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

The Impact of Fiber Source on Digestive Function, Fecal Microbiota, and Immune Response in Adult Dogs

This study evaluated the impact of different fiber sources on intestinal function, fecal microbiota, and overall health in dogs. Twelve dogs were used in a crossover design, involving three periods of 6 weeks and three diets: a low-fiber diet (CTR), a cereal-fiber and beet-pulp-supplemented diet (BRA), and a fruit-fiber-supplemented diet (FRU). Each period included a digestibility trial and fecal and blood sampling in the last week. Short-chain fatty acids (SCFAs) and microbiota taxonomy (16S rRNA Illumina-MiSeq) and functionality (Shotgun-NovaSeq 6000) were determined in the feces. General biochemistry, complete blood cells, and lymphocyte subsets were also analyzed. The fiber-supplemented diets showed lower digestibility without significant changes in the fecal consistency. The BRA diet showed higher total SCFA concentrations (p = 0.056), with increases in alpha diversity and particular beneficial genera, such as Lachnospira, Bifidobacterium, and Faecalibacterium. The BRA microbiota was also associated with an overabundance of genes related to carbohydrate and amino acid metabolism. The FRU diet had a distinct impact on the microbiota composition and functionality, leading to higher levels of CD8 lymphocytes. These findings emphasize the importance of selecting the right fiber source when formulating dog diets, as it can have a differential impact on gut microbiota and animal health.

The Importance of Dietary Fiber for Metabolic Health

Dietary fiber are non-digestible carbohydrates that are diverse, have varied functions, and are acquired by consuming plant-based foods. Some forms of fiber are digested by the gut microbiota and produce bioactive metabolites called short chain fatty acids-butyrate, acetate, and propionate. Dietary fiber is able to alter human physiology through multiple mechanisms that can result in health benefits. Unfortunately, nearly 19 out of 20 Americans do not consume the minimum recommended amount of fiber each day. This bears profound relevance to public health because at least six of the ten leading causes of death are potentially preventable or clinically improved through dietary means. Additionally, these same conditions share a common underlying pathophysiology-metabolic dysfunction. This can manifest as abdominal obesity, high blood pressure, insulin resistance, dyslipidemia, or collectively as metabolic syndrome. In this review, we will assess the evidence that consumption of dietary fiber undermines these forms of metabolic dysfunction, examine the mechanism of action for these physiologic effects, and consider the potential for dietary fiber to improve human health on a public health level by simply encouraging our patients to consume more plant-based foods in abundance and diversity.

Acute Effects of Dietary Fiber in Starchy Foods on Glycemic and Insulinemic Responses: A Systematic Review of Randomized Controlled Crossover Trials

Dietary fiber (DF) consumption has been associated with improved glycemic control in epidemiological and long-term interventional studies. However, its acute effects are not yet clear. This systematic review aims to elucidate the postprandial effects of DF in starchy products on glycemia and insulinemia. An electronic search of databases was conducted, and forty-one records met the inclusion criteria and underwent a risk-of-bias assessment. It was shown that soluble DF does not clearly affect glycemia in individuals with normal weight, while resistant starch may be more effective in flattening glycemic responses. Concerning insulinemia, both soluble DF and resistant starch have mixed results, with either favorable or no effects. Data on insoluble DF and glucose metabolism are scarce. The same mixed results for glycemia can be seen in healthy volunteers with overweight/obesity, while resistant starch seems to improve insulinemic responses. Finally, more studies need to examine the acute effects of DF in starchy foods on glucose metabolism and insulin secretion in individuals facing glucose abnormalities. Additionally, more studies are needed to prove whether ingesting high-fiber carbohydrate-containing products per se can result in blunted glycemic and insulinemic responses and which DF type and amount are more effective.

Effects of low-GI biscuits as pre-loads or mid-meal snacks on post-prandial glycemic excursions in women with recent gestational diabetes: A protocol for a randomized crossover trial and an extended tailored intervention

Background

Increased post-prandial glycemic excursions contribute to the development of diabetes and have been observed in women with recent gestational diabetes mellitus (GDM) and with normal glucose tolerance at post-partum. As a convenient meal replacement, low-GI biscuits are helpful for improving glycemic excursions in patients with type 2 diabetes. However, it is unknown whether low-GI biscuits as pre-loads or mid-meal snacks have a better effect in diminishing post-prandial glycemic excursions from the individual level in women with recent GDM. Therefore, the aim of this trial is to tailor a better dietary strategy utilizing low-GI biscuits (Fitmeal) to improve post-prandial glycemic excursions through within-subject comparison in such a population and observe the long-term effect of a tailored dietary approach in glycemic control.

