Glycemic index and glycemic load of selected Chinese traditional foods

Glycaemic index and glycaemic load of selected packaged vegan foods

While there are data regarding the glycaemic index (GI) and glycaemic load (GL) of many foods in the literature, the values for packaged vegan analogue foods have not been previously published, although processed vegan foods usually contain more carbohydrates than their animal-based counterparts. This study was carried out to determine the GI and GL values of a selection of packaged vegan foods popular in Türkiye. To determine the GI and GL of test foods, 12 healthy volunteer females participated in the study. Participants randomly consumed test and reference foods (glucose and white bread) on each trial day, and capillary blood glucose was measured at baseline, 15, 30, 45, 60, 90 and 120 mins in duplicate. The GIs of vegan schnitzel, vegan chickpea burger, vegan mince pita, vegan chocolate, vegan snack bar and vegan cheese were 26.1 ± 19.61 (low), 27.1 ± 17.21 (low), 65.1 ± 28.60 (moderate), 42.7 ± 22.32 (low), 63.6 ± 45.86 (moderate), 36.4 ± 16.85 (low), respectively, according to the glucose reference, and were 28.2 ± 16.17 (low), 34.7 ± 18.26 (low), 81.2 ± 31.96 (high), 48.8 ± 12.87 (low), 82.0 ± 54.05 (high), 46.7 ± 28.66 (low), respectively, according to the white bread reference. GLs were 3.5 ± 2.66 (low), 8.6 ± 5.46 (low), 26.6 ± 11.67 (high), 6.1 ± 3.19 (low), 14.2 ± 10.28 (moderate), 5.7 ± 2.63 (low), respectively, according to the glucose reference, and were 3.8 ± 2.19 (low), 11.0 ± 5.80 (moderate), 33.1 ± 13.04 (high), 7.0 ± 1.84 (low), 18.4 ± 12.12 (moderate), 7.3 ± 4.47 (low), respectively, according to the white bread reference. The data from this study provide preliminary data for the GIs and GLs of packaged and processed vegan foods and show that the GIs and GLs of meat and cheese vegan analogues, while still low or moderate, tend to be higher than their animal-based counterparts which have lower or no glycaemic responses. Further research on the GIs and GLs of more vegan foods is needed.

Cognition of diet quality and dietary management in elderly patients with coronary and other atherosclerotic vascular disease in western China, a qualitative research study

BACKGROUND

Healthy eating is one of the most important nonpharmacologic treatments for patients with atherosclerosis(AS). However, it is unclear how elderly AS patients in western China perceive their dietary status and which type of nutritional assistance they would be willing to receive. Therefore, the primary purpose of this study was to understand the level of knowledge about current dietary habits and healthy eating habits among elderly AS patients in western China, and the secondary purpose was to identify acceptable nutritional assistance measures or pathways for those patients to help them manage disease progression.

METHODS

An implementation study approach was used to recruit elderly patients with AS-related diseases in western China for semistructured interviews.

RESULTS

14 participants were included in the study, and the following three themes were identified from the interviews:(1) the diet with regional characteristics; (2) low nutrition-related health literacy; (3) complex attitudes towards nutritional assistance. Most participants had misconceptions about healthy eating, and the sources of their knowledge might not be trustworthy. Participants expressed a preference for personalized nutritional assistance, especially that provided by medical-nursing combined institutions.

CONCLUSION

Patients in western China need nutritional assistance for their regional dietary habits; therefore, healthy dietary patterns consistent with the regional culture are proposed to improve the prevailing lack of knowledge about healthy diets, improve the dietary structure of patients, and control the development of the disease.

Cake of Japonica, Indica and glutinous rice: Effect of matcha powder on the volatile profiles, nutritional properties and optimal production parameters

Matcha addition decreased the relative crystallinity and provided with a refreshing flavor for all types of rice cakes. Matcha also significantly enhanced the phenolic content and the oxidant defense of cakes. Compared with the other two types of rice cakes, the one made of glutinous rice are with the lowest starch digestibility. Adding matcha to rice cakes inhibited the in vitro starch digestion, and a significant decrease in the expected glycemic index (eGI) and an increase in resistant starch (RS) were observed. Besides, according to the results of sensory evaluation, an optimized formulation of matcha rice cake was expected to contain 1.6% matcha, 82% water and steamed for 39 min. These findings suggest that matcha could be a favorable food additive to improve both the flavour and nutritional value of steamed rice cake.

Seaweeds as Ingredients to Lower Glycemic Potency of Cereal Foods Synergistically-A Perspective

Seaweeds are traditional food ingredients mainly in seaside regions. Modern food science and nutrition researchers have identified seaweed as a source of functional nutrients, such as dietary soluble and insoluble fibers, proteins, omega-3 fatty acids, prebiotic polysaccharides, polyphenols, and carotenoids. Owing to the rich nutrients, seaweeds and seaweed extract can be used as functional ingredients by modifying the nutrients composition to reduce the proportion of available carbohydrates, delaying the gastric emptying time and the absorption rate of glucose by increasing the digesta viscosity, and attenuating the digesting rate by blocking the activity of digestive enzymes. This review presents the concept of using seaweed as unconventional ingredients that can function synergistically to reduce the glycemic potency of cereal products.

