysis was undertaken using exhaustive chi-square automatic interaction detection (exhaustive CHAID) to analyse the predictive value of the independent outcomes to develop pregnancy GI. PlI was the strongest predictor implicated in the GI throughout pregnancy and after delivery. During the second and third trimesters the presence of Porphyromonas gingivalis significantly contributed to the worsening of gingival inflammation. When compared with the non-pregnant group, significant differences were found in TNF-α amounts and concentrations and in the third trimester site-specific GI. Bacterial challenge to the gingival tissues, both quantitatively (PlI) and qualitatively (harbouring P. gingivalis) appears to affect the level of gingival inflammation observed during pregnancy. © 2011 John Wiley & Sons A/S.

Canadian Potential Healthcare and Societal Cost Savings from Consumption of Pulses: A Cost-Of-Illness Analysis

PubMed Central

Abdullah, Mohammad M. H.; Marinangeli, Christopher P. F.; Jones, Peter J. H.; Carlberg, Jared G.

2017-01-01

Consumption of dietary pulses, including beans, peas and lentils, is recommended by health authorities across jurisdictions for their nutritional value and effectiveness in helping to prevent and manage major diet-related illnesses of significant socioeconomic burden. The aim of this study was to estimate the potential annual healthcare and societal cost savings relevant to rates of reduction in complications from type 2 diabetes (T2D) and incidence of cardiovascular disease (CVD) following a low glycemic index (GI) or high fiber diet that includes pulses, or 100 g/day pulse intake in Canada, respectively. A four-step cost-of-illness analysis was conducted to: (1) estimate the proportions of individuals who are likely to consume pulses; (2) evaluate the reductions in established risk factors for T2D and CVD; (3) assess the percent reduction in incidences or complications of the diseases of interest; and (4) calculate the potential annual savings in relevant healthcare and related costs. A low GI or high fiber diet that includes pulses and 100 g/day pulse intake were shown to potentially yield Can$6.2 (95% CI $2.6–$9.9) to Can$62.4 (95% CI $26–$98.8) and Can$31.6 (95% CI $11.1–$52) to Can$315.5 (95% CI $110.6–$520.4) million in savings on annual healthcare and related costs of T2D and CVD, respectively. Specific provincial/territorial analyses suggested annual T2D and CVD related cost savings that ranged from up to Can$0.2 million in some provinces to up to Can$135 million in others. In conclusion, with regular consumption of pulse crops, there is a potential opportunity to facilitate T2D and CVD related socioeconomic cost savings that could be applied to Canadian healthcare or re-assigned to other priority domains. Whether these potential cost savings will be offset by other healthcare costs associated with longevity and diseases of the elderly is to be investigated over the long term. PMID:28737688

Improvement in anthropometric parameters after rational dietary intervention in women with Polycystic Ovary Syndrom as the best method to support treatment

PubMed

Szczuko, Małgorzata; Malarczyk, Inez; Zapałowska-Chwyć, Marta

Polycystic ovary syndrome (PCOS) is a disorder often occurring in women at reproductive age. An important factor in PCOS pathogenesis is insulin resistance, which pronounces hyperandrogenism and leads to the development of various metabolic disorders The aim of this study is to determine the effect of reduction diet with low glycemic index (GI) on anthropometric parameters of women with PCOS and the assessment of the effectiveness of the diet on body mass and adipose tissue reduction The study was performed on 24 women with PCOS diagnosed with Rotterdam’s criteria. Anthropometric measurements and bioelectrical impedance were performed. All participants received 7-day diet and recommendations relating to the change in lifestyle. After three months of using the dietary recommendations the measurements were repeated Statistical significance was observed for body mass (↓on average by 5.93 kg±2.95), BMI (↓2.14 kg/m2±1.2), circumference of: waist (↓7.7 cm±5.9), hip (↓4.8 cm±5.4), arm (↓1.9 cm±3.7) and measurements of skin fold under the shoulder blade (↓4.8 mm±4,6), above iliac crest (↓6.76 mm±5.7) and above triceps brachii muscle (↓5.25 mm±7.4). Considering body composition measurements, statistically significant were differences in the measurements of BCMI (↑18.042±8.8), TBW expressed in percentage (↑2.729±2.75) and in litres (↑0.071±5.15), FM in percentage (↓3.291±5.6) and in kg (3.354 kg±4.9) Body mass reduction using a rational diet with low GI is an effective method to support of PCOS treatment. Using reduction diet for three months together with increased physical activity enables to reduce body weight by on average 5.93 kg, which increases the chances to treat infertility in women. This should be the suggested type of diet in PCOS treatment

Nutrition in Diabetes.

PubMed

Hamdy, Osama; Barakatun-Nisak, Mohd-Yusof

2016-12-01

Medical nutrition therapy (MNT) is a key component of diabetes management. The importance of balancing macronutrients, reducing carbohydrate load, lowering glycemic index, and implementing an overall healthy dietary pattern are emerging as better approaches for MNT in diabetes. Recent research points to improved glycemic control, reduction in body weight, and improvement in many cardiovascular risk factors when these approaches are provided by registered dietitians or health care providers. This review article discusses the current evidence about the role of sensible nutrition in diabetes management. Specific eating plans for weight reduction and for patients with type 1 diabetes are also discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

Assessment of Blood Glucose Control in the Pediatric Intensive Care Unit: Extension of the Glycemic Penalty Index toward Children and Infants

PubMed Central

Van Herpe, Tom; Gielen, Marijke; Vanhonsebrouck, Koen; Wouters, Pieter J; Van den Berghe, Greet; De Moor, Bart; Mesotten, Dieter

2011-01-01

Background: The glycemic penalty index (GPI) is a measure to assess blood glucose (BG) control in critically ill adult patients but needs to be adapted for children and infants. Method: The squared differences between a clinical expertise penalty function and the corresponding polynomial function are minimized for optimization purposes. The average of all penalties (individually assigned to all BG readings) represents the patient-specific GPI. Results: Penalization in the hypoglycemic range is more severe than in the hyperglycemic range as the developing brains of infants and children may be more vulnerable to hypoglycemia. Similarly, hypoglycemia is also more heavily penalized in infants than in children. Conclusions: Extending the adult GPI toward the age-specific GPI is an important methodological step. Long-term clinical studies are needed to determine the clinically acceptable GPI cut-off level. PMID:21527105

[Effect of different porcelain-fused-to-metal crown inner metal materials on the level of soluble intercellular adhesion molecule-1 and interleukin-1beta in gingival crevicular fluid].

PubMed

Yuan, Tangxia; Zhang, Yanbiao; Wu, Zheng-Hua

2011-10-01

To investigate the effect of different inner metal materials of porcelain-fused-to-metal (PFM) crown on periodontal tissue by means of measuring the level of soluble intercellular adhesion molecule-1 (sICAM-1) and interleukin-1beta (IL-1beta) in gingival crevicular fluid (GCF) after PFM restorations. 30 teeth were divided into three groups (Ni-Cr alloy group, Co-Cr alloy group and Au-Pt alloy group, 10 teeth each group), and restored by Ni-Cr alloy, Co-Cr alloy and Au-Pt alloy PFM crown according grouping. At the point of pre-restoration, 6-month and 12-month after cementation, the clinical parameters including plaque index (PLI), gingival index (GI) and gingival crevice depth (GCD) were detected, and GCF was collected from labial and lingual of mesial site and distal site. The level of sICAM-1 and IL-1beta were detected. At the point of 6-month and 12-month after cementation, Ni-Cr alloy group showed significant difference for GI, GCD and all GCF indexes when compared to pre-restoration, Co-Cr alloy group and Au-Pt alloy group (P < 0.05). At the point of 12-month after cementation, Co-Cr alloy group showed significant difference for GI, GCD and all GCF indexes when compared to pre-restoration and Au-Pt alloy group (P < 0.05). All indexes have no significant difference for Au-Pt alloy group during the 12-month experiment times when compared to pre-restoration (P > 0.05). Non-noble metal has bad effect on the periodontal tissue.

Multicenter Evaluation of Octreotide as Secondary Prophylaxis in Patients With Left Ventricular Assist Devices and Gastrointestinal Bleeding.

PubMed

Shah, Keyur B; Gunda, Sampath; Emani, Sitaramesh; Kanwar, Manreet K; Uriel, Nir; Colombo, Paolo C; Uber, Patricia A; Sears, Melissa L; Chuang, Joyce; Farrar, David J; Brophy, Donald F; Smallfield, George B

2017-11-01

Gastrointestinal (GI) bleeding is one of the most common complications after continuous-flow left ventricular assist device implantation. More than one third of patients with incident bleed go on to develop recurrent GI bleeding. Octreotide, a somatostatin analog, is proposed to reduce the risk of recurrent GI bleeding in this population. This multicenter, retrospective analysis evaluated 51 continuous-flow left ventricular assist device patients who received secondary prophylaxis with octreotide after their index GI bleed from 2009 to 2015. All patients had a hospitalization for GI bleed and received octreotide after discharge. Patient demographics, medical and medication history, and clinical characteristics of patients who rebled after receiving octreotide were compared with non-rebleeders. These data were also compared with matched historical control patients previously enrolled in the HMII (HeartMate II) clinical trials, none of whom received octreotide, to provide a context for the bleeding rates. Twelve patients (24%) who received secondary octreotide prophylaxis developed another GI bleed, whereas 39 (76%) did not. There were similar intergroup demographics; however, significantly more bleeders had a previous GI bleeding history before left ventricular assist device placement (33% versus 5%; P =0.02) and greater frequency of angiodysplasia confirmed during endoscopy (58% versus 23%; P =0.03). Fewer patients in this study experienced a recurrent GI bleed compared with a matched historical control group that did not receive octreotide (24% versus 43%; P =0.04). Patients with continuous-flow left ventricular assist device receiving secondary prophylaxis with octreotide had a significantly lower GI bleed recurrence compared with historical controls not treated with octreotide. Additional prospective studies are needed to confirm these data. © 2017 American Heart Association, Inc.

Radiomorphometric indices of mandibular bones in an 18th century population.

PubMed

Ivanišević Malčić, Ana; Matijević, Jurica; Vodanović, Marin; Knezović Zlatarić, Dubravka; Prpić Mehičić, Goranka; Jukić, Silvana

2015-05-01

To estimate four radiomorphometric indices of mandibular bones in an 18th century population sample, and possibly associate the findings with bone mass loss related to sex, age, nutritional habits and pathologies reflecting on the bone. Thirty-six sculls (31 males, 5 females), recovered from the crypt of Požega Cathedral in Croatia were analyzed. Age estimation was based on tooth wear, and Eichner class was determined according to the number of occlusal supporting zones. The parameters in recording analogue orthopantomographs were set to constant current of 16 mA, exposure time of 14.1s, and voltage between 62-78 kV. Films were processed in an automatic dark chamber processor for 12 min, and digitized at 8-bit, 300 dpi. The thickness of the mandibular cortex was assessed below the mental foramen (MI), at antegonion (AI), at gonion (GI). Qualitative mandibular cortical index (MCI) was assessed. Average values of MI, AI and GI were 3.97 ± 0.94 mm, 2.98 ± 0.56 mm, and 1.99 ± 0.55 mm, respectively. Statistically significant differences between males and females were found for AI right (p=0.014), GI left (p=0.010) and GI average (p=0.006), and were in all cases higher in males. There were no statistically significant differences between age groups for either index (p>0.05). Considering Eichner classification the differences were not significant for MI (p=0.422), AI (p=0.516), and GI (p=0.443), but in Eichner classes II, MCI was significantly higher (p=0.02). The obtained data does not suggest generalized malnutrition or calcium, phosphorus and vitamin D deprivation in the historic population studied. Copyright © 2015 Elsevier Ltd. All rights reserved.

Reducing Dental Plaque and Gingivitis With 0.6% Cortex Ilicis Rotundae Toothpaste: A Randomized, Double-Masked Clinical Trial.

PubMed

Liu, Hongchun; Yin, Wei

2016-03-01

Cortex Ilicis Rotundae has antioxidant and anti-inflammatory properties. Few studies have evaluated the effects of toothpastes containing Cortex Ilicis Rotundae. This study evaluates the antiplaque and antigingivitis effects of a test toothpaste containing 0.6% Cortex Ilicis Rotundae extract in a calcium carbonate base compared with a control toothpaste without any active ingredient. One hundred adults with a mean plaque index (PI) ≥ 1.5 and a mean gingival index (GI) ≥ 1.0 were enrolled in this randomized, double-masked, placebo-controlled clinical trial. They were assigned randomly to use a test toothpaste or a control toothpaste. At baseline, 6 weeks, and 12 weeks, they received examinations of oral hard and soft tissues, using Löe-Silness GI for gingivitis and the Turesky modification of the Quigley-Hein PI for PI. Adverse events were monitored. When the study was completed, the test group reported lower mean GI than the control group (1.13 ± 0.22 versus 1.30 ± 0.23; P = 0.001) and lower mean PI than the control group (2.53 ± 0.5 versus 2.93 ± 0.44; P < 0.001). Compared to the baseline, the test group had reductions in GI and PI of 14.39% and 17.86%, respectively (both P < 0.001); the control group had reductions in GI and PI of 3.7% and 3.93%, respectively (both P < 0.001). No adverse events were reported during the course of the study. The toothpaste containing 0.6% Cortex Ilicis Rotundae was effective in reducing dental plaque and gingivitis after 12 weeks of use compared with a negative control toothpaste.

Wholegrain oat-based cereals have prebiotic potential and low glycaemic index.

PubMed

Connolly, M L; Tuohy, K M; Lovegrove, J A

2012-12-28

Population studies show a positive association between increased dietary intake of wholegrains and reduced risk of cardiometabolic disorders. Consumption of wholegrain food has been associated with lower blood glucose and therefore may contribute to a low-glycaemic load diet. The ability to mediate a prebiotic modulation of gut microbiota has recently been suggested to have an inverse correlation with risk of cardiometabolic disease. To date very little work has been carried out on the functionality of wholegrain breakfast cereals in terms of glycaemic response or impact on gut microbiota. An investigation into identifying wholegrain-based breakfast cereals demonstrating both low glycaemic index (GI) and prebiotic attributes was performed. After in vitro digestion, cereal samples were supplemented to pH-controlled anaerobic batch cultures of the human faecal microbiota. Total bacteria populations increased significantly (P < 0·05) in all treated cultures, and the fermentation of a wholegrain oat cluster cereal was associated with proliferation of the Bifidobacterium genus (P = 0·02). Smaller, but significant increases in the Bifidobacterium genus were observed for a further four oat-based cereals. Significant increases in the Lactobacillus-Enterococcus group were observed for granola (P = 0·01), 100 % wholegrain aggregate (P = 0·04) and 70 % wholegrain loops (P = 0·01). Cereals demonstrating prebiotic potential were selected for GI determination in twelve healthy subjects. The wholegrain oat aggregate cereal achieved the lowest GI value (40), three other cereals ranged between 44 and 74, with instant porridge resulting in a GI value similar to the standard glucose control. The present study suggests that wholegrain oat-based breakfast cereals may be prebiotics and have the potential to have low GI.

Gastrointestinal symptoms and well-being of adults living on a gluten-free diet: a case for nursing in celiac disease.

PubMed

Roos, Susanne; Kärner, Anita; Hallert, Claes

2009-01-01

Women with celiac disease (CD) living on a gluten-free diet (GFD) show a lower health-related quality of life and report a higher rate of gastrointestinal (GI) symptoms than men with CD. Uncertainty exists as to whether GI symptoms may explain the poorer treatment outcome of women with CD. This study was designed to explore relationships of GI symptoms and psychological well-being in men and women with long-standing CD. Patients with CD (n = 108; 59% women), aged 45-64 years, treated with a GFD for at least 8 years were evaluated by the Gastrointestinal Symptom Rating Scale and the Psychological General Well-Being index. The results show that women with a high rate of GI symptoms have no lower level of psychological well-being than corresponding men with CD and that women with CD with reduced psychological well-being have no more GI symptoms than corresponding men. Our results fail to support the notion that the reduced subjective health in CD is explained by GI symptoms. They may be secondary to perceived difficulties in managing everyday life, suggesting that launching a nurse-led follow-up may be helpful, as has been proven to be useful in other lifelong disorders.

Relationships Between Glycemic Control and Cardiovascular Fitness.

PubMed

Moxley, Elizabeth W; Smith, Donald; Quinn, Lauretta; Park, Chang

2018-07-01

Diabetes is a serious health problem affecting approximately 29.1 million individuals in the United States. Another 86 million have prediabetes. The development and implementation of lifestyle modifications such as physical activity for these persons are among the most effective methods for prevention and treatment. The aim of this study was to examine relationships between glycemic control (HbA1c) and cardiovascular fitness (peak maximal oxygen uptake [VO 2 peak] and ventilatory threshold [VT]) in overweight/obese subjects with and without type 2 diabetes (T2DM). In addition, the influences of body mass index (BMI) and insulin sensitivity (homeostasis model assessment [HOMA %S]) on the relationship between glycemic control and cardiovascular fitness were explored. Data were abstracted from a completed study that included 51 overweight or obese subjects with T2DM ( n = 18), impaired glucose tolerance ( n = 8), or normal glucose tolerance ( n = 25). Relationships between glycemic control (HbA1c) and cardiovascular fitness (VO 2 peak and VT) were determined using correlational analysis and multiple linear regression analyses. A statistically significant relationship was observed between HbA1c and cardiovascular fitness. However, BMI and HOMA %S did not influence the relationship between glycemic control and cardiovascular fitness. HbA1c contributes to VO 2 peak and VT in obese and overweight subjects across glucose tolerance categories. Significant results were achieved despite the fact that there was a limited range of HbA1c based on the study inclusion criteria. This finding suggests that even a mild decrease in glycemic control can negatively influence cardiovascular fitness.

Glycemic Status Affects the Subgingival Microbiome of Diabetic Patients.

