Glycemic impact and health: new horizons in white bread formulations

The Construction of Sodium Alginate/Carboxymethyl Chitosan Microcapsules as the Physical Barrier to Reduce Corn Starch Digestion

To enhance the resistant starch (RS) content of corn starch, in this work, carboxymethyl chitosan/corn starch/sodium alginate microcapsules (CMCS/CS/SA) with varying concentrations of SA in a citric acid (CA) solution were designed. As the SA concentration increased from 0.5% to 2%, the swelling of the CMCS/CS/SA microcapsule decreased from 15.28 ± 0.21 g/g to 3.76 ± 0.66 g/g at 95 °C. Comparatively, the onset, peak, and conclusion temperatures (To, Tp, and Tc) of CMCS/CS/SA microcapsules were higher than those of unencapsulated CS, indicating that the dense network structure of microcapsules reduced the contact area between starch granules and water, thereby improving thermal stability. With increasing SA concentration, the intact and dense network of CMCS/CS/SA microcapsules remained less damaged after 120 min of digestion, suggesting that the microcapsules with a high SA concentration provided better protection to starch, thereby reducing amylase digestibility. Moreover, as the SA concentration increased from 0.5% to 2%, the RS content of the microcapsules during in vitro digestion rose from 42.37 ± 0.07% to 57.65 ± 0.45%, attributed to the blocking effect of the microcapsule shell on amylase activity. This study offers innovative insights and strategies to develop functional starch with glycemic control properties, holding significant scientific and practical value in preventing diseases associated with abnormal glucose metabolism.

Development, Analysis, and Sensory Evaluation of Improved Bread Fortified with a Plant-Based Fermented Food Product

In response to the demand for healthier foods in the current market, this study aimed to develop a new bread product using a fermented food product (FFP), a plant-based product composed of soya flour, alfalfa meal, barley sprouts, and viable microorganisms that showed beneficial effects in previous studies. White bread products prepared with three different substitution levels (5, 10, and 15%) of FFP were evaluated for physical characteristics (loaf peak height, length, width), color indices (lightness, redness/greenness, yellowness/blueness), quality properties (loaf mass, volume, specific volume), protein content, crumb digital image analysis, and sensory characteristics. The results revealed that FFP significantly affected all studied parameters, and in most cases, there was a dose-response effect. FFP supplementation affected the nutritional profile and increased the protein content (p < 0.001). The sensory test indicated that consumer acceptance of the studied sensory attributes differed significantly between groups, and bread with high levels of FFP (10 and 15% FFP) was generally more poorly rated than the control (0%) and 5% FFP for most of the variables studied. Despite this, all groups received acceptable scores (overall liking score ≥ 5) from consumers. The sensory analysis concluded that there is a possible niche in the market for these improved versions of bread products.

Short-term effects of sugar-free apricot jam, cocoa powder and dried cranberry cereal bar on glycaemic responses in healthy adults: a randomised clinical trial

High sugar intake has been associated with adverse effects on health, with some types of breakfast being highly linked to overweight and obesity. The aim was to compare the effects of four sugar-free breakfast items, apricot jam with white bread (JWB), white bread (WB), cocoa with fat-free milk (CM), and dried cranberry cereal bar (CB), compared to d-glucose on the glycaemic responses. Using a cross-over design, twelve healthy individuals (25 ± 4 years; BMI 22 ± 2 kg/m²) received isoglucidic test meals (25 g of available carbohydrate) and 25 g glucose reference, in random order. Glycaemic index/load (GI/GL) were calculated, and capillary blood glucose samples were collected at 0–120 min after meal consumption. Subjective appetite was assessed with visual analogue scales. Sugar-free apricot jam and cocoa powder contained traces of available carbohydrates and were consumed along with bread and fat-free milk, respectively. JWB and WB were classified as medium GI, low-to-medium GL; CM as medium GI, low GL; and CB as high GI, low-to-medium GL. Subjective hunger was lower after JWB, fullness was higher after CM and pleasure was higher after CB (P for all < 0⋅05). In conclusion, sugar-free apricot jam with and without WB and cocoa powder with fat-free milk are suitable healthy breakfast options leading to improved glycaemic and subjective appetite responses.