Impact of processing techniques on the glycemic index of rice

Rice is an important starchy staple food and generally, rice varieties are known to have a higher glycemic index (GI). Over the years, the significance of GI on human health is being better understood and is known to be associated with several lifestyle disorders. Apart from the intrinsic characteristics of rice, different food processing techniques are known to have implications on the GI of rice. This work details the effect of domestic and industrial-level processing techniques on the GI of rice by providing an understanding of the resulting physicochemical changes. An attempt has been made to relate the process-dependent digestion behavior, which in turn reflects on the GI. The role of food constituents is elaborated and the various in vitro and in vivo approaches that have been used to determine the GI of foods are summarized. Considering the broader perspective, the effect of cooking methods and additives is explained. Given the significance of the cereal grain, this work concludes with the challenges and key thrust areas for future research.

A glycaemic index compendium of non-western foods

Current international tables published on the glycaemic index (GI) of foods represent valuable resources for researchers and clinicians. However, the vast majority of published GI values are of Western origin, notably European, Australian and North American. Since these tables focus on Western foods with minimal inclusion of other foods from non-Western countries, their application is of limited global use. The objective of this review is to provide the GI values for a variety of foods that are consumed in non-Western countries. Our review extends and expands on the current GI tables in an attempt to widen its application in many other regions of the world.

Breakfast preferences and consumption location among children at a median age of 7 in Shenzhen: Implications for managing overweight and obesity

BACKGROUND

Breakfast is commonly described as the most important meal of the day; however, we have little information regarding its relevance for childhood overweight and obesity in southern mainland China. This study aimed to assess the association between breakfast preferences, consumption location and overweight and obesity for children in Shenzhen.

METHODS

Among 6126 children (median age 7.2 years) at primary schools, 3504 were finally included after a questionnaire survey and physical examination. Ten commonly consumed foods/beverages for breakfast in southern China were exposure variables, and consumption location, total energy demographic and other dietary characteristics were covariates in logistic regression to determine the effect of breakfast preferences on overweight and obesity, estimating odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

Probability of overweight/general obesity was inversely associated with children eating plain congee for breakfast (adjusted OR 0.689, 95% CI 0.566-0.838), restricted to boys after stratification. Probability of overweight/general obesity and central obesity was positively associated with usually eating steamed rice roll for breakfast (OR 1.309, 95% CI 1.090-1.571 and OR 1.351, 95% CI 1.064-1.717, respectively), but the effect on overweight/obesity remained statistically significant for only boys after stratification. Eating steamed rice roll for breakfast and eating out for breakfast had an additive interaction on overweight/obesity. Additionally, eating bread for breakfast had a mild favorable effect on overweight/obesity but only for girls.

CONCLUSIONS

Keeping a healthy weight might benefit children who eat plain congee or bread for breakfast in China. However, frequent consumption of steamed rice roll for breakfast and especially eating out could contribute to overweight and obesity. Thus, we need to promote a healthier breakfast pattern among children in southern China to reduce the odds of obesity.

Glycemic index of pulses and pulse-based products: a review

Pulses are a major source for plant-based proteins, with over 173 countries producing and exporting over 50 million tons annually. Pulses provide many of the essential nutrients and vitamins for a balanced and healthy diet, hence are health beneficial. Pulses have been known to lower glycemic index (GI), as they elicit lower post prandial glycemic responses, and can prevent insulin resistance, Type 2 diabetes and associated complications. This study reviews the GI values (determined by in vivo methodology) reported in 48 articles during the year 1992-2018 for various pulse type preparations consumed by humans. The GI ranges (glucose and bread as a reference respectively) for each pulse type were: broad bean (40 ± 5 to 94 ± 4, 75 to 93), chickpea (5 ± 1 to 45 ± 1, 14 ± 3 to 96 ± 21), common bean (9 ± 1 to 75 ± 8, 18 ± 2 to 99 ± 11), cowpea (6 ± 1 to 56 ± 0.2, 38 ± 19 to 66 ± 7), lentil (10 ± 3 to 66 ± 6, 37 to 87 ± 6), mung bean (11 ± 2 to 90 ± 9, 28 ± 1 to 44 ± 6), peas (9 ± 2 to 57 ± 2, 45 ± 8 to 93 ± 9), pigeon peas (7 ± 1 to 54 ± 1, 31 ± 4), and mixed pulses (35 ± 5 to 66 ± 23, 69 ± 42 to 98 ± 29). It was found that the method of preparation, processing and heat applications tended to affect the GI of pulses. In addition, removal of the hull, blending, grinding, milling and pureeing, reduced particle size, contributed to an increased surface area and exposure of starch granules to the amylolytic enzymes. This was subsequently associated with rapid digestion and absorption of pulse carbohydrates, resulting in a higher GI. High or increased heat applications to pulses were associated with extensive starch gelatinization, also leading to a higher GI. The type of reference food used (glucose or white bread) and the other nutrients present in the meal also affected the GI.

