Simple vs. Complex Carbohydrate Dietary Patterns and the Global Overweight and Obesity Pandemic

Global burden and epidemiological prediction of polycystic ovary syndrome from 1990 to 2019: A systematic analysis from the Global Burden of Disease Study 2019

OBJECTIVE

To comprehensively assess the global, regional and national burden of polycystic ovary syndrome (PCOS) in incidence, prevalence, and years lived with disability (DLYs) based on the Global Burden of Disease Study (GBD) 2019.

METHODS

This was a cross-sectional descriptive study. Data on PCOS incidence, prevalence, and DLYs from 1990 to 2019 were obtained from the GBD study 2019. According to the commonwealth income, WHO region, and the sociodemographic index, the estimates were demonstrated along with the estimated annual percentage change (EAPC). The EAPC data were analyzed by four levels of hierarchical clustering and displayed in the world map. The Autoregressive Integrated Moving Average (ARIMA) and Bayesian age-period-cohort (BAPC) model was used to predict the PCOS burden in the next 20 years.

RESULTS

From 1990 to 2019, the number of PCOS incidence in one year increased from 1.4 million in 1990 to 2.1 million in 2019 (54.3%). Only the EAPC estimates of incidence in the Region of the Americas decreased, and their aged-standardized incidence rate (ASIR) values were the highest in 1990 and 2019. There was no significant correlation between human development index (HDI) and EAPC. However, when HDI < 0.7, EAPC of incidence and prevalence was positively correlated with HDI, and when HDI > 0.7, EAPC of incidence and prevalence was negatively correlated with HDI. Countries with the middle level HDI have the highest increasing trend of ASIR and age-standardized prevalence rate (ASPR). The 10 to 19 years old group had the highest incidence counts of PCOS globally. Besides, the ARIMA and BAPC model showed the consistent increasing trend of the burden of PCOS.

CONCLUSION

In order to better promote the early diagnosis and treatment, expert consensus and diagnosis criteria should be formulated according to the characteristics of different ethnic groups or regions. It is necessary to emphasize the early screening and actively develop targeted drugs for PCOS.

Socio-demographic and economic factors associated with the consumption of processed foods in South Africa - Evidence from Demographic and Health Survey VII

OBJECTIVE

The primary objective of this study was to examine the socio-demographic and economic factors associated with the consumption of processed foods in South Africa.

STUDY DESIGN

This is an empirical study where secondary data analysis was performed from the South African Demographic and Health Survey VII.

METHODS

A nationally representative sample of 10,336 participants (aged ≥15 years) was included in the analysis. Using regression models, we studied the association between socio-demographic and economic predictors and the intake of processed foods.

RESULTS

The regression models found that the odds of consumption of any type of processed foods were significantly high in all South African provinces but specifically higher in urban settings, those with any level of education, and young adults. The odds of processed meat consumption were significantly higher among the coloured population, while that of fried food, fast food, and salty snacks was significant in the white population. The odds of consumption increased irrespective of marital status and were higher among males, specifically among those in the poorer and poorest wealth quintiles.

CONCLUSION

These findings warrant advocacy and action for healthy food choices in the population. The role of industry, ethnic vulnerability, and gender stereotypes in food preparation are areas that need priority attention.

Eating Compulsivity in Inpatients with Severe Obesity and the General Population: The Italian Version of the Measure of Eating Compulsivity (MEC10-IT)

This study aimed to validate and investigate the psychometric properties of the Italian version of the Measure of Eating Compulsivity-10 (MEC10-IT) in a sample of inpatients with severe obesity (Study 1), and to test the measurement invariance of the measure across non-clinical and clinical samples (Study 2). In the first study, a confirmatory factorial analysis (CFA) was conducted among 452 patients in order to confirm the factorial structure of the MEC10-IT. In the second study, the psychometric properties of the MEC10-IT were tested on 453 inpatients with severe obesity and a community sample of 311 participants. The CFA confirmed the factorial structure of the MEC10-IT among an Italian sample of adult inpatients with severe obesity (Study 1). The MEC10-IT was also demonstrated to be invariant between the clinical and the community sample and to possess good psychometric properties, as well as excellent screening abilities for classifying individuals with problematic eating behaviors (Study 2). In conclusion, the MEC10-IT could be considered as a valid and reliable tool for the assessment of compulsive eating in both non-clinical and clinical samples and represents a psychometrically sound measure for clinical and research purposes.