Methods

We have designed a two-phase trial including a randomized, crossover, non-blinded trial in the first phase, followed by a 4-week tailored intervention in the second phase. A total of 52 post-partum women with recent GDM will be allocated into four meal plans: (1) Fitmeal pre-load 30 min before standard lunch meal (P+L), (2) Fitmeal as a mid-meal snack 2 h before standard lunch meal (S+L), (3) isocaloric standard control with co-ingestion of Fitmeal and standard lunch meal (CL) at the same time, and (4) placebo control with 200 ml of water taken 30 min before standard lunch meal (W + L), on four consecutive days. Acute post-prandial glycemic response (PGR) measured by continuous glucose monitoring (CGM) will be compared among the four meals. In the second phase, all participants will receive a 4-week tailored intervention using Fitmeal as pre-loads or mid-meal snacks based on within-subject PGR results from the first phase. Glycemic metrics, dietary behaviors, and psychosocial factors (e.g., quality of life, self-efficacy, perceived stress, and depression) will be examined at baseline and end-point.

Discussion

This trial is expected to optimize the use of low-GI biscuits as pre-loads or mid-meal snacks in improving individual post-prandial glycemic excursions among women with recent GDM. Furthermore, the findings of this study will provide novel information on how to deliver an effective dietary intervention at the individual level and guide future clinical practice of medical nutrition therapy for diabetes prevention.

Trial registration number

Chinese clinical trial registry, ChiCTR2200060923.

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.

Evaluation of graded levels of corn-fermented protein on stool quality, apparent nutrient digestibility, and palatability in healthy adult cats

Dried distillers' grains, coproducts from the ethanol industry, may provide sustainable ingredients for pet food. Due to new post-fermentation separation techniques, corn-fermented protein (CFP) is higher in protein and lower in fiber compared with traditional dried distillers' grains, increasing its appeal for inclusion into pet food. Therefore, the objectives of this study were to determine the effects of increasing levels of CFP on stool quality, apparent total tract digestibility (ATTD), and palatability in adult cats. Four extruded diets were fed to 11 adult cats in an incomplete 4 × 4 replicated Latin square design. The control diet contained 15% soybean meal (0C) and CFP was exchanged for soybean meal at either 5%, 10%, or 15% (5C, 10C, 15C). Cats were fed each dietary treatment for 9-d adaption followed by 5-d total fecal collection. Feces were scored on a 1 to 5 scale, with 1 representing liquid diarrhea and 5 representing hard pellet-like (Carciofi et al., 2008). A fecal score of 3.5 to 4 was considered ideal. Titanium dioxide was added to all diets (0.4%) as a marker to estimate digestibility. Data were analyzed using a mixed model in SAS (version 9.4, SAS Institute, Inc., Cary, NC) with treatment as a fixed effect and cat and period as random effects. Fecal dry matter percent and dry fecal output were greater (P < 0.05) at elevated levels of CFP. Stool scores were maintained (P > 0.05) throughout treatments (average; 4). Dry matter, organic matter, crude protein, and gross energy ATTD decreased when cats were fed 15C. There was no difference in ATTD of fat or total dietary fiber among treatments. For palatability assessment, cats preferred 5C over 0C but had no preference with increased CFP inclusion. These results suggest that CFP is comparable to SBM, but there may be a maximum inclusion level of 10% when fed to cats.

Modulation of 1,2-Dicarbonyl Compounds in Postprandial Responses Mediated by Food Bioactive Components and Mediterranean Diet

Glycoxidative stress with the consequent generation of advanced glycation end products has been implied in the etiology of numerous non-communicable chronic diseases. During the postprandial state, the levels of 1,2-dicarbonyl compounds can increase, depending on numerous factors, including characteristics of the subjects mainly related to glucose metabolism disorders and nutritional status, as well as properties related to the chemical composition of meals, including macronutrient composition and the presence of dietary bioactive molecules and macromolecules. In this review, we examine the chemical, biochemical, and physiological pathways that contribute to postprandial generation of 1,2-dicarbonyl compounds. The modulation of postprandial 1,2-dicarbonyl compounds is discussed in terms of biochemical pathways regulating the levels of these compounds, as well as the effect of phenolic compounds, dietary fiber, and dietary patterns, such as Mediterranean and Western diets.