Dietary intervention strategies for ethnic Chinese women with gestational diabetes mellitus: A systematic review and meta-analysis

AIM

Ethnic Chinese women are one of the populations at high risk of gestational diabetes mellitus (GDM) internationally. This systematic review aimed to determine which dietary intervention strategies were found to be effective in improving glycaemic control and pregnancy outcomes among ethnic Chinese women with GDM.

METHODS

The review protocol was registered with PROSPERO (CRD42016043585). Eight English and four Chinese language databases were searched for randomised controlled trials and cohort studies of dietary intervention among ethnic Chinese women with GDM. Review Manager 5.3 and GRADE criteria were used in meta-analysis and assessment of quality of evidence.

RESULTS

Included studies comprised 3944 women in 29 eligible studies. Compared to standard treatment, low glycaemic index (GI) diets, low glycaemic load (GL) diets and fibre-enriched diets were associated with a reduction in fasting plasma glucose, 2-hour plasma glucose and HbA1c, and improved neonatal outcomes. Low GL diets were associated with reduced caesarean section risk.

CONCLUSIONS

In ethnic Chinese women with GDM, low GI diets, low GL diets and fibre-enriched diets were associated with improved glycaemic control and pregnancy outcomes. Given the lack of direct comparison of these three diets, future direct comparison trials are necessary to determine optimal dietary intervention strategies.

Dietary patterns and their association with the components of metabolic syndrome: A cross-sectional study of adults from northeast Thailand

Background: Nutritional transition influences a shift in eating behaviour that is associated with a rise in the prevalence of non-communicable diseases (NCDs). Metabolic syndrome (MetS) comprises a set of NCD risk factors. This study aimed to investigate dietary patterns and to determine the relationship between dietary patterns and MetS and its components. Methods: A cross-sectional study was conducted among 468 healthy adults aged 35-60 years who were residents of a semi-urban district of one of the central provinces in the northeast of Thailand. A factor analysis identified dietary patterns based on the consumption of 21 food groups, which were assessed by using a semi-quantitative food frequency questionnaire. MetS was identified by using the harmonized criteria that were stipulated by six leading international organisations. The association between dietary patterns and MetS and its components were evaluated by multiple logistic regressions. The confounding factors adjusted in the model were age, sex, smoking status, physical activity, and medication intake. Results: Two dietary patterns were identified: a traditional pattern characterised by high intakes of sticky rice and animal source foods; a mixed pattern included high intakes of white rice and a variety of food groups. The two dietary patterns did not show any association with MetS. Participants in the highest tertile of the traditional pattern was significantly related to high triglycerides (adjusted OR = 1.74, 95% CI: 1.10-2.88), in comparison to those from the lowest tertile, whereas participants in the highest tertile of the mixed pattern was inversely associated with abdominal obesity (adjusted OR= 0.49, 95% CI: 0.30-0.81) than those in the lowest tertile. Conclusions: Adherence to a traditional dietary pattern among the northeast Thai adults, in the context of nutrition transition, was associated with high triglyceride levels while the mixed dietary pattern was inversely related to abdominal obesity.

Dietary patterns and their association with the components of metabolic syndrome: A cross-sectional study of adults from northeast Thailand

Background: Nutritional transition influences a shift in eating behaviour that is associated with a rise in the prevalence of non-communicable diseases (NCDs). Metabolic syndrome (MetS) comprises a set of NCD risk factors. This study aimed to investigate dietary patterns and to determine the relationship between dietary patterns and MetS and its components. Methods: An analytical cross-sectional study was conducted among 468 adults aged 35-60 years who were residents of a semi-urban district of one of the central provinces in the northeast of Thailand. A factor analysis identified dietary patterns based on the consumption of 21 food groups, which were assessed by using a semi-quantitative food frequency questionnaire. MetS was identified by using the harmonized criteria that were stipulated by six leading international organisations. The association between dietary patterns and MetS and its components were evaluated by multiple logistic regressions. The confounding factors adjusted in the model were age, sex, smoking status, physical activity, and medication intake. Results: Two dietary patterns were identified: a traditional pattern characterised by high intakes of sticky rice and animal source foods; a mixed pattern included high intakes of white rice and a variety of food groups. The two dietary patterns did not show any association with MetS. Participants in the highest tertile of the traditional pattern was significantly related to high triglycerides (adjusted OR = 1.74, 95% CI: 1.10-2.88), in comparison to those from the lowest tertile, whereas participants in the highest tertile of the mixed pattern was inversely associated with abdominal obesity (adjusted OR= 0.49, 95% CI: 0.30-0.81) than those in the lowest tertile. Conclusions: Adherence to a traditional dietary pattern among the northeast Thai adults, in the context of nutrition transition, was associated with high triglyceride levels while the mixed dietary pattern was inversely related to abdominal obesity.