Alterations of the Gut Microbiome Associated to Methane Metabolism in Mexican Children with Obesity

Gut microbiota is associated with the development of metabolic disorders. To study its association with childhood obesity, we performed a cross-sectional study with 46 children (6–12 years old). We collected fecal samples, food-frequency questionnaires (FFQs), and anthropometric measurements. Shotgun metagenomics were used to obtain the microbial taxonomic diversity and metabolic potential. We identified two dietary profiles characterized by complex carbohydrates and proteins (pattern 1) and saturated fat and simple carbohydrates (pattern 2). We classified each participant into normal weight (NW) or overweight and obese (OWOB) using their body mass index (BMI) z-score. The ratio of Firmicutes/Bacteroidetes and alpha diversity were not different between the BMI groups. Genera contributing to beta diversity between NW and OWOB groups included Bacteroides rodentium, B. intestinalis, B. eggerthii, Methanobrevibacter smithii, Eubacterium sp., and Roseburia sp. B. rodentium was associated with lower BMI and dietary pattern 1 intake. Eubacterium sp. and Roseburia sp. were associated with BMI increments and high consumption of dietary pattern 2. Methane and energy metabolism were found enriched in under-represented KEGG pathways of NW group compared to OWOB. Complex dietary and microbiome interaction leads to metabolic differences during childhood, which should be elucidated to prevent metabolic diseases in adolescence and adulthood.

Isorhamnetin attenuates high-fat and high-fructose diet induced cognitive impairments and neuroinflammation by mediating MAPK and NFκB signaling pathways

Isorhamnetin (ISO), a flavonoid compound isolated from sea-buckthorn (Hippophae rhamnoides L.) fruit, has anti-inflammatory effects. However, the effects of ISO on neuroinflammation and cognitive function are still unclear. The purpose of this study was to evaluate the protective effect of ISO on cognitive impairment in obese mice induced by a high-fat and high fructose diet (HFFD). It has been found that oral administration of ISO (0.03% w/w and 0.06% w/w) for 14 weeks significantly reduced the body weight, food intake, liver weight, liver lipid level, and serum lipid level of HFFD-fed mice. ISO can also significantly prevent HFFD-induced neuronal working, spatial, and long-term memory impairment. Notably, the ISO treatment activated the CREB/BDNF pathway and increased neurotrophic factors in the brains of mice. Furthermore, ISO inhibited HFFD-induced microglial overactivation and down-regulated inflammatory cytokines in both serum and the brain. It can also inhibit the expression of p-JNK, p-p38, and p-NFκB protein in the mouse brain. In conclusion, these results indicated that ISO mitigated HFFD-induced cognitive impairments by inhibiting the MAPK and NFκB signaling pathways, suggesting that ISO might be a plausible nutritional intervention for metabolic syndrome-related cognitive complications.

Simple versus complex carbohydrates and health: A frequently neglected problem

AIMS

For several decades, there has been a notion that dietary fat is made of different components (at least SAFA, MUFA, and PUFA) that exhibit different and sometimes contrasting effects when associated with health and diseases: coronary heart disease (CHD) and cardiovascular diseases (CVD) in general. A similar fact is not noticed in carbohydrates and their components considering that even some major recent studies on the issue did not segregate simple carbohydrates from complex carbohydrates. In this study, we aimed to stress this need.

DATA SYNTHESIS

A small number of selected studies are presented and commented where segregation of simple from complex carbohydrates was either performed or disregarded to address the inconsistency of not disentangling them.

CONCLUSIONS

If only total fats were considered in investigations where fat was studied, the present notion and attitude toward different roles of the various classes of fats, at least SAFA versus unsaturated (MUFA and PUFA) would be missing. Therefore, there is a need to disentangle simple from complex carbohydrates, and this should be systematically applied when addressing CHD or CVD mortality risks and their preventive measures.

Maternal exposure to high-fat diet modifies anxiety-like/depression-like behaviors and compounds of Serotonergic System in offspring: A preclinical systematic review