Effects of Xanthan Gum, Lambda-Carrageenan and Psyllium Husk on the Physical Characteristics and Glycaemic Potency of White Bread

White bread contains a high proportion of easily digestible starch, which contributes to an undesirable rapid increase in blood glucose concentration. This study investigated the effects of nonstarch polysaccharides (NSP) -xanthan gum, lambda-carrageenan and psyllium husk on the physical functionality and glycaemic potency of white bread. The amount of water for each formulation was adjusted based on DoughLab set at a target torque value of ~500 FU for sufficient dough development. Adding NSP generally resulted in significantly increased loaf volumes and decreased hardness. The glycaemic potency (glycaemic glucose equivalents (GGE) g) of bread was found to be reduced with the addition of NSP at all levels (1, 3 and 5% w/w based on flour weight). Increasing the concentration of xanthan gum and lambda-carrageenan did not show any further decrease in the glycaemic potency. Notably, adding 5% w/w psyllium husk significantly reduced the glycaemic potency from ~49 GGE/100 g in the reference bread to 32 GGE/100 g. The reduction in the glycaemic potency was attributed to viscosity effects (for xanthan) and starch–NSP interactions (for psyllium husk). Overall, the 5% w/w psyllium husk bread sample was most promising in terms of both physical characteristics and its effect on in vitro glucose release.

Functional, Nutritional, and Sensory Quality of Mixed Flours-Based Breads as Compared to Durum Wheat Semolina-Based Breads

Increasing preference of consumers and bakers towards bread manufactured with mixed flours and/or sourdough drove us to investigate about influence of flours and sourdough on crumb grain, chemical, sensory, and in vitro glycaemic index (GI) and antioxidant activity of bread. To this aim, we produced and compared six experimental breads: three were based on a mixture of flours (soft wheat, durum wheat semolina, barley, oat, rye, and buckwheat); three were semolina-based breads. Two different sourdoughs (wheat or mixed flours) were assessed. Compared to semolina breads, those containing a mixture of flours showed higher specific volume. The use of sourdough led to increased concentrations of total free amino acids (FAA). Mixed flours bread with addition of mixed flours sourdough was rich in some essential FAA and amino acid derivative bioactive gamma-aminobutyric acid. Type of flours had higher influence than sourdough addition on volatile organic compounds. All the mixed flours breads, although showing profiles of volatile organic compounds differing from those of semolina breads, resulted acceptable. In addition, they had lower GI and higher antioxidant activity than semolina breads. Type of flours had much higher impact on GI and antioxidant activity than sourdough.

Glycaemic potency reduction by coarse grain structure in breads is largely eliminated during normal ingestion

The hypothesis that coarse grain particles in breads reduce glycaemic response only if the particles remain intact during ingestion was tested. Three breads were formulated: (1) White bread (WB – reference), (2) 75 % of kibbled purple wheat in 25 % white bread matrix (PB) and (3) a 1:1 mixture of 37·5 % kibbled soya beans and 37·5 % of kibble purple wheat in 25 % white bread matrix (SPB). Each bread was ingested in three forms: unchewed (U), as customarily consumed (C) and homogenised (H). Twelve participants ingested 40 g available carbohydrate portions of each bread in each form, with post-prandial blood glucose measured over 120 min. Glycaemic responses to WB were the same regardless of its form when ingested. Unchewed PB had significantly less glycaemic effect than WB, whereas the C and H forms were similar to WB. Based on a glycaemic index (GI) of 70 for WB, the GI values for the C, U and H breads, respectively, were WB: 70·0, 70 and 70, PB: 75, 42 and 61, SPB: 57, 48 and 55 (%) (Least significant difference = 17·43, P < 0·05, bold numbers significantly different from WB). The similar glycaemic response to the H and C forms of the breads, and their difference from the U form, showed that the glycaemia-moderating effect of grain structure on starch digestion was lost during customary ingestion of bread. We conclude that the kibbled-grain structure may not effectively retard starch digestion in breads as normally consumed because it is largely eliminated by ingestive processes including chewing.

