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Zhang Y, Feng H, Li X, Chen Q, Shao R, Wang C, Gao Y. Association of dietary glycemic index and glycemic load with the risk of gestational diabetes mellitus: a systematic review and dose-response meta-analysis. Gynecol Endocrinol 2024; 40:2375564. [PMID: 38976721 DOI: 10.1080/09513590.2024.2375564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 06/28/2024] [Indexed: 07/10/2024] Open
Abstract
OBJECTIVE To comprehensively assess the dose-response association between dietary glycemic index (GI) and glycemic load (GL) and gestational diabetes mellitus (GDM) risk. METHODS PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang, and VIP databases were searched up to May 29, 2024. Studies with at least three exposure categories were included. Dose-response analysis was also performed when covariates were adjusted in the included studies. RESULTS Thirteen studies involving 39,720 pregnant women were included. A linear relationship was found between GI and the risk of GDM (χ2 = 4.77, Pnon-linearity = .0923). However, association was not significant (χ2 = 0.06, p = .8000). For every unit increase in GI (range 0-30), GDM risk increased by 0.29%. After adjusting for covariates, the linear relationship persisted (χ2 = 4.95, Pnon-linearity = .084) with no significant association (χ2 = 0.08, p = .7775). For GL, a linear relationship was also found (χ2 = 4.17, Pnon-linearity =.1245), but GL was not significantly associated with GDM risk (χ2 = 2.63, p = .1049). The risk of GDM increased by 0.63% per unit increase in GL. After covariate adjustment, a significant association was observed (χ2 = 6.28, p = .0122). CONCLUSION No significant association between GI and GDM risk was found. After adjusting for covariates, GL shows a significant association with GDM risk. Our findings emphasize the importance of considering dietary GL in managing the risk of GDM. Future research should continue to explore these relationships with standardized diagnostic criteria and robust adjustment for potential confounders.
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Affiliation(s)
- Yu Zhang
- Department of Obstetrics and Gynecology, People's Hospital of Chongqing Banan District, Banan Hospital of Chongqing Medical University, Chongqing, China
| | - Huanrong Feng
- Department of Obstetrics and Gynecology, Liaocheng People's Hospital and Liaocheng Clinical School of Shandong First Medical University, Shandong, Liaocheng, China
| | - Xuefeng Li
- Department of Obstetrics and Gynecology, People's Hospital of Chongqing Banan District, Banan Hospital of Chongqing Medical University, Chongqing, China
| | - Qiong Chen
- Department of Obstetrics and Gynecology, People's Hospital of Chongqing Banan District, Banan Hospital of Chongqing Medical University, Chongqing, China
| | - Ruyue Shao
- School of Clinical Medicine, Chongqing Medical and Pharmaceutical College, Chongqing, China
- Chongqing Engineering Research Center of Pharmaceutical Sciences, Chongqing, China
| | - Chengli Wang
- Department of Obstetrics and Gynecology, People's Hospital of Chongqing Banan District, Banan Hospital of Chongqing Medical University, Chongqing, China
| | - Yimeng Gao
- Department of Obstetrics and Gynecology, Liaocheng People's Hospital and Liaocheng Clinical School of Shandong First Medical University, Shandong, Liaocheng, China
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Djousse L, Zhou X, Lim J, Kim E, Sesso HD, Lee IM, Buring JE, McClelland RL, Gaziano JM, Steffen LM, Manson JE. Potato Consumption and Risk of Type 2 Diabetes Mellitus: A Harmonized Analysis of 7 Prospective Cohorts. J Nutr 2024; 154:3079-3087. [PMID: 39289134 DOI: 10.1016/j.tjnut.2024.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/27/2024] [Accepted: 07/12/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND Data on the relation of potato consumption with risk of type 2 diabetes (T2D) are limited and inconsistent. It is unclear whether the plant-based diet index (PDI), which is a novel and comprehensive tool to assess overall dietary pattern, modifies the association of potato intake with T2D. OBJECTIVES We examined the association of total, combined baked, boiled, and mashed potatoes and fried potatoes with risk of T2D and test the interaction between PDI score and potato consumption on T2D risk. METHODS We conducted a de novo, harmonized, individual-level data from 7 United States cohorts (N = 105,531). Cox regression was used to estimate hazard ratios (HRs) separately in each cohort adjusting for anthropometric, demographic, and lifestyle factors and cohort-specific results were pooled using an inverse-variance weighted method. RESULTS Mean age ranged from 25 to 72 y, 65% women, and mean consumption of total potatoes ranged from 1.9 to 4.3 times per week. In the primary analysis, total potato intake was not associated with T2D risk: multivariable adjusted HR of 1.01 (95% confidence interval [CI]: 0.95, 1.08) for consumption of 1-2 servings/wk; 1.01 (95% CI: 0.93, 1.10) for >2-3 servings/wk; 1.05 (95% CI: 0.99, 1.12) for >3 to <5 servings/wk; and 1.07 (95% CI: 0.99, 1.16) for 5+ servings/wk compared with no potato intake. In secondary analyses, consumption of combined baked, boiled, and mashed potatoes was not associated with T2D risk, whereas fried potato consumption was positively associated with T2D risk: HR were 1 (ref), 1.07 (95% CI: 1.02, 1.12), and 1.12 (95% CI: 1.03, 1.22) for intake frequency of 0/wk, >0 to 1/wk, and >1/wk, respectively (P-trend = 0.04). There was no significant interaction between PDI score and potato consumption on T2D risk. CONCLUSIONS Although consumption of total potato is not associated with T2D risk, a modest elevated risk of T2D is observed with fried potato consumption.
