Lemon juice, but not tea, reduces the glycemic response to bread in healthy volunteers: a randomized crossover trial

An overview of the nutritional quality and health benefits linked to the world diversity of citrus fruits/juices

Citrus juices represent a nutrient-dense beverage due to the remarkable balance in their bioactive compounds (vitamins, minerals, dietary fibers, and phytochemicals such as flavonoids and carotenoids). This review aims to examine the nutritional quality and the health benefits of citrus juice consumption linked to the world diversity of citrus fruits. This work provides heterogenous data found on the main citrus bioactive compounds, especially carotenoids and flavonoids, which are difficult to correlate to particular geographic areas. Through an example of study, this work addresses the question of how and to what extent the content of citrus bioactive compounds is linked to the health benefits observed in humans. We explore through the more recent human clinical trials, the health effects of consuming citrus fruit or taking dietary supplements of bioactive compounds to prevent the exponential increase of world chronic diseases (type 2 diabetes, cardiovascular diseases, and obesity) and discuss the effects of dose. Finally, even if the data highlight the importance of geographical origin in accumulation of carotenoids or flavonoids from different Citrus species, the difference of content in front of the complex human metabolism of their absorption has lesser consequences for health than the fact of consuming citrus or not. The citrus health effect results in a synergistic action of numerous phytochemicals whose targeted health benefits vary depending more on the diversity of Citrus species than their geographic origin. Therefore, the use of the diversity of Citrus species could be an interesting approach to providing functional food.

Health effects of 100% fruit and vegetable juices: evidence from human subject intervention studies

The health effects of 100% fruit and vegetable juices (FVJ) represent a controversial topic. FVJ contain notable amounts of free sugars, but also vitamins, minerals, and secondary compounds with proven biological activities like (poly)phenols and carotenoids. The review aimed to shed light on the potential impact of 100% FVJ on human subject health, comprehensively assessing the role each type of juice may have in specific health outcomes for a particular target population, as reported in dietary interventions. The effects of a wide range of FVJ (orange, grapefruit, mandarin, lemon, apple, white, red, and Concord grapes, pomegranate, cranberry, chokeberry, blueberry, other minor berries, sweet and tart cherry, plum, tomato, carrot, beetroot, and watermelon, among others) were evaluated on a series of outcomes (anthropometric parameters, body composition, blood pressure and vascular function, lipid profile, glucose homeostasis, biomarkers of inflammation and oxidative stress, cognitive function, exercise performance, gut microbiota composition and bacterial infections), providing a thorough picture of the contribution of each FVJ to a health outcome. Some juices demonstrated their ability to exert potential preventive effects on some outcomes while others on other health outcomes, emphasising how the differential composition in bioactive compounds defines juice effects. Research gaps and future prospects were discussed. Although 100% FVJ appear to have beneficial effects on some cardiometabolic health outcomes, cognition and exercise performance, or neutral effects on anthropometric parameters and body composition, further efforts are needed to better understand the impact of 100% FVJ on human subject health.

Olive Leaf Tea Impact on Postprandial Glycemia: A Randomized Cross-Over Trial

This study investigates the effect of olive leaf tea (OLT) on postprandial glycemia in healthy volunteers when ingested with a high-carbohydrate meal, compared with a placebo tea (CON). Healthy adults participated in a double-blind, randomized, placebo-controlled, and cross-over design trial receiving a high-rich carbohydrate meal with either 250 mL of OLT or CON at two different times after a washout period. The sequence order was randomized at a ratio of 1:1. Capillary blood glucose was measured in a 2 h period after ingestion. Eighteen participants were initially randomized. Of these, thirteen completed the trial and were analyzed. The consumption of OLT resulted in a delay in peak time (48.5 ± 4.2 min vs. 35.7 ± 4.0 min, p = 0.03) and a significant increase in glucose area under the curve compared to placebo (14,502.7 ± 640.8 vs. 13,633.3 ± 869.4 mg/dL·min, p = 0.03). Results are depicted as mean ± SEM. The OLT and CON palatability were generally well accepted. No adverse effects were reported. OLT did not ameliorate a glycemic curve induced by carbohydrate-rich meal ingestion, suggesting that at least when ingested acutely in a single meal, OLT does not have antihyperglycemic effects. Future studies should account for chronic consumption providing a better understanding of glycemic regulation over time.

Actinidin diversity: discovery of common and selective substrates for actinidin isoforms and Actinidia cultivars

The actinidin proteinase family has a striking sequence diversity; isoelectric points range from 3.9 to 9.3. The biological drive for this variation is thought to be actinidin's role as a defense-related protein. In this study we map mutations in the primary sequence onto the 3D structure of the protein and show that the region with the highest diversity is close to the substrate binding groove. Non-conservative substitutions in the active site determine substrate preference and therefore create problems for quantification of actinidin activity. Here we use a peptide substrate library to compare two actinidin isoforms, one from the kiwiberry cultivar 'Hortgem Tahi' (Actinidia arguta), and the other from the familiar kiwifruit cultivar 'Hayward' (Actinidia chinensis var. deliciosa). Among 360 octamer substrates we find one substrate (RVAAGSPI) with the useful property of being readily cleaved by all the functionally active actinidins in a set of A. arguta and A. chinensis var. deliciosa isoforms. In addition, we find that two substrates (LPPKSQPP & ILRDKDNT) have the ability to differentiate different isoforms from a single fruit. We compare actinidins from 'Hayward' and A. arguta for their ability to digest the allergenic gluten peptide (PFPQPQLPY) but find the peptide to be indigestible by all sources of actinidin. The ability to inactivate salivary amylase is shown to be a common trait in Actinidia cultivars due to proteolysis by actinidin and is particularly strong in 'Hortgem Tahi'. A mixture of 10% 'Hortgem Tahi' extract with 90% saliva inactivates 100% of amylase activity within 5 minutes. Conceivably, 'Hortgem Tahi' might lower the glycaemic response in a meal rich in cooked starch.