Influencing Factors and Social Media Reflections of Bakery Products Consumption in Romania

Bakery products, and bread specifically, represent an important part of the Romanian diet. Whether this situation is motivated by quality factors or by quantitative factors is an important aspect that needs to be investigated. In addition, the relation between peoples’ interest in a particular product such as bread during a crisis period should point out important characteristics of that population. Aiming at determining both the influencing factors of bakery product consumption and the importance given to this type of product in the media during a crisis, this empirical study highlights the profound connections between income level and the fear of not having food security for the people of a less developed country such as Romania. The study considers the use of both qualitative and quantitative methods to reach its objectives. The results point to a strong reliance of the respondents on cheap white-flour bakery products in their regular diet, and a significant increase in interest in bakery products during the COVID-19 pandemic.

Impact of Grape Pomace Powder on the Phenolic Bioaccessibility and on In Vitro Starch Digestibility of Wheat Based Bread

Breads were prepared by substituting common wheat flour with 0 (GP0), 5 (GP5) and 10 (GP10) g/100 g (w/w) of grape pomace powder (GPP) and were analyzed for the phenolic profile bioaccessibility as well as the in vitro starch digestion during simulated digestion. The free and bound phenolic composition of native GPP and resulting breads were profiled using ultra-high-performance chromatography-quadrupole-time-of-flight (UHPLC-QTOF). The raw GPP was characterized by 190 polyphenols with the anthocyanins representing the most abundant class, accounting for 11.60 mg/g of cyanidin equivalents. Regarding the fortified bread, the greatest (p < 0.05) content in phenolic compounds was recorded for the GP10 sample (considering both bound and free fractions) being 127.76 mg/100 g dry matter (DM), followed by the GP5 (106.96 mg/100 g DM), and GP0 (63.76 mg/100 g DM). The use of GPP determined an increase of anthocyanins (considered the markers of the GPP inclusion), recording 20.98 mg/100 g DM in GP5 and 35.82 mg/100 g DM in GP10. The bioaccessibility of anthocyanins increased in both GP5 and GP10 breads when moving from the gastric to the small intestine in vitro digestion phase with an average value of 24%. Both the starch hydrolysis and the predicted glycemic index decreased with the progressive inclusion of GPP in bread. Present findings showed that GPP in bread could promote an antioxidant environment in the digestive tract and influence the in vitro starch digestion.

Daily intake of wheat germ-enriched bread may promote a healthy gut bacterial microbiota: a randomised controlled trial

PURPOSE

Wheat bran fibre has a beneficial effect on gastrointestinal function, but evidence for wheat germ is scarce. Accordingly, we evaluated the effects of daily intake of wheat germ on gastrointestinal discomfort and gut microbiota by adding wheat germ to refined (white) wheat bread, the most consumed bread type. We hypothesised that an improvement in the composition of refined bread could beneficially affect intestinal health without compromising consumers' acceptance.

METHODS

Fifty-five healthy adults were recruited for a randomised, double-blind, crossover, controlled trial comprising two 4-week intervention periods separated by a 5-week washout stage. During the first 4-week period, one group consumed wheat bread enriched with 6 g of wheat germ and the control group consumed non-enriched wheat bread.

RESULTS

Wheat germ-enriched bread was well-appreciated and the number of participants that demonstrated minimal gastrointestinal improvements after wheat-germ intake was higher than in the control arm. Importantly, intake of wheat germ-enriched bread decreased the perceived gastrointestinal discomfort-related quality of life (subscale worries and concerns) over refined white bread. The improvements in the gastrointestinal function were accompanied by favourable changes in gut microbiota, increasing the number of Bacteroides spp. and Bifidobacterium spp.

CONCLUSIONS

Adding wheat germ to industrially made white bread without altering sensory properties may promote a healthy gut bacterial microbiota and the gastrointestinal health.