PubMed

Longo, Priscila Larcher; Dabdoub, Shareef; Kumar, Purnima; Artese, Hilana Paula Carillo; Dib, Sergio Atala; Romito, Giuseppe Alexandre; Mayer, Marcia Pinto Alves

2018-05-09

Periodontitis is correlated with type 2 diabetes mellitus (T2DM), but little is known about glycemic status effect on subgingival microbiota associated with periodontitis. This study evaluated if periodontal microbiome of T2DM patients is affected by glycemic status. 21 T2DM non-smoking patients with chronic periodontitis and body mass index ≤40kg/m 2 were allocated into two groups according to systemic glycemic status: inadequate (DMI- HbA1c≥8%) and adequate (DMA- HbA1c<7.8%). Subgingival biofilm was collected from sites with moderate (PD=4-6mm) and severe disease (PD≥7mm) in two quadrants. The V5-V6 hypervariable region of the 16SrRNA was sequenced using the GS-FLX-454Titanium platform. Sequences were compared to HOMD database using QIIME and PhyloToAST pipelines. Statistical comparisons were made using 2-sample t-tests. DMA microbiome presented higher diversity than DMI. Inadequate glycemic control favored fermenting species, especially those associated with propionate/succinate production, whereas those forming butyrate/pyruvate were decreased in DMI. Higher abundances of anginosus group and Streptococcus agalactiae in DMI may indicate that subgingival sites can be reservoir of potentially invasive pathogens. Altered subgingival microbiome in DMI may represent an additional challenge in the periodontal treatment of these patients and in the prevention of more invasive infections. Glycemic status in T2DM patients seems to modulate subgingival biofilm composition. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Do Perceptions of Empowerment Affect Glycemic Control and Self-Care Among Adults with Type 2 Diabetes?

PubMed Central

D’Souza, Melba Sheila; Karkada, Subrahmanya Nairy; Hanrahan, Nancy P.; Venkatesaperumal, Ramesh; Amirtharaj, Anandhi

2015-01-01

Background: The Arab adult with T2DM is understudied with less known facts about the perception of empowerment and its relationship with self-care and glycemic control. Purpose: The purpose of this study was to determine the extent to which perception of empowerment by Arab adults living with Type 2 Diabetes Mellitus (T2DM) was associated with better glycemic control and self-care management. Methods: A cross-sectional descriptive study was led among 300 Arab adults living in Oman with T2DM in an outpatient diabetes clinic. The Diabetes Empowerment Scale (DES), glycosylated haemaglobin (HbA1c) and Body mass index was assessed. The DES was found to be valid and reliable for the population. ANOVA, Regression analysis, and Structural equation modeling was used for analysis. Results: The composite score and three subscales of DES were a significant and strong predictor of good glycemic control among Omani adults with T2DM (p<0.001). Age, education, duration of DM, prior DM education program and medications were significantly associated with DES. Conclusion: Diabetes nurse educators engaged in the care of adults with T2DM should assess self-empowerment and tailor interventions to increase empowerment for better glycemic control. Patient empowerment plays an essential role in maintaining self-care behaviours and HbA1c. PMID:26156908

Quality of life and glycemic profile of type 2 diabetes mellitus patients of Indonesian: a descriptive study

NASA Astrophysics Data System (ADS)

Amelia, R.; Lelo, A.; Lindarto, D.; Mutiara, E.

2018-03-01

The prevalence of diabetes type 2 is increasing globally. Quality of life (QOL) in diabetic patients is the primary goal of care. Today, there is an increasing awareness suggesting that patient’sQOLand treatment satisfaction were improved after good glycemic control. This study aimed to demonstrate the quality of life and the glycemic profiles of type 2 Diabetes Mellitus patients. This study was a descriptive study of across-sectional design. A sample of 115 out-patients attending eight public health centers in Binjai City, Indonesia. Patient’s quality of life was assessedin four domains of role limitation due to physical health, psychosocial, social and environment in a four Likert point. Two glycemic profiles which are blood sugar level and glycated hemoglobin (HbA1c) were measured by Spectrophotometer Colorimeter + Full Automatic method and affinity Doronad + Modified HPLC technique, respectively. In the results, we confirmed that almost 80.0% of diabetes mellitus type 2 patients are in good QOL(score 81-100) in three QOL dimensions; Physical health, Social relationship and Environment health but not in Psychological health dimension. The blood sugar level and HbA1clevel are beyond the normal value, 267.5±103.2mg/dLand9.9±2.3%,respectively. The better controlled glycemic index, the better patient’s QOL.

Exercise training with weight loss and either a high or low glycemic diet reduces metabolic syndrome severity in older adults

PubMed Central

Malin, Steven K.; Niemi, Nicole; Solomon, Thomas P.J.; Haus, Jacob M.; Kelly, Karen R.; Filion, Julianne; Rocco, Michael; Kashyap, Sangeeta R.; Barkoukis, Hope; Kirwan, John P.

2012-01-01

Background The efficacy of combining carbohydrate quality with exercise on metabolic syndrome risk is unclear. Thus, we determined the effects of exercise training with a low or high glycemic diet on metabolic syndrome severity (Z-score). Methods Twenty-one adults (66.2 ± 1.1 yr; BMI = 35.3 ± 0.9 kg/m2) with metabolic syndrome were randomized to 12 weeks of exercise (60 minutes/d for 5 d/week at ~85% HRmax) and provided a low-glycemic (n=11; LoGIx) or high glycemic (n=10; HiGIx) diet. Z-scores were determined from: blood pressure, triglycerides (TG), high-density lipoproteins (HDL), fasting plasma glucose (FPG), and waist circumference (WC) before and after the intervention. Body composition, aerobic fitness, insulin resistance, and non-esterfied fatty acid (NEFA) suppression were also assessed. Results LoGIx and HiGIx decreased body mass and insulin resistance and increased aerobic fitness comparably (p < 0.05). LoGIx and HiGIx decreased the Z-score similarly, as each intervention decreased blood pressure, TG, FPG, and WC (p < 0.05). HiGIx tended to suppress NEFA during insulin stimulation compared to LoGIx (p = 0.06). Conclusions Our findings highlight that exercise with weight loss reduces metabolic syndrome severity whether individuals were randomized to a high or low glycemic index diet. PMID:23036993

The comparative evaluation of xanthan gel with chlorhexidine (Chlosite) in smokers and non-smokers: A clinical and microbiological assessment

PubMed Central

Chandra, Chetan; Valavalkar, Narayan; Vandana, K. L.

2011-01-01

Background and Objectives: Prevention of the periodontal disease progression is the primary goal of periodontal therapy. When conventional therapy is found inadequate to attain periodontal health in chronic periodontitis, local antimicrobial agents have been used as an adjunct with scaling and root planning (SRP) which has reproduced encouraging results. Hence, this study was undertaken to evaluate the new sustained released local drug Chlosite clinically and microbiologically in smokers and non-smokers. Materials and Methods: The patients were grouped into experimental group A treated with SRP plus Chlosite (SRP + CHL), experimental group B treated with Chlosite alone (CHL), and control group C treated only with SRP alone. A total number of 141 sites from six patients (67 sites from three non-smoker patients and 74 sites from three smoker patients) participated in this study. The clinical parameters, Plaque index (PI), Gingival index (GI), Bleeding index (BI), and Relative attachment level (RAL), were recorded and subgingival plaque samples were collected and subjected to microbiological analysis. Results: On comparison of smokers and non-smokers, in SRP group, non-smokers showed a higher reduction in BI and GI and smokers showed a higher reduction in PI. There was no significant gain in RAL of both smokers and non-smokers. In SRP + CHL group, non-smokers showed a higher reduction in relation to BI and GI and smokers showed a higher reduction in relation to PI. There was no significant gain in RAL of both smokers and non-smokers. In CHL group, both smokers and non-smokers showed a nonsignificant reduction in BI, GI, and RAL, but smokers showed a significant reduction in PI as compared with non-smokers. All the groups showed reduction in the microbial count of Fusobacterium nucleatum, Porphyromonas gingivalis, and Tannerella forsythia which were found to be statistically not significant when it was compared between non-smokers and smokers. Interpretation and Conclusion: In this study, all treatment groups were found to be efficacious in the treatment of periodontal disease as demonstrated by improvement in PI, GI, BI, and RAL. Combination of SRP and Chlosite resulted in added benefits compared with the two treatment groups. PMID:22028508

Sex Hormones Enhance Gingival Inflammation without Affecting IL-1β and TNF-α in Periodontally Healthy Women during Pregnancy

PubMed Central

Wu, Min; Chen, Shao-Wu; Su, Wei-Lan; Zhu, Hong-Ying; Ouyang, Shu-Yuan; Cao, Ya-Ting; Jiang, Shao-Yun

2016-01-01

Hormones (progesterone and estradiol) change greatly during pregnancy; however, the mechanism of hormonal changes on gingival inflammation is still unclear. This study is to evaluate the effects of hormonal changes during pregnancy on gingival inflammation and interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in gingival crevicular fluid (GCF). 30 periodontally healthy pregnant women were evaluated in the first, second, and third trimesters. 20 periodontally healthy nonpregnant women were evaluated twice (once per subsequent month). Clinical parameters including probing pocket depth (PPD), bleeding index (BI), gingival index (GI), clinical attachment level (CAL), and plaque index (PLI) were recorded. GCF levels of IL-1β and TNF-α and serum levels of progesterone and estradiol were measured. From the data, despite low PLI, BI and GI increased significantly during pregnancy; however, no significant changes in PLI, CAL, IL-1β, or TNF-α GCF levels were observed. Although IL-1β, not TNF-α, was higher in pregnant group than in nonpregnant group, they showed no correlation with serum hormone levels during pregnancy. GI and BI showed significant positive correlation with serum hormone levels during pregnancy. This study suggests that sex hormone increase during pregnancy might have an effect on inflammatory status of gingiva, independent of IL-1β and TNF-α in GCF. PMID:27034591

Sex Hormones Enhance Gingival Inflammation without Affecting IL-1β and TNF-α in Periodontally Healthy Women during Pregnancy.

PubMed

Wu, Min; Chen, Shao-Wu; Su, Wei-Lan; Zhu, Hong-Ying; Ouyang, Shu-Yuan; Cao, Ya-Ting; Jiang, Shao-Yun

2016-01-01

Hormones (progesterone and estradiol) change greatly during pregnancy; however, the mechanism of hormonal changes on gingival inflammation is still unclear. This study is to evaluate the effects of hormonal changes during pregnancy on gingival inflammation and interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in gingival crevicular fluid (GCF). 30 periodontally healthy pregnant women were evaluated in the first, second, and third trimesters. 20 periodontally healthy nonpregnant women were evaluated twice (once per subsequent month). Clinical parameters including probing pocket depth (PPD), bleeding index (BI), gingival index (GI), clinical attachment level (CAL), and plaque index (PLI) were recorded. GCF levels of IL-1β and TNF-α and serum levels of progesterone and estradiol were measured. From the data, despite low PLI, BI and GI increased significantly during pregnancy; however, no significant changes in PLI, CAL, IL-1β, or TNF-α GCF levels were observed. Although IL-1β, not TNF-α, was higher in pregnant group than in nonpregnant group, they showed no correlation with serum hormone levels during pregnancy. GI and BI showed significant positive correlation with serum hormone levels during pregnancy. This study suggests that sex hormone increase during pregnancy might have an effect on inflammatory status of gingiva, independent of IL-1β and TNF-α in GCF.

Diet Intervention and Cerebrospinal Fluid Biomarkers in Amnestic Mild Cognitive Impairment

PubMed Central

Bayer-Carter, Jennifer L.; Green, Pattie S.; Montine, Thomas J.; VanFossen, Brian; Baker, Laura D.; Watson, G. Stennis; Bonner, Laura M.; Callaghan, Maureen; Leverenz, James B.; Walter, Brooke K.; Tsai, Elaine; Plymate, Stephen R.; Postupna, Nadia; Wilkinson, Charles W.; Zhang, Jing; Lampe, Johanna; Kahn, Steven E.; Craft, Suzanne

2011-01-01

Objective To compare the effects of a 4-week high–saturated fat/high–glycemic index (HIGH) diet with a low–saturated fat/low–glycemic index (LOW) diet on insulin and lipid metabolism, cerebrospinal fluid (CSF) markers of Alzheimer disease, and cognition for healthy adults and adults with amnestic mild cognitive impairment (aMCI). Design Randomized controlled trial. Setting Veterans Affairs Medical Center clinical research unit. Participants Forty-nine older adults (20 healthy adults with a mean [SD] age of 69.3 [7.4] years and 29 adults with aMCI with a mean [SD] age of 67.6 [6.8] years). Intervention Participants received the HIGH diet (fat, 45% [saturated fat, >25%]; carbohydrates, 35%–40% [glycemic index, >70]; and protein, 15%–20%) or the LOW diet (fat, 25%; [saturated fat, <7%]; carbohydrates, 55%–60% [glycemic index, <5]; and protein, 15%–20%) for 4 weeks. Cognitive tests, an oral glucose tolerance test, and lumbar puncture were conducted at baseline and during the fourth week of the diet. Main Outcome Measures The CSF concentrations of β-amyloid (Aβ42 and Aβ40), tau protein, insulin, F2-isoprostanes, and apolipoprotein E, plasma lipids and insulin, and measures of cognition. Results For the aMCI group, the LOW diet increased CSF Aβ42 concentrations, contrary to the pathologic pattern of lowered CSF Aβ42 typically observed in Alzheimer disease. The LOW diet had the opposite effect for healthy adults, ie, decreasing CSF Aβ42, whereas the HIGH diet increased CSF Aβ42. The CSF apolipoprotein E concentration was increased by the LOW diet and decreased by the HIGH diet for both groups. For the aMCI group, the CSF insulin concentration increased with the LOW diet, but the HIGH diet lowered the CSF insulin concentration for healthy adults. The HIGH diet increased and the LOW diet decreased plasma lipids, insulin, and CSF F2-isoprostane concentrations. Delayed visual memory improved for both groups after completion of 4 weeks of the LOW diet. Conclusion Our results suggest that diet may be a powerful environmental factor that modulates Alzheimer disease risk through its effects on central nervous system concentrations of Aβ42, lipoproteins, oxidative stress, and insulin. PMID:21670398

Canagliflozin as an Initial Therapy in Drug-Naïve Subjects with Type 2 Diabetes Mellitus: A Potential Involvement of Atherogenic Lipids in its Glycemic Efficacy.

PubMed

Kutoh, Eiji; Wada, Asuka; Murayama, Teruma; Takizawa, Yui

2017-06-01

The aim of this study is to investigate canagliflozin as an initial therapy in type 2 diabetes mellitus and to explore the effects on metabolic parameters in relation to effects on glycemic control. Treatment-naïve subjects with type 2 diabetes mellitus received canagliflozin 50-100 mg/day monotherapy. At 3 months, levels of glycemic and non-glycemic parameters were compared with those at baseline (n = 39). As a comparator, our previous data of baseline glycosylated hemoglobin (HbA 1c )-matched treatment-naïve subjects with ipragliflozin 25-50 mg monotherapy (n = 27) were employed. Significant reductions in HbA 1c (from 9.96 to 8.33%), fasting blood glucose (-23.9%), homeostasis model assessment-R (HOMA-R, -33.5%), body mass index (-1.8%), and uric acid (UA, -5.2%) levels and significant increases in homeostasis model assessment-B (HOMA-B, 30.1%) levels were observed. Approximately one third of the subjects experienced certain adverse events. Similar results were obtained with ipragliflozin. Baseline levels of HbA 1c , triglycerides, non-high-density lipoprotein-cholesterol (HDL-C), and low-density lipoprotein-cholesterol (LDL-C) were chosen as significant contributing factors for the changes in HbA 1c levels with canagliflzoin, while only baseline HbA 1c levels were selected as such a factor with ipragliflozin. Significant positive correlations between the changes in HbA 1c and changes in non-HDL-C (R = 0.3954) or between changes in HbA 1c and changes in LDL-C (R = 0.4317) were observed with canagliflozin. With ipragliflozin, no such correlations were noted. No correlations between the changes in HbA 1c and changes in body mass index were seen with both drugs. These results suggest that (1) canagliflozin appears to offer clinically beneficial outcomes as an initial therapy in subjects with type 2 diabetes mellitus, although with certain adverse events. (2) Atherogenic cholesterols including non-HDL-C and LDL-C could be involved in the glycemic efficacy of canagliflozin. This was not the case with ipragliflozin. (3) Unexpectedly, weight reductions with canagliflozin are not associated with its glycemic efficacy.

Enrichment of extruded snack products with coproducts from chestnut mushroom (Agrocybe aegerita) production: interactions between dietary fiber, physicochemical characteristics, and glycemic load.

PubMed

Brennan, Margaret A; Derbyshire, Emma; Tiwari, Brijesh K; Brennan, Charles S

2012-05-02

Mushrooms are a common vegetable product that have also been linked to pharmaceutical and medicinal uses. However, the production of the fruiting bodies of mushrooms results in a large quantity of food waste in the form of spent compost. Hyphae and the base of fruit bodies from Agrocybe aegerita were retrieved from spent mushroom compost and refined as a freeze-dried powder. This fiber-rich ingredient was used in the manufacture of ready-to-eat extruded cereal snack products. Inclusions rates were 0, 5, 10, and 15% w/w replacement levels for wheat flour from a control recipe. Inclusion of mushroom coproduct material (MCM) was significantly correlated to increased product expansion (r = 0.848) and density (r = 0.949) but negatively correlated to water absorption index (WAI; r = -0.928) and water solubility index (WSI; r = -0.729). Fiber content could not be correlated to differences in pasting properties of extruded snacks even though snack products with MCM showed significantly lower final viscosity values compared to the control. The potential glycemic response of foods was significantly lowered by including MCM (p < 0.05) with a negative correlation between fiber content and overall AUC following a standardized in vitro digestion method (r = -0.910). Starch content, WAI, and WSI were positively correlated to AUC of extruded snacks (r = 0.916, 0.851, and 0.878. respectively). The results illustrate a reduction in the potential glycemic response from including 5% (w/w) of MCM in extruded snacks exceeds 20%. Thus, the incorporation of MCM in ready-to-eat snack foods may be of considerable interest to the food industry in trying to regulate the glycemic response of foods.

Launch device using endlessly single-mode PCF for ultra-wideband WDM transmission in graded-index multi-mode fiber.