Does the ingestion of a 24 hour low glycaemic index Asian mixed meal diet improve glycaemic response and promote fat oxidation? A controlled, randomized cross-over study

BACKGROUND

The health benefits of consuming a low glycaemic index (GI) diet to reduce the risk of type 2 Diabetes are well recognized. In recent years the GI values of various foods have been determined. Their efficacy in constructing and consuming a low GI diet over 24 h in modulating glycaemic response has not been fully documented. The translation of using single-point GI values of foods to develop a 24 h mixed meal diet can provide valuable information to consumers, researchers and dietitians to optimize food choice for glycaemic control. By using GI values of foods to develop mixed meals, our study is the first to determine how both blood glucose and substrate oxidation may be modulated over 24 h.

METHODS

The study included 11 Asian men with a BMI between 17-24 kg/m² who followed both a 1-day low GI and 1-day high GI diet in a randomized, controlled cross-over design. Test meals included breakfast, lunch, snack and dinner. Glycaemic response was measured continuously for over 24 h and postprandial substrate oxidation for 10 h inside a whole body calorimeter.

RESULTS

The low GI diet resulted in lower 24 h glucose iAUC (860 ± 440 vs 1329 ± 614 mmol/L.min; p = 0.014) with lower postprandial glucose iAUC after breakfast (p < 0.001), lunch (p = 0.009), snack (p = 0.012) and dinner (p = 0.003). Moreover, 24 h mean amplitude of glycaemic excursion was lower during the low GI vs high GI diet (1.44 ± 0.63 vs 2.33 ± 0.82 mmol/L; p < 0.001). Simultaneously, decrease in 10 h fat oxidation was less during the low vs high GI diet (-0.033 ± 0.021 vs -0.050 ± 0.017 g/min; p < 0.001), specifically after breakfast (p < 0.001) and lunch (p < 0.001).

CONCLUSIONS

Our study corroborates that using low GI local foods to construct a 24 h low GI diet, is able to reduce glycaemic response and variability as recorded by continuous glucose monitoring. Our observations also confirm that a low GI diet promotes fat oxidation over carbohydrate oxidation when compared to a high GI diet. These observations provide public health support for the encouragement of healthier nutrition choices by consuming low GI foods.

TRIAL REGISTRATION

NCT 02631083 (Clinicaltrials.gov).

Dietary glycaemic index and glycaemic load among Australian adults - results from the 2011-2012 Australian Health Survey

This study aimed to determine the major food groups contributing to dietary glycaemic load (GL). Plausible food intake data collected using a multiple-pass 24 hour recall from a weighted sample of 6326 adult respondents (52% male) of the 2011-2012 Australian Health Survey dataset (AHS) were analysed. The GI of foods was estimated based on a previously published step-wise method. Descriptive statistics were calculated for dietary glycaemic index (GI), GL and contribution to GL by major food groups, stratified by age and sex. Trends across age groups were assessed using linear regression. Pearson's χ² was used to test for differences between age groups for categorical demographics variables. The mean (SD) dietary GI and GL was 54 (7) and 135 (59) respectively and the top 3 contributors to dietary GL were breads (14.4%), cereal-based dishes (10.3%) and breakfast cereals (ready to eat) (6.6%). There were small but significant differences in the GL contribution pattern between the sexes. The findings indicate that the average dietary GI of Australian adults is similar to that of other population groups, with a large proportion of starchy and energy-dense nutrient-poor foods that contribute to a high GL.

The Association of Bread and Rice with Metabolic Factors in Type 2 Diabetic Patients

Purpose

Carbohydrates are shown to have an important role in blood glucose control, type 2 diabetes and cardiovascular diseases risk. This is even more challenging when considering populations consuming refined grains diets. Bread and rice are staple foods which supply main proportion of Iranian calorie intake. This study was designed to investigate the effect of bread and rice intake on blood glucose control, lipid profile and anthropometric measurements in Iranian type 2 diabetic patients.

Methods

426 patients with type 2 diabetes were included in this study. Anthropometric measurements were done using standard methods. Dietary information was assessed by a valid and reliable food frequency questionnaire (FFQ). Fasting blood glucose (FBG), glycated hemoglobin (HbA1c), serum triglycride (TG), total cholesterol (TC), low density lipoprotein (LDL) and high density lipoprotein (HDL) cholesterol were examined after 12-hour fasting.

Results

The results represented that people in the highest tertile compared to the lowest tertile of calorie adjusted total bread intake have higher FBG. FBG in the highest tertile of calorie adjusted total bread-rice intake was also significantly higher than the lowest. The association remained significant after adjusting for potential confounders. Rice intake showed no association with cardio-metabolic risk factors.