Does intake of bread supplemented with wheat germ have a preventive role on cardiovascular disease risk markers in healthy volunteers? A randomised, controlled, crossover trial

OBJECTIVE

Intake of whole grains is associated with a reduced risk of cardiovascular disease (CVD). This evidence is also strong for bran alone, but findings about germ are conflicting. Our aim was to elucidate the role of germ in primary prevention of cardiovascular events, and therefore, a staple food was selected for 6 g of germ supplementation. This corresponds to sixfold increase in the global mean consumption of germ, while preserving the sensory proprieties of refined bread which is crucial for consumer's acceptance.

DESIGN

Randomised, double-blinded, crossover, controlled clinical trial with 15-week follow-up comprising a 2-week run-in, two intervention periods of 4 weeks each and a 5-week washout period.

SETTING

A single centre in the north of Portugal.

PARTICIPANTS

55 eligible healthy adults (mean age of 34 years and body mass index between 19 and 38 kg/m²) were randomly assigned.

INTERVENTIONS

The study consisted of two intervention periods including daily intake of refined wheat bread enriched with 6 g of wheat germ and control (non-enriched bread).

OUTCOMES

Changes in fasting cholesterol and triglycerides, fasting and postprandial glucose, insulin sensitivity and C reactive protein.

RESULTS

We observed no significant effect of daily intake of wheat germ on cholesterol and triglycerides levels, on postprandial glucose response and on insulin sensitivity. Incremental area under curve glucose and homeostasis model assessment for insulin resistance did not change, suggesting that 6 g of wheat germ have no effect on glucose metabolism. No effect was also observed in the subgroup of participants who complied with the protocol (n=47).

CONCLUSIONS

The absence of alterations on lipid and glucose profiles suggests that germ up to 6 g/day may have no preventive effect on CVD risk. However, it is important to investigate other food vehicles that can accommodate higher doses of wheat germ in future studies.

TRIAL REGISTRATION NUMBER

NCT02405507.

Modification of appetite by bread consumption: A systematic review of randomized controlled trials

The inclusion of different ingredients or the use of different baking technologies may modify the satiety response to bread, and aid in the control of food intake. The aim of this study was to perform a systematic search of randomized clinical trials on the effect of bread consumption on appetite ratings in humans. The search equation was ("Bread"[MeSH]) AND ("Satiation"[MeSH] OR "Satiety response"[MeSH]), and the filter "clinical trials." As a result of this procedure, 37 publications were selected. The satiety response was considered as the primary outcome. The studies were classified as follows: breads differing in their flour composition, breads differing in ingredients other than flours, breads with added organic acids, or breads made using different baking technologies. In addition, we have revised the data related to the influence of bread on glycemic index, insulinemic index and postprandial gastrointestinal hormones responses. The inclusion of appropriate ingredients such as fiber, proteins, legumes, seaweeds and acids into breads and the use of specific technologies may result in the development of healthier breads that increase satiety and satiation, which may aid in the control of weight gain and benefit postprandial glycemia. However, more well-designed randomized control trials are required to reach final conclusions.

Effect of Cold Storage and Reheating of Parboiled Rice on Postprandial Glycaemic Response, Satiety, Palatability and Chewed Particle Size Distribution

Background: Globally, hot cooked refined rice is consumed in large quantities and is a major contributor to dietary glycaemic load. This study aimed to compare the glycaemic potency of hot- and cold-stored parboiled rice to widely available medium-grain white rice. Method: Twenty-eight healthy volunteers participated in a three-treatment experiment where postprandial blood glucose was measured over 120 min after consumption of 140 g of rice. The three rice samples were freshly cooked medium-grain white rice, freshly cooked parboiled rice, and parboiled rice stored overnight at 4 °C. All rice was served warm at 65 °C. Chewing time was recorded. Results: incremental area under the curve (iAUC) of the control rice, freshly cooked medium-grain white rice, was the highest: 1.7-fold higher (1.2, 2.6) than reheated parboiled rice (p < 0.001) and 1.5-fold higher (1.0, 2.2) than freshly cooked parboiled rice (p = 0.001). No significant difference in postprandial glycaemic response was observed between freshly cooked and reheated parboiled rice samples (p = 0.445). Chewing time for 10 g cold-stored parboiled rice was 6 s (25%) longer and was considered more palatable, visually appealing and better tasting than freshly cooked medium-grain (all p < 0.05). Conclusions: For regular consumers of rice, reheating cooked rice after cold storage would lower the dietary glycaemic load and, in the long term, may reduce the risk for type 2 and gestational diabetes. More trials are needed to identify the significance.