PubMed

Ma, Lin; Hanzawa, Nobutomo; Tsujikawa, Kyozo; Azuma, Yuji

2012-10-22

We demonstrated ultra-wideband wavelength division multiplexing (WDM) transmission from 850 to 1550 nm in graded-index multi-mode fiber (GI-MMF) using endlessly single-mode photonic crystal fiber (ESM-PCF) as a launch device. Effective single-mode guidance is obtained in multi-mode fiber at all wavelengths by splicing cm-order length ESM-PCF to the transmission fiber. We achieved 3 × 10 Gbit/s WDM transmission in a 1 km-long 50-μm-core GI-MMF. We also realized penalty free 10 Gbit/s data transmission at a wavelength of 850 nm by optimizing the PCF structure. This method has the potential to achieve greater total transmission capacity for MMF systems by the addition of more wavelength channels.

Primary aortoduodenal fistula associated with abdominal aortic aneurysm with presentation of gastrointestinal bleeding: a case report.

PubMed

Lin, Tzu-Chieh; Tsai, Chung-Lin; Chang, Yao-Tien; Hu, Sung-Yuan

2018-06-07

Primary aortoduodenal fistula (ADF) is a rare cause of gastrointestinal (GI) bleeding and is difficult to diagnose as the clinical presentation is subtle. Clinicians should keep a high level of suspicion for an unknown etiology of GI bleeding, especially in older patients with or without abdominal aortic aneurysm (AAA). Computed tomographic angiography (CTA) can be used to detect primary ADF. Open surgery or endovascular aortic repair (EVAR) for ADF with bleeding will improve the survival rate. We report a rare case of AAA complicating ADF with massive GI bleeding in a 73-year-old Taiwanese man. He presented with abdominal pain and tarry stool for 5 days and an initial upper GI endoscopy at a rural hospital showed gastric ulcer only, but hypotension with tachycardia and a drop in hemoglobin of 9 g/dl from 12 g/dl occurred the next day. He was referred to our hospital for EVAR and primary closure of fistula defect due to massive GI bleeding with shock from ADF caused by AAA. Diagnosis was made by CTA of aorta. A timely and accurate diagnosis of primary ADF may be challenging due to insidious episodes of GI bleeding, which are frequently under-diagnosed until the occurrence of massive hemorrhage. Clinical physicians should keep a high index of awareness for primary ADF, especially in elderly patients with unknown etiology of upper GI bleeding with or without a known AAA.

Relationship of locus of control with plaque and gingival status before and after oral health education in a group of college students - an experimental study.

PubMed

Potdar, S; Lakshminarayan, N; Goud Reddy, S

2015-02-01

In health psychology, several models are being constructed to understand human behaviour. Multidimensional health locus of control (MHLC) is one among them. We sought to know the relationship of MHLC with dental plaque and gingival status before and after oral health education programme among 286 college students, aged 18-21 years in Davangere city. Multidimensional health locus of control questionnaire consisting of questions measuring internal health locus of control (IHLC), powerful others health locus of control (PHLC) and chance health locus of control (CHLC) was administered to students. Dental plaque and gingival health status were recorded using Plaque Index (PLI) and Gingival Index (GI), 1967. Oral health education was provided using power point presentation after the baseline oral examination. After 10 weeks of intervention, the students were given the same proforma followed by the assessment of plaque and gingival status. A negative correlation was observed between PHLC and IHLC with PLI and GI and positive correlation of CHLC with PLI and GI at a level of P < 0.01. The difference between 'pre-test' and 'post-test' mean PLI scores, GI scores, PHLC was found to be statistically significant at a level of P < 0.05. Oral health education was found to be effective and this could change the behaviour of individuals. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Ontogenetic pattern of gyrification in fetuses of cynomolgus monkeys.

PubMed

Sawada, K; Sun, X-Z; Fukunishi, K; Kashima, M; Saito, S; Sakata-Haga, H; Sukamoto, T; Aoki, I; Fukui, Y

2010-05-19

The ontogenetic pattern of gyrification and its relationship with cerebral cortical volume were examined in cynomolgus monkey fetuses. T(1)-weighted coronal magnetic resonance (MR) images at 7 T were acquired from the fixed cerebra of three male fetuses, each at embryonic days (EDs) 70 to 150, and the gyrification index (GI) of each slice was estimated. The mean GI was low (1.1-1.2) during EDs 70 to 90, and then increased dramatically on ED 100. The developmental profiles of the rostrocaudal GI distribution revealed that cortical convolution was more frequent in the parietooccipital region than in other regions during EDs 100 to 150, forming an adult-like pattern by ED 150. The mean GI was closely correlated with the volume of cortical gray matter (r=0.9877), and also with the volume of white matter/intermediate zone (r=0.8961). These findings suggest that cortical convolution is correlated with either the maturation of cortical gray matter or the development of white matter bundles. The characteristic GI distribution pattern of catarrhines was formed by ED 150 in correlation with the progressive sulcal infolding in the parietooccipital region of the cerebrum. Copyright 2010 IBRO. Published by Elsevier Ltd. All rights reserved.

Glycaemic index, glycaemic load and dietary fibre characteristics of two commercially available fruit smoothies.

PubMed

Saltaouras, Georgios; Shaw, Patricia K; Fraser, Ann C; Hawes, Chris; Smith, Harry; Handley, Louisa; Whitby, Helen; Thondre, Sangeetha P; Lightowler, Helen J

2018-06-11

In light of the updated Eatwell Guide and the corresponding change in the consumption of fruit smoothies, the aim of this study was to measure the glycaemic index and load of two commercial fruit smoothies and to investigate the retention of dietary fibre following production. In vitro analysis was performed to identify fibre material (cellulose and pectins) using calcofluor staining and immunocytochemical labelling. A repeated measures cross-over study was conducted (n 10) to determine the glycaemic index (GI) and glycaemic load (GL) of the smoothies. Results showed that dietary fibre was still present in the smoothies after processing (16.9-17.5% cellular material by dry weight). The GI was low for both smoothies (39 and 36), whereas the GL was medium and borderline-low, respectively (11.4 and 9.7). The retention of fibre in these smoothies may have a potential positive effect on glycaemic response and may contribute to daily fibre requirements.

Gamma index evaluation of IMRT technique using gafchromic film EBT3 for homogeneous and inhomogeneous material

NASA Astrophysics Data System (ADS)

Nisauf, T. A.; Wibowo, W. E.; Pawiro, S. A.

2017-07-01

This study was done to evaluate the gamma index for registering between the planar of dose planning and the measurement of EBT film. The treatment plan was simulated for 5 patients using Fan Beam Computerized Tomography (FBCT) modality, Philips Pinnacle planning system, 6 MV photon energy, 50 segments IMRT technique, and calculation grid resolution (CGR) of 0.2 cm. Gamma Index (GI) evaluation was done with criteria of dose difference (DD) of 2 %, dose to agreement (DTA) of 2 mm and dose difference (DD) of 5 % DTA of 3 mm, SAD 100 cm, depth of 5 cm and 10 cm of the phantom. The result shows that GI for homogeneous material is greater than for inhomogeneous material with discrepancy to previous work is about 1.98 % for homogeneous material (depth 5 cm) and 2.05 % (depth 10 cm) while it was found of 2.98 % for inhomogeneous material (equivalent depth 5 cm) and 4.59 % (equivalent depth 10 cm).

Periodontal disease status during pregnancy and 3 months post-partum, in a rural population of Sri-Lankan women.

PubMed

Tilakaratne, A; Soory, M; Ranasinghe, A W; Corea, S M; Ekanayake, S L; de Silva, M

2000-10-01

The aim of this investigation was to study the effects of pregnancy on the periodontium, in a rural population of Sri-Lankan women. The study group consisted of 47 pregnant women and 47 non-pregnant women who served as matched controls. All subjects were examined for plaque (plaque index: PLI), gingival condition (gingival index: GI) and loss of periodontal attachment (LA) levels, 4 x during the study, at 3-monthly intervals. Despite similar scores for plaque levels in both pregnant and non-pregnant women, the GI of pregnant women was significantly increased, during the 1st and 2nd trimesters compared to the controls (p<0.01, 2-way ANOVA). During the 3rd trimester, GI was further increased (p<0.001), but dropped at 3 months post-partum. Values for LA did not show significant differences from that of controls, during any of the stages of pregnancy. The results of this study show that pregnancy had an effect only on the gingivae and not on periodontal attachment levels. The effects of oestrogen and progesterone could give rise to a more florid response to the irritant effects of plaque, resulting in severe gingivitis.

Serum leveis of inflammatory markers in type 2 diabetes patients with chronic periodontitis

PubMed Central

LONGO, Priscila Larcher; ARTESE, Hilana Paula Carillo; RABELO, Marianade Sousa; KAWAMOTO, Dione; FOZ, Adriana Moura; ROMITO, Giuseppe Alexandre; DIB, Sérgio Atala; MAYER, Marcia Pinto Alves

2014-01-01

Diabetes has been associated with periodontitis, but the mechanisms through which periodontal diseases affect the metabolic control remain unclear. Objective This study aimed to evaluate serum leveis of inflammatory markers, IL-8, IL-6 and monocyte chemoattractant protein 1 (MCP-1), in type 2 diabetic patients in the presence of chronic periodontitis. Material and Methods Forty two individuals were enrolled in this study and assigned to one of five groups: diabetes mellitus with inadequate glycemic control and periodontitis (DMI+P, n = 10), diabetes mellitus with adequate glycemic control and periodontitis (DMA+P, n = 10), diabetes mellitus without periodontitis (DM, n = 10), periodontitis without diabetes (P, n=6), and neither diabetes nor periodontitis (H, n = 6). Periodontal clinical examination included visible plaque index (PL), gingival bleeding index (GB), probing depth (PD), attachment level (AL) and bleeding on probing (BP). Glycemic control was evaluated by serum concentration of glycated hemoglobin (HbAlc). Inflammatory serum markers IL-8, IL-6 and (MCP-1) were measured by ELISA. Results DMI+P and DMA+P groups presented higher PD (p=0.025) and AL (p=0.003) values when compared to the P group. There were no significant differences among groups for IL-6, IL-8 and MCP-1 serum levels. Conclusions Although periodontitis was more severe in diabetic patients, the serum levels of the investigated inflammatory markers did not differ among the groups. PMID:24676580

Associations among binge eating behavior patterns and gastrointestinal symptoms: a population-based study

PubMed Central

Cremonini, F; Camilleri, M; Clark, MM; Beebe, TJ; Locke, GR; Zinsmeister, AR; Herrick, LM; Talley, NJ

2009-01-01

Background The psychological symptoms associated with binge eating disorder (BED) have been well documented. However, the physical symptoms associated with BED have not been explored. Gastrointestinal (GI) symptoms such as heartburn and diarrhea are more prevalent in obese adults, but the associations remain unexplained. Patients with bulimia have increased gastric capacity. The objective of the study was to examine if the severity of binge eating episodes would be associated with upper and lower GI symptoms. Methods Population-based survey of community residents through a mailed questionnaire measuring GI symptoms, frequency of binge eating episodes and physical activity level. The association of GI symptoms with frequency of binge eating episodes was assessed using logistic regression models adjusting for age, gender, body mass index (BMI) and physical activity level. Results In 4096 subjects, BED was present in 6.1%. After adjusting for BMI, age, gender, race, diabetes mellitus, socioeconomic status and physical activity level, BED was independently associated with the following upper GI symptoms: acid regurgitation (P < 0.001), heartburn (P < 0.001), dysphagia (P < 0.001), bloating (P < 0.001) and upper abdominal pain (P < 0.001). BED was also associated with the following lower GI symptoms: diarrhea (P < 0.001), urgency (P < 0.001), constipation (P < 0.01) and feeling of anal blockage (P = 0.001). Conclusion BED appears to be associated with the experience of both upper and lower GI symptoms in the general population, independent of the level of obesity. The relationship between increased GI symptoms and physiological responses to increased volume and calorie loads, nutritional selections and rapidity of food ingestion in individuals with BED deserves further study. PMID:19139750

The Optimal Cut-Off Value of Neutrophil-to-Lymphocyte Ratio for Predicting Prognosis in Adult Patients with Henoch–Schönlein Purpura

PubMed Central

Park, Chan Hyuk; Han, Dong Soo; Jeong, Jae Yoon; Eun, Chang Soo; Yoo, Kyo-Sang; Jeon, Yong Cheol; Sohn, Joo Hyun

2016-01-01

Background The development of gastrointestinal (GI) bleeding and end-stage renal disease (ESRD) can be a concern in the management of Henoch–Schönlein purpura (HSP). We aimed to evaluate whether the neutrophil-to-lymphocyte ratio (NLR) is associated with the prognosis of adult patients with HSP. Methods Clinical data including the NLR of adult patients with HSP were retrospectively analyzed. Patients were classified into three groups as follows: (a) simple recovery, (b) wax & wane without GI bleeding, and (c) development of GI bleeding. The optimal cut-off value was determined using a receiver operating characteristics curve and the Youden index. Results A total of 66 adult patients were enrolled. The NLR was higher in the GI bleeding group than in the simple recovery or wax & wane group (simple recovery vs. wax & wane vs. GI bleeding; median [IQR], 2.32 [1.61–3.11] vs. 3.18 [2.16–3.71] vs. 7.52 [4.91–10.23], P<0.001). For the purpose of predicting simple recovery, the optimal cut-off value of NLR was 3.18, and the sensitivity and specificity were 74.1% and 75.0%, respectively. For predicting development of GI bleeding, the optimal cut-off value was 3.90 and the sensitivity and specificity were 87.5% and 88.6%, respectively. Conclusions The NLR is useful for predicting development of GI bleeding as well as simple recovery without symptom relapse. Two different cut-off values of NLR, 3.18 for predicting an easy recovery without symptom relapse and 3.90 for predicting GI bleeding can be used in adult patients with HSP. PMID:27073884

Investigation of Body Image as a Mediator of the Effects of Bowel and GI Symptoms on Psychological Distress in Female Survivors of Rectal and Anal Cancer

PubMed Central

Benedict, Catherine; Rodriguez, Vivian M.; Carter, Jeanne; Temple, Larissa; Nelson, Christian; DuHamel, Katherine

2016-01-01

Purpose Treatment for rectal and anal cancer (RACa) can result in persistent bowel and gastrointestinal (GI) dysfunction. Body image problems may develop over time and exacerbate symptom-related distress. RACa survivors are an understudied group, however, and factors contributing to post-treatment well-being are not well understood. This study examined whether poorer body image explained the relation between symptom severity and psychological distress. Methods Participants (N=70) completed the baseline assessment of a sexual health intervention study. Bootstrap methods tested body image as a mediator between bowel and GI symptom severity and two indicators of psychological distress (depressive and anxiety symptoms), controlling for relevant covariates. Measures included the EORTC-QLQ-CR38 Diarrhea, GI Symptoms, and Body Image subscales and Brief Symptom Index Depression and Anxiety subscales. Results Women averaged 55 years old (SD=11.6), White (79%), and 4-years post-treatment. Greater Depression related to poorer body image (r=−.61) and worse diarrhea (r=.35) and GI symptoms (r=.48). Greater Anxiety related to poorer body image (r=−.42) and worse GI symptoms (r=.45), but not diarrhea (r=.20). Body image mediated the effects of bowel and GI symptoms on Depression, but not on Anxiety. Conclusions Long-term bowel and GI dysfunction are distressing and affect how women perceive and relate to their bodies, exacerbating survivorship difficulties. Interventions to improve adjustment post-treatment should address treatment side effects, but also target body image problems to alleviate depressive symptoms. Reducing anxiety may require other strategies. Body image may be a key modifiable factor to improve well-being in this understudied population. Longitudinal research is needed to confirm findings. PMID:26446699

Lower education predicts poor response to dietary intervention in pregnancy, regardless of neighbourhood affluence: secondary analysis from the ROLO randomised control trial.

PubMed

O'Brien, Eileen C; Alberdi, Goiuri; Geraghty, Aisling A; McAuliffe, Fionnuala M

2017-11-01

To determine if response to a low glycaemic index (GI) dietary intervention, measured by changes in dietary intake and gestational weight gain, differed across women of varying socio-economic status (SES). Secondary data analysis of the ROLO randomised control trial. The intervention consisted of a two-hour low-GI dietary education session in early pregnancy. Change in GI was measured using 3 d food diaries pre- and post-intervention. Gestational weight gain was categorised as per the 2009 Institute of Medicine guidelines. SES was measured using education and neighbourhood deprivation. The National Maternity Hospital, Dublin, Ireland. Women (n 625) recruited to the ROLO randomised control trial. The intervention significantly reduced GI and excess gestational weight gain (EGWG) among women with third level education residing in both disadvantaged (GI, mean (sd), intervention v. control: -3·30 (5·15) v. -0·32 (4·22), P=0·024; EGWG, n (%), intervention v. control: 7 (33·6) v. 22 (67·9); P=0·022) and advantaged areas (GI: -1·13 (3·88) v. 0·06 (3·75), P=0·020; EGWG: 41 (34·1) v. 58 (52·6); P=0·006). Neither GI nor gestational weight gain differed between the intervention and control group among women with less than third level education, regardless of neighbourhood deprivation. A single dietary education session was not effective in reducing GI or gestational weight gain among less educated women. Multifaceted, appropriate and practical approaches are required in pregnancy interventions to improve pregnancy outcomes for less educated women.

Quantifying direct effects of social determinants of health on glycemic control in adults with type 2 diabetes.