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Affiliation(s)
- Luc Djousse
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States; Department of Medicine, Harvard Medical School, Boston, MA, United States.
| | - Xia Zhou
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Jaewon Lim
- Department of Biostatistics, University of Washington, Seattle, WA, United States
| | - Eunjung Kim
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Howard D Sesso
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States; Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - I-Min Lee
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States; Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Julie E Buring
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States; Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Robyn L McClelland
- Department of Biostatistics, University of Washington, Seattle, WA, United States
| | - John M Gaziano
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States; Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Lyn M Steffen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States; Department of Medicine, Harvard Medical School, Boston, MA, United States
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3
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Kavanagh ME, Back S, Chen V, Glenn AJ, Viscardi G, Houshialsadat Z, Sievenpiper JL, Kendall CWC, Jenkins DJA, Chiavaroli L. The Portfolio Diet and HbA1c in Adults Living with Type 2 Diabetes Mellitus: A Patient-Level Pooled Analysis of Two Randomized Dietary Trials. Nutrients 2024; 16:2817. [PMID: 39275135 PMCID: PMC11397446 DOI: 10.3390/nu16172817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2024] [Revised: 08/17/2024] [Accepted: 08/20/2024] [Indexed: 09/16/2024] Open
Abstract
(1) Background: The Portfolio Diet, a dietary pattern of cholesterol-lowering foods, is also rich in low glycemic index (GI) foods. While strong evidence supports clinically meaningful reductions in cholesterol, evidence on the relationship between the Portfolio Diet and diabetes management is lacking. (2) Objective: To evaluate the relationship between the Portfolio Diet and glycated hemoglobin (HbA1c) as a determinant of glycemic control among adults living with type 2 diabetes mellitus (T2DM). (3) Methods: Patient-level data was pooled from two randomized dietary trials of low glycemic index interventions compared to high cereal fibre control diets in adults living with T2DM where HbA1c was collected (clinicaltrials.gov identifiers: NCT00438698, NCT00438698). Dietary exposure was assessed using weighed 7-day diet records. Adherence to the Portfolio Diet and its pillars (nuts and seeds, plant protein, viscous fibre, plant sterols, monounsaturated fatty acid [MUFA] oils) was determined using the validated clinical Portfolio Diet Score (c-PDS). Multiple linear regression was used to assess the association between change in the c-PDS and change in HbA1c over 6-months with covariate adjustments. (4) Results: A total of 267 participants, predominantly White (67%) and male (63%), were included, with a mean ± standard error age of 62 ± 0.5 years, baseline BMI of 30.2 ± 0.3 kg/m2, HbA1c of 7.08 ± 0.03%, and a c-PDS of 4.1 ± 0.3 points out of 25. Change in the c-PDS was significantly associated with a change in HbA1c (β: -0.04% per point, 95% CI: -0.07, -0.02, p = 0.001). A 7.5-point (30%) increase in the c-PDS was associated with a 0.3% reduction in HbA1c. Of the individual pillars, a 1-point change in nut and seeds intake (β: -0.07%, 95% CI: -0.12, -0.02, p = 0.009) or in plant protein intake (β: -0.11%, 95% CI: -0.18, -0.03, p = 0.009) was associated with a change in HbA1c. Further analysis of plant protein intake revealed that an increase in dietary pulse intake, a particularly low-GI food, was significantly associated with a reduction in HbA1c (β: -0.24% per 1-cup points cooked pulses (226 g) or 2 c-PDS points, 95% CI: -0.45, -0.03, p = 0.028). (5) Conclusions: Among adults living with T2DM, the Portfolio Diet was associated with lower HbA1c over a 6-month period, predominantly driven by two pillars: nuts and seeds and plant protein, particularly dietary pulses. These data have implications for including the Portfolio Diet in dietary recommendations for glycemic control in T2DM. A trial demonstrating the direct causal effect of the Portfolio Diet in a diverse group is warranted.