Maternal nutrition affects offspring physiology and behavior including susceptibility to mental health-related states. Perinatal high-fat diet (HFD) consumption has been associated with lower levels of serotonin as well as the development of anxiety-like and depression-like behaviors in offspring. The aim of this systematic review was to investigate the effects of maternal HFD during pregnancy and/or lactation on these behaviors and on some aspects of the serotonergic system. Criteria for eligibility included studies of offspring of rodents and non-human primates exposed to HFD at least during pregnancy and/or lactation, offspring that showed outcomes related to anxiety-like and depression-like behaviors and to the serotonergic system. The searches were realized in the LILACS, Web of Science, Scopus, and PubMed databases. The systematic review protocol was registered on the CAMARADES website. The internal validity was assessed by the SYRCLE risk of bias tool. The Kappa index was used for analyzing agreement among the reviewers. In addition, the PRISMA statement was used to report this systematic review. Sixteen articles were included in this review. Most of which studied HFD prior to mating and during pregnancy and lactation. All studies analyzed outcomes related to emotional behavior; three analyzed outcomes related to serotonin system compounds. Maternal consumption of HFD was found to be associated with an inconsistent pattern of the expression of TPH2 as well as reduced the immunoreactivity of 5-HT in the prefrontal cortex and increased 5-HT1A receptor expression in the dorsal raphe of offspring. An association between an HFD and alterations in emotional behavior was found in most of the studies selected.

Associations between Dietary Patterns and Inflammatory Markers during Pregnancy: A Systematic Review

Elevated inflammation in pregnancy has been associated with multiple adverse pregnancy outcomes and potentially an increased susceptibility to future chronic disease. How maternal dietary patterns influence systemic inflammation during pregnancy requires further investigation. The purpose of this review was to comprehensively evaluate studies that assessed dietary patterns and inflammatory markers during pregnancy. This review was guided by the Preferred Reporting Items for Systematic Review and Meta-Analyses. Included studies were sourced from EMBASE, PubMed, Web of Science, and Scopus and evaluated using The Quality Assessment Tool for Quantitative Studies. Inclusion criteria consisted of human studies published in English between January 2007 and May 2020 that addressed associations between dietary patterns and inflammatory markers during pregnancy. Studies focused on a single nutrient, supplementation, or combined interventions were excluded. A total of 17 studies were included. Despite some inconsistent findings, maternal diets characterized by a higher intake of animal protein and cholesterol and/or a lower intake of fiber were shown to be associated with certain pro-inflammatory markers (C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF- α), IL-8, serum amyloid A (SAA), and glycoprotein acetylation (GlycA)). Future studies that explore a broader range of inflammatory markers in the pregnant population, reduce measurement errors, and ensure adequate statistical adjustment are warranted.

Relationship Between National Economic Development and Body Mass Index in Chinese Children and Adolescents Aged 5-19 From 1986 to 2019

Obesity represents a major risk factor for population health. No studies have evaluated how economic expansion impacts the prevalence of obesity. The purpose of this study was to assess the relationship between national economic development and body mass index (BMI) in Chinese children and adolescents. Data of mean BMI in children and adolescents aged 5-19 from 1986 to 2019 were extracted from an international database of cardiometabolic risk factors. Chinese economic development was quantified by the gross domestic product (GDP), which was extracted from the International Monetary Fund. The relationships between GDP and BMI were assessed in 1-year age groups for ages 5-19 years. In addition, the linear regression from the main data and estimated GDP growth allowed the projections of mean BMI for each age group between 2020 and 2025. The results suggest there was a linear increase in BMI over years, which means that there has been a steady increase in BMI over the economic expansion. Overall, 97% of the variance (Pearson correlation coefficient) of BMI in boys can be explained by the GDP expansion, and the same pattern (98% of the variance) occurred in girls. Projected mean BMI were provided for constructing future national strategies to prevent overweight and obesity in youth. In conclusion, BMI in children and adolescents aged 5-19 trended upwards between 1986 and 2019. Our analyses for the first time suggest that globalization has a major impact on BMI in China. Economic expansion was highly predictive of BMI increases.

Obesity and Heath-Carter Somatotyping of 3438 Adults in the Xinjiang Uygur Autonomous Region of China by Multivariate Analysis

INTRODUCTION

This study aimed to investigate the somatotype and obesity of adults in the Xinjiang Uygur Autonomous Region of China and to explore multivariate path analysis for the feasibility and scientificity of using somatotypes to evaluate obesity.

SUBJECTS AND METHODS

According to anthropometric methods, a cross-sectional study was performed on 10 indexes of 3438 adults (1690 men and 1748 women, aged > 20 years) living in the Xinjiang Uygur Autonomous Region of China (including Kazakh, Kyrgyz, Xibe, Uzbek, Tatar and Tajik). The Heath-Carter anthropometric method and body mass index (BMI) were used to evaluate somatotype and obesity, respectively. The feasibility and scientificity of using somatotypes to evaluate obesity were analysed by correspondence analysis.