Dietary Fibre and Organic Acids in Kiwifruit Suppress Glycaemic Response Equally by Delaying Absorption-A Randomised Crossover Human Trial with Parallel Analysis of 13C-Acetate Uptake

Non-sugar components of kiwifruit reduce the amplitude of the glycaemic response to co-consumed cereal starch. We determined the relative contribution of different non-sugar kiwifruit components to this anti-glycaemic effect. Healthy participants (n = 9) ingested equal carbohydrate meals containing 20 g starch as wheat biscuit (WB, 30 g), and the sugar equivalent of two kiwifruit (KFsug, 20.4 g), either intrinsic or added as glucose, fructose and sucrose (2:2:1). The meals were WB+KFsug (control, no non-sugar kiwifruit components), WB + whole kiwifruit pulp (WB+KF), WB + neutralised kiwifruit pulp (WB+KFneut), WB + low-fibre kiwifruit juice (WB+KFjuice) and WB+KFsug + kiwifruit organic acids (WB+KFsug+OA). All meals were spiked with 100 mg sodium [1-13C] acetate to measure intestinal absorption. Each participant ingested all meals in random order. Blood glucose and breath 13CO2 were measured at ingestion and at 15 min intervals up to 180 min. Compared with WB+KFsug, whole kiwifruit pulp (WB+KF) almost halved glycaemic response amplitude (p < 0.001), reduced incremental area under the blood glucose response curve (iAUC) at 30 min (peak) by 50% (p < 0.001), and averted late postprandial hypoglycaemia. All other treatments suppressed response amplitude half as much as whole kiwifruit and averted acute hypoglycaemia, with little effect on iAUC. Effects on 13CO2 exhalation paralleled effects on blood glucose (R2 = 0.97). Dietary fibre and organic acids contributed equally to the anti-glycaemic effect of kiwifruit by reducing intestinal absorption rate. Kiwifruit flesh effectively attenuates glycaemic response in carbohydrate exchange, as it contains fructose, dietary fibre and organic acids.

The contribution of gastric digestion of starch to the glycaemic index of breads with different composition or structure

Breads of higher density exhibit lower glycaemic index (GI) both in vivo and in vitro, a phenomenon generally attributed to a slower intestinal starch digestion. The aim of this work was to gain a better understanding of the relationship between bread density, oral and gastric digestion, and GI. Three breads were studied: industrial-style and traditional-style French baguettes (similar composition, different densities), and whole-wheat baguette. In vitro GI predictions confirmed that, for an identical composition, higher bread density was associated with a lower GI. Subsequent oro-gastric digestions, using the dynamic system DIDGI®, showed extensive starch digestion at the gastric stage by salivary α-amylase, in line with recently published data. They further showed that higher bread density led to a lower hydrolysis rate. The concurrence of these results with those of in vivo studies, suggests a mediating role for gastric digestion in the relationship between bread density and GI, possibly via the repercussions on the starch proportion that remains to be hydrolysed in the small intestine. This study therefore adds to the scientific knowledge of the importance of salivary α-amylase to starch digestion, and draws special attention to the possible role of the gastric phase in determining the GI.

Glycemic response, satiety, gastric secretions and emptying after bread consumption with water, tea or lemon juice: a randomized crossover intervention using MRI

PURPOSE

Numerous studies, including our previous work with lemon juice, have reported that low-pH meals reduce the glycemic response to starchy foods. However, the underlying mechanism is not yet understood. Tea, for its polyphenol content, has also been investigated. The main objective of this research was to concurrently study gastric emptying, appetite perceptions and glycemic responses to bread consumed with water, tea, or lemon juice.

METHODS

In this randomized, crossover intervention, ten participants consumed equal portions of bread (100 g) with 250 mL of water, water-diluted lemon juice, or black tea at breakfast. Gastric volumes, blood glucose concentrations and appetite perceptions were alternately assessed over 180 min using magnetic resonance imaging, the finger-prick method and visual analogue scales, respectively.

RESULTS

Compared to water, lemon juice led to a 1.5 fold increase of the volume of gastric contents, 30 min after the meal (454.0 ± 18.6 vs. 298.4 ± 19.5 mL, [Formula: see text]  ± SEM P < 0.00001). Gastric emptying was also 1.5 times faster (P < 0.01). Conversely, lemon juice elicited a lower glycemic response than water (blood glucose concentrations at t = 55 min were 35% lower, P = 0.039). Tea had no effect. Changes in appetite perceptions and gastric volumes correlated well, but with no significant differences between the meals.

CONCLUSIONS

Lemon juice lowered the glycemic response and increased both gastric secretions and emptying rate. The results are compatible with the hypothesis that the reduction of the glycemic response is mainly due to the interruption of starch hydrolysis via the acid-inhibition of salivary α-amylase.

TRIAL REGISTRATION NUMBER

NCT03265392, August 29, 2017.

Translating the advanced glycation end products (AGEs) knowledge into real-world nutrition strategies

Advanced glycation end products (AGEs) are glycated proteins or lipids derived from complex metabolic pathways involved in the pathophysiology of various diseases, especially diabetes and diabetes-related complications. These compounds are omnipresent in human life, with both endogenous and exogenous sources. Despite the well-elucidated disease mechanisms, little is known about the AGEs/nutrition nexus in the circles of clinical practice recommendations. This review seeks to translate the accumulated knowledge about the biochemistry and pathophysiology of AGEs into a nutritional intervention based on real-world prescriptions.