Attenuation of glycaemic and insulin responses following tapioca resistant maltodextrin consumption in healthy subjects: a randomised cross-over controlled trial

Oligomalt, a New Slowly Digestible Carbohydrate, Reduces Post-Prandial Glucose and Insulin Trajectories Compared to Maltodextrin across Different Population Characteristics: Double-Blind Randomized Controlled Trials in Healthy Individuals, People with Obesity, and People with Type 2 Diabetes

We assessed the glucometabolic effects of oligomalt, a novel fully slowly digestible carbohydrate, compared with maltodextrin, in cross-over randomized controlled trials (NCT05058144; NCT05963594) involving healthy volunteers (HV), people with overweight or obesity (PwO), and people with type 2 diabetes (T2D). We tested 33 g and/or 50 g of oligomalt/maltodextrin, which were dissolved in 300 mL of water and consumed after fasting in the morning. The primary exploratory endpoint was the incremental area under the curve (iAUC) for postprandial glucose, assessed by frequent blood sampling over 3 h. Insulin levels were also assessed. In the HV cohort, a 4 h hydrogen breath test was performed with 15 g of inulin as a positive control. Analysis was performed by a mixed model. Oligomalt elicited a lower post-prandial glucose response compared to maltodextrin in HV (50 g, n = 15 [7 women], mean age/BMI 31 years/22.6 kg/m2), in PwO (33 g and 50 g, n = 26 [10 women], age/BMI 44 years/29.9 kg/m2, mean HbA1c 5.3%), and in people with T2D (50 g, n = 22 [13 women], age/BMI 61 years/31.8 kg/m2, HbA1c 7.4%), with significant reductions observed in PwO and T2D for the 0-1 h window (HV: -19% [p = 0.149]/PwO33g-38% [p = 0.0002]/PwO50g-28% [p = 0.0027]/T2D-38% [p < 0.0001]; the 0-2 h window (HV: -17% [p = 0.311]/PwO33g-34% [p = 0.0057]/PwO50g-21% [p = 0.0415]/T2D-37% [p < 0.0001]), and the 0-3 h window (HV: -15% [p = 0.386]/PwO33g-30% [p = 0.0213]/PwO50g0-19% [p = 0.0686]/T2D-37% [p = 0.0001]). The post-prandial insulin response was significantly lower, by 38-60%, across all populations, dose, and time points, with oligomalt. In HV, the breath-hydrogen pattern was comparable between oligomalt and maltodextrin, but increased significantly with inulin. These data support the glucometabolic advantages of oligomalt over maltodextrin, hence confirming it as a healthier carbohydrate, and underscoring its full digestibility. This therefore opens up the possibility for the incorporation of oligomalt in relevant food products/matrices.

Determination of glycaemic response to the consumption of two specialised formulas for glycaemic control

To assess the glycaemic response after ingestion of two specialised oral and enteral nutrition formulas for glycaemic control. The participants were sixteen healthy volunteers, aged 21-49 years, with normal glucose tolerance. The volunteers attended the tests fasting for 10 h, for 5 weeks, and consumed the reference food - glucose solution - for 3 weeks, and the two formulas DiamaxO and DiamaxIG in the following weeks, in amounts equivalent to 25 g of available carbohydrates. During the period of 120 min, seven blood samples were taken through capillary blood sampling to determine the glycaemic response. The glycaemic index (GI) was calculated according to the trapezoidal rule, ignoring areas below the fasting line. The glycaemic load (GL) was determined by the formula GL = ((GI(glucose = reference) × 'g' of available carbohydrate per serving]/100. The formulas showed low GI and GL. GI = 37·8 and GL = 6·6 for DiamaxO and GI = 21·5 and GL = 3·5 for DiamaxIG. The peak of the glycaemic response occurred 30 min after ingestion, with a marked difference in blood glucose between the Diamax products in relation to glucose. Differences were also significant at times 15, 45, 60 and 90 min in relation to glucose (ANOVA with post hoc Bonferroni, P < 0·005), but not between the two products. However, the AUC and the GI of DiamaxIG are significantly smaller than that of the DiamaxO second t test (P = 0·0059). The glycaemic response to the products is quite reduced, presenting a curve with a little accentuated shape, without high peak, especially in the modified product.

Acute postprandial gut hormone, leptin, glucose and insulin responses to resistant starch in obese children: a single blind crossover study

INTRODUCTION

Resistant starch (RS) has beneficial effects on postprandial glucose metabolism in both animals and adults. Hitherto, there have been no studies in children of the acute metabolic and hormonal effects of RS-containing meals.

OBJECTIVES

We aimed to compare serial plasma glucose, insulin, gut hormone, leptin profiles and satiety scores in obese children after meals containing variable amounts of RS.

METHODS

This was a single blind, non-randomised, crossover study of 20 obese children aged 10-14 years old without comorbidities. Three test meals containing rice (M1), rice cooked with coconut oil (M2), rice cooked in coconut oil with lentils (M3) were given in sequence after a 12-hour fast . Blood samples were analysed for glucose (PG), insulin, leptin, glucagon-like polypeptide (GLP) 1, ghrelin and peptide YY (PYY) at appropriate times between 0 and 180 min.