Biscuits: a systematic review and meta-analysis of improving the nutritional quality and health benefits

Biscuits are ready-to-eat foods that are traditionally prepared mainly with wheat flour, fat, and sugar. Recently, biscuits’ technologies have been rapidly developed to improve their nutritional properties. This study aimed to determine the strategies of improving the nutritional quality of biscuits and the potential health benefits associated with them. A systematic review and meta-analysis were conducted, including articles on biscuits improved by technological processes and raw materials variation. Studies were searched from Google Scholar, PubMed, Scopus, and Web of Science published between 1997 and 2020, in English and French. The meta-analysis was performed using RStudio software, version 4.0.4 to classify the biscuits. One hundred and seven eligible articles were identified. Rice, pea, potato, sorghum, buckwheat, and flaxseed flours were respectively the most found substitutes to wheat flour. But the meta-analysis shown that the copra and foxtail millet biscuit fortified with amaranth, the wheat biscuits fortified with okra, and rice biscuits fortified with soybeans had a high protein content. These biscuits therefore have a potential to be used as complementary foods. The substitution of sugar and fat by several substitutes lead to a decrease in carbohydrates, fat, and energy value. It has also brought about an increase in other nutrients such as dietary fiber, proteins/amino acids, fatty acids, and phenolic compounds. Among the sugar and fat substitutes, stevia and inulin were respectively the most used. Regarding the use of biscuits in clinical trials, they were mainly used for addressing micronutrient deficiency and for weight loss.

Comparison of the Effects of a Bean-Based and a White Rice-Based Breakfast Diet on Postprandial Glucose and Insulin Levels in Chinese Patients with Type 2 Diabetes

BACKGROUND This study compared the effects of a bean-based and a white rice-based breakfast diet on postprandial glucose and insulin levels in Chinese patients with type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS We recruited 63 patients with T2DM. The patients participated in the randomized 2×2 crossover trial. The bean-based diet group and white rice control group were matched for 50 g of available carbohydrate at breakfast. The patients followed the diets for 3 days. Vein blood samples were collected at 0, 30, 60, 120, and 180 min after eating. Data were analyzed using a repeated-measures analysis of variance. The results are expressed as the mean±standard error of mean (SEM) or as the median with interquartile range values. RESULTS Compared with the white rice control, postprandial glucose was significantly lower with the bean-based diet treatments at 60 min (P=0.004), 120 min (P=0.000), and 180 min (P=0.000). The insulin levels of the bean-based diet group were significantly higher at 60 min (P=0.013). The C-peptide levels of the bean-based diet group were significantly higher at 30 min (P=0.042) and 60 min (P=0.005) postprandial. The glucose area under the curve (AUC) showed a similar trend (P=0.000). There were no statistically significant differences in the AUC of insulin and C-peptide, except C-peptide AUC at 0 to 60 min (P=0.027). CONCLUSIONS Compared with a white rice-based breakfast, a bean-based diet significantly reduced postprandial glucose levels and promoted insulin secretion. These results support a dietary approach to reduce postprandial hyperglycemia.

Effect of soluble-viscous dietary fibre on coronary heart disease risk score across 3 population health categories: data from randomized, double-blind, placebo-controlled trials

We applied the Framingham risk equation in healthy, metabolic syndrome, and diabetes populations, following treatment with viscous fibre from konjac-based blend (KBB). KBB yielded reduction in estimated risk score by 16% (1.04 ± 0.03 vs. 0.87 ± 0.04, p < 0.01) in type 2 diabetes, 24% (1.08 ± 0.01 vs. 0.82 ± 0.02, p < 0.01) in metabolic syndrome, and 25% (1.09 ± 0.05 vs. 0.82 ± 0.06, p < 0.01) in healthy individuals. Drivers for decreased risk were improvements in blood cholesterol and systolic blood pressure. The composite coronary heart disease risk across populations was reduced 22% (p < 0.01). Novelty Viscous fibre from konjac-xanthan reduced 10-year relative coronary heart disease using Framingham Risk Score across the glycemic status spectrum.

The effects of prebiotic bread containing oat ß-glucan and resistant starch on the glycemic index and glycemic load in healthy individuals

Purpose

The enrichment of bread with non-digestible prebiotic ingredients may exert health-promoting effects and provide healthier food choices for those suffering from metabolic diseases, including obesity and diabetes. The purpose of this study was to investigate the effects of ß-glucan and resistant starch incorporation on the glycemic index (GI) and glycemic load (GL) of white bread.

Design/methodology/approach

Seven different formulations of prebiotic bread were produced using different proportions of ß-glucan (0.8, 1 and 1.2 per cent), resistant starch (5.5, 8 and 10.5 per cent) and the combination of resistant starch and ß-glucan in a ratio of 4:0.5.

Findings

The GI and GL of the prebiotic bread prepared with 1 per cent ß-glucan (w/w) were 55.7 and 7.8, respectively, whereas those of the prebiotic bread prepared with 8 per cent resistant starch (w/w) were 64.8 and 8.42, respectively, with both breads having significantly lower GI and GL values than the control (P < 0.05). It was concluded that the incorporation of 1 per cent ß-glucan may be beneficial in producing prebiotic bread with both low GI and low GL.