PubMed

Walker, Rebekah J; Gebregziabher, Mulugeta; Martin-Harris, Bonnie; Egede, Leonard E

2015-02-01

The aim of this study was to investigate if self-care is the pathway through which social determinants of health impact diabetes outcomes by analyzing the direct and indirect effects of socioeconomic and psychosocial factors on self-care and glycemic control. Six hundred fifteen adults were recruited from two primary care clinics in the southeastern United States. A series of confirmatory factor analyses identified the latent factors underlying social status, psychosocial determinants (psychological distress, self-efficacy, and social support), and self-care (diet, exercise, foot care, glucose testing, and medication adherence). Structured equation modeling investigated the relationship among social determinants, self-care and glycemic control. Latent variables were created for diabetes self-care, psychological distress, self-efficacy, social support, and social status. The final model [χ(2)(275)=450.07, P<0.001, R(2)=99, root mean square error of approximation=0.03, comparative fit index=0.98] showed lower psychological distress (r=-0.13, P=0.012), higher social support (r=0.14, P=0.01), and higher self-efficacy (r=0.47, P<0.001) were significantly related to diabetes self-care. Lower psychological distress (r=0.10, P=0.03), lower social support (r=0.10, P=0.02), and higher self-efficacy (r=-0.37, P<0.001) were significantly related to lower glycemic control. When social determinants of health variables were included in the model, self-care was no longer significantly associated with glycemic control (r=0.01, P=0.83). This study suggests a direct relationship between psychosocial determinants of health and glycemic control. Although associated with self-care, the relationship between social determinants of health and glycemic control is not mediated by self-care. Development of interventions should take psychosocial factors into account as independent influences on diabetes outcomes, rather than as indirect influences via self-care behavior.

Impact of postoperative glycemic control and nutritional status on clinical outcomes after total pancreatectomy.

PubMed

Shi, Hao-Jun; Jin, Chen; Fu, De-Liang

2017-01-14

To evaluate the impact of glycemic control and nutritional status after total pancreatectomy (TP) on complications, tumor recurrence and overall survival. Retrospective records of 52 patients with pancreatic tumors who underwent TP were collected from 2007 to 2015. A series of clinical parameters collected before and after surgery, and during the follow-up were evaluated. The associations of glycemic control and nutritional status with complications, tumor recurrence and long-term survival were determined. Risk factors for postoperative glycemic control and nutritional status were identified. High early postoperative fasting blood glucose (FBG) levels (OR = 4.074, 95%CI: 1.188-13.965, P = 0.025) and low early postoperative prealbumin levels (OR = 3.816, 95%CI: 1.110-13.122, P = 0.034) were significantly associated with complications after TP. Postoperative HbA1c levels over 7% (HR = 2.655, 95%CI: 1.299-5.425, P = 0.007) were identified as one of the independent risk factors for tumor recurrence. Patients with postoperative HbA1c levels over 7% had much poorer overall survival than those with HbA1c levels less than 7% (9.3 mo vs 27.6 mo, HR = 3.212, 95%CI: 1.147-8.999, P = 0.026). Patients with long-term diabetes mellitus (HR = 15.019, 95%CI: 1.278-176.211, P = 0.031) and alcohol history (B = 1.985, SE = 0.860, P = 0.025) tended to have poor glycemic control and lower body mass index levels after TP, respectively. At least 3 mo are required after TP to adapt to diabetes and recover nutritional status. Glycemic control appears to have more influence over nutritional status on long-term outcomes after TP. Improvement in glycemic control and nutritional status after TP is important to prevent early complications and tumor recurrence, and improve survival.

[The optimal blood glucose target in critically ill patient: comparison of two intensive insulin therapy protocols].

PubMed

Raurell Torredà, Marta; del Llano Serrano, César; Almirall Solsona, Dolors; Catalan Ibars, Rosa María; Nicolás Arfelis, José María

2014-03-04

Recent studies in critically ill patients receiving insulin intravenous therapy (IIT) have shown an increased incidence of severe hypoglycemia, while intermittent subcutaneous insulin «sliding scales» (conventional insulin therapy [CIT]) is associated with hyperglycemia. The objective of this study is to assess whether glycemic control range IIT can affect glucose levels and their variability and to compare it with CIT. Prospective comparative cohort study in intensive care unit, with 2 study periods: Period 1, IIT with glycemic target range 110-140 mg/dL, and Period 2, IIT of 140-180 mg/dL. In both periods CIT glycemic target was 110-180 mg/dL. We assessed severe hypoglycemia (< 50 mg/dL), moderate hypoglycemia (51-79 mg/dL), hyperglycemia (> 216 mg/L) and the variability of blood glucose. We studied 221 patients with 12.825 blood glucose determinations. Twenty-six and 17% of patients required IIT for glycemic control in Period 1 and 2, respectively. Hypoglycemia was associated with a discontinuous nutritional intake, glycemic target 110-140 mg/dL and low body mass index (BMI) (P = .002). Hyperglycemia was exclusively associated with a history of diabetes mellitus (OR 2.6 [95% CI 1.6 to 4.5]). Glycemic variability was associated with a discontinuous nutritional intake, low BMI, CIT insulinization, diabetes mellitus, elderly and high APACHE II (P < .001). The use of IIT is useful to reduce the variability of blood glucose. Although the 140-180 mg/dL range would be more secure as to presenting greater variability and hyperglycemia, the 110-140 mg/dL range is most suitable. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Sedentary Patterns, Physical Activity, and Cardiorespiratory Fitness in Association to Glycemic Control in Type 2 Diabetes Patients

PubMed Central

Sardinha, Luís B.; Magalhães, João P.; Santos, Diana A.; Júdice, Pedro B.

2017-01-01

Background: Sedentary behavior has been considered an independent risk factor for type-2 diabetes (T2D), with a negative impact on several physiological outcomes, whereas breaks in sedentary time (BST) have been proposed as a viable solution to mitigate some of these effects. However, little is known about the independent associations of sedentary pursuits, physical activity, and cardiorespiratory fitness (CRF) variables with glycemic control. We investigated the independent associations of total sedentary time, BST, moderate-to-vigorous physical activity (MVPA), and CRF with glycemic outcomes in patients with T2D. Methods: Total sedentary time, BST, and MVPA were assessed in 66 participants (29 women) with T2D, using accelerometry. Glucose and insulin were measured during a mixed meal tolerance test, with the respective calculations of HOMA-IR and Matsuda index. Glycated hemoglobin (HbA1c) was also analyzed. CRF was measured in a maximal treadmill test with breath-by-breath gases analysis. Multiple regressions were used for data analysis. Results: Regardless of CRF, total sedentary time was positively associated with HbA1c (β = 0.25, p = 0.044). Adjusting for MVPA, total sedentary time was related to fasting glucose (β = 0.32, p = 0.037). No associations between total sedentary time and the remaining glycemic outcomes, after adjusting for MVPA. BST had favorable associations with HOMA-IR (β = −0.28, p = 0.047) and fasting glucose (β = −0.25, p = 0.046), when adjusted for MVPA, and with HOMA-IR (β = −0.25, p = 0.036), Matsuda index (β = 0.26, p = 0.036), and fasting glucose (β = −0.22, p = 0.038), following adjustment for CRF. When adjusting for total sedentary time, only CRF yielded favorable associations with HOMA-IR (β = −0.29, p = 0.039), fasting glucose (β = −0.32, p = 0.012), and glucose at 120-min (β = −0.26, p = 0.035), and no associations were found for MVPA with none of the metabolic outcomes. Conclusion: The results from this study suggest that sedentary time and patterns are relevant for the glycemic control in patients with T2D. Still, MVPA and CRF counteracted most of the associations for total sedentary time but not for the BST. MVPA was not associated with metabolic outcomes, and CRF lost some of the associations with glycemic indicators when adjusted for total sedentary time. Future interventions aiming to control/improve T2D must consider reducing and breaking up sedentary time as a viable strategy to improve glycemic control. PMID:28503154

Low Glycemic Index Treatment in pediatric refractory epilepsy: the first Middle East report.

PubMed

Karimzadeh, Parvaneh; Sedighi, Mostafa; Beheshti, Maryam; Azargashb, Enzollah; Ghofrani, Mohammad; Abdollahe-Gorgi, Fatemeh

2014-08-01

Intractable epilepsy is a challenging aspects of pediatric epilepsy. This study was conducted to determine the efficacy and tolerability of Low Glycemic Index Treatment (LGIT) in pediatric patients referred to a Children's Hospital in Iran with intractable epilepsy. We studied 42 children with refractory epilepsy aged between 1.5 and 17 years of age, from October 2009 to April 2011 in the pediatric neurology department of Mofid Children's Hospital. Patient information on clinical status, seizure type, and baseline frequency, blood and urine biochemistry, neuro-imaging and the EEG were collected. LGIT was initiated on an outpatient basis and the diet was composed of 65% fat, 25% protein and 10% carbohydrate (40-60 g), and the glycemic index of foods was limited to below 50. 84% of patients were categorized as having more than one seizure per day at study entry, with the remaining children as experiencing over one seizure per week. A greater than 50% seizure reduction was observed in 71.4% of the patients after the second week, in 73.8% at the end of the first month and in 77.8% at the end of the second month. In 30% of the patients a mild increase in blood urea nitrogen (BUN) was detected. The most important reasons for discontinuation of LGIT were restrictiveness, lack of satiation and excessive meat in this diet. No significant complications were observed during the administration of the diet. LGIT is a safe and effective adjuvant antiepileptic therapy and may be used as an alternative to the ketogenic diet in conditions when this diet cannot be used. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Gestational glucose intolerance modifies the association between magnesium and glycemic variables in mothers and daughters 15 years post-partum.

PubMed

Del Gobbo, Liana C; Song, Yiqing; Elin, Ronald J; Meltzer, Sara J; Egeland, Grace M

2012-07-01

Gestational diabetes mellitus (GDM) and low magnesium (Mg) intake and status are associated with an increased risk of type 2 diabetes. However, Mg homeostasis may be modified by GDM. We sought to determine if a history of GDM prospectively modifies associations between Mg and glycemic variables in mothers and their offspring. Plasma and dietary Mg, anthropometric, lifestyle and glycemic variables were assessed in mothers affected by GDM during 1989-1990, a comparative group of normoglycemic women, pregnant during the same time period, and the 15-year-old, nondiabetic daughters of affected and unaffected pregnancies (n = 332). Multivariate regression analyses evaluated the cross-sectional association between plasma and dietary Mg with glycemic variables in mothers and daughters. Plasma Mg was lower in mothers with a history of GDM in comparison to control mothers after adjustment for current type 2 diabetes, race and body mass index (0.90 ± 0.01 versus 0.96 ± 0.01 mmol/L; p = 0.002). Plasma Mg was significantly associated with insulin sensitivity and was inversely associated with fasting insulin in GDM mothers only (p<0.05). Plasma and dietary Mg were significantly inversely associated with glycated hemoglobin and fasting glucose, respectively, in nondiabetic teenage daughters. For fasting glucose, plasma Mg was inversely associated in GDM-born daughters only. Associations between plasma Mg and some glycemic variables may be stronger in mothers and offspring with a history of GDM.

In-home networks integrating high-capacity DMT data and DVB-T over large-core GI-POF.

PubMed

Beltrán, Marta; Shi, Yan; Okonkwo, Chigo; Llorente, Roberto; Tangdiongga, Eduward; Koonen, Ton

2012-12-31

The low-cost in-home distribution of full-standard digital TV jointly with high-bitrate data using 50 m long 1 mm core diameter graded-index plastic optical fiber (GI-POF) is proposed and experimentally demonstrated. Discrete multitone (DMT) modulation is demonstrated to provide an adaptive bitrate which can spectrally coexist with digital video broadcasting-terrestrial (DVB-T) signals in 470-862 MHz. A 3 Gb/s DMT signal and two DVB-T channels are generated, transmitted and received exhibiting excellent performance.

Neutrophil Response to Dental Plaque by Gender and Race

PubMed Central

Wahaidi, V.Y.; Dowsett, S.A.; Eckert, G.J.; Kowolik, M.J.

2009-01-01

The inflammatory response, which has both genetic and environmental components, is a central mechanism linking oral and systemic diseases. We hypothesized that dental plaque accumulation over 21 days in the experimental gingivitis model would elicit systemic inflammatory responses [change in white blood cell (WBC) count and neutrophil activity], and that these responses would differ by gender/race. We recruited 156 healthy young adults, including black and white males and females. Plaque Index (PI), Gingival Index (GI), systemic WBC counts, and peripheral neutrophil oxidative activity were recorded. Overall, 128 participants completed the study. During the experimental phase, the correlation between PI and GI was 0.79. Total WBC and neutrophil counts did not change. Neutrophil activity increased in blacks but not whites, suggesting that there may be racial differences in the inflammatory response to dental plaque accumulation. PMID:19734456

Evaluation of the antigingivitis effect of a chlorhexidine mouthwash with or without an antidiscoloration system compared to placebo during experimental gingivitis.

PubMed

Li, Wen; Wang, Ren E; Finger, Martin; Lang, Niklaus P

2014-02-01

The aim of the present study was to evaluate the effectiveness of chlorhexidine (CHX) with an antidiscoloration system (ADS) on stain, plaque accumulation, and gingivitis. A randomized, controlled clinical trial was conducted in 26 students. After a preparatory period, the students were randomly assigned to either group P (placebo), group T1 (0.12% CHX without an ADS), or group T2 (0.12% CHX with an ADS). During the 3-week experimental period, all mechanical oral hygiene was abolished. Rinsing with 10 mL mouthwash or placebo was performed twice daily under supervision. The parameters assessed on days 0, 7, 14, and 21 included the Discoloration Index (DI), Plaque Index (PII), and Gingival Index (GI). There were no significant mean differences in the DI, PII, or GI between groups T2 and P. Significant mean differences existed in the DI between groups T2 and T1 on days 14 and 21. Significant mean differences existed in the PI between groups T2 and T1 on days 7, 14, and 21. Likewise, significant mean differences existed in the GI between groups T2 and T1 on days 14 and 21. CHX with an ADS did not prevent plaque or gingivitis development. In fact, the CHX mouthwash with an ADS showed no superior effect over placebo on oral hygiene or the prevention of gingivitis. © 2013 Wiley Publishing Asia Pty Ltd.

Glycaemic index of selected foodstuffs in healthy persons.

PubMed

Fajkusova, Zuzana; Jadviscokova, Tereza; Pallayova, Maria; Matuskova, Veronika; Luza, Jiri; Kuzmina, Galina

2007-12-01

The aim of this study was to determine glycaemic index (GI) of 10 popular foodstuffs/mixed meals in healthy persons. Ten tested foodstuffs and glucose standard were consumed in three replicates in the course of a defined 9-day meal plan: puffed rice squares with chocolate, dark chocolate, white bread, honey and glucose for breakfast (at 7 a.m.) and dinner (at 8 p.m.); pasta with meat, fried fish with mashed potatoes, and buttered apricot dumplings for lunch (at 12 a.m.); wafers, puffed spelt squares with chocolate, and tomato soup for snack (at 4 p.m.). Each portion contained 50 g of carbohydrates and was consumed within 30 minutes. Glucose concentrations were measured by means of the Continous Glucose Monitoring System (CGMS, Medtronic Minimed, Northridge, CA, USA). The results were processed by Solutions Software (Medtronic Minimed, Northridge, CA, USA) and DegifXL4 software, Palacký University, Olomouc, CZ. Twenty healthy persons aged 21.9 +/- 1.39 y (mean +/- SE), BMI 23.6 +/- 0.63 kg/m(2) completed the study. GI of tested foodstuffs ranged from 34.7 % (chocolate) to 105.3 % (puffed rice squares with chocolate). There were more than tenfold differences between minimal and maximal values of the GI for some foodstuffs. Significant interindividual differences were found between GIs of foodstuffs. In twenty healthy persons the glycaemic indexes of ten popular foodstuffs were determined, to be added to the nutritional labels in order to facilitate the optimum meal planning.

Effects of human milk and formula on postprandial glycaemia and insulinaemia.

PubMed

Wright, C J; Atkinson, F S; Ramalingam, N; Buyken, A E; Brand-Miller, J C

2015-08-01

Consumption of formula in place of human milk may produce differences in postprandial glycaemia and insulinaemia that contribute to metabolic programming in the first year of life. The objective of the current study was to determine glycaemic and insulinaemic responses to human milk compared with a typical commercial formula, and then compare 11 other formulas. On separate mornings in random order, 10 healthy breastfeeding mothers consumed 25 g available carbohydrate portions of their own milk, a formula and reference food (25 g glucose on two occasions). In the second study, 10 different healthy subjects consumed 25 g available carbohydrate portions of 11 different commercial formulas and three reference foods (25 g glucose on three occasions). Fingerpick blood samples were taken at regular intervals over 2 h, and the glycaemic index (GI) and insulin index determined according to a standardised protocol. There were no significant differences in postprandial glycaemia or insulinaemia after human milk vs a typical formula (P = 0.3). Both produced a low GI (mean ± s.e.m.: 38 ± 7 vs 34 ± 7, respectively) and high insulin index (87 ± 14 vs 94 ± 16). The GI and insulin indices of the other formulas ranged from 18 ± 3 to 67 ± 6 and 53 ± 9 to 209 ± 33, respectively. Human milk and a typical formula elicit similar postprandial glycaemic and insulinaemic responses, but there is a wide range of responses to other formulas.

Efficacy of grape seed extract gel in the treatment of chronic periodontitis: A randomized clinical study.