Effects of a healthier snack on snacking habits and glycated Hb (HbA1c): a 6-week intervention study

Dietary behaviour modification may change eating habits and reduce the impact of poor nutrition. This study aimed to evaluate the effects of daily consumption of a healthier snack bar on snacking habits and glycated Hb (HbA1c) within a 6-week intervention. In all, twenty-eight participants were randomly allocated to two groups to either consume the bars as the main snack for 6 weeks (n 14) or receipt of the bars was delayed for 6 weeks (n 14) following a stepped-wedge design. All participants had HbA1c concentrations measured at weeks -1, 0, 4, 6, 10 and 12. A short dietary habits questionnaire was self-completed at weeks 0, 6 and 12. Participants consumed the bars they received instead of other snacks, and found that the healthier snack bar was acceptable as part of their daily dietary pattern. Over the 12 weeks, there was a significant reduction in intake of biscuits, cakes and pies (approximately 2 servings/week, P<0·05) in both groups. Fruit juice intake was reduced (approximately 1 serving/week, P=0·029) in the first group. In all, twenty participants (71·4 %) experienced a decrease (n 15) or no change (n 5) in HbA1c (range 0-4 mmol/mol), whereas eight participants experienced an increase in HbA1c (range 0·5-2·5 mmol/mol). There was high compliance with the healthier snack intervention and a trend towards a favourable effect on glucose homoeostasis. Habitual snacking behaviour has the potential to be improved through changes in the food supply, and in the longer term may reduce the impact of poor nutrition on public health.

The acute impact of the intake of four types of bread on satiety and blood concentrations of glucose, insulin, free fatty acids, triglyceride and acylated ghrelin. A randomized controlled cross-over trial

The purpose of the present study is to compare the effects of four different breads (one commercial par-baked wheat bread, three sourdough breads prepared with commercial wheat flour, organic wheat flour, organic einkorn flour) in 16 healthy subjects. The primary outcome of this randomized cross-over trial was evaluating intra-individual changes in glycemic areas-under-the-curve (AUCs) after 50g carbohydrate portions of each bread; secondary outcomes were changes in insulin, fatty free acids (FFA), triglyceride, acylated ghrelin and satiety AUCs. Blood samples and satiety ratings were collected every 30-min for 2-h after the consumption of each bread. The einkorn flour showed the lowest amylase activity, the commercial flour the highest; commercial bread had the highest carbohydrate content and the lowest dietary fiber content. Glucose AUCs were significantly lower after the consumption of sourdough breads made with organic (12,754±1433mg/dL×h) and einkorn flour (12,216±1210mg/dL×h), with respect to the commercial bread (13,849±2193mg/dL×h). Insulin AUCs decreased after the consumption of all sourdough breads when compared to commercial bread. FFA and triglyceride AUCs did not differ by kind of breads. Median ghrelin AUC was significantly lower and satiety higher after the einkorn bread (3710pg/mL×h; 3225±2414, respectively) than after commercial bread consumption (4140pg/mL×h; 1706±1766, respectively), but not with other sourdough breads. In conclusion, the use of sourdough may improve the nutritional features of breads; einkorn bread induced the least disturbance in carbohydrate homeostasis and the greater satiety. If confirmed by further research, these results might have implications in the approach towards chronic dysmetabolic diseases.

Can wheat germ have a beneficial effect on human health? A study protocol for a randomised crossover controlled trial to evaluate its health effects

INTRODUCTION

Cardiovascular diseases (CVD) are the leading cause of mortality worldwide and diet is an important contributor to CVD risk. Thus, several food derivatives are being investigated for their beneficial impact on reducing cardiometabolic risk factors, either in risk groups or in healthy population as a preventive measure. Wheat germ is a food by-product with high nutritional value, especially as a concentrated source of dietary fibre and essential fatty acids, but its incorporation into the diet has been rare up to now. Previous studies do not clarify the hypothesised potential causal relationship between the consumption of wheat germ and benefits for human health.