Originality/value

Although white bread is a main food source in human diet, its high GI and GL make it an unhealthy food choice. The incorporation of ingredients with prebiotic effects, such as ß-glucan and resistant starch, can improve the nutritional value of this product by lowering its GI and GL.

Perspective: Physiologic Importance of Short-Chain Fatty Acids from Nondigestible Carbohydrate Fermentation

In recent years, it has become increasingly obvious that dietary fiber or nondigestible carbohydrate (NDC) consumption is critical for maintaining optimal health and managing symptoms of metabolic disease. In accordance with this, the US FDA released its first official definition of dietary fiber in 2016 for regulation of Nutrition and Supplement Facts labels. Included in this definition is the requirement of an isolated or synthetic NDC to produce an accepted physiologic health benefit, such as improved laxation or reduced fasting cholesterol concentrations, upon consumption. Even though NDC fermentation and production of short-chain fatty acids elicit many physiologic effects, including serving as a source of energy for colonocytes, curbing glycemic response and satiety, promoting weight loss, enhancing mineral absorption, reducing systemic inflammation, and improving intestinal health, the process of fermentation is not considered a physiologic endpoint. Instead, expensive and laborious clinical trials must be conducted and an accepted physiologic benefit observed. In this review, we discuss the physiologic importance of NDC fermentation through extensive examination of clinical evidence and propose that the degree of fermentability of an NDC, rather than the endpoints of a clinical trial, may be appropriate for classifying it as a dietary fiber.

The effects of gelled konjac glucomannan fibre on appetite and energy intake in healthy individuals: a randomised cross-over trial

Konjac glucomannan (KGM) is a viscous dietary fibre that can form a solid, low-energy gel when hydrated and is commonly consumed in a noodle form (KGM-gel). Increased meal viscosity from gel-forming fibres have been associated with prolonged satiety, but no studies to date have evaluated this effect with KGM-gel. Thus, our objective was to evaluate subsequent food intake and satiety of KGM-gel noodles when replacing a high-carbohydrate preload, in a dose–response manner. Utilising a randomised, controlled, cross-over design, sixteen healthy individuals (twelve females/four males; age: 26·0 (sd 11·8) years; BMI: 23·1 (sd 3·2) kg/m2) received 325 ml volume-matched preloads of three KGM-gel noodle substitution levels: (i) all pasta with no KGM-gel (1849 kJ (442 kcal), control), half pasta and half KGM-gel (1084 kJ (259 kcal), 50-KGM) or no pasta and all KGM-gel (322 kJ (77 kcal), 100-KGM). Satiety was assessed over 90 min followed by an ad libitum dessert. Compared with control, cumulative energy intake was 47 % (−1761 kJ (−421 kcal)) and 23 % (−841 kJ (−201 kcal)) lower for 100-KGM and 50-KGM, respectively (both P<0·001), but no differences in subsequent energy intake was observed. Ratings of hunger were 31 % higher (P=0·03) for 100-KGM when compared with control, and were 19 % lower (P=0·04) for fullness and 28 % higher (P=0·04) for prospective consumption when comparing 100-KGM to 50-KGM. Palatability was similar across all treatments. Replacement of a high-carbohydrate preload with low-energy KGM-gel noodles did not promote additional food intake despite large differences in energy. The energy deficit incurred from partial KGM-gel substitution may have relevance in weight loss regimens, and should be further evaluated beyond the healthy population.

Co-administration of a konjac-based fibre blend and American ginseng (Panax quinquefolius L.) on glycaemic control and serum lipids in type 2 diabetes: a randomized controlled, cross-over clinical trial

PURPOSE

Use of polypharmacy in the treatment of diabetes is the norm; nonetheless, optimal control is often not achieved. Konjac-glucomannan-based fibre blend (KGB) and American ginseng (AG) have individually been shown to improve glycaemia and CVD risk factors in type 2 diabetes. The aim of this study was to determine whether co-administration of KGB and AG could improve diabetes control beyond conventional treatment.

METHOD

Thirty-nine participants with type 2 diabetes (6.5 > A1c < 8.4%) were enrolled between January 2002 and May 2003 at the Risk Factor Modification Centre at St Michaels Hospital in a randomized, placebo-controlled, crossover trial with each intervention lasting 12-weeks. Medications, diet and lifestyle were kept constant. Interventions consisted of 6 g of fibre from KGB together with 3 g of AG (KGB and AG) or wheat bran-based, fibre-matched control. Primary endpoint was the difference in HbA1c levels at week 12.