Conclusion

We founded that higher total bread intake and total bread-rice intake were associated with FBG in type 2 diabetic patients whereas rice intake was not associated with glucose and lipid profile. This result should be confirmed in prospective studies, considering varieties, glycemic index (GI), glycemic load (GL) and cooking method of bread and rice.

Dietary glycaemic index and glycaemic load among Australian children and adolescents: results from the 2011–2012 Australian Health Survey

This study aimed to examine the dietary glycaemic index (GI) and glycaemic load (GL) of Australian children and adolescents, as well as the major food groups contributing to GL, in the recent 2011–2012 Australian Health Survey. Plausible food intake data from 1876 children and adolescents (51 % boys), collected using a multiple-pass 24-h recall, were analysed. The GI of foods was assigned based on a step-wise published method using values from common GI databases. Descriptive statistics were calculated for dietary GI, GL and contribution to GL by food groups, stratified by age group and sex. Linear regression was used to test for trends across age groups for BMI, dietary GI and GL, and intakes of energy, nutrients and food groups. Pearson’s χ2 test was used to test for differences between age groups for categorical subject characteristic variables. Mean dietary GI and GL of participants were 55·5 (sd 5·3) and 137·4 (sd 50·8), respectively. The main contributors to dietary GL were starchy foods: breads, cereal-based dishes, breakfast cereals, flours, grains and potatoes accounted for 41 % of total GL. Sweetened beverages, fruit and vegetable juices/drinks, cake-type desserts and sweet biscuits contributed 15 %. No significant difference (at P<0·001) was observed between sexes. In conclusion, Australian children and adolescents appear to consume diets with a lower GI than European children. Exchanging high-GI foods for low-GI alternatives within core and non-core foods may improve diet quality of Australian children and adolescents.

Gender Differences in Dietary Patterns and Their Association with the Prevalence of Metabolic Syndrome among Chinese: A Cross-Sectional Study

Few studies have investigated gender differences in dietary intake. The objective of this cross-sectional study was to examine gender differences in dietary patterns and their association with the prevalence of metabolic syndrome. The food intakes of 3794 subjects enrolled by a two-stage cluster stratified sampling method were collected using a valid semi-quantitative food frequency questionnaire (FFQ). Metabolic syndrome (MetS) was defined according to the International Diabetes Federation (IDF) and its prevalence was 35.70% in the sample (37.67% in men and 24.67% in women). Dietary patterns were identified using factor analysis combined with cluster analysis and multiple group confirmatory factor analysis was used to assess the factorial invariance between gender groups. The dominating dietary pattern for men was the “balanced” dietary pattern (32.65%) and that for women was the “high-salt and energy” dietary pattern (34.42%). For men, the “animal and fried food” dietary pattern was related to higher risk of MetS (odds ratio: 1.27; 95% CI: 1.01–1.60), after adjustment for age, marital status, socioeconomic status and lifestyle factors. For women, the “high-salt and energy” dietary pattern was related to higher risk of MetS (odds ratio: 2.27; 95% CI: 1.24–4.14). We observed gender differences in dietary patterns and their association with the prevalence of MetS. For men, the “animal and fried food” dietary pattern was associated with enhancive likelihood of MetS. For women, it was the “high-salt and energy” dietary pattern.

Postprandial changes in cardiometabolic disease risk in young Chinese men following isocaloric high or low protein diets, stratified by either high or low meal frequency - a randomized controlled crossover trial

BACKGROUND

Cardio-Metabolic Disease (CMD) is the leading cause of death globally and particularly in Asia. Postprandial elevation of glycaemia, insulinaemia, triglyceridaemia are associated with an increased risk of CMD. While studies have shown that higher protein intake or increased meal frequency may benefit postprandial metabolism, their combined effect has rarely been investigated using composite mixed meals. We therefore examined the combined effects of increasing meal frequency (2-large vs 6-smaller meals), with high or low-protein (40 % vs 10 % energy from protein respectively) isocaloric mixed meals on a range of postprandial CMD risk markers.

METHODS

In a randomized crossover study, 10 healthy Chinese males (Age: 29 ± 7 years; BMI: 21.9 ± 1.7 kg/m(2)) underwent 4 dietary treatments: CON-2 (2 large Low-Protein meals), CON-6 (6 Small Low-Protein meals), PRO-2 (2 Large High-Protein meals) and PRO-6 (6 Small High-Protein meals). Subjects wore a continuous glucose monitor (CGM) and venous blood samples were obtained at baseline and at regular intervals for 8.5 h to monitor postprandial changes in glucose, insulin, triglycerides and high sensitivity C-reactive protein (hsCRP). Blood pressure was measured at regular intervals pre- and post- meal consumption. Urine was collected to measure excretion of creatinine and F2-isoprostanes and its metabolites over the 8.5 h postprandial period.