METHODS AND ANALYSIS

We are conducting a randomised, double-blinded, crossover, placebo-controlled clinical trial designed to assess the physiological effects of daily consumption of wheat germ-enriched bread (containing 6 g of wheat germ) compared with non-enriched bread, over a 4-week period with a 15-week follow-up, in a healthy human population. A total of 55 participants (healthy volunteers, aged 18-60) have been recruited from the Porto metropolitan area in northern Portugal. Our aim is to evaluate the health effects of wheat germ on blood cholesterol and triglycerides, postprandial glycaemic response, gastrointestinal function and discomfort, and changes in intestinal microbiota and insulin resistance as secondary outcomes. The study follows the best practices for evaluating health claims in food according to the European Food Safety Authority (EFSA) scientific opinion, namely random allocation, double blinding, reporting methods to measure and maximise compliance, and validated outcomes with beneficial physiological effects as recommended by EFSA.

ETHICS AND DISSEMINATION

The study has been approved by the Health Ethics Committee of São João Hospital Centre (156-15) and the Ethics Committee of Faculty of Medicine of the University of Porto (PCEDCSS-FMUP07/2015). Results will be disseminated through peer-reviewed publications and presentations at international scientific meetings.

TRIAL REGISTRATION NUMBER

NCT02405507; pre-results.

Resistant Starch Bagels Reduce Fasting and Postprandial Insulin in Adults at Risk of Type 2 Diabetes

BACKGROUND

Type 2 diabetes (T2D) incidence continues to rise. Although increasing dietary fiber intake is an established strategy for improved glycemic control, most adults consume insufficient amounts. Fiber-enhanced functional foods can increase fiber intake, and there is particular interest in resistant starch (RS) as a high-fiber ingredient. Studies show that high-amylose maize resistant starch, type 2 (HAM-RS2) improves acute and chronic glycemic responses, but more studies are needed in individuals at high risk of T2D with RS delivered in commonly consumed foods.

OBJECTIVE

The objective of this study was to examine the chronic effects of consuming bagels high in HAM-RS2 on fasting and postprandial glycemic markers in adults at increased risk of T2D.

METHODS

With the use of a randomized, double-blind crossover design, 24 men and women with a mean ± SE age of 55.3 ± 1.59 y and body mass index (in kg/m²) of 30.2 ± 0.57 consumed 1 bagel containing 25 g HAM-RS2/d or 1 control wheat bagel/d for 56 d each, separated by a 4-wk washout. Fasting and postprandial oral-glucose-tolerance test (OGTT) glucose and insulin were measured on study days 1 and 57 of each bagel treatment.

RESULTS

The RS bagel treatment resulted in significantly lower fasting (22.1%, P = 0.04), 2-h (23.3%, P < 0.008), and 3-h (18.9%, P = 0.05) insulin incremental areas under the curve and fasting insulin resistance (homeostasis model assessment of insulin resistance; 23.1%, P = 0.04) than did the control bagel treatment. Fasting and postprandial OGTT glucose concentrations did not differ between the RS and control bagel treatments on study days 1 or 57.

CONCLUSIONS

These data suggest that consumption of a high-HAM-RS2 bagel improves glycemic efficiency by reducing the amount of insulin required to manage postprandial glucose while improving fasting insulin sensitivity in adults at increased risk of T2D. This research provides support for a feasible dietary strategy for T2D risk reduction. This trial was registered at clinicaltrials.gov as NCT02129946.