RESULTS

Thirty participants (18M:12F; age: 64 ± 7 years; BMI: 28 ± 5 kg/m²; HbA1c: 7.0 ± 1.0%) completed the study, and consumed 5.5 and 4.9 g/day of fibre from KGB and wheat bran control, respectively, and 2.7 g/day of AG. At week 12, HbA1c levels were 0.31% lower on the KGB and AG compared to control (p = 0.011). Mean (±SEM) plasma lipids decreased on the KGB and AG vs control by 8.3 ± 3.1% in LDL-C (p = 0.002), 7.5 ± 2.4% in non-HDL-C (p = 0.013), 5.7 ± 1.9% in total-C (p = 0.012), 4.1 ± 2.1% in total-C:HDL-C ratio (p = 0.042), 9.0 ± 2.3% in ApoB (p = 0.0005) and 14.6 ± 4.2% in ApoB:ApoA1 ratio (p = 0.049).

CONCLUSIONS

Co-administration of KGB and AG increases the effectiveness of conventional therapy through a moderate but clinically meaningful reduction in HbA1c and lipid concentrations over 12 weeks in patients with type 2 diabetes.

CLINICAL TRIALS REGISTRATION

NCT02806349 ( https://clinicaltrials.gov/ ).

Effects of Higher Dietary Protein and Fiber Intakes at Breakfast on Postprandial Glucose, Insulin, and 24-h Interstitial Glucose in Overweight Adults

Dietary protein and fiber independently influence insulin-mediated glucose control. However, potential additive effects are not well-known. Men and women (n = 20; age: 26 ± 5 years; body mass index: 26.1 ± 0.2 kg/m²; mean ± standard deviation) consumed normal protein and fiber (NPNF; NP = 12.5 g, NF = 2 g), normal protein and high fiber (NPHF; NP = 12.5 g, HF = 8 g), high protein and normal fiber (HPNF; HP = 25 g, NF = 2 g), or high protein and fiber (HPHF; HP = 25 g, HF = 8 g) breakfast treatments during four 2-week interventions in a randomized crossover fashion. On the last day of each intervention, meal tolerance tests were completed to assess postprandial (every 60 min for 240 min) serum glucose and insulin concentrations. Continuous glucose monitoring was used to measure 24-h interstitial glucose during five days of the second week of each intervention. Repeated-measures ANOVA was applied for data analyses. The HPHF treatment did not affect postprandial glucose and insulin responses or 24-h glucose total area under the curve (AUC). Higher fiber intake reduced 240-min insulin AUC. Doubling the amount of protein from 12.5 g to 25 g/meal and quadrupling fiber from 2 to 8 g/meal at breakfast was not an effective strategy for modulating insulin-mediated glucose responses in these young, overweight adults.

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

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.

Addition of Orange Pomace to Orange Juice Attenuates the Increases in Peak Glucose and Insulin Concentrations after Sequential Meal Ingestion in Men with Elevated Cardiometabolic Risk

BACKGROUND

Prospective cohort studies show that higher dietary fiber intake is associated with reduced cardiovascular disease risk, yet the impact on postprandial glucose and insulin responses is unclear.

OBJECTIVE

This study aims to evaluate the effects of orange beverages with differing fiber concentrations on postprandial glycemic responses (secondary outcome measure) after a sequential breakfast and lunch challenge in men with increased cardiometabolic risk.

METHODS

Thirty-six men (aged 30-65 y; body mass index 25-30 kg/m(2): fasting triacylglycerol or total cholesterol concentrations: 0.8-2.2 or 6.0-8.0 mmol/L, respectively) were provided with a high-fat mixed breakfast and were randomly assigned to consume 240 mL Tropicana (PepsiCo, Inc.) pure premium orange juice without pulp (OJ), OJ with 5.5 g added orange pomace fiber (OPF), juice made from lightly blended whole orange, or an isocaloric sugar-matched control (Control) on 4 occasions separated by 2 wk. A medium-fat mixed lunch was provided at 330 min. Blood samples were collected before breakfast and on 11 subsequent occasions for 420 min (3 time points postlunch) to determine postprandial glucose, insulin, lipid, and inflammatory biomarker responses. Repeated-measures ANOVA was used for data analysis.

RESULTS

OPF significantly (P < 0.05) reduced the maximal change in glucose concentrations (1.9 ± 0.21 mmol/L) reached after breakfast compared with other treatments (2.3-2.4 mmol/L) and after lunch (3.0 ± 0.05 mmol/L) compared with OJ (3.6 ± 0.05 mmol/L). The maximal change in insulin concentration (313 ± 25 pmol/L) was also lower compared with Control (387 ± 30 pmol/L) and OJ (418 ± 39 pmol/L) after breakfast. OPF significantly delayed the time to reach the peak glucose concentration compared with Control and OJ, and of insulin compared with Control after breakfast.