PubMed

Rayyan, Mohammad; Terkawi, Tammam; Abdo, Hajer; Abdel Azim, Dalia; Khalaf, Aseel; AlKhouli, Zenab; Meziad, Maha; Alshamma'a, Marwa; Abu Naim, Horiyah

2018-05-01

The aim of the present study was to assess the effectiveness of applying grape seed extract (GSE) gel in periodontal pockets for the treatment of chronic periodontitis. Eighty-six sites with pocket depth (PD) >4 mm were selected from five systemically-healthy patients in whom scaling, and root planing were performed, and oral instructions were given, a week earlier. PD, gingival index (GI), plaque index (PI), and bleeding on probing (BOP) were measured, and sites were then divided into the control group (N = 38) and GSE group (N = 48). Four doses of formulated 2% mucoadhesive GSE gel were applied to GSE group sites at baseline visit (T0), and 3, 6, and 9 days after T0. Similarly, a control gel was applied to the control sites. PD, PI, GI and BOP were re-evaluated after 4 weeks and 6 months of first gel application. Paired t test for both the control and GSE groups showed a significant reduction for all variables after 6 months of gel application (P < .05). The independent t test showed a significant difference (P < .05) only in the reduction of gingival index (mean: 0.85 ± 0.77 for control and 1.3 ± 0.8 for GSE) and plaque index (mean: 0.75 ± 0.71 for control and 1.12 ± 0.7 for GSE). The subgingival application of the formulated 2% mucoadhesive GSE gel showed significant improvement in the PI and GI only. © 2018 John Wiley & Sons Australia, Ltd.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kuo, C

Purpose: To analyze and compare the characteristics of dose distributions between Gamma Knife (GK) and CyberKnife (CK), in treating arteriovenous malformations (AVMs), and evaluate the influences on their clinical applications. Methods: Twenty four patients with AVMs treated with CK of prescribed dose (PD) of 16–25 Gy in single fraction were selected. Each patient’s CT images used for CK treatment planning with contours of targets and critical organs were exported and then loaded into the GK planning system. GK treatment plan with the same PD used in CK was generated for each patient. The metrics for dose comparison between GK andmore » CK included conformity index (CI), gradient index (GI) of 75%, 50% and 25% of the PD, heterogeneity index (HI), volume of brain tissues covered by 10 Gy and 12 Gy, maximum dose to brainstem and beam-on time. Paired Samples t-test was used to analyze these metrics for significance (p value). Results: The CI were 0.744 ± 0.075 (GK) and 0.768 ± 0.086 (CK), p = 0.281. The GI75%, GI50%, and GI25% in GK and CK were 1.735 ± 0.100 and 2.439 ± 0.338 (p < 0.001), 3.169 ± 0.265 and 4.972 ± 0.852 (p < 0.001), and 8.650 ± 0.914 and 14.261 ± 2.476 (p < 0.001). The HI were 0.728 ± 0.072 (GK) and 0.313 ± 0.069 (CK), p < 0.001. There were significant differences both for volume of brain tissues covered by 10 Gy and 12 Gy in GK and CK (p < 0.001). GK had smaller maximum dose to brainstem. CK had shorter beam-on time. Conclusion: GK has similar dose conformity as CK, and has better normal tissue sparing but is less efficient than CK.« less

Long-term effects of guar gum in subjects with non-insulin-dependent diabetes mellitus.

PubMed

Groop, P H; Aro, A; Stenman, S; Groop, L

1993-10-01

The effects of 15 g guar gum/d on glycemic control, lipids, and insulin secretion were studied in 15 (8 male, 7 female) diet-treated subjects with non-insulin-dependent diabetes mellitus for 48 wk. Mean age (+/- SD) was 60 +/- 2 y (range 45-70 y), body mass index (in kg/m2) 28.6 +/- 0.9 (range 21.6 +/- 39.2), and duration of diabetes 6 +/- 1 y (range 2-14 y). Guar gum was preceded and followed by 8-wk placebo periods. Guar gum improved long-term glycemic control, postprandial glucose tolerance and lipid concentrations. The C-peptide response to a test meal increased by time during guar gum treatment, whereas the insulin response remained unchanged. This indicates that insulin secretion is enhanced by guar gum as reflected by increased C-peptide. A decreased molar ratio of insulin to C-peptide suggests that guar gum may increase hepatic insulin extraction. In conclusion, guar gum has favorable long-term effects on glycemic control and lipid concentrations.

Glycemic index of sweetpotato as affected by cooking methods

USDA-ARS?s Scientific Manuscript database

Understanding the effect of cooking on glucose availability will aid in the recommendation for including sweet potatoes as a regular component in American diets. Heating breaks down starch granules to allow amylopectin and amylose to be more readily digested by pancreatic amylase, which theoreticall...

[Effect of consumption of bread with amaranth (Amaranthus dubius Mart. ex Thell.) on glycemic response and biochemical parameters in Sprague dawley rats].

PubMed

Montero-Quintero, Keyla Carolina; Moreno-Rojas, Rafael; Molina, Edgar Alí; Colina-Barriga, Máximo Segundo; Sánchez-Urdaneta, Adriana Beatriz

2014-11-01

The incorporation of functional ingredients like amaranth (Amaranthus dubius Mart. ex Thell.) in bread making is a strategy to increase fiber intake, which is associated with beneficial health effects, improving glycemic response and lipid profile. Thirty male Sprague dawley rats were randomized into three groups: diet of bread with 0% amaranth (PA0, control), diet of bread with 10% amaranth (PA10) and bread diet with 20% amaranth (PA20) for determining the feed intake, weight gain, triglyceride, total cholesterol, VLDL-C, LDL-C, HDL-C, protein and postprandial glycemic response. Data were analyzed using a completely randomized with 10 replications analysis, using the comparison test of Tukey for biochemical parameters. Postprandial glycemic response was analyzed by the method of repeated measures over time. The daily intake and weight gain was not affected (P>0.05) in the groups with PA10 and PA20. The concentration of glucose, triglycerides and protein showed statistically significant differences (P>0.05) by the difference in content of amaranth diets. The values of total cholesterol, LDL-C, and atherogenic risk factor index were statistically significant (P. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

The effect of using mobile applications for improving oral hygiene in patients with orthodontic fixed appliances: a randomised controlled trial.

PubMed

Alkadhi, Omar H; Zahid, Mohammed N; Almanea, Read S; Althaqeb, Husam K; Alharbi, Turki H; Ajwa, Nancy M

2017-09-01

To investigate the effect of using mobile applications active reminders to improve oral hygiene in comparison to verbal oral hygiene instructions. Two-arm parallel randomised controlled trial. orthodontic clinics at two branches of a university hospitals of the college of dentistry of Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia. Forty-four 12-year-old and older subjects. Subjects undergoing orthodontic treatment with fixed appliances were randomly assigned to one of two groups using simple randomisation. Group I: subjects received a mobile application that sends active reminders of oral hygiene three times a day (n = 22). Group II: subjects received verbal oral hygiene instructions verbally during their routine orthodontic visits (n = 22). Two primary outcomes were assessed using plaque index (PI) and gingival index (GI) for Ramfjord teeth to evaluate the level of oral hygiene at baseline and after 4 weeks. Mean differences for PI and GI for group I were reduced from T1 to T2 (P < 0.05, P < 0.05) but did not significantly change for group II (P > 0.05, P > 0.05). Both PI and GI significantly reduced for group I compared to group II between T1 and T2 (P < 0.05, P < 0.05). PI and GI all significantly decreased after 4 weeks of using active reminders of oral hygiene instructions on mobile application compared to verbal oral hygiene instructions. The study was registered at clinicaltrials.gov with number: NCT03109769.

Postprandial glycaemic response: how is it influenced by characteristics of cereal products?

PubMed

Meynier, Alexandra; Goux, Aurélie; Atkinson, Fiona; Brack, Olivier; Vinoy, Sophie

2015-06-28

Cereal products exhibit a wide range of glycaemic indexes (GI), but the interaction of their different nutrients and starch digestibility on blood glucose response is not well known. The objective of this analysis was to evaluate how cereal product characteristics can contribute to GI and insulinaemic index and to the parameters describing glycaemic or insulinaemic responses (incremental AUC, maximum concentration and Δpeak). Moreover, interactions between the different cereal products characteristics and glycaemic response parameters were assessed for the first time. Relationships between the cereal products characteristics and the glycaemic response were analysed by partial least square regressions, followed by modelling. A database including 190 cereal products tested by the usual GI methodology was used. The model on glycaemic responses showed that slowly digestible starch (SDS), rapidly digestible starch (RDS) and fat and fibres, and several interactions involving them, significantly explain GI by 53 % and Δpeak of glycaemia by 60 %. Fat and fibres had important contributions to glycaemic response at low and medium SDS contents in cereal products, but this effect disappears at high SDS levels. We showed also for the first time that glycaemic response parameters are dependent on interactions between starch digestibility (interaction between SDS and RDS) and nutritional composition (interaction between fat and fibres) of the cereal products. We also demonstrated the non-linear effect of fat and fibres (significant effect of their quadratic terms). Hence, optimising both the formula and the manufacturing process of cereal products can improve glucose metabolism, which is recognised as strongly influential on human health.

Assessment of efficacy of two chlorhexidine mouthrinses on oral hygiene and gingival health in adolescents wearing two types of orthodontic brackets.

PubMed

Jurišić, S; Verzak, Ž; Jurišić, G; Jurić, H

2018-05-01

To investigate the efficacy of two formulations of chlorhexidine 0.2% (CHX) mouthrinses in terms of oral hygiene and gingival health status in adolescents with fixed orthodontic appliances wearing two different types of brackets during 18 weeks. Eighty subjects were randomly divided into two equal groups according to brackets type: (i) metal-stainless steel, (ii) ceramic. Four weeks after the placement of the fixed orthodontic appliances the subjects from each group were randomly allocated into two equal subgroups and were provided with two different mouthrinses for 14 days: (i) alcohol-free CHX, (ii) CHX with antidiscoloration system (CHX-ADS). Assessment was carried out according to gingival index (GI) and oral hygiene index-simplified (OHI-S) performed prior to the placement of the appliance (t 1 ), 6 weeks (t 2 ), and 18 weeks (t 3 ) after the placement. To analyse the data, two-way mixed model MANOVA. Pearson correlations, one-way ANOVA and Independent Samples t test were conducted. Statistically significant decrease in GI and OHI-S indices after 6 weeks and then increase after 18 weeks for all groups was found. Both GI and OHI-S values were lower in subjects wearing ceramic brackets, with statistically significant difference for GI after the usage of the mouthrinse for 14 days, at t 2 (P<.05). The results revealed that the ceramic brackets as well as usage of CHX-ADS resulted in improved gingival status. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Dietary carbohydrates and cardiovascular disease risk factors in the Framingham Offspring Cohort

USDA-ARS?s Scientific Manuscript database

Evidence from observational studies has suggested that carbohydrate quality rather than absolute intake is associated with greater risk of chronic diseases. The aim of this study was to examine the relationship between carbohydrate intake and dietary glycemic index and several cardiovascular disease...

Effect of Apolipoprotein E Genotype and Diet on Apolipoprotein E Lipidation and Amyloid Peptides

PubMed Central

Hanson, Angela J.; Bayer-Carter, Jennifer L.; Green, Pattie S.; Montine, Thomas J.; Wilkinson, Charles W.; Baker, Laura D.; Watson, G. Stennis; Bonner, Laura M.; Callaghan, Maureen; Leverenz, James B.; Tsai, Elaine; Postupna, Nadia; Zhang, Jing; Lampe, Johanna; Craft, Suzanne

2013-01-01

Importance Sporadic Alzheimer disease (AD) is caused in part by decreased clearance of the β-amyloid (Aβ) peptide breakdown products. Lipid-depleted (LD) apolipoproteins are less effective at binding and clearing Aβ, and LD Aβ peptides are more toxic to neurons. However, not much is known about the lipid states of these proteins in human cerebrospinal fluid. Objective To characterize the lipidation states of Aβ peptides and apolipoprotein E in the cerebrospinal fluid in adults with respect to cognitive diagnosis and APOE ε4 allele carrier status and after a dietary intervention. Design Randomized clinical trial. Setting Veterans Affairs Medical Center clinical research unit. Participants Twenty older adults with normal cognition (mean [SD] age, 69 [7] years) and 27 with amnestic mild cognitive impairment (67 [6] years). Interventions Randomization to a diet high in saturated fat content and with a high glycemic index (High diet;45% of energy from fat [>25% saturated fat], 35%-40%fromcarbohydrates with a mean glycemic index >70, and15%-20% from protein) or a diet low in saturated fat content and with a low glycemic index (Low diet; 25% of energy from fat [<7% saturated fat], 55%-60% from carbohydrates with a mean glycemic index <55, and 15%-20% from protein). Main Outcomes and Measures Lipid-depleted Aβ42 and Aβ40 and apolipoprotein E in cerebrospinal fluid. Results Baseline levels of LD Aβ were greater for adults with mild cognitive impairment compared with adults with normal cognition (LD Aβ42, P=.05; LD Aβ40, P=.01).These findings were magnified in adults with mild cognitive impairment and the ε4 allele, who had higher LD apolipoprotein E levels irrespective of cognitive diagnosis (P<.001). The Low diet tended to decrease LD Aβ levels, whereas the High diet increased these fractions (LD Aβ42, P=.01; LD Aβ40, P=.15). Changes in LD Aβ levels with the Low diet negatively correlated with changes in cerebrospinal fluid levels of insulin (LD Aβ42 and insulin, r= −0.68 [P=.01]; LD Aβ40 and insulin, r= −0.78 [P=.002]). Conclusions and Relevance The lipidation states of apolipoproteins and Aβ peptides in the brain differ depending on APOE genotype and cognitive diagnosis. Concentrations can be modulated by diet. These findings may provide insight into the mechanisms through which apolipoprotein E4 and unhealthy diets impart risk for developing AD. PMID:23779114

Quality of Life and Toxicity From Passively Scattered and Spot-Scanning Proton Beam Therapy for Localized Prostate Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pugh, Thomas J.; Munsell, Mark F.; Choi, Seungtaek

Purpose: To report quality of life (QOL)/toxicity in men treated with proton beam therapy for localized prostate cancer and to compare outcomes between passively scattered proton therapy (PSPT) and spot-scanning proton therapy (SSPT). Methods and Materials: Men with localized prostate cancer enrolled on a prospective QOL protocol with a minimum of 2 years' follow-up were reviewed. Comparative groups were defined by technique (PSPT vs SSPT). Patients completed Expanded Prostate Cancer Index Composite questionnaires at baseline and every 3-6 months after proton beam therapy. Clinically meaningful differences in QOL were defined as ≥0.5 × baseline standard deviation. The cumulative incidence ofmore » modified Radiation Therapy Oncology Group grade ≥2 gastrointestinal (GI) or genitourinary (GU) toxicity and argon plasma coagulation were determined by the Kaplan-Meier method. Results: A total of 226 men received PSPT, and 65 received SSPT. Both PSPT and SSPT resulted in statistically significant changes in sexual, urinary, and bowel Expanded Prostate Cancer Index Composite summary scores. Only bowel summary, function, and bother resulted in clinically meaningful decrements beyond treatment completion. The decrement in bowel QOL persisted through 24-month follow-up. Cumulative grade ≥2 GU and GI toxicity at 24 months were 13.4% and 9.6%, respectively. There was 1 grade 3 GI toxicity (PSPT group) and no other grade ≥3 GI or GU toxicity. Argon plasma coagulation application was infrequent (PSPT 4.4% vs SSPT 1.5%; P=.21). No statistically significant differences were appreciated between PSPT and SSPT regarding toxicity or QOL. Conclusion: Both PSPT and SSPT confer low rates of grade ≥2 GI or GU toxicity, with preservation of meaningful sexual and urinary QOL at 24 months. A modest, yet clinically meaningful, decrement in bowel QOL was seen throughout follow-up. No toxicity or QOL differences between PSPT and SSPT were identified. Long-term comparative results in a larger patient cohort are warranted.« less

Dose-Volume Histogram Predictors of Chronic Gastrointestinal Complications After Radical Hysterectomy and Postoperative Concurrent Nedaplatin-Based Chemoradiation Therapy for Early-Stage Cervical Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Isohashi, Fumiaki, E-mail: isohashi@radonc.med.osaka-u.ac.jp; Yoshioka, Yasuo; Mabuchi, Seiji

2013-03-01

Purpose: The purpose of this study was to evaluate dose-volume histogram (DVH) predictors for the development of chronic gastrointestinal (GI) complications in cervical cancer patients who underwent radical hysterectomy and postoperative concurrent nedaplatin-based chemoradiation therapy. Methods and Materials: This study analyzed 97 patients who underwent postoperative concurrent chemoradiation therapy. The organs at risk that were contoured were the small bowel loops, large bowel loop, and peritoneal cavity. DVH parameters subjected to analysis included the volumes of these organs receiving more than 15, 30, 40, and 45 Gy (V15-V45) and their mean dose. Associations between DVH parameters or clinical factors andmore » the incidence of grade 2 or higher chronic GI complications were evaluated. Results: Of the clinical factors, smoking and low body mass index (BMI) (<22) were significantly associated with grade 2 or higher chronic GI complications. Also, patients with chronic GI complications had significantly greater V15-V45 volumes and higher mean dose of the small bowel loops compared with those without GI complications. In contrast, no parameters for the large bowel loop or peritoneal cavity were significantly associated with GI complications. Results of the receiver operating characteristics (ROC) curve analysis led to the conclusion that V15-V45 of the small bowel loops has high accuracy for prediction of GI complications. Among these parameters, V40 gave the highest area under the ROC curve. Finally, multivariate analysis was performed with V40 of the small bowel loops and 2 other clinical parameters that were judged to be potential risk factors for chronic GI complications: BMI and smoking. Of these 3 parameters, V40 of the small bowel loops and smoking emerged as independent predictors of chronic GI complications. Conclusions: DVH parameters of the small bowel loops may serve as predictors of grade 2 or higher chronic GI complications after postoperative concurrent nedaplatin-based chemoradiation therapy for early-stage cervical cancer.« less

Incorporation of dietary fibre-rich oyster mushroom (Pleurotus sajor-caju) powder improves postprandial glycaemic response by interfering with starch granule structure and starch digestibility of biscuit.

PubMed

Ng, Sze Han; Robert, Sathyasurya Daniel; Wan Ahmad, Wan Amir Nizam; Wan Ishak, Wan Rosli

2017-07-15

The purpose of this study was to determine the effects of Pleurotus sajor-caju (PSC) powder addition at 0, 4, 8 and 12% levels on the nutritional values, pasting properties, thermal characteristics, microstructure, in vitro starch digestibility, in vivo glycaemic index (GI) and sensorial properties of biscuits. Elevated incorporation levels of PSC powder increased the dietary fibre (DF) content and reduced the pasting viscosities and starch gelatinisation enthalpy value of biscuits. The addition of DF-rich PSC powder also interfered with the integrity of the starch granules by reducing the sizes and inducing the uneven spherical shapes of the starch granules, which, in turn, resulted in reduced starch susceptibility to digestive enzymes. The restriction starch hydrolysis rate markedly reduced the GI of biscuits. The incorporation of 8% PSC powder in biscuits (GI=49) could be an effective way of developing a nutritious and low-GI biscuit without jeopardizing its desirable sensorial properties. Copyright © 2017 Elsevier Ltd. All rights reserved.

Glycaemic responses to liquid food supplements among three Asian ethnic groups.