RESULTS

The high-protein meals, irrespective of meal frequency were beneficial for glycaemic health since glucose incremental area under the curve (iAUC) for PRO-2 (185 ± 166 mmol.min.L(-1)) and PRO-6 (214 ± 188 mmol.min.L(-1)) were 66 and 60 % lower respectively (both p < 0.05), compared with CON-2 (536 ± 290 mmol.min.L(-1)). The iAUC for insulin was the lowest for PRO-6 (13.7 ± 7.1 U.min.L(-1)) as compared with CON-2 (28.4 ± 15.6 U.min.L(-)1), p < 0.001. There were no significant differences in postprandial responses in other measurements between the dietary treatments.

CONCLUSIONS

The consumption of composite meals with higher protein content, irrespective of meal frequency appears to be beneficial for postprandial glycemic and insulinemic responses in young, healthy Chinese males. Implications of this study may be useful in the Asian context where the consumption of high glycemic index, carbohydrate meals is prevalent.

TRIAL REGISTRATION

NCT02529228 .

Dietary glycemic index and glycemic load and their relationship to cardiovascular risk factors in Chinese children

The purpose of this study was to examine the cross-sectional associations between dietary glycemic index (GI) and glycemic load (GL) and cardiovascular disease (CVD) risk factors in Chinese children. A total of 234 Chinese schoolchildren aged 8-11 years in Guangdong participated in the study. Dietary intake was assessed via a 3-day dietary record. Seven established cardiovascular indicators were analyzed in this study: fasting plasma glucose (FPG), fasting triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), systolic blood pressure, and diastolic blood pressure. Higher dietary GI was significantly associated with higher TG levels (P = 0.037) and lower HDL-C levels (P = 0.005) after adjusting for age, sex, nutritional intake, physical activity, and body mass index z score. LDL-C was found to differ across tertiles of dietary GL. The middle tertile tended to show the highest level of LDL-C. TC, FPG, and blood pressure were independent of both dietary GI and GL. Our findings suggest that higher dietary GI is differentially associated with some CVD risk factors, including lower HDL-C and higher TG, in school-aged children from south China.

Contributors to dietary glycaemic index and glycaemic load in the Netherlands: the role of beer

Diets high in glycaemic index (GI) and glycaemic load (GL) have been associated with a higher diabetes risk. Beer explained a large proportion of variation in GI in a Finnish and an American study. However, few beers have been tested according to International Organization for Standardization (ISO) methodology. We tested the GI of beer and estimated its contribution to dietary GI and GL in the Netherlands. GI testing of pilsner beer (Pilsner Urquell) was conducted at The University of Sydney according to ISO international standards with glucose as the reference food. Subsequently, GI and GL values were assigned to 2556 food items in the 2011 Dutch food composition table using a six-step methodology and consulting four databases. This table was linked to dietary data from 2106 adults in the Dutch National Food Consumption Survey 2007-2010. Stepwise linear regression identified contribution to inter-individual variation in dietary GI and GL. The GI of pilsner beer was 89 (SD 5). Beer consumption contributed to 9·6 and 5·3% inter-individual variation in GI and GL, respectively. Other foods that contributed to the inter-individual variation in GI and GL included potatoes, bread, soft drinks, sugar, candy, wine, coffee and tea. The results were more pronounced in men than in women. In conclusion, beer is a high-GI food. Despite its relatively low carbohydrate content (approximately 4-5 g/100 ml), it still made a contribution to dietary GL, especially in men. Next to potatoes, bread, sugar and sugar-sweetened beverages, beer captured a considerable proportion of between-person variability in GI and GL in the Dutch diet.

Glycaemic index and glycaemic load of selected popular foods consumed in Southeast Asia

The objective of the present study was to determine the glycaemic index (GI) and glycaemic load (GL) values of standard portion sizes of Southeast Asian traditional foods. A total of fifteen popular Southeast Asian foods were evaluated. Of these foods, three were soft drinks, while the other twelve were solid foods commonly consumed in this region. In total, forty-seven healthy participants (eighteen males and twenty-nine females) volunteered to consume either glucose at least twice or one of the fifteen test foods after a 10-12 h overnight fast. Blood glucose concentrations were analysed before consumption of the test food, and 15, 30, 45, 60, 90 and 120 min after food consumption, using capillary blood samples. The GI value of each test food was calculated by expressing the incremental area under the blood glucose response curve (IAUC) value of the test food as a percentage of each participant's average IAUC value, with glucose as the reference food. Among the fifteen foods tested, six belonged to low-GI foods (Ice Green Tea, Beehoon, Pandan Waffle, Curry Puff, Youtiao and Kaya Butter Toast), three belonged to medium-GI foods (Barley Drink, Char Siew Pau and Nasi Lemak), and the other six belonged to high-GI foods (Ice Lemon Tea, Chinese Carrot Cake, Chinese Yam Cake, Chee Cheong Fun, Lo Mai Gai and Pink Rice Cake). The GI and GL values of these traditional foods provide valuable information to consumers, researchers and dietitians on the optimal food choice for glycaemic control. Moreover, our dataset provides GI values of fifteen foods that were not previously tested extensively, and it presents values of foods commonly consumed in Southeast Asia.