CONCLUSION

OPF consumed with breakfast may lower postprandial glycemic and insulinemic responses to typical meal ingestion in men with increased cardiometabolic risk. This trial is registered at clinicaltrials.gov as NCT01963416.

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

A diet with a high glycemic index (GI) is associated with an elevated risk for obesity or type 2 diabetes.

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.

Effect of the novel functional fibre, polyglycoplex (PGX), on body weight and metabolic parameters: A systematic review of randomized clinical trials

BACKGROUND & AIMS

Hundreds of dietary supplements are marketed as weight loss pills, but the evidence for effectiveness for most is unproven. The objective of this review was to critically appraise and evaluate the evidence from published randomized clinical trials (RCTs) examining the effectiveness of polyglycoplex (PGX), a novel functional fibre, on body weight and metabolic parameters.

METHODS

We conducted electronic searches in Medline, Embase, Amed, Cinahl and The Cochrane Library. Only double-blinded RCTs were considered for inclusion. The reporting quality of included studies was assessed using the Cochrane criteria. Two reviewers independently determined eligibility, assessed the quality of reporting, and extracted the data.

RESULTS

We included four RCTs with a total of 217 participants. The RCTs varied in the quality of their reporting. The evidence from the RCTs suggested that PGX has no significant effects on body weight; however, significant reductions were noted for total and LDL cholesterol. Adverse events reported included diarrhea and abdominal bloating.

CONCLUSION

The evidence from available RCTs does not indicate that PGX intake causes reductions in body weight. PGX may cause reductions in total and LDL cholesterol. Few trials examining the effects of PGX have been conducted; they are characterized by small sample sizes, deficiencies in reporting quality, and are funded by a single manufacturer. Future clinical trials evaluating its effect should be adequately powered and better reported.

Randomized clinical trial in healthy individuals on the effect of viscous fiber blend on glucose tolerance when incorporated in capsules or into the carbohydrate or fat component of the meal

BACKGROUND/OBJECTIVE

Addition of viscous fiber to foods has been shown to significantly reduce postprandial glucose excursions. However, palatability issues and the variability in effectiveness due to different methods of administration in food limits it use. This study explores the effectiveness of a viscous fiber blend (VFB) in lowering postprandial glycemia using different methods of incorporation.

METHODS

Two acute, randomized, controlled studies were undertaken: Study 1: Twelve healthy individuals (mean ± SD, age: 36 ± 13 years, body mass index [BMI]: 27 ± 4 kg/m(2)) consumed 8 different breakfasts. All meals consisted of 50 g of available carbohydrate from white bread (WB) and 10 g margarine. Zero, 1, 2, or 4 g of the VFB was baked into WB or mixed with the margarine. Study 2: Thirteen healthy individuals (mean ± SD, age: 39 ± 17 years, BMI: 25 ± 5 kg/m(2)) consumed 6 test meals, consisting of 50 g of available carbohydrate from WB. Six capsules containing either cornstarch or VFB were taken at 4 different time points during the glucose tolerance test. After obtaining a fasting finger-prick blood sample, volunteers consumed the test meal over a 10-minute period. Additional blood samples were taken at 15, 30, 45, 60, 90, and 120 minutes from the start of the meal. For study 2, an additional fasting sample was obtained at -30 minutes.

RESULTS

Study 1: Irrespective of VFB dose, glucose levels were lower at 30 and 45 minutes when VFB was mixed into the margarine compared to the control (p < 0.05). Incremental areas under the curve were significantly lower compared to control when 4 g of VFB was mixed into the margarine. Study 2: There was no effect of the VFB on postprandial glucose levels when administered in capsules.

CONCLUSION

Incorporation of VFB into margarine was more effective in lowering postprandial glycemia than when the VFB was baked into bread and no effect when given in capsules.

Alternative dietary fiber sources in companion animal nutrition

The US has a pet population of approximately 70 million dogs and 74 million cats. Humans have developed a strong emotional bond with companion animals. As a consequence, pet owners seek ways to improve health, quality of life and longevity of their pets. Advances in canine and feline nutrition have contributed to improved longevity and well-being. Dietary fibers have gained renewed interest in the pet food industry, due to their important role in affecting laxation and stool quality. More recently, because of increased awareness of the beneficial effects of dietary fibers in health, as well as the popularity of functional foods and holistic and natural diets, alternative and novel carbohydrates have become widespread in human and pet nutrition. Fiber sources from cereal grains, whole grains and fruits have received increasing attention by the pet food industry and pet owners. While limited scientific information is available on the nutritional and nutraceutical properties of alternative fiber sources, studies indicate that corn fiber is an efficacious fiber source for pets, showing no detrimental effects on palatability or nutrient digestibility, while lowering the glycemic response in adult dogs. Fruit fiber and pomaces have good water-binding properties, which may be advantageous in wet pet food production, where a greater water content is required, along with low water activity and a firm texture of the final product. Rice bran is a palatable fiber source for dogs and may be an economical alternative to prebiotic supplementation of pet foods. However, it increases the dietary requirement of taurine in cats. Barley up to 40% in a dry extruded diet is well tolerated by adult dogs. In addition, consumption of complex carbohydrates has shown a protective effect on cardiovascular disease and oxidative stress. Alternative fiber sources are suitable ingredients for pet foods. They have been shown to be nutritionally adequate and to have potential nutraceutical properties.