RESULTS

Among the six populations, the somatotypes were mainly distributed as endomorphic mesomorph, mesomorph-endomorph and mesomorphic endomorph populations, accounting for 66.5% of males and 78.8% of females. The obesity rate (27.4% in males, 27.8% in females) of the six populations in the Xinjiang Uygur Autonomous Region of China was much higher than the average Chinese adult obesity rate (12.1%) and the global adult obesity rate (male: 11%, female: 15%). The distribution of BMI was significantly different (male: P=0.000, female: P=0.033) in different populations, and the incidence of overweight and obesity in the Xinjiang Uygur Autonomous Region of China increased gradually. This study found that there were significant differences in somatotype distribution among different obesity groups in the Xinjiang Uygur Autonomous Region of China (P=0.000). There was a strong correlation between overweight or obesity and endomorph-mesomorph, endomorphic mesomorph and mesomorphic endomorph. Furthermore, this study indicated that using somatotypes to evaluate obesity was reliable and scientific.

CONCLUSION

This study concluded that the somatotype of overweight or obese people was mainly related to endomorphic mesomorph, mesomorph-endomorph, and mesomorphic endomorph.

Carbohydrate and fat intake associated with risk of metabolic diseases through epigenetics of CPT1A

BACKGROUND

Epigenome-wide association studies identified the cg00574958 DNA methylation site at the carnitine palmitoyltransferase-1A (CPT1A) gene to be associated with reduced risk of metabolic diseases (hypertriglyceridemia, obesity, type 2 diabetes, hypertension, metabolic syndrome), but the mechanism underlying these associations is unknown.

OBJECTIVES

We aimed to elucidate whether carbohydrate and fat intakes modulate cg00574958 methylation and the risk of metabolic diseases.

METHODS

We examined associations between carbohydrate (CHO) and fat (FAT) intake, as percentages of total diet energy, and the CHO/FAT ratio with CPT1A-cg00574958, and the risk of metabolic diseases in 3 populations (Genetics of Lipid Lowering Drugs and Diet Network, n = 978; Framingham Heart Study, n = 2331; and REgistre GIroní del COR study, n = 645) while adjusting for confounding factors. To understand possible causal effects of dietary intake on the risk of metabolic diseases, we performed meta-analysis, CPT1A transcription analysis, and mediation analysis with CHO and FAT intakes as exposures and cg00574958 methylation as the mediator.

RESULTS

We confirmed strong associations of cg00574958 methylation with metabolic phenotypes (BMI, triglyceride, glucose) and diseases in all 3 populations. Our results showed that CHO intake and CHO/FAT ratio were positively associated with cg00574958 methylation, whereas FAT intake was negatively correlated with cg00574958 methylation. Meta-analysis further confirmed this strong correlation, with β = 58.4 ± 7.27, P = 8.98 x 10-16 for CHO intake; β = -36.4 ± 5.95, P = 9.96 x 10-10 for FAT intake; and β = 3.30 ± 0.49, P = 1.48 x 10-11 for the CHO/FAT ratio. Furthermore, CPT1A mRNA expression was negatively associated with CHO intake, and positively associated with FAT intake, and metabolic phenotypes. Mediation analysis supports the hypothesis that CHO intake induces CPT1A methylation, hence reducing the risk of metabolic diseases, whereas FAT intake inhibits CPT1A methylation, thereby increasing the risk of metabolic diseases.

CONCLUSIONS

Our results suggest that the proportion of total energy supplied by CHO and FAT can have a causal effect on the risk of metabolic diseases via the epigenetic status of CPT1A.Study registration at https://www.clinicaltrials.gov/: the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN)-NCT01023750; and the Framingham Heart Study (FHS)-NCT00005121.

Polymorphic Appetite Effects on Waist Circumference Depend on rs3749474 CLOCK Gene Variant

Chronobiological aspects controlled by CLOCK genes may influence obesity incidence. Although there are studies that show an association between the expression of these genes and energy intake, waist circumference or abdominal obesity phenotypes, interactions with appetite have been insufficiently investigated in relation to chrononutrition. The objective was to identify interactions between CLOCK genetic variants involved in appetite status. A total of 442 subjects (329 women, 113 men; aged 18 to 65 years) were recruited. Anthropometric, dietary and lifestyle data were collected by trained nutritionists. Participants were classified according to their appetite feelings with a Likert scale. Multiple linear regression models were used to examine associations of the type genotype x appetite status on adiposity-related variables. p values were corrected by the Bonferroni method. A significant influence was found concerning the effects of appetite on waist circumference with respect to rs3749474 CLOCK polymorphism (p < 0.001). An additive model analysis (adjusted by age, gender, exercise and energy intake) showed that risk allele carriers, increased the waist circumference around 14 cm (β = 14.1, CI = 6.3-22.0) by each increment in the level of appetite. The effects of appetite on waist circumference may be partly modulated by the rs3749474 CLOCK polymorphism.