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Affiliation(s)
- Meaghan E Kavanagh
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
| | - Songhee Back
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
| | - Victoria Chen
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
| | - Andrea J Glenn
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Gabrielle Viscardi
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
| | - Zeinab Houshialsadat
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
- Division of Endocrinology and Metabolism, St. Michael's Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Cyril W C Kendall
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - David J A Jenkins
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
- Division of Endocrinology and Metabolism, St. Michael's Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Laura Chiavaroli
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
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Wang J, Wei Y, Galizzi MM, Kwan HS, Zee BCY, Fung H, Yung TKC, Wong ELY, Yue Q, Lee MKL, Wu Y, Wang K, Wu H, Yeoh EK, Chong KC. Evaluating the impact of sugar-sweetened beverages tax on overweight, obesity, and type 2 diabetes in an affluent Asian setting: A willingness-to-pay survey and simulation analysis. Prev Med 2024; 184:107994. [PMID: 38723779 DOI: 10.1016/j.ypmed.2024.107994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/03/2024] [Accepted: 05/06/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND The potential health effects of taxing sugar-sweetened beverages (SSBs) has been insufficiently examined in Asian contexts. This study aimed to assess the impact of SSB taxation on the prevalence of obesity/overweight and type 2 diabetes mellitus (T2DM) in Hong Kong using a willingness-to-pay (WTP) survey and simulation analysis. METHODS A random telephone survey was conducted with 1000 adults from May to June 2020. We used a contingent valuation approach to assess individuals' WTP for SSBs under four tax payment scenarios (5%, 10%, 40%, and 50% of the current market price). Based on the WTP, a simulation analysis was conducted to project changes in SSB purchase and associated reductions in the prevalence of obesity/overweight and T2DM over a 10-year simulation period. FINDINGS When 5% and 10% taxation rates were introduced, approximately one-third of the population were unwilling to maintain their SSB purchase. Our simulation demonstrated a gradual decline in the prevalence of obesity/overweight and diabetes with a more pronounced decrease when higher taxation rates were introduced. 10% taxation resulted in a mean reduction of 1532.7 cases of overweight/obesity per 100 thousand population at the sixth year, while T2DM prevalence decreased by 267.1 (0.3%). CONCLUSIONS This study underscores the effects of an SSB tax on purchase behaviors and health outcomes in an affluent Asia setting, with a more pronounced influence on adult population. These findings are expected to inform policymakers in making decisions regarding an effective and equitable tax rate on SSBs.
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Affiliation(s)
- Jingxuan Wang
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuchen Wei
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, China
| | - Matteo M Galizzi
- Department of Psychological and Behavioural Science, London School of Economics and Political Science, London, UK
| | - Hoi Shan Kwan
- School of Life Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Benny Chung Ying Zee
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Hong Fung
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Tony Ka Chun Yung
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Eliza Lai Yi Wong
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Qianying Yue
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Yushan Wu
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, China
| | - Kailu Wang
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, China
| | - Hongjiang Wu
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Eng Kiong Yeoh
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, China
| | - Ka Chun Chong
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, China; Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China.
