Demystifying the Pizza Bolus: The Effect of Dough Fermentation on Glycemic Response-A Sensor-Augmented Pump Intervention Trial in Children with Type 1 Diabetes Mellitus

Unlocking the potential of low FODMAPs sourdough technology for management of irritable bowel syndrome

Consumption of high FODMAP (Fermentable Oligo-, Di-, and Monosaccharides and Polyols) diet is the leading cause of alteration in the human gut microbiome, thereby, causing irritable bowel syndrome (IBS). Therefore, sourdough technology can be exploited for reduction of FODMAPs in various foods to alleviate the symptoms of IBS. Several microorganisms viz. Pichia fermentans, Lactobacillus fetmentum, Saccharomyces cerevisiae, Torulaspora delbrueckii, Kluyveromyces marxianus etc. have been identified for the production of low FODMAP type II sourdough fermented products. However, more research on regulation of end-product and volatilome profile is required for maximal exploitation of FODMAP-reducing microorganisms. Therefore, the present review is focused on utilisation of lactic acid bacteria and yeasts, alone and in synergy, for the production of low FODMAP sourdough foods. Moreover, the microbial bioprocessing of cereal and non-cereal based low FODMAP fermented sourdough products along with their nutritional and therapeutic benefits have been elaborated. The challenges and future prospects for the production of sourdough fermented low FODMAP foods, thereby, bringing out positive alterations in gut microbiome, have also been discussed.

The Impact of Different Types of Rice and Cooking on Postprandial Glycemic Trends in Children with Type 1 Diabetes with or without Celiac Disease

The aims of this study were to evaluate: (i) the chemical and nutritional composition of rice before and after cooking and (ii) postprandial glycemic impacts in children and adolescents with type 1 diabetes (T1D) after eating two different types of rice (“Gigante Vercelli” white rice and “Artemide” black rice) or white rice cooked “risotto” style or boiled using an advanced hybrid closed loop (AHCL) system (Tandem Control-IQTM). General composition and spectrophotometric analyses of raw and cooked rice were performed. Eight T1D subjects (four males and four females, aged 11 ± 1.4 years), two with celiac disease (CD), using an AHCL system were enrolled. “Gigante Vercelli” white rice cooked as risotto or boiled and boiled “Artemide” rice were prepared by the same cook on two evenings. Continuous glucose monitoring metrics were evaluated for 12 h after meal consumption. Total dietary fiber was higher for both rice types after cooking compared with raw rice. Cooking as risotto increased polyphenols and antioxidants (p < 0.05) in both rice varieties, and total starch decreased after boiling (p < 0.05) in white rice. There was a significant peak in glycemia after consuming risotto and boiled white rice (p < 0.05), while the mean glycemic peak remained <180 mg/dL in individuals eating boiled Artemide rice. There were no significant differences in automatic basal or auto-bolus insulin deliveries by the AHCL according to different types of rice or cooking method. Our findings suggest that glycemic trends are impacted by the different chemical and nutritional profiles of rice but are nevertheless well controlled by AHCL systems.

Too Much Dietary Flexibility May Hinder, Not Help: Could More Specific Targets for Daily Food Intake Distribution Promote Glycemic Management among Youth with Type 1 Diabetes?

Average glycemic levels among youth with type 1 diabetes (T1D) have worsened in some parts of the world over the past decade despite simultaneous increased uptake of diabetes technology, thereby highlighting the persistent need to identify effective behavioral strategies to manage glycemia during this life stage. Nutrition is fundamental to T1D management. We reviewed the evidence base of eating strategies tested to date to improve glycemic levels among youth with T1D in order to identify promising directions for future research. No eating strategy tested among youth with T1D since the advent of flexible insulin regimens—including widely promoted carbohydrate counting and low glycemic index strategies—is robustly supported by the existing evidence base, which is characterized by few prospective studies, small study sample sizes, and lack of replication of results due to marked differences in study design or eating strategy tested. Further, focus on macronutrients or food groups without consideration of food intake distribution throughout the day or day-to-day consistency may partially underlie the lack of glycemic benefits observed in studies to date. Increased attention paid to these factors by future observational and experimental studies may facilitate identification of behavioral targets that increase glycemic predictability and management among youth with T1D.