PubMed

Tey, Siew Ling; Van Helvoort, Ardy; Henry, Christiani Jeyakumar

2016-12-01

A limited number of studies have compared the glycaemic index (GI) and glycaemic responses (GR) to solid foods between Caucasians and Asians. These studies have demonstrated that Asians have greater GI and GR values for solid foods than Caucasians. However, no study has compared the GI and GR to liquids among various Asian ethnic groups. A total of forty-eight males and females (16 Chinese, 16 Indians, and 16 Malay) took part in this randomised, crossover study. Glycaemic response to the reference food (glucose beverage) was measured on three occasions, and GR to three liquids were measured on one occasion each. Liquids with different macronutrient ratio's and carbohydrate types were chosen to be able to evaluate the response to products with different GIs. Blood glucose concentrations were measured in duplicate at baseline (-5 and 0 min) and once at 15, 30, 45, 60, 90, and 120 min after the commencement of beverage consumption. There were statistically significant differences in GI and GR between the three liquids (P < 0.01 in all cases). However, there were no statistically significant differences in GI and GR for the liquids between the ethnic groups (Chinese vs. Indian vs. Malay). The GR for three different types of liquid nutritional supplements did not differ between the three main ethnic groups in Asia. It appears that the GI of liquid food derived from one Asian ethnicity can be applicable to other Asian populations.

An Unusual Clinical Presentation of Gastrointestinal Metastasis From Invasive Lobular Carcinoma of Breast.

PubMed

Balakrishnan, Bathmapriya; Shaik, Sufiya; Burman-Solovyeva, Irina

2016-01-01

Introduction. We present an unusual case of metastatic lobular breast carcinoma. Typical areas of metastasis include bone, gynecological organs, peritoneum, retroperitoneum, and gastrointestinal (GI) tract, in order of frequency. With regard to GI metastasis, extrahepatic represents a rare site. Case. Two years after being diagnosed with invasive lobular breast carcinoma, a 61-year-old female complained of 3 months of nonspecific abdominal pain and diarrhea. A colonoscopy revealed 5 tubular adenomatous polyps in the ascending and transverse colon. Contrast computed tomography (CT) of the abdomen and pelvis was done 7 months after the colonoscopy to further evaluate persistent diarrhea. The CT results were consistent with infectious or inflammatory enterocolitis. Despite conservative management, symptoms failed to improve and a repeat diagnostic colonoscopy was obtained. Random colonic biopsies revealed metastatic high-grade adenocarcinoma of the colon. Discussion. Metastatic lobular breast carcinoma to the GI tract can distort initial interpretation of endoscopic evaluation with lesions mimicking inflammation. The interval between discovery of GI metastasis and diagnosis of lobular breast cancer can vary widely from synchronous to 30 years; however, progression is most often much sooner. Nonspecific symptoms and subtle appearance of metastatic lesions may confound the diagnosis. A high index of suspicion is needed for possible metastatic spread to the GI tract in patients with a history of invasive lobular breast carcinoma. Perhaps, patients with nonspecific GI symptoms should have an endoscopic examination with multiple random biopsies as invasive lobular carcinoma typically mimics macroscopic changes consistent with colitis.

Effects of Brazilian Propolis on Dental Plaque and Gingiva in Patients with Oral Cleft Malformation Treated with Multibracket and Removable Appliances: A Comparative Study.

PubMed

Machorowska-Pieniążek, Agnieszka; Skucha-Nowak, Małgorzata; Mertas, Anna; Tanasiewicz, Marta; Niedzielska, Iwona; Morawiec, Tadeusz; Baron, Stefan

2016-01-01

Orthodontic appliances modify the local environment of the oral cavity, increase the accumulation of dental plaque, and affect the condition of the gingiva. The aim of this study is assessment of Brazilian propolis toothpaste's effect on plaque index (PLI) and gingival index (GI) in patients with CL/CLP treated using orthodontic appliances in the 35-day study period. The study population included 96 patients of an Orthodontic Outpatient Clinic, ACSiMS in Bytom. All the patients participated in the active phase of orthodontic treatment using buccal multibracket appliances or removable appliances. During the first examination, each patient was randomly qualified to the propolis group or control group. A statistically significant decrease in GI and PLI in the entire propolis group (P < 0.01) was shown during repeated examination. Insignificant change in GI was in the entire control group during the repeated examination compared to the baseline. Similar result was obtained in patients treated with multibracket and removable appliances. The orthodontic appliance type did not affect the final dental plaque amount and gingival condition in patients using the propolis toothpaste. These results may be clinically useful to improve prevention and control oral infectious diseases during orthodontic treatment patients with oral cleft.

Effects of Brazilian Propolis on Dental Plaque and Gingiva in Patients with Oral Cleft Malformation Treated with Multibracket and Removable Appliances: A Comparative Study

PubMed Central

Tanasiewicz, Marta; Niedzielska, Iwona

2016-01-01

Orthodontic appliances modify the local environment of the oral cavity, increase the accumulation of dental plaque, and affect the condition of the gingiva. The aim of this study is assessment of Brazilian propolis toothpaste's effect on plaque index (PLI) and gingival index (GI) in patients with CL/CLP treated using orthodontic appliances in the 35-day study period. The study population included 96 patients of an Orthodontic Outpatient Clinic, ACSiMS in Bytom. All the patients participated in the active phase of orthodontic treatment using buccal multibracket appliances or removable appliances. During the first examination, each patient was randomly qualified to the propolis group or control group. A statistically significant decrease in GI and PLI in the entire propolis group (P < 0.01) was shown during repeated examination. Insignificant change in GI was in the entire control group during the repeated examination compared to the baseline. Similar result was obtained in patients treated with multibracket and removable appliances. The orthodontic appliance type did not affect the final dental plaque amount and gingival condition in patients using the propolis toothpaste. These results may be clinically useful to improve prevention and control oral infectious diseases during orthodontic treatment patients with oral cleft. PMID:27672397

RETRACTED: Acarbose on insulin resistance after an oral fat load: a double-blind, placebo controlled study.

PubMed

Derosa, Giuseppe; Maffioli, Pamela; D'Angelo, Angela; Fogari, Elena; Bianchi, Lucio; Cicero, Arrigo F G

2011-01-01

We evaluated the effects of acarbose on insulin resistance parameters in diabetic patients before and after a standardized oral fat load (OFL). Patients were assigned to take acarbose 50 mg three times a day or placebo; after the first month, acarbose was titrated to 100 mg three times a day. We evaluated body mass index, glycemic control, fasting plasma insulin (FPI), post-prandial plasma insulin (PPI), homeostasis model assessment insulin resistance index (HOMA-IR), blood pressure, lipid profile, retinol binding protein-4 (RBP-4), adiponectin (ADN), tumor necrosis factor-α and resistin (r). Furthermore, at the baseline and at the end of the study, all patients underwent an OFL and an euglycemic hyperinsulinemic clamp. We observed that acarbose was better than placebo in improving glycemic control and HOMA-IR and that it was also more effective in improving lipid profile, RBP-4 and ADN. Regarding FPI, PPI and r, we did not obtain any significant differences between the two groups. During the second OFL, performed after 7 months of therapy with acarbose, we observed a significant decrease of blood glucose, lipid profile and all insulin resistance parameters peaks compared with the OFL administered at baseline with acarbose, but not with placebo. Acarbose was more effective than placebo in improving glycemic and lipid profile and in reducing the post-OFL peaks of the various parameters including the insulin resistance biomarkers. Copyright © 2011 Elsevier Inc. All rights reserved.

Postprandial glucose response to Chinese foods in patients with type 2 diabetes.

PubMed

Chan, Eliza M Y; Cheng, Winnie M W; Tiu, Sau-Cheung; Wong, Lily L L

2004-12-01

The objective of this study is to examine the glycemic response to common Chinese foods in patients with type 2 diabetes. Twenty-four Chinese adults with type 2 diabetes participated. Subjects were allocated to eat a pair of test meals in random order. Test meals included plain porridge with lean pork (meal 1A), plain porridge and Shrimp Shao Mai (Doll Brand, Winner Food Products Limited, Hong Kong) (meal 1B), boiled rice with boiled egg white (meal 2A), fried rice with whole egg (meal 2B), plain noodles in clear soup (meal 3A), and Pickled Vegetable and Pork-flavored Instant Bowl Noodles (Doll Brand, Winner Food Products Limited) (meal 3B). Nutritional content of the meals was calculated from the nutritional label on the food package and the food composition table. Plasma glucose was checked before the meal and in 30-minute intervals for up to 4 hours after the meal. Significant differences in the area under the curve of glucose up to 2 hours after the meal were detected between meal 1A and 2A ( P =.044), 1A and 3A ( P =.001), and 3A and 3B ( P =.017). The results suggest that fat alone does not alter the glycemic response to rice or porridge. Porridge produces a higher glycemic response than rice and noodles despite similar carbohydrate contents, and different noodles lead to differences in glycemic excursion, suggesting that the glycemic index of common Chinese foods is affected by cooking methods and food processing.

A Double-Blind, Randomized Pilot Trial of Chromium Picolinate for Overweight Individuals with Binge-Eating Disorder: Effects on Glucose Regulation.

PubMed

Sala, Margarita; Breithaupt, Lauren; Bulik, Cynthia M; Hamer, Robert M; La Via, Maria C; Brownley, Kimberly A

2017-03-04

Chromium treatment has been shown to improve glucose regulation in some populations. The purpose of this study was to evaluate whether chromium picolinate (CrPic) supplementation improves glucose regulation in overweight individuals with binge-eating disorder (BED). In this double-blinded randomized pilot trial, participants (N = 24) were randomized to high (HIGH, 1000 mcg/day, n = 8) or moderate (MOD, 600 mcg/day, n = 9) dose of CrPic or placebo (PL, n = 7) for 6 months. Participants completed an oral glucose tolerance test (OGTT) at baseline, 3 months, and 6 months. Fixed effects models were used to estimate mean change in glucose area under the curve (AUC), insulin AUC , and insulin sensitivity index (ISI). Results revealed a significant group and time interaction (p < 0.04) for glucose AUC , with glucose AUC increasing significantly in the PL group (p < 0.02) but decreasing significantly in the MOD group (p < 0.03) at 6 months. Insulin AUC increased significantly over time (main effect, p < 0.02), whereas ISI decreased significantly over time (main effect, p < 0.03). As anticipated, a moderate dose of CrPic was associated with improved glycemic control, whereas PL was associated with decreased glycemic control. It was unexpected that the improved glycemic control seen in the MOD dose group was not seen in the HIGH dose group. However, although participants randomized to the HIGH dose group did not have improved glycemic control, they had better glycemic control than participants randomized to the PL group. These findings support the need for larger trials.

NEURAL TUBE DEFECTS IN OFFSPRING ASSOCIATED WITH MATERNAL PERICONCEPTIONAL DIETARY INTAKE OF SIMPLE SUGARS AND GLYCEMIC INDEX. (R828292)

EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

Adherence to the Gluten-free Diet and Health-related Quality of Life in an Ethnically Diverse Pediatric Population With Celiac Disease.

PubMed

Mager, Diana R; Marcon, Margaret; Brill, Herbert; Liu, Amanda; Radmanovich, Kristin; Mileski, Heather; Nasser, Roseann; Alzaben, Abeer; Carroll, Matthew W; Yap, Jason; Persad, Rabin; Turner, Justine M

2018-06-01

Celiac disease (CD) is an autoimmune disease that requires lifelong adherence to a gluten-free diet (GFD). Adherence to the GFD in childhood may be poor and adversely influence health-related quality of life (HRQOL). The study purpose was to determine sociodemographic and socioeconomic factors influencing adherence to the GFD and HRQOL in a multiethnic cohort of youth with CD. A multisite (Edmonton, Hamilton, Toronto) study examining child-parent HRQOL in youth with CD (n = 243) and/or mild gastrointestinal complaints (GI-CON; n = 148) was conducted. Sociodemographic (age, child-parental age/education/ethnicity/place of birth), anthropometric (weight, height, body mass index), disease (diagnosis, age at diagnosis, duration, Marsh score, serology), household characteristics (income, family size, region, number of children/total household size), HRQOL (Peds TM/KINDL and Celiac Disease DUX), GI Complaints (PedsQL: Gastrointestinal Symptom Scale) and gluten intake were measured. Younger age (<10 years), non-Caucasian ethnicity (parent/child), and presence of GI symptoms were associated with the highest rates of adherence to the GFD in CD children (P < 0.05). CD children (parent/child) had higher HRQOL (average, composite domains) than GI-CON (P < 0.05), but CD children were comparable to healthy children. Lack of GI symptoms, non-Caucasian ethnicity and age (<10 years) were associated with increased HRQOL in composite/average domains for CD (P < 0.05). Child-parent perceptions of HRQOL in a multiethnic population with CD are comparable to healthy reference populations, but significantly higher than in parent/child GI-CON. Adherence to the GFD in ethnically diverse youth with CD was related to GI symptoms, age of the child, and ethnicity of the parent-child.

Dietary milled flaxseed and flaxseed oil improve N-3 fatty acid status and do not affect glycemic control in individuals with well-controlled type 2 diabetes.

PubMed

Taylor, Carla G; Noto, Amy D; Stringer, Danielle M; Froese, Sylvia; Malcolmson, Linda

2010-02-01

To determine the effects of dietary consumption of milled flaxseed or flaxseed oil on glycemic control, n-3 fatty acid status, anthropometrics, and adipokines in individuals with type 2 diabetes. Thirty-four participants were randomized into a parallel, controlled trial. The participants were adults with type 2 diabetes (age 52.4 +/- 1.5 years, body mass index 32.4 +/- 1.0 kg/m(2), n = 17 men and 17 women). Participants consumed a selection of bakery products containing no flax (control group [CTL], n = 9), milled flaxseed (FXS, n = 13; 32 g/d), or flaxseed oil (FXO, n = 12; 13 g/d) daily for 12 weeks. The FXS and FXO groups received equivalent amounts of alpha-linolenic acid (ALA; 7.4 g/day). The primary outcome measures were fasting plasma hemoglobin A(1c), glucose, insulin, and phospholipid fatty acid composition. The secondary outcome measures were fasting circulating leptin and adiponectin, as well as body weight, body mass index, and waist circumference. Dietary intake assessment and calculations for homeostasis model assessment for insulin resistance and quantified insulin sensitivity check were also completed. The FXS and FXO groups had increases in plasma phospholipid n-3 fatty acids (ALA, eicosapentaenoic acid [EPA], or decosapentaenoic acid [DPA], but not docosahexaenoic acid), and the FXO group had more EPA and DPA in plasma phospholipids compared to the FXS group. All groups had similar caloric intakes; however, the CTL group experienced a 4% weight gain compared to baseline (p < 0.05), while both flax groups had constant body weights during the study period. All other parameters, including glycemic control, were unchanged by dietary treatment. Milled FXS and FXO intake does not affect glycemic control in adults with well-controlled type 2 diabetes. Possible prevention of weight gain by flax consumption warrants further investigation.

Body mass index and glycemic control influence lipoproteins in children with type 1 diabetes.

PubMed

Vaid, Shalini; Hanks, Lynae; Griffin, Russell; Ashraf, Ambika P

2016-01-01

Patients with type 1 diabetes mellitus (T1DM) have an extremely high risk of cardiovascular disease (CVD) morbidity and mortality. It is well known that dyslipidemia is a subclinical manifestation of atherosclerosis. To analyze presence and predicting factors of lipoprotein abnormalities prevalent in children with T1DM and whether race-specific differences exist between non-Hispanic white (NHW) and non-Hispanic black (NHB) in the lipoprotein characteristics. A retrospective electronic chart review including 600 (123 NHB and 477 NHW) T1DM patients aged 7.85 ± 3.75 years who underwent lipoprotein analysis. Relative to NHW counterparts, NHB T1DM subjects had a higher HbA1c, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), apoB 100, lipoprotein (a), and high-density lipoprotein cholesterol (HDL-c), HDL-2, and HDL-3. Body mass index (BMI) was positively associated with TC, LDL-c, apoB 100, and non-HDL-c and inversely associated with HDL, HDL-2, and HDL-3. HbA1c was positively associated with TC, LDL-c, apoB 100, non-HDL-c, and HDL-3. Multilinear regression analysis demonstrated that HbA1c was positively associated with apoB 100 in both NHB and NHW, and BMI was a positive determinant of apoB 100 in NHW only. Poor glycemic control and high BMI may contribute to abnormal lipoprotein profiles. Glycemic control (in NHB and NHW) and weight management (in NHW) may have significant implications in T1DM. ApoB 100 concentrations in subjects with T1DM were determined by modifiable risk factors, BMI, HbA1C, and blood pressure, indicating the importance of adequate weight, glycemic, and blood pressure control for better diabetes care and likely lower CVD risk. Copyright © 2016 National Lipid Association. Published by Elsevier Inc. All rights reserved.

The Association between Oral Hygiene and Gastric Pathology in Patients with Dyspepsia: a Cross-Sectional Study in Southeast Iran.

PubMed

Zahedi, Leili; Jafari, Elham; Torabi Parizi, Molook; Shafieipour, Sara; Hayat Bakhsh Abbasi, Mehdi; Darvish Moghadam, Sodaif; Zahedi, Mohammad Javad

2017-01-01

BACKGROUND Many studies have reported an association between periodontal infections and some systemic diseases such as respiratory and cardiovascular diseases. Some studies found a direct association between chronic gastritis caused by Helicobacter pylori (HP) infection and poor periodontal health. METHODS In a cross-sectional study from November 2014 to December 2015 in Kerman, the largest province in southeast Iran, patients with dyspepsia who were candidate for diagnostic upper gastrointestinal (GI) endoscopy were included in our study. Decayed, Missing, and Filled Teeth (DMFT) index and Loe plaque index that are two popular indexes in dental epidemiology were used to assess the oral health by a dentist before the upper GI endoscopy. According to the Loe plaque index, score: 0= no plaque, score: 1= a film of plaque attaching to the free gingival border and near area of the tooth, score: 2= moderate reposition of deposits within the gingival pocket, score :3= plenty of soft matter within the gingival pocket±on the tooth and gingival border. Scores ≤1, 2 and 3 equal to good, moderate, and poor oral hygiene, respectively. During upper GI endoscopy a total of six biopsy samples were taken from fundus, body, and antrum. A pathologist reported these samples according to Sidney's classification into superficial gastritis, atrophic gastritis, intestinal metaplasia, and dysplasia. RESULTS According to Sidney's classification 77 (89.5%) patients had superficial gastritis, 3 (3.5%) had atrophic gastritis, and 6 (7%) had intestinal metaplasia. HP was found in 80.2% of the gastric mucosal biopsy samples. There were not statistically significant relationship between Sidney's classification, presence of HP in gastric mucosal biopsies, and hygiene indicators ( p >0.05). No relation was found between the DMFT index and superficial gastritis, atrophic gastritis, and intestinal metaplasia ( p >0.05). Gastric infection with HP was found in 70%, 75%, and 100% of patients with mild, moderate, and sever DMFT index, respectively. CONCLUSION Our study showed that there might be a relation between poor oral hygiene and gastric precancerous lesions. In addition, HP infection in gastric histopathology might be associated with periodontal disease.