Three distinct clustering patterns in metabolic syndrome abnormalities are differentially associated with dietary factors in Korean adults

Dietary factors are not consistently associated with metabolic syndrome abnormalities. In this cross-sectional study, we hypothesized that distinct clustering patterns exist in metabolic syndrome abnormalities and that those patterns are differentially associated with dietary factors. To test this hypothesis, we examined distinct clustering patterns of metabolic syndrome abnormalities and their association with dietary factors in Korean adults. A total of 141 subjects were recruited through the Family Medicine Division of the General Hospital in Seoul. Subjects who had complete data on waist circumference, blood pressure, blood glucose and lipid indicators, and no medication usage were included in this study. Dietary intake data were obtained by multiple 24-hour recalls (2-4 days) through on-site or telephone interviews. To identify clustering patterns of metabolic syndrome abnormalities, factor analysis was used for waist circumference, systolic and diastolic blood pressure, blood glucose, triglycerides, and high-density lipoprotein cholesterol. Three distinct clustering patterns were identified: (1) high blood pressure, (2) dyslipidemia, and (3) high blood glucose. The high blood pressure pattern was significantly associated with higher alcohol intake and lower carbohydrate intake. The dyslipidemia pattern was significantly associated with a diet of high glycemic index and glycemic load. The high blood glucose pattern was associated with lower carbohydrate intake. Metabolic syndrome abnormalities had 3 distinct clustering patterns independently associated with dietary factors. Diets with high glycemic index and glycemic load were strongly linked with the dyslipidemia pattern, and high alcohol intake was linked with the high blood pressure pattern in Korean adults.

A randomized controlled trial to investigate the impact of a low glycemic index (GI) diet on body mass index in obese adolescents

BACKGROUND

The role of a low glycemic index (GI) diet in the management of adolescent obesity remains controversial. In this study, we aim to evaluate the impact of low GI diet versus a conventional Chinese diet on the body mass index (BMI) and other obesity indices of obese adolescents.

METHODS

Obese adolescents aged 15-18 years were identified from population-recruited, territory-wide surveys. Obesity was defined as BMI ≥95th percentile of Hong Kong local age- and sex-specific references. Eligible subjects were randomized to either an intervention with low GI diet (consisting of 45-50% carbohydrate, 30-35% fat and 15-20% protein) or conventional Chinese diet as control (consisting of 55-60% carbohydrate, 25-30% fat and 10-15% protein). We used random intercept mixed effects model to compare the differential changes across the time points from baseline to month 6 between the 2 groups.

RESULTS

104 obese adolescents were recruited (52 in low GI group and 52 in control group; 43.3% boys). Mean age was 16.7 ± 1.0 years and 16.8 ±1.0 years in low GI and control group respectively. 58.7% subjects completed the study at 6 months (65.4% in low GI group and 51.9% in control group). After adjustment for age and sex, subjects in the low GI group had a significantly greater reduction in obesity indices including BMI, body weight and waist circumference (WC) compared to subjects in the control group (all p <0.05). After further adjustment for physical activity levels, WC was found to be significantly lower in the low GI group compared to the conventional group (p = 0.018).

CONCLUSION

Low GI diet in the context of a comprehensive lifestyle modification program may be an alternative to conventional diet in the management of obese adolescents.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov Ref. No: NCT01278563.

Dietary patterns based on carbohydrate nutrition are associated with the risk for diabetes and dyslipidemia

Several studies have been conducted on dietary patterns based on carbohydrate nutrition in Asian populations. We examined the cross-sectional associations in dietary patterns based on carbohydrate nutrition, including the glycemic index (GI) with dyslipidemia and diabetes among the Korean adult population. We analyzed 9,725 subjects (3,795 men and 5,930 women, ≥ 20 years) from the Fourth Korea National Health and Nutrition Examination Survey. Dietary information was collected using single 24-hour recall. Reduced rank regression was used to derive dietary patterns from 22 food groups as predictor variables and four dietary factors related to the quantity and quality of carbohydrates as response variables. Two dietary patterns were identified: 1) the balanced pattern was characterized by high intake of various kinds of foods including white rice, and 2) the rice-oriented pattern was characterized by a high intake of white rice but low intake of vegetables, fruits, meat, and dairy products. Both patterns had considerable amounts of total carbohydrate, but GI values differed. The rice-oriented pattern was positively associated with hypertriglyceridemia in men and low high density lipoprotein-cholesterol in both men and women. The balanced pattern had no overall significant association with the prevalence of dyslipidemia or diabetes, however, men with energy intake above the median showed a reduced prevalence of diabetes across quintiles of balanced pattern scores. The results show that dietary patterns based on carbohydrate nutrition are associated with prevalence of dyslipidemia and diabetes in the Korean adult population.