Knowledge, Attitude, and Practice of Adolescent Parents on Free Sugar and Influencing Factors about Recognition

Physiological problems caused by excessive intake of free sugar have been concerning important public health issues, especially the impact on adolescents. The World Health Organization (WHO) strongly recommends controlling daily sugar intake in order to reduce the stress caused by high sugar uptake. Finding out the factors that affect adolescents’ sugar intake will help further interventions to control the intake of sugar. Therefore, we conducted a cross-sectional study among 10 middle schools in Changsha, the capital of Hunan province. Two classes of the first and second grades were randomly selected from each school, and their parents in these classes participated in the survey. Questionnaires were used to access the status of adolescent parents’ knowledge, attitude and practice (KAP) towards free sugar. Out of 1136 valid participants, 70.4% of respondents were female with the mean (Standard Deviation) age of 41.76 (±5.27) years. They had a good attitude but relatively poor knowledge and behavior towards free sugar. Binary logistic regression analysis found that parents whose gender is female, with a high education level and a girl as their child, hold a high level of free sugar recognition. These findings could help free sugar control interventions for adolescents in the future.

Association between dietary patterns during the third trimester and the risk of postpartum depression in China

BACKGROUND

Postpartum depression, which has affected one in six women after giving birth, can exert detrimental effects on maternal, children and family well-being. This study investigated the association between dietary patterns and postpartum depression among Chinese women.

METHODS

A total of 1659 participants were recruited and collected between July 2015 and June 2017 in Tianjin, China. The Chinese version of the Self-Rating Depression Scale was used to assess depressive symptoms at 6-12 weeks postpartum. Information about diet was obtained using an 81-item food frequency questionnaire. Logistic regression models were used to assess relationships between dietary patterns and the risk of postpartum depression.

RESULTS

Six dietary patterns were identified by principal component analysis, including beverage, vegetable, cereal-meat, nut-fruit, egg and seafood patterns. The highest tertile (T3) of the nut-fruit pattern was significantly associated with a decreased risk of postpartum depression (OR: 0.740, 95% CI: 0.573-0.955, p = =0.020). Moreover, T3 of the seafood pattern was associated with a lower risk of postpartum depression than the lowest tertile (T1) of this pattern (OR: 0.753, 95% CI: 0.580-0.978, p = =0.033). No other associations were found.

LIMITATIONS

A retrospective study.

CONCLUSIONS

The nut-fruit pattern and seafood pattern were associated with a decreased risk of postpartum depression in Chinese women. The present findings reinforce the importance of an adequate diet of fruit, nuts, and seafood for postpartum women.

Structural Features, Modification, and Functionalities of Beta-Glucan

Β-glucan is a strongly hydrophilic non-starchy polysaccharide, which, when incorporated in food, is renowned for its ability to alter functional characteristics such as viscosity, rheology, texture, and sensory properties of the food product. The functional properties of β-glucans are directly linked to their origin/source, molecular weight, and structural features. The molecular weight and structural/conformational features are in turn influenced by method of extraction and modification of the β-glucan. For example, whereas physical modification techniques influence only the spatial structures, modification by chemical agents, enzyme hydrolysis, mechanical treatment, and irradiation affect both spatial conformation and primary structures of β-glucan. Consequently, β-glucan can be modified (via one or more of the aforementioned techniques) into forms that have desired morphological, rheological, and (bio)functional properties. This review describes how various modification techniques affect the structure, properties, and applications of β-glucans in the food industry.

A prioritization regimen of the acupuncture treatment for simple obesity: Protocol for systematic review and network meta-analysis

BACKGROUND

Patients with simple obesity suffer from poor quality of life, as well as high risk of hypertension, diabetes, cardiovascular, and cerebrovascular accidents. Lots of Clinical trials suggested that acupuncture is beneficial for simple obesity, and it aims to gather solid evidence in order to provide reliable reference in establishing guidelines for acupuncture treatment of simple obesity in this study.