Hypoglycemic and hypolipidemic potential of a high fiber diet in healthy versus diabetic rabbits

The aim of this study was to investigate potential hypoglycaemic and hypolipidemic effects of Plantago ovata husk included in the diet, in healthy and diabetic rabbits. We also examined the effects of this fiber in other biochemical parameters. Two groups of 18 rabbits were used. The first group was fed with standard chow and the second with chow supplemented with Plantago ovata husk (3.5 mg/kg/day). On day 14 diabetes mellitus was induced by the intravenous administration of alloxan (80 mg/kg). After an oral glucose load (3 g), glucose, insulin, and other biochemical parameters were determined on day 14 (healthy rabbits) and on day 28 (diabetic rabbits). In healthy rabbits, fiber did not modify glucose or insulin levels but decreased significantly total cholesterol, LDL-cholesterol, atherogenic index, and glycosylated hemoglobin. In diabetic rabbits, fiber was more beneficial in mild diabetics than in severe diabetics with significant decreases in glucose levels and increases in insulin concentrations. In these animals fiber caused an important reduction in cholesterol, indicating a beneficial effect of Plantago ovata husk in diabetic rabbits. Although further studies in patients are necessary, we think that Plantago ovata husk offers interesting perspectives to be administered to patients with diabetes mellitus.

Dessert formulation using sucralose and dextrin affects favorably postprandial response to glucose, insulin, and C-peptide in type 2 diabetic patients

BACKGROUND

Dessert compositions may conform to diabetic diet when it contains low sugar or artificial sweetener to replace sugar. However, it is still questionable whether glycemic control in type 2 diabetes patients is improved by the use of diet-conforming dessert compositions.

OBJECTIVE

To compare, in type 2 diabetes patients, the glycemic, insulin, and C-peptide responses to seven modified dessert compositions for diabetics (D-dessert) with the response to seven similar desserts of non-modified composition, used as control desserts (C-dessert).

METHODS

Seventy type 2 diabetes patients were allocated to seven groups of ten. On three occasions, each patient received either the meal which consisted of bread and cheese, or the meal and D-dessert, or the meal and the respective C-dessert. Differences in postprandial glucose, insulin, and C-peptide were evaluated using analysis of repeated measures at 0, 30, 60, 90, and 120 min after consumption.

RESULTS

D-cake and D-pastry cream resulted in lower glucose levels (8.81 ± 0.32 mmol/l and 8.67 ± 0.36 mmol/l, respectively) and D-strawberry jelly in lower insulin levels (16.46 ± 2.66 μU/ml) than the respective C-desserts (9.99 ± 0.32 mmol/l for C-cake, 9.28 ± 0.36 mmol/l for C-pastry cream, and 27.42 ± 2.66 μU/ml for C-strawberry jelly) (p < 0.05). Compared with the meal, D-cake did not increase glucose or insulin levels (p < 0.05), while C-cake did (p < 0.05). D-pastry cream increased glucose to a lesser extent than C-pastry cream (p < 0.05). Similar effects were reported for D-milk dessert, D-millefeuille, and D-chocolate on glucose, insulin, and C-peptide at specific timepoints. D-crème caramel showed no effect.

CONCLUSIONS

Some desserts formulated with sugar substitutes and soluble fiber may have a favorable effect on postprandial levels of glucose, insulin, and C-peptide in type 2 diabetic patients.

Viscosity rather than quantity of dietary fibre predicts cholesterol-lowering effect in healthy individuals