The Association between Oral Hygiene and Gastric Pathology in Patients with Dyspepsia: a Cross-Sectional Study in Southeast Iran

PubMed Central

Zahedi, Leili; Jafari, Elham; Torabi Parizi, Molook; Shafieipour, Sara; Hayat Bakhsh Abbasi, Mehdi; Darvish Moghadam, Sodaif; Zahedi, Mohammad Javad

2017-01-01

BACKGROUND Many studies have reported an association between periodontal infections and some systemic diseases such as respiratory and cardiovascular diseases. Some studies found a direct association between chronic gastritis caused by Helicobacter pylori (HP) infection and poor periodontal health. METHODS In a cross-sectional study from November 2014 to December 2015 in Kerman, the largest province in southeast Iran, patients with dyspepsia who were candidate for diagnostic upper gastrointestinal (GI) endoscopy were included in our study. Decayed, Missing, and Filled Teeth (DMFT) index and Loe plaque index that are two popular indexes in dental epidemiology were used to assess the oral health by a dentist before the upper GI endoscopy. According to the Loe plaque index, score: 0= no plaque, score: 1= a film of plaque attaching to the free gingival border and near area of the tooth, score: 2= moderate reposition of deposits within the gingival pocket, score :3= plenty of soft matter within the gingival pocket±on the tooth and gingival border. Scores ≤1, 2 and 3 equal to good, moderate, and poor oral hygiene, respectively. During upper GI endoscopy a total of six biopsy samples were taken from fundus, body, and antrum. A pathologist reported these samples according to Sidney’s classification into superficial gastritis, atrophic gastritis, intestinal metaplasia, and dysplasia. RESULTS According to Sidney’s classification 77 (89.5%) patients had superficial gastritis, 3 (3.5%) had atrophic gastritis, and 6 (7%) had intestinal metaplasia. HP was found in 80.2% of the gastric mucosal biopsy samples. There were not statistically significant relationship between Sidney’s classification, presence of HP in gastric mucosal biopsies, and hygiene indicators (p>0.05). No relation was found between the DMFT index and superficial gastritis, atrophic gastritis, and intestinal metaplasia (p>0.05). Gastric infection with HP was found in 70%, 75%, and 100% of patients with mild, moderate, and sever DMFT index, respectively. CONCLUSION Our study showed that there might be a relation between poor oral hygiene and gastric precancerous lesions. In addition, HP infection in gastric histopathology might be associated with periodontal disease. PMID:28316764

Setting ventilation parameters guided by electrical impedance tomography in an animal trial of acute respiratory distress syndrome

NASA Astrophysics Data System (ADS)

Czaplik, Michael; Biener, Ingeborg; Leonhardt, Steffen; Rossaint, Rolf

2014-03-01

Since mechanical ventilation can cause harm to lung tissue it should be as protective as possible. Whereas numerous options exist to set ventilator parameters, an adequate monitoring is lacking up to date. The Electrical Impedance Tomography (EIT) provides a non-invasive visualization of ventilation which is relatively easy to apply and commercially available. Although there are a number of published measures and parameters derived from EIT, it is not clear how to use EIT to improve clinical outcome of e.g. patients suffering from acute respiratory distress syndrome (ARDS), a severe disease with a high mortality rate. On the one hand, parameters should be easy to obtain, on the other hand clinical algorithms should consider them to optimize ventilator settings. The so called Global inhomogeneity (GI) index bases on the fact that ARDS is characterized by an inhomogeneous injury pattern. By applying positive endexpiratory pressures (PEEP), homogeneity should be attained. In this study, ARDS was induced by a double hit procedure in six pigs. They were randomly assigned to either the EIT or the control group. Whereas in the control group the ARDS network table was used to set the PEEP according to the current inspiratory oxygen fraction, in the EIT group the GI index was calculated during a decremental PEEP trial. PEEP was kept when GI index was lowest. Interestingly, PEEP was significantly higher in the EIT group. Additionally, two of these animals died ahead of the schedule. Obviously, not only homogeneity of ventilation distribution matters but also limitation of over-distension.

Investigation of body image as a mediator of the effects of bowel and GI symptoms on psychological distress in female survivors of rectal and anal cancer.

PubMed

Benedict, Catherine; Rodriguez, Vivian M; Carter, Jeanne; Temple, Larissa; Nelson, Christian; DuHamel, Katherine

2016-04-01

Treatment for rectal and anal cancer (RACa) can result in persistent bowel and gastrointestinal (GI) dysfunction. Body image problems may develop over time and exacerbate symptom-related distress. RACa survivors are an understudied group, however, and factors contributing to post-treatment well-being are not well understood. This study examined whether poorer body image explained the relation between symptom severity and psychological distress. Participants (N = 70) completed the baseline assessment of a sexual health intervention study. Bootstrap methods tested body image as a mediator between bowel and GI symptom severity and two indicators of psychological distress (depressive and anxiety symptoms), controlling for relevant covariates. Measures included the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC-QLQ-CR38) Diarrhea, GI Symptoms, and Body Image subscales and Brief Symptom Index Depression and Anxiety subscales. Women averaged 55 years old (SD = 11.6), White (79 %), and were 4 years post-treatment. Greater Depression was related to poorer Body Image (r = -.61) and worse Diarrhea (r = .35) and GI Symptoms (r = .48). Greater Anxiety was related to poorer Body Image (r = -.42) and worse GI Symptoms (r = .45), but not Diarrhea (r = .20). Body Image mediated the effects of bowel and GI symptoms on Depression, but not on Anxiety. Long-term bowel and GI dysfunction are distressing and affect how women perceive and relate to their bodies, exacerbating survivorship difficulties. Interventions to improve adjustment post-treatment should address treatment side effects, but also target body image problems to alleviate depressive symptoms. Reducing anxiety may require other strategies. Body image may be a key modifiable factor to improve well-being in this understudied population. Longitudinal research is needed to confirm findings.

Short-term effects of a hypocaloric diet with low glycemic index and low glycemic load on body adiposity, metabolic variables, ghrelin, leptin, and pregnancy rate in overweight and obese infertile women: a randomized controlled trial.

PubMed

Becker, Geórgia F; Passos, Eduardo P; Moulin, Cileide C

2015-12-01

Obesity is related to hormonal disorders that affect the reproductive system. Low-glycemic index (LGI) diets seem to exert a positive effect on weight loss and on metabolic changes that result from obesity. We investigated the effects of a hypocaloric diet with an LGI and low glycemic load on anthropometric and metabolic variables, ghrelin and leptin concentrations, and the pregnancy rate in overweight and obese infertile women who were undergoing in vitro fertilization (IVF). The study was a randomized block-design controlled trial in which we analyzed 26 overweight or obese infertile women. Patients were assigned to a hypocaloric LGI-diet group or a control group and followed the protocol for 12 wk. Body weight, body mass index (BMI), percentage of body fat, glucose, insulin, homeostasis model assessment of insulin resistance, serum lipids, reproductive hormones, leptin, acylated ghrelin, number of oocytes retrieved in the IVF cycle, and pregnancy rate were determined. There were greater reductions in body mass, BMI, percentage of body fat, waist:hip ratio, and leptin in the LGI-diet group than in the control group (P < 0.05). Despite a change of 18% in mean values, there was no significant increase in acylated ghrelin concentrations in the LGI group compared with the control group (P = 0.215). The LGI-diet group had 85.4% more oocytes retrieved than did the control group (7.75 ± 1.44 and 4.18 ± 0.87, respectively; P = 0.039) in the IVF cycle. Three patients (21.4%) in the LGI group experienced a spontaneous pregnancy during the follow-up, which generated 3 live births. The hypocaloric LGI diet promoted a decrease in BMI, percentage of body fat, and leptin concentrations, which improved oocyte development and pregnancy rate. These results support the clinical recommendation to advise overweight and obese women to lose weight through a balanced diet before being submitted for treatment with assisted reproduction technologies. A hypocaloric diet combined with LGI foods seems to be beneficial for these patients, but additional studies are required before this treatment is recommended. This trial was registered at clinicaltrials.gov as NCT02416960. © 2015 American Society for Nutrition.

Guide for Preparation of Waterways Experiment Station Technical Information Reports

DTIC Science & Technology

1993-01-01

Printing .......................... F1 Appendix G: Index .................................... GI SF 298 List of Figures Figure 1. Distribution statements...dimensional R rainwater riverside Ramm river wall Range 5 roadbed rattail rockbound (adj) real-time rockfall (n) reentrants rock-fill (adj

First-line systemic treatment adherence, healthcare resource utilization, and costs in patients with gastrointestinal neuroendocrine tumors (GI NETs) in the USA.

PubMed

Broder, Michael S; Cai, Beilei; Chang, Eunice; Yan, Tingjian; Benson, Al B

2018-05-25

To assess treatment adherence, healthcare resource utilization, and costs in gastrointestinal neuroendocrine tumor (GI NET) patients initiating pharmacologic treatments in the US. In two US commercial claims databases, patients ≥18 years with ≥1 inpatient or ≥2 outpatient GI NET claims within 12 months were identified. The first claim for pharmacologic treatments (e.g. somatostatin analogs [SSAs], cytotoxic chemotherapy [CC], targeted therapy [TT]) following diagnosis, between July 1, 2009 - December 31, 2014, was defined as the index date. A 6-month pre-index NET treatment-free period, and ≥1-year post-index enrollment were required. Proportion of days covered (PDC) was calculated during the follow-up period. Outcomes were reported separately for patients with 1- and 2-years post-index enrollment. Descriptive statistics, including means, standard deviations, and frequencies and percentages for continuous and categorical data, respectively, were reported. Of 1,322 patients with 1-year follow-up, 847 initiated SSA, 397 CC, 35 TT, two interferon, and 41 various combinations. Mean (SD) PDC was 0.669 (0.331) for SSA, 0.466 (0.236) for CC, and 0.505 (0.328) for TT. Mean (SD) office visits and hospitalizations, respectively, were 20.5 (13.5) and 0.59 (1.03) for SSA, 30.5 (19.8) and 0.89 (1.45) for CC, and 17.7 (12.5) and 1.23 (1.93) for TT. Total annual cost for patients during year 1 was $99,691 (82,423) for SSA, $134,912 (116,078) for CC, and $158,397 (82,878) for TT. Among 685 patients with 2-years follow-up, annual mean costs in year 2 were $8,071, $58,944, and $36,248 lower than year 1 for SSA, CC, and TT, respectively. Findings may not be generalizable to the US population. Claims are designed for reimbursement, not research. The study may under-estimate costs not covered by insurance. This study reports utilization and costs associated with different treatment therapies. Costs were higher in year 1 than year 2. This two-database study offers new information on the magnitude and trends in the cost of pharmacologically-treated GI NETs.

Effect of a viscous fiber bar on postprandial glycemia in subjects with type 2 diabetes.

PubMed

Flammang, Ann M; Kendall, David M; Baumgartner, C John; Slagle, Trish D; Choe, Yong S

2006-10-01

To compare the effect of an experimental viscous fiber (VF) crispy bar on the postprandial glucose, insulin, and C-peptide response in adult subjects with type 2 diabetes to two commercially available control crispy bars. The study was a randomized, double-blinded, three period, crossover study. The study was conducted at two sites: Park Nicollet Institute, International Diabetes Center, Minneapolis, MN, and Radiant Research, Inc., Minneapolis, MN. A total of 60 adults with type 2 diabetes taking oral antihyperglycemic medication participated in the study. After an overnight fast, subjects consumed a test meal containing an equicaloric amount (300 kcal) of an experimental VF crispy bar or one of two commercially available crispy bars at each of three test visits, followed by a four hour meal tolerance test. Subjects also completed gastrointestinal (GI) response records for the 24 hours following each test visit. The VF crispy bars produced significantly lower glucose (p < 0.0001), insulin (p < 0.0001), and C-peptide (p < 0.0001) responses (as measured by positive area under the curve) in subjects with type 2 diabetes, as compared with the two commercially available bars. Intensity (p < 0.05) and frequency (p < 0.05) of flatulence were significantly higher with the VF bar as compared with the 2 commercial bars. While the VF bar produced significant subjective GI tolerance scoring values, the mean value was below 3 on a scale of 0 (no effect) to 10 (most severe effect) for all tested materials. The incorporation of VF into a crispy bar provided a means to improve blood glucose levels by reducing postprandial glucose, insulin, and C-peptide responses in subjects with type 2 diabetes. Though associated with some GI symptoms, VF may have application in improving the postprandial glycemic response in people with diabetes attempting intensive glucose control.

Nutritional status, glycemic control and its associated risk factors among a sample of type 2 diabetic individuals, a pilot study.

PubMed

Firouzi, Somayyeh; Barakatun-Nisak, Mohd Yusof; Azmi, Kamaruddin Nor

2015-01-01

The prevalence of type 2 diabetes is increasing in Malaysia, with most patients poorly controlled. Hence, this study aimed to determine nutritional and metabolic status as well as blood pressure of Malaysian patients with type 2 diabetes mellitus and identify associated risk factors for poor glycemic control. A total of 104 type 2 diabetic patients were recruited and completed a questionnaire covering socio-demographic status, 3-day diet records, and physical activity. Anthropometry and glycemic control parameters, lipid profile and blood pressure were also measured. Subjects were on average 56.7±9.9 years old with a mean duration of diabetes of 6.5 ± 5.0 years. The mean hemoglobin A1c of the subjects was 7.6% ± 1.4%, with only 20.2% achieving the target goal of <6.5% with no significant differences between genders. The mean body mass index was 26.9 ± 4.7 kg/m(2), with 86.5% either were overweight or obese. Only 10.6% of the subjects exercised daily. The proportions of macronutrients relative to total energy intake were consistent with the recommendations of most diabetes associations. The adjusted odds of having poor glycemic control were 3.235 (1.043-10.397) (P < 0.05) higher among those who had high density lipoprotein cholesterol levels below the normal range. Those taking one or two types of oral anti-diabetic drugs had 19.9 (2.959-87.391) (P < 0.01) and 14.3 (2.647-77.500) (P < 0.01) higher odds of poor glycemic control respectively compared to those who were being treated by diet alone. Poor glycemic control was prevalent among Malaysian diabetic patients, and this could be associated with low levels of HDL and being treated with oral anti-diabetes agents.

Sleep Pattern, Duration and Quality in Relation with Glycemic Control in People with Type 2 Diabetes Mellitus.

PubMed

Gozashti, Mohammad Hossein; Eslami, Nazanin; Radfar, Mohammad Hadi; Pakmanesh, Hamid

2016-11-01

Sleep disturbances have been shown to be associated with diabetes control, but the relation between planned wakings or napping with glycemic indices has not been evaluated yet. This study evaluated the relation between sleep quality, duration, and pattern, including daytime napping of people with diabetes and their glycemic control. A cross-sectional correlation research design was used for this study. We enrolled 118 people with type 2 diabetes receiving oral agents without major complications at the Shahid Bahonar Center, Kerman. The age, weight, height, serum HbA1c, as well as other glycemic indices and lipid profile were measured. BMI was also calculated. All participants were requested to fill in the Pittsburgh Sleep Quality Index (PSQI) questionnaire to evaluate their sleep quality. In addition, they were inquired about their sleep schedule during day and night. Pearson correlation and multiple regression analyses were conducted to examine the correlation between HbA1c and sleep pattern variables. The variables were also compared between participants with or without napping using t-test. All analyses were performed with the SPSS version 19 (SPSS, Chicago, IL, USA). The mean age was 58±11 years and mean HbA1c (%) was 7.8±11 (62±13 mmol/mol). Sleep duration and the number of sleep segments significantly predicted HbA1c (F (2,114)=5.232, P=0.007, R2=0.084). A one-hour increment in sleep duration was associated with a 0.174% (1.4 mmol/mol) decrement in HbA1c. PSQI score did not contribute to the regression model. Moreover, participants who napped (66%) had a lower HbA1c (7.6±1) compared to others (8.1±1.3) (P=0.04). We concluded that napping and segmented sleep are associated with a better glycemic control in type 2 diabetes and there is a linear correlation between sleep duration and better glycemic control.

Enhanced fitness: a randomized controlled trial of the effects of home-based physical activity counseling on glycemic control in older adults with prediabetes mellitus.