METHODS

Relevant databases including Cochrane Library, PubMed, Cochrane Central Register of Controlled Trials, Medline University Resource Center, Chinese Biomedical Literature Service System, and China National Knowledge Infrastructure will be retrieved from January 1950 to November 2018. Two authors will screen studies independently according to the inclusion and exclusion criteria and extract the data in a form of sheet. Quality evaluations and bias risk assessments will be performed for the methodology of included studies. Dichotomous data will be analyzed using odds ratio (OR), and continuous data using mean differences. Network meta-analysis will be conducted by using Stata 14.0. The Development and Evaluation approach will be used to rate the certainty of the evidence of estimates derived from meta-analysis. The primary outcome is body mass index (BMI), and the secondary outcomes are triglycerides, total cholesterol, low-density lipoprotein-cholesterol, effective rate, adverse effects, and recurrence rate. Trial registration number is CRD42019117387.

RESULTS

Based on current evidence, this review will rank the efficacy and safety of the various acupuncture regimen in decreasing BMI, triglycerides, total cholesterol of patients with simple obesity, and to summarize a prioritization regimen.

CONCLUSION

This evidence may be useful for clinicians, patients, and guideline-makers to select the optimum proposal of acupuncture for the simple obesity treatment.

Prevalence of overweight and obesity and associated risk factors among adult residents of northwest China: a cross-sectional study

OBJECTIVE

Overweight and obesity have been shown to be related to multiple chronic conditions, leading to a heavy economic burden on society throughout the world. This study aims to estimate the prevalence of overweight and obesity and determine potential influencing factors among adults in Xinjiang, northwest China.

DESIGN

A community-based observational study.

SETTING

The First Affiliated Hospital of Xinjiang Medical University.

METHODS

In total, 14 618 adult participants (7799 males; 6819 females) aged over 35 years were recruited from the Cardiovascular Risk Survey conducted in 2010. Data were obtained from face-to-face interviews and physical examinations. The sample was used to estimate the prevalence of overweight (body mass index (BMI) 24-28 kg/m²) and obesity (BMI ≥28 kg/m²) in Xinjiang Province. Influencing factors were analysed based on statistical methods.

RESULTS

In Xinjiang Province, the overall prevalence of overweight was 36.5% (male 40.1%; female 33.4%), and the prevalence of obesity was 26.5% (male 27.2%; female 25.8%). The prevalence of both overweight and obesity were higher in women than in men (p<0.001). The main influencing factors for overweight and obesity were sex, age, race, marital status, education level, occupation, smoking, drinking, hypertension, diabetes and dyslipidaemia (p<0.05).

CONCLUSIONS

This study estimated that the prevalence of overweight and obesity among adult residents of Xinjiang Province, northwest China, was high. These data suggest that efforts related to the prevention and control of overweight and obesity should be a public health priority in northwest China.

A novel natural tracer method to measure complex carbohydrate metabolism

While the triple tracer isotope dilution method has enabled accurate estimation of carbohydrate turnover after a mixed meal, use of the simple carbohydrate glucose as the carbohydrate source limits its translational applicability to everyday meals that typically contain complex carbohydrates. Hence, utilizing the natural enrichment of [¹³C]polysaccharide in commercially available grains, we devised a novel tracer method to measure postprandial complex carbohydrate turnover and indices of insulin action and β-cell function and compared the parameters to those obtained after a simple carbohydrate containing mixed meal. We studied healthy volunteers after either rice (n = 8) or sorghum (n = 8) and glucose (n = 16) containing mixed meals and modified the triple tracer technique to calculate carbohydrate turnover. All meals were matched for calories and macronutrient composition. Rates of meal glucose appearance (2,658 ± 736 vs. 4,487 ± 909 μM·kg^-1·2 h^-1), endogenous glucose production (-835 ± 283 vs. -1,123 ± 323 μM·kg^-1·2 h^-1) and glucose disappearance (1,829 ± 807 vs. 3,606 ± 839 μM·kg^-1·2 h^-1) differed (P < 0.01) between complex and simple carbohydrate containing meals, respectively. Interestingly, there were significant increase in indices of insulin sensitivity (32.5 ± 3.5 vs. 25.6 ± 3.2 10^-5 (dl·kg^-1·min^-2)/pM, P = 0.006) and β-cell responsivity (disposition index: 1,817 ± 234 vs. 1,236 ± 159 10^-14 (dl·kg^-1·min^-2)/pM, P < 0.005) with complex than simple carbohydrate meals. We present a novel triple tracer approach to estimate postprandial turnover of complex carbohydrate containing mixed meals. We also report higher insulin sensitivity and β-cell responsivity with complex than with simple carbohydrates in mixed meals of identical calorie and macronutrient compositions in healthy adults.