The well-documented lipid-lowering effects of fibre may be related to its viscosity, a phenomenon that has been understudied, especially when fibre is given against the background of a typical North American (NA) diet. In this three-arm experiment, we compared the lipid-lowering effect of low-viscosity wheat bran (WB), medium-viscosity psyllium (PSY) and a high-viscosity viscous fibre blend (VFB), as part of a fibre intervention aimed at increasing fibre intake to recommended levels within the context of a NA diet in apparently healthy individuals. Using a randomised cross-over design, twenty-three participants (twelve males and eleven females; age 35 (SD 12) years; LDL-cholesterol (C) 2.9 (SEM 0.6) mmol/l) consuming a typical NA diet received a standard, fibre-enriched cereal, where approximately one-third of the fibre was either a low-viscosity (570 centipoise (cP)) WB, medium-viscosity (14,300 cP) PSY or a high-viscosity (136,300 cP) novel VFB, for 3 weeks separated by washout periods of ≥ 2 weeks. There were no differences among the treatments in the amount of food consumed, total dietary fibre intake, reported physical activity and body weight. Final intake of the WB, PSY and VFB was 10.8, 9.0 and 5.1 g, respectively. Reduction in LDL-C was greater with the VFB compared with the medium-viscosity PSY (-12.6 (SEM 3.5) %, P = 0.002) and low-viscosity WB (-14.6 (SEM 4.2) %, P = 0.003). The magnitude of LDL-C reduction showed a positive association with fibre apparent viscosity (r - 0.41, P = 0.001). Despite the smaller quantity consumed, the high-viscosity fibre lowered LDL-C to a greater extent than lower-viscosity fibres. These data support the inclusion of high-viscosity fibre in the diet to reduce plasma lipids among apparently healthy individuals consuming a typical NA diet.

Pectin from Passiflora edulis shows anti-inflammatory action as well as hypoglycemic and hypotriglyceridemic properties in diabetic rats

Flour made from Passiflora edulis fruit peel has been used in Brazil to treat diabetes. This study evaluated the effects of pectin from P. edulis on rats with alloxan-induced diabetes, on myeloperoxidase release from human neutrophils, and on carrageenan-induced paw edema. In the experiments on carrageenan-induced paw edema, paws were dissected for hematoxylin-eosin staining and immunohistochemistry determinations of tumor necrosis factor-α and inducible nitric oxide synthase. Male Wistar rats were divided into the following groups: diabetic controls and diabetic treated with pectin daily for 5 days (0.5-25 mg/kg orally). Glibenclamide and metformin were used as reference drugs. Forty-eight hours after alloxan administration, blood measures were determined (before treatment) and again 5 days later (after treatment). Pectin decreased blood glucose and triglyceride levels in diabetic rats. Pectin also decreased edema volume and release of myeloperoxidase (0.1-100 μg/mL). It also significantly decreased neutrophil infiltration and partially decreased immunostaining for tumor necrosis factor-α and inducible nitric oxide synthase. In conclusion, these data indicated that pectin, a bioactive compound present in P. edulis, has potential as a useful alternative treatment for type 2 diabetes. Its anti-inflammatory properties are probably involved in its antidiabetic action.

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

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

CLINICAL TRIAL REGISTRATION

NCT00935350.

Dietary oat beta-glucan reduces peak net glucose flux and insulin production and modulates plasma incretin in portal-vein catheterized grower pigs

Net glucose and SCFA flux and insulin secretion into the portal vein might be associated with the incretins glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1). Our objectives were to clarify this association and study the impact of 2 doses of dietary oat beta-glucan on the variables. Three 35-kg portal vein-catheterized pigs were fed 3 diets containing 0, 3, or 6% oat beta-glucan concentrate (BG0, BG3, and BG6) for 7 d in a repeated 3 x 3 Latin square. On d 7, blood was sampled for 12 h postprandially. Net glucose flux and apparent hormone production were calculated from plasma portal-arterial differences x flow. Postprandially, pigs fed BG6 had lower (P < 0.05) portal glucose at 15, 30, and 45 min and a lower (P < 0.05) net glucose flux during the first hour. Pigs fed BG6 tended to have lower (P < 0.10) portal C-peptide without lowering insulin, indicating that pigs fed BG6 had lower actual insulin release combined with a higher prehepatic retention of insulin. Pigs fed BG6 had lower (P < 0.05) portal GIP and GLP-1, which in turn were correlated (R(2) = 0.81 and 0.88, respectively; P < 0.01) with portal glucose. Pigs fed BG3 and BG6 had a higher (P < 0.05) net SCFA flux than pigs fed BG0, indicating increased fermentation. In conclusion, dietary supplementation of 6% oat beta-glucan concentrate decreased net glucose flux, increased net SCFA flux, and decreased peak apparent insulin production, changes that were associated with GIP and GLP-1 mediation.

Fiber facts: benefits and recommendations for individuals with type 2 diabetes

In randomized controlled trials, viscous soluble fibers have demonstrated acute and long-term metabolic improvements in type 2 diabetes, such as reductions in hemoglobin A1c, fasting and post-prandial glycemia, insulinemia, and cardiovascular risk factors. In addition, they may be helpful in weight control through promoting feelings of fullness. Increasing consumption of foods containing fiber or use of fiber supplements could play an important role in managing diabetes with positive outcomes on vascular complications and reduced cardio-vascular disease risk.