High carbohydrate intake was inversely associated with high-density lipoprotein cholesterol among Korean adults

The traditional Asian diet, which is characterized as being high in carbohydrate with an abundance of vegetables, may be beneficial for preventing metabolic syndrome abnormalities within the Asian population. However, the prevalence of metabolic syndrome is increasing in Asian countries. This study explored the association between dietary carbohydrates and low high-density lipoprotein cholesterol (HDL-C) prevalence, one of the abnormalities of metabolic syndrome in Korean adults. We used the data from the Fourth Korea National Health and Nutrition Examination Survey and evaluated a total of 9947 Korean adults older 20 years. To measure carbohydrate quality and quantity, total carbohydrate intake (g/d), percentage of energy from carbohydrate, glycemic index, and glycemic load were divided into quintiles. Mean levels of HDL-C significantly decreased across the quintiles for all types of dietary carbohydrate intake except glycemic index after adjusting for potential variables in both men and women. Odds ratios for having low HDL-C in the highest quintile were 1.66 (95% confidence interval, 1.24-2.22) for total carbohydrate, 1.34 (1.02-1.75) for percentage of energy from carbohydrate, and 1.54 (1.17-2.03) for glycemic load in men as compared with the second quintile as a reference. Odds ratio for low HDL-C was 1.38 (1.12-1.71) for percentage of energy from carbohydrate in women. In conclusion, our study indicates that low HDL-C is associated with high carbohydrate intake without regard to energy or fat intake. Further studies would be necessary to optimize carbohydrate intake quantitatively on dyslipidemia for Asian population.

Effect of glycemic index and fructose content in lunch on substrate utilization during subsequent brisk walking

The purpose of the present study was to investigate the effect of glycemic index (GI) and fructose content in lunch on substrate utilization during subsequent brisk walking. Ten healthy young males completed 3 main trials in a counterbalanced crossover design. They completed 60 min of brisk walking at approximately 50% maximal oxygen consumption after consuming a standard breakfast and 1 of 3 lunch meals, i.e., a low GI meal without fructose (LGI), a low GI meal that included fructose beverage (LGIF), or a high GI meal (HGI). The 3 lunch meals were isocaloric and provided 1.0 g·kg⁻¹ carbohydrate. Substrate utilization was measured using indirect respiratory calorimetry method. Blood samples were collected at certain time points. During the 2-h postprandial period after lunch, the incremental area under the blood response curve values of glucose and insulin were higher (p < 0.05) in the HGI trial than those in the LGI and LGIF trials (HGI vs. LGI and LGIF: glucose, 223.5 ± 24.4 vs. 92.5 ± 10.4 and 128.0 ± 17.7 mmol·min·L⁻¹; insulin, 3603 ± 593 vs. 1425 ± 289 and 1888 ± 114 mU·min·L⁻¹). During brisk walking, decreased carbohydrate oxidation was observed (p < 0.05) in the LGI trial than in the LGIF and HGI trials (LGI vs. LGIF and HGI: 60.8 ± 4.0 vs. 68.1 ± 6.0 and 74.4 ± 4.7 g). No difference was found in fat oxidation among the 3 trials (LGI vs. LGIF vs. HGI: 21.6 ± 2.3 vs. 19.2 ± 2.3 vs. 16.4 ± 2.2 g). It appeared that fructose content was an important influencing factor when considering the effect of different GI lunch meals on substrate utilization during subsequent moderate intensity exercise.

In vitro and in vivo assessment of the glycemic index of bakery products: influence of the reformulation of ingredients

PURPOSE

To evaluate whether the modification of ingredients of two bakery products, muffins and bread, reduces their glycemic index, by means of in vitro and in vivo procedures.

METHODS

In vitro and in vivo glycemic index were evaluated for two types of bread and two types of muffins including one standard product for each category. For the in vitro determination, kinetics of starch digestion method was used. For the in vivo procedure, postprandial glucose measured as IAUC was obtained in a group of eighteen healthy volunteers (ten did the test with muffins and eight with breads).

RESULTS

In in vitro, a reduction in the expected glycemic index regarding the control muffin was achieved with the partial substitution of wheat flour by a mixture of resistant starch, dextrin and lentil flour. In breads, with the partial substitution of wheat flour by a mixture of resistant starch and dextrins, a decrease in the expected glycemic index was also observed. In in vivo, a reduction in GI was also achieved both in muffin and in bread. All the obtained GI was higher in in vitro method.

CONCLUSIONS

Despite the fact that in vitro overestimate in vivo method, the trend in the reduction in GI seems to be similar in both methods. With the substitution assayed, a reduction in the expected glycemic index and the glycemic index were obtained both in muffins and in breads.