RESULTS

Meal M2 resulted in significantly lower postprandial glucose values compared with meal M1 (maximal incremental glucose, ∆C_max, p<0.05; area under the curve, ∆AUC_0-3, p<0.01) and meal M3 (maximal concentration, C_max, p<0.01; ∆C_max, p<0.001, and ∆AUC_0-3p<0.01). M2 also produced lower insulin values compared with M1 (p<0.05). Postprandial ghrelin was significantly higher after M1 compared with M3 (p<0.05). PYY, GLP1 and median satiety scores were not significantly different between the three meals.

CONCLUSION

This study shows that M2, the meal containing RS alone, induced beneficial effects on acute postprandial glucose, insulin and ghrelin concentrations in obese children without diabetes. Acute postprandial satiety scores were not significantly affected by the three meals.

TRIAL REGISTRATION NUMBER

SLCTR/2020/007.

The Effects of Soluble Dietary Fibers on Glycemic Response: An Overview and Futures Perspectives

The properties of each food, composition, and structure affect the digestion and absorption of nutrients. Dietary fiber (DF), especially viscous DF, can contribute to a reduction in the glycemic response resulting from the consumption of carbohydrate-rich foods. Target and control of postprandial glycemic values are critical for diabetes prevention and management. Some mechanisms have been described for soluble DF action, from the increase in chyme viscosity to the production of short-chain fatty acids resulting from fermentation, which stimulates gastrointestinal motility and the release of GLP-1 and PYY hormones. The postprandial glycemic response due to inulin and resistant starch ingestion is well established. However, other soluble dietary fibers (SDF) can also contribute to glycemic control, such as gums, β-glucan, psyllium, arabinoxylan, soluble corn fiber, resistant maltodextrin, glucomannan, and edible fungi, which can be added alone or together in different products, such as bread, beverages, soups, biscuits, and others. However, there are technological challenges to be overcome, despite the benefits provided by the SDF, as it is necessary to consider the palatability and maintenance of their proprieties during production processes. Studies that evaluate the effect of full meals with enriched SDF on postprandial glycemic responses should be encouraged, as this would contribute to the recommendation of viable dietary options and sustainable health goals.

Improvement of Glycemic Control by a Functional Food Mixture Containing Maltodextrin, White Kidney Bean Extract, Mulberry Leaf Extract, and Niacin-Bound Chromium Complex in Obese Diabetic db/db Mice

Steady-fiber granule (SFG) is a mixture containing maltodextrin, white kidney bean extract, mulberry leaf extract, and niacin-bound chromium complex. These active ingredients have been shown to be associated with improving either hyperglycemia or hyperlipidemia. This study was undertaken to evaluate the potential of SFG in the regulation of blood glucose homeostasis under obese diabetic conditions. Accordingly, db/db mice (8 weeks old) were administered with SFG at doses of 1.025, 2.05, or 5.125 g/kg BW daily via oral gavage for 4 weeks. No body weight loss was observed after SFG supplementation at all three doses during the experimental period. Supplementation of SFG at 2.05 g/kg BW decreased fasting blood glucose, blood fructosamine, and HbA1c levels in db/db mice. Insulin sensitivity was also improved, as indicated by HOMA-IR assessment and oral glucose tolerance test, although the fasting insulin levels were no different in db/db mice with or without SFG supplementation. Meanwhile, the plasma levels of triglyceride were reduced by SFG at all three doses. These findings suggest that SFG improves glycemic control and insulin sensitivity in db/db mice and can be available as an option for functional foods to aid in management of type 2 diabetes mellitus in daily life.

Tapioca Resistant Maltodextrin as a Carbohydrate Source of Oral Nutrition Supplement (ONS) on Metabolic Indicators: A Clinical Trial

Tapioca resistant maltodextrin (TRM) is a novel non-viscous soluble resistant starch that can be utilized in oral nutrition supplements (ONS). This study aims to evaluate acute and long-term metabolic responses and the safe use of ONS containing TRM. This study comprised of two phases: In Phase I, a randomized-cross over control study involving 17 healthy adults was conducted to evaluate three ONS formulations: original (tapioca maltodextrin), TRM15 (15% TRM replacement), and TRM30 (30% TRM replacement). Plasma glucose, serum insulin, and subjective appetite were evaluated postprandially over 180 min. In Phase II, 22 participants consumed one serving/day of ONS for 12 weeks. Blood glucose, insulin, lipid profile, and body composition were evaluated. Gastrointestinal tolerability was evaluated in both the acute and long-term period. During phase I, TRM30 decreased in area under the curve of serum insulin by 33.12%, compared to the original formula (2320.71 ± 570.76 uIU × min/mL vs. 3470.12 ± 531.87 uIU × min/mL, p = 0.043). In Phase II, 12-week TRM30 supplementation decreased HbA1C in participants (from 5.5 ± 0.07% to 5.2 ± 0.07%, p < 0.001), without any significant effect on fasting glucose, insulin, lipid profile, and body composition. The ONS was well-tolerated in both studies. TRM is therefore, a beneficial functional fiber for various food industries.