Effect of fat type in baked bread on amylose-lipid complex formation and glycaemic response

The formation of amylose-lipid complexes (ALC) had been associated with reduced starch digestibility. A few studies have directly characterised the extent of ALC formation with glycaemic response. The objectives of this study were to investigate the effect of using fats with varying degree of saturation and chain length on ALC formation as well as glycaemic and insulinaemic responses after consumption of bread. Healthy men consumed five test breads in a random order: control bread without any added fats (CTR) and breads baked with butter (BTR), coconut oil (COC), grapeseed oil (GRP) or olive oil (OLV). There was a significant difference in glycaemic response between the different test breads (P=0·002), primarily due to COC having a lower response than CTR (P=0·016), but no significant differences between fat types were observed. Insulinaemic response was not altered by the addition of fats/oils. Although BTR was more insulinotropic than GRP (P<0·05), postprandial β-cell function did not differ significantly. The complexing index (CI), a measure of ALC formation, was significantly higher for COC and OLV compared with BTR and GRP (P<0·05). CI was significantly negatively correlated with incremental AUC (IAUC) of change in blood glucose concentrations over time (IAUCglucose) (r -0·365, P=0·001). Linear regression analysis showed that CI explained 13·3 % of the variance and was a significant predictor of IAUCglucose (β=-1·265, P=0·001), but IAUCinsulin did not predict IAUCglucose. Our study indicated that a simple way to modulate glycaemic response in bread could lie in the choice of fats/oils, with coconut oil showing the greatest attenuation of glycaemic response.

Sodium and potassium urinary excretion and dietary intake: a cross-sectional analysis in adolescents

Background

Hypertension is the leading cause for heart disease and stroke, for mortality and morbidity worldwide, and a high sodium-to-potassium intake ratio is considered a stronger risk factor for hypertension than sodium alone.

Objective

This study aims to evaluate sodium and potassium urinary excretion, and assess the food sources of these nutrients in a sample of Portuguese adolescents.

Design

A cross-sectional study with a sample of 250 Portuguese adolescents. Sodium and potassium excretion were measured by one 24-h urinary collection, and the coefficient of creatinine was used to validate completeness of urine collections. Dietary sources of sodium and potassium were assessed using a 24-h dietary recall.

Results

Valid urine collections were provided by 200 adolescents (118 girls) with a median age of 14.0 in both sexes (p=0.295). Regarding sodium, the mean urinary excretion was 3,725 mg/day in boys and 3,062 mg/day in girls (p<0.01), and 9.8% of boys and 22% of girls met the World Health Organization (WHO) recommendations for sodium intake. Concerning potassium, the mean urinary excretion was 2,237 mg/day in boys and 1,904 mg/day in girls (p<0.01), and 6.1% of boys and 1.7% of girls met the WHO recommendations for potassium intake. Major dietary sources for sodium intake were cereal and cereal products (41%), meat products (16%), and milk and milk products (11%); and for potassium intake, main sources were milk and milk products (21%), meat products (17%), and vegetables (15%).

Conclusions

Adolescents had a high-sodium and low-potassium diet, well above the WHO recommendations. Health promotion interventions are needed in order to decrease sodium and increase potassium intake.

Glycemic responses, appetite ratings and gastrointestinal hormone responses of most common breads consumed in Spain. A randomized control trial in healthy humans

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.

Toward a more standardised and accurate evaluation of glycemic response to foods: recommendations for portion size calculation

This study aimed at evaluating the adequacy of calculation methods for portions to be provided to subjects in clinical trials evaluating glycemic response to foods. Portion sizes were calculated for 140 food samples, based on Nutrition Facts labels (current practice) and actual available carbohydrate content (current recommendation), and compared against the amount of monosaccharides yielded by the digestive breakdown of their actual available carbohydrate content (basis for glycemic response to food). The current practice can result in significant under- or over-feeding of carbohydrates in 10% of tested cases, as compared to the targeted reference dosage. The method currently recommended can result in significantly inadequate yields of monosaccharides in 24% of tested cases. The current and recommended calculation methods do not seem adequate for a standardised evaluation of glycemic response to foods. It is thus recommended to account for the amount of absorbable monosaccharides of foods for portion size calculation.