PubMed

Morey, Miriam C; Pieper, Carl F; Edelman, David E; Yancy, William S; Green, Jennifer B; Lum, Helen; Peterson, Matthew J; Sloane, Richard; Cowper, Patricia A; Bosworth, Hayden B; Huffman, Kim M; Cavanaugh, James T; Hall, Katherine S; Pearson, Megan P; Taylor, Gregory A

2012-09-01

To determine whether a home-based multicomponent physical activity counseling (PAC) intervention is effective in reducing glycemic measures in older outpatients with prediabetes mellitus. Controlled clinical trial. Primary care clinics of the Durham Veterans Affairs (VA) Medical Center between September 29, 2008, and March 25, 2010. Three hundred two overweight (body mass index 25-45 kg/m(2) ), older (60-89) outpatients with impaired glucose tolerance (fasting blood glucose 100-125 mg/dL, glycosylated hemoglobin (HbA1c) <7%) randomly assigned to a PAC intervention group (n = 180) or a usual care control group (n = 122). A 12-month, home-based multicomponent PAC program including one in-person baseline counseling session, regular telephone counseling, physician endorsement in clinic with monthly automated encouragement, and customized mailed materials. All study participants, including controls, received a consultation in a VA weight management program. The primary outcome was a homeostasis model assessment of insulin resistance (HOMA-IR), calculated from fasting insulin and glucose levels at baseline and 3 and 12 months. HbA1c was the secondary indicator of glycemic control. Other secondary outcomes were anthropometric measures and self-reported physical activity, health-related quality of life, and physical function. There were no significant differences between the PAC and control groups over time for any of the glycemic indicators. Both groups had small declines over time of approximately 6% in fasting blood glucose (P < .001), and other glycemic indicators remained stable. The declines in glucose were not sufficient to affect the change in HOMA-IR scores due to fluctuations in insulin over time. Endurance physical activity increased significantly in the PAC group (P < .001) and not in the usual care group. Home-based telephone counseling increased physical activity levels but was insufficient to improve glycemic indicators in older outpatients with prediabetes mellitus. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Nutritional status, glycemic control and its associated risk factors among a sample of type 2 diabetic individuals, a pilot study

PubMed Central

Firouzi, Somayyeh; Barakatun-Nisak, Mohd Yusof; Azmi, Kamaruddin Nor

2015-01-01

Background: The prevalence of type 2 diabetes is increasing in Malaysia, with most patients poorly controlled. Hence, this study aimed to determine nutritional and metabolic status as well as blood pressure of Malaysian patients with type 2 diabetes mellitus and identify associated risk factors for poor glycemic control. Materials and Methods: A total of 104 type 2 diabetic patients were recruited and completed a questionnaire covering socio-demographic status, 3-day diet records, and physical activity. Anthropometry and glycemic control parameters, lipid profile and blood pressure were also measured. Results: Subjects were on average 56.7±9.9 years old with a mean duration of diabetes of 6.5 ± 5.0 years. The mean hemoglobin A1c of the subjects was 7.6% ± 1.4%, with only 20.2% achieving the target goal of <6.5% with no significant differences between genders. The mean body mass index was 26.9 ± 4.7 kg/m2, with 86.5% either were overweight or obese. Only 10.6% of the subjects exercised daily. The proportions of macronutrients relative to total energy intake were consistent with the recommendations of most diabetes associations. The adjusted odds of having poor glycemic control were 3.235 (1.043-10.397) (P < 0.05) higher among those who had high density lipoprotein cholesterol levels below the normal range. Those taking one or two types of oral anti-diabetic drugs had 19.9 (2.959-87.391) (P < 0.01) and 14.3 (2.647-77.500) (P < 0.01) higher odds of poor glycemic control respectively compared to those who were being treated by diet alone. Conclusion: Poor glycemic control was prevalent among Malaysian diabetic patients, and this could be associated with low levels of HDL and being treated with oral anti-diabetes agents. PMID:25767521

[Physical activity in outpatients with type 2 diabetes in a National Hospital of Peru].

PubMed

Manzaneda, Ana Josefina; Lazo-Porras, María; Málaga, Germán

2015-01-01

In order to determine the level of physical activity performed by outpatients with type 2 diabetes seen at a National Hospital in Lima, Peru, we surveyed 120 patients with the International Physical Activity Questionnaire (IPAQ). 66% were women, the mean age was 61.6 years, and 70% had poor glycemic control. 20% of the patients qualified as inactive, 68% as minimally active, and 12% had adequate physical activity. No relationship between physical activity, duration of disease, glycemic control, and body mass index was found. Age was negatively associated with physical activity. It is concluded that there are low levels of physical activity in patients with Type 2 diabetes and these are not focused on leisure activities that provide health benefits.

Implementing Low-Cost, Community-Based Exercise Programs for Middle-Aged and Older Patients with Type 2 Diabetes: What Are the Benefits for Glycemic Control and Cardiovascular Risk?

PubMed

Mendes, Romeu; Sousa, Nelson; Reis, Victor Machado; Themudo-Barata, Jose Luis

2017-09-13

The purpose of this study was to analyze the effects of a long-term, community-based, combined exercise program developed with low-cost exercise strategies on glycemic control and cardiovascular risk factors in middle-aged and older patients with type 2 diabetes. Participants ( n = 124; 63.25 ± 7.20 years old) engaged in either a 9-month supervised exercise program ( n = 39; consisting of combined aerobic, resistance, agility/balance, and flexibility exercise; three sessions per week; 70 min per session) or a control group ( n = 85) who maintained their usual care. Glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease were assessed before and after the 9-month intervention. A significant time * group interaction effect ( p < 0.001) was identified in the values of the glycated hemoglobin, fasting plasma glucose, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, systolic blood pressure, diastolic blood pressure, body mass index, waist circumference, and the 10-year risk of coronary artery disease. A long-term, community-based, combined exercise program developed with low-cost exercise strategies was effective in inducing significant benefits on glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease in middle-aged and older patients with type 2 diabetes. Clinical Trial Identification Number: ISRCTN09240628.

Sexual Sensation Seeking, Sexual Compulsivity, and Gender Identity and Its Relationship With Sexual Functioning in a Population Sample of Men and Women.

PubMed

Burri, Andrea

2017-01-01

Despite awareness of the importance of psycho-affective factors in the development of sexual problems, there is a lack of studies exploring the relation of sexual sensation seeking (SSS) and sexual compulsivity (SC) to sexual functioning. Because sex differences in SSS and SC have been reported, gender identity (GI; an individual's own experience of his or her gender that is unrelated to the actual biological sex) might act as a moderator in this relation. To understand the role of SSS and SC for men and women's sexual functioning and to explore whether these potential associations are moderated by GI. A population-based cross-sectional online survey targeted 279 individuals (69.2% women, 30.8% men; mean age = 32 years). Validated questionnaires, including the Sexual Sensation Seeking Scale, the Sexual Compulsivity Scale, the Female Sexual Function Index, the Premature Ejaculation Diagnostic Tool, and the International Index of Erectile Function, were applied. Variations in SSS and SC and their association with sexual functioning were investigated using Spearman rank correlation. Moderation analyses were conducted using regression models in which the interaction terms between SSS and GI and between SCS and GI as predictors of sexual functioning were included. A statistically significant correlation between SSS and SC could be detected in men and women (r = 0.41 and 0.33, respectively; P < .001 for the two comparisons). In women, higher levels of SSS were associated with higher levels of desire, arousal, lubrication, and orgasm and less sexual pain (P < .05 for all comparisons). No moderating effect of GI could be detected. In men, GI was a significant moderator in the relation between SC and erectile function (β = 0.47; P < .001) and between SSS and erectile and ejaculatory function (β = -0.41 and 0.30; P < .001 for the two comparisons). The present study is the first to show a link between SSS and SC and sexual functioning. The results might have important clinical implications and can provide useful information for programs aimed at sexual health enhancement. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Abnormal gastric myoelectrical activity in postural tachycardia syndrome.

PubMed

Seligman, William H; Low, David A; Asahina, Masato; Mathias, Christopher J

2013-04-01

Postural tachycardia syndrome (PoTS) is an important cause of orthostatic intolerance resulting from cardiovascular autonomic dysfunction. In addition to postural symptoms, PoTS patients may have allied features, including gastrointestinal (GI) symptoms, which have not yet been thoroughly investigated. We evaluated gastric myoelectrical activity in PoTS patients. Using cutaneous electrogastrography (EGG), we recorded gastric myoelectrical activity before and after standard liquid meal ingestion in 15 PoTS patients (age 27 ± 4 years); including 7 with and 8 without GI symptoms, and in 11 healthy individuals (age 23 ± 7 years). We performed spectral analysis of EGG recordings to obtain the dominant frequency of gastric pacemaker rhythm (DF), instability coefficient of DF (ICDF), and low (LFR%), normal (NFR%), and high (HFR%) range power percentages of the total power. Instability coefficient of DF, an index of variability of gastric pacemaker rhythm, was significantly elevated both pre- and post-prandially (30-45 min after the meal) in the PoTS group (8.8 ± 6, 10.0 ± 8 %) compared with controls (4.0 ± 3, 4.0 ± 3 %; both p < 0.05). Patients with GI symptoms had significantly higher post-prandial ICDF (15.0 ± 5 %) than those without GI symptoms (5.6 ± 4 %; p < 0.05). There were no significant differences in DF, LFR%, NFR% and HFR% before and after the meal between the PoTS and control groups, or between PoTS patients with and without GI symptoms. Our study revealed increased variability of gastric pacemaker rhythm in PoTS, and these findings might be related to pathophysiology of functional GI symptoms in PoTS.

The location of the Trait Emotional Intelligence in the Zuckerman's Personality Model space and the role of General Intelligence and social status.

PubMed

Blanco, Eduardo; García, Luis Francisco; Aluja, Anton

2016-10-01

The aim of this study was to investigate the relationships between Emotional Intelligence (EI) measured by the Trait Emotional Intelligence Questionnaire (TEIQue) and personality measured by the Zuckerman-Kuhlman-Aluja Personality Questionnaire (ZKA-PQ) with the purpose of analyzing similarities and differences of both psychological constructs. Additionally, we studied the relationship among EI, personality, General Intelligence (GI) and a social position index (SPI). Results showed that the ZKA-PQ predicts the 66% (facets) and the 64% (factors) of the TEIQue. High scores in EI correlated negatively with Neuroticism (r: -0.66) and Aggressiveness (r: -0.27); and positively with Extraversion (r: 0.62). Oblique factorial analyses demonstrated that TEIQue scales were located basically in the Neuroticism and Extraversion factors. The SPI and GI no loaded in any factor. These findings showed that EI is a not a distinct construct of personality and it cannot be isolated in the ZKA-PQ personality space. GI is related with the SPI (r: 0.26), and EI correlated with GI (r: 0.18) and SPI (r: 0.16). Nevertheless, we found differences between GI high groups and the TEIQue and ZKA-PQ factors when controlling age and sex. These findings are discussed in the individual differences context. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Effect of pregnancy on gingival inflammation in systemically healthy women: a systematic review.

PubMed

Figuero, Elena; Carrillo-de-Albornoz, Ana; Martín, Conchita; Tobías, Aurelio; Herrera, David

2013-05-01

To obtain an overall quantitative estimate of the association between pregnancy and gingival inflammation. Medline and EMBASE databases were searched through August 2011. Prospective cohort or cross-sectional studies assessing the effect of pregnancy on gingival inflammation evaluated by the gingival index (GI) and/or bleeding on probing were included. Meta-analyses were performed if possible. Forty-four articles representing 33 studies (14 cohort and 19 cross-sectional) were included. Meta-analyses, performed whenever possible, revealed (1) a significantly lower GI in pregnant women in the first term compared with those in their second or third term of pregnancy; (2) a lower mean GI score in post-partum women compared with women in their second [WMD = 0.143; 95% CI (0.031; 0.255); p = 0.012] or third term [WMD = 0.256; 95% CI (0.151; 0.360); p < 0.001] of pregnancy, when considering cohort studies; (3) Non-pregnant women had lower mean GI values than women in their second or third term of pregnancy. Small changes in plaque levels were reported. Despite the limited number of studies included in the meta-analyses, the present systematic review confirms the existence of a significant increase in GI throughout pregnancy and between pregnant versus post-partum or non-pregnant women, without a concomitant increase in plaque levels. © 2012 John Wiley & Sons A/S.

Interplay between heritability, genetic correlation and economic weighting in a selection index with and without genomic information.

PubMed

Haberland, A M; Pimentel, E C G; Ytournel, F; Erbe, M; Simianer, H

2013-12-01

The availability of genomic information demands proper evaluation on how the kind (phenotypic versus genomic) and the amount of information influences the interplay of heritability (h(2)), genetic correlation (r(GiGj)) and economic weighting of traits with regard to the standard deviation of the index (σI). As σI is directly proportional to response to selection, it was the chosen parameter for comparing the indices. Three selection indices incorporating conventional and genomic information for a two trait (i and j) breeding goal were compared. Information sources were chosen corresponding to pig breeding applications. Index I incorporating an own performance in trait j served as reference scenario. In index II, additional information in both traits was contributed by a varying number of full-sibs (2, 7, 50). In index III, the conventional own performance in trait j was combined with genomic information for both traits. The number of animals in the reference population (NP = 1000, 5000, 10,000) and thus the accuracy of GBVs were varied. With more information included in the index, σI became more independent of r(GiGj), h(j)(2) and relative economic weighting. This applied for index II (more full-sibs) and for index III (more accurate GBVs). Standard deviations of index II with seven full-sibs and index III with NP = 1000 were similar when both traits had the same heritability. If the heritability of trait j was reduced (h(j)(2) = 0.1), σI of index III with NP = 1000 was clearly higher than for index II with seven full-sibs. When enhancing the relative economic weight of trait j, the decrease in σI of the conventional full-sib index was much stronger than for index III. Our results imply that NP = 1000 can be considered a minimum size for a reference population in pig breeding. These conclusions also hold for comparing the accuracies of the indices. © 2013 Blackwell Verlag GmbH.

Comparison of glycemic control and β-cell function in new onset T2DM patients with PCOS of metformin and saxagliptin monotherapy or combination treatment.

PubMed

Tao, Tao; Wu, Peihong; Wang, Yuying; Liu, Wei

2018-02-27

Impaired insulin activity in women with polycystic ovary syndrome might differ from that seen in type 2 diabetes mellitus without polycystic ovary syndrome. This study was designed to compare the effects of treatment with metformin, saxagliptin, and their combination in newly diagnosed women with type 2 diabetes mellitus and polycystic ovary syndrome in China. A total of 75 newly diagnosed patients from Shanghai, China with type 2 diabetes mellitus and polycystic ovary syndrome were included in this randomized, parallel, open-label study. All patients received treatment for 24 weeks with metformin, saxagliptin, or their combination. Patients were allocated to one of three treatment groups by a computer-generated code that facilitated equal patient distribution of 25 patients per group. The primary outcome was a change in glycemic control and β-cell function. A total of 63 patients completed the study (n = 21, for each group). The reduction in hemoglobin A1c was significant in the combination group, compared to the monotherapy groups (saxagliptin vs. combination treatment vs. metformin: - 1.1 vs. -1.3 vs. -1.1%, P = 0.016), whereas it was comparable between the metformin and saxagliptin groups (P > 0.05). Saxagliptin, metformin, and the combination treatment significantly reduced the homeostasis model assessment- insulin resistance index and increased the deposition index (P < 0.01 for all). However, no significant change was observed in the homeostasis model assessment- β-cell function among the metformin and combination groups, and no significant changes were observed in the insulinogenic index among all three groups (P > 0.05 for all). In addition, saxagliptin and metformin treatments significantly reduced body mass index and high-sensitivity C-reactive protein levels (P < 0.01 for both). Saxagliptin and metformin were comparably effective in regulating weight loss, glycemic control, and β-cell function, improving lipid profiles, and reducing inflammation in newly diagnosed type 2 diabetes mellitus patients with polycystic ovary syndrome. ChiCTR-IPR-17011120 (retrospectively registered on 2017-04-12).

Obesity-Related Genomic Loci Are Associated with Type 2 Diabetes in a Han Chinese Population

PubMed Central

Zhao, Qi; He, Jiang; Chen, Li; Zhao, Zhigang; Li, Qiang; Ge, Jiapu; Chen, Gang; Guo, Xiaohui; Lu, Juming; Weng, Jianping; Jia, Weiping; Ji, Linong; Xiao, Jianzhong; Shan, Zhongyan; Liu, Jie; Tian, Haoming; Ji, Qiuhe; Zhu, Dalong; Zhou, Zhiguang; Shan, Guangliang; Yang, Wenying

2014-01-01

Background and Aims Obesity is a well-known risk factor for type 2 diabetes. Genome-wide association studies have identified a number of genetic loci associated with obesity. The aim of this study is to examine the contribution of obesity-related genomic loci to type 2 diabetes in a Chinese population. Methods We successfully genotyped 18 obesity-related single nucleotide polymorphisms among 5338 type 2 diabetic patients and 4663 controls. Both individual and joint effects of these single nucleotide polymorphisms on type 2 diabetes and quantitative glycemic traits (assessing β-cell function and insulin resistance) were analyzed using logistic and linear regression models, respectively. Results Two single nucleotide polymorphisms near MC4R and GNPDA2 genes were significantly associated with type 2 diabetes before adjusting for body mass index and waist circumference (OR (95% CI) = 1.14 (1.06, 1.22) for the A allele of rs12970134, P = 4.75×10−4; OR (95% CI) = 1.10 (1.03, 1.17) for the G allele of rs10938397, P = 4.54×10−3). When body mass index and waist circumference were further adjusted, the association of MC4R with type 2 diabetes remained significant (P = 1.81×10−2) and that of GNPDA2 was attenuated (P = 1.26×10−1), suggesting the effect of the locus including GNPDA2 on type 2 diabetes may be mediated through obesity. Single nucleotide polymorphism rs2260000 within BAT2 was significantly associated with type 2 diabetes after adjusting for body mass index and waist circumference (P = 1.04×10−2). In addition, four single nucleotide polymorphisms (near or within SEC16B, BDNF, MAF and PRL genes) showed significant associations with quantitative glycemic traits in controls even after adjusting for body mass index and waist circumference (all P values<0.05). Conclusions This study indicates that obesity-related genomic loci were associated with type 2 diabetes and glycemic traits in the Han Chinese population. PMID:25093408

Breeding for improved potato nutrition: High amylose starch potatoes show promise as fiber source

USDA-ARS?s Scientific Manuscript database

Potato starch is composed of approximately 75% amylopectin and 25% amylose. We are interested in breeding for higher amylose content, which would increase the fiber content of potato and decrease glycemic index. In order to make progress in a breeding program, we have developed a high throughput ass...

Regulatory role of mucosal maltase-glucoamylase in starch digestion and glucose homeostasis

USDA-ARS?s Scientific Manuscript database

Slower rates of starch digestion by sucrase-isomaltase (Si) in Mgam null mice may fail to regulate gluconeogenesis (GNG). Mgam nulls have 40% reduction of glucose production from starch. The aim of this study was to measure glycemic index and rate of gluconeogenesis (fGNG) as fraction of total gluc...