Impact of α-amylase during breadmaking on in vitro kinetics of starch hydrolysis and glycaemic index of enriched bread with bran

Nowadays, the use of enzymes has become a common practice in the bakery industry, as they can improve dough quality and texture of final product. However, the use of α-amylases could have a negative effect in the glycaemic load of product, due to the released sugars from the starch hydrolysis that are not used by yeasts during the fermentation process. This study evaluated the effect of the addition of α-amylase in bakery products with bran on in vitro kinetics of starch hydrolysis. The use of flour with a high degree of extraction or high bran amount could decrease the GI even with the inclusion of α-amylase in the formulation. It should be taken into account the amount of bran and α-amylase when formulating breads in order to obtain products with lower GI than white bread. However, the fact that kinetics of starch hydrolysis remained unaltered indicates that the use of α-amylase in bread-making processes could provide technological advantages improving quality of breads without markedly changes in their glycaemic index.

The impact of mastication, salivation and food bolus formation on salt release during bread consumption

Health authorities recommend higher fibre and lower salt content in bread products.

Glycemic, insulinemic, and appetite responses of patients with type 2 diabetes to commonly consumed breads

PURPOSE

The purpose of this study was to identify the breads most commonly consumed by adults with type 2 diabetes (T2DM) and then examine the postprandial glycemic, insulinemic, and appetite responses that these breads elicit.

METHODS

One hundred people with T2DM were surveyed to identify the varieties of bread they most frequently consumed. According to a randomized crossover design, 11 fasting participants with T2DM consumed 50 g of available carbohydrate from 4 breads. Glucose and insulin concentrations and appetite ratings were determined over 270 minutes.

RESULTS

Three commonly consumed varieties (white, whole wheat buttermilk, whole grain) identified in the survey-plus a lower-glycemic-index "control" bread (pumpernickel rye)-were tested in the second phase. Despite perceived differences between "brown" and "white" breads, the white, whole wheat buttermilk, and wholegrain breads promoted similar glycemic and insulinemic responses. Pumpernickel bread resulted in a significantly lower peak glucose (P < .01) than all other breads and a lower peak insulin (P < .001) than white or wholegrain bread. Similar appetite responses were found with all 4 breads.

CONCLUSIONS

Adults with T2DM are choosing a variety of breads with perceived differential effects on glycemic, insulinemic, and appetite responses. Appreciable benefits, however, are not conferred by the commonly consumed breads. If breads known to promote favorable metabolic responses are unavailable, the primary emphasis in education should be placed on portion control. Conveying this information to patients is crucial if nutrition education is to achieve its aim of empowering individuals to manage their diabetes through their food choices.

Barley cultivar, kernel composition, and processing affect the glycemic index

Barley has a low glycemic index (GI), but it is unknown whether its GI is affected by variation in carbohydrate composition in different cultivars and by food processing and food form. To examine the effect of these factors on GI, 9 barley cultivars varying in amylose and β-glucan content were studied in 3 experiments in separate groups of 10 healthy participants. In Expt. 1, 3 barley cultivars underwent 2 levels of processing: hull removal [whole-grain (WG)] and bran, germ, and crease removal [white pearled (WP)]. GI varied by cultivar (CDC Fibar vs. AC Parkhill, [mean ± SEM]: 26 ± 3 vs. 53 ± 4, respectively; P < 0.05) and pearling (WG vs. WP: 26 ± 4 vs. 35 ± 3, respectively; P < 0.05) with no cultivar × pearling interaction. In Expt. 2, the GI of 7 WG cultivars ranged from 21 ± 4 to 36 ± 8 (P = 0.09). In Expt. 3, WG and WP AC Parkhill and Celebrity cultivars were ground and made into wet pasta. The GI of AC Parkhill pasta (69 ± 3) was similar to that of Celebrity pasta (64 ± 4) but, unlike in Expt. 1, the GI of WP pasta (61 ± 3) was less than that of WG pasta (72 ± 4) (P < 0.05). Pooled data from Expts. 1 and 2 showed that GI was correlated with total fiber (r = -0.75, P = 0.002) but not with measures of starch characteristics. We conclude that the GI of barley is influenced by cultivar, processing, and food form but is not predicted by its content of amylose or other starch characteristics.