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5
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Sequeira-Bisson IR, Lu LW, Silvestre MP, Plank LD, Middleditch N, Acevedo-Fani A, Parry-Strong A, Hollingsworth KG, Tups A, Miles-Chan JL, Krebs JD, Foster M, Poppitt SD. Glycaemic Response to a Nut-Enriched Diet in Asian Chinese Adults with Normal or High Glycaemia: The Tū Ora RCT. Nutrients 2024; 16:2103. [PMID: 38999851 PMCID: PMC11243085 DOI: 10.3390/nu16132103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 06/27/2024] [Accepted: 06/28/2024] [Indexed: 07/14/2024] Open
Abstract
Nut-based products are a good source of high-quality plant protein in addition to mono- and polyunsaturated fatty acids, and may aid low-glycaemic dietary strategies important for the prevention of type 2 diabetes (T2D). In particular, they may be advantageous in populations susceptible to dysglycaemia, such as Asian Chinese. The present study aimed to compare effects of a higher-protein nut bar (HP-NB, also higher in total fibre and unsaturated fats, comprising mixed almonds and peanuts) vs. an isoenergetic higher-carbohydrate cereal bar (HC-CB) within the diet of 101 Chinese adults with overweight and normo- or hyperglycaemia. Ectopic pancreas and liver fat were characterised using magnetic resonance imaging and spectroscopy (MRI/S) as a secondary outcome. Participants were randomized to receive HP-NB or HC-CB daily as a 1 MJ light meal or snack replacement, in addition to healthy eating advice. Anthropometry and clinical indicators of T2D risk were assessed fasted and during an oral glucose tolerance test (OGTT), pre- and post-intervention. No significant difference was observed between diet groups for body weight, body mass index, waist or hip circumference, blood pressure, glucoregulatory markers, lipid profile or inflammatory markers over 12 weeks (all, p > 0.05). No difference was observed between glycaemic subgroups or those with normal versus high ectopic organ fat. Although HP-NB can attenuate postprandial glycaemia following a meal, no effects were observed for either fasting or glucose-mediated outcomes following longer-term inclusion in the habitual diet of Chinese adults with overweight, including at-risk subgroups.
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Affiliation(s)
- Ivana R. Sequeira-Bisson
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland 1024, New Zealand; (I.R.S.-B.); (L.W.L.); (M.P.S.); (J.L.M.-C.)
- High Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (N.M.); (A.A.-F.); (J.D.K.); (M.F.)
- Riddet Institute, Massey University, Palmerston North 4442, New Zealand
| | - Louise W. Lu
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland 1024, New Zealand; (I.R.S.-B.); (L.W.L.); (M.P.S.); (J.L.M.-C.)
- High Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (N.M.); (A.A.-F.); (J.D.K.); (M.F.)
| | - Marta P. Silvestre
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland 1024, New Zealand; (I.R.S.-B.); (L.W.L.); (M.P.S.); (J.L.M.-C.)
- High Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (N.M.); (A.A.-F.); (J.D.K.); (M.F.)
- Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS), NOVA University of Lisbon, 1169-056 Lisbon, Portugal
| | - Lindsay D. Plank
- Department of Surgery, University of Auckland, Auckland 1023, New Zealand;
| | - Nikki Middleditch
- High Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (N.M.); (A.A.-F.); (J.D.K.); (M.F.)
- School of Food and Advanced Technology, Massey University, Palmerston North 4442, New Zealand
| | - Alejandra Acevedo-Fani
- High Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (N.M.); (A.A.-F.); (J.D.K.); (M.F.)
- Riddet Institute, Massey University, Palmerston North 4442, New Zealand
| | - Amber Parry-Strong
- Department of Medicine, University of Otago, Dunedin 9054, New Zealand;
- Centre for Endocrine, Diabetes and Obesity Research (CEDOR), Te Whatu Ora, Capital and Coast Health, Wellington 6242, New Zealand
| | - Kieren G. Hollingsworth
- Translational and Clinical Research Institute, Faculty of Medical Science, Newcastle University, Newcastle-upon-Tyne NE1 7RU, UK
| | - Alexander Tups
- Centre for Neuroendocrinology, University of Otago, Dunedin 9054, New Zealand;
| | - Jennifer L. Miles-Chan
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland 1024, New Zealand; (I.R.S.-B.); (L.W.L.); (M.P.S.); (J.L.M.-C.)
- High Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (N.M.); (A.A.-F.); (J.D.K.); (M.F.)
- Riddet Institute, Massey University, Palmerston North 4442, New Zealand
| | - Jeremy D. Krebs
- High Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (N.M.); (A.A.-F.); (J.D.K.); (M.F.)
- Department of Medicine, University of Otago, Dunedin 9054, New Zealand;
- Centre for Endocrine, Diabetes and Obesity Research (CEDOR), Te Whatu Ora, Capital and Coast Health, Wellington 6242, New Zealand
| | - Meika Foster
- High Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (N.M.); (A.A.-F.); (J.D.K.); (M.F.)
- Edible Research Ltd., Ohoka, Christchurch 7475, New Zealand
| | - Sally D. Poppitt
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland 1024, New Zealand; (I.R.S.-B.); (L.W.L.); (M.P.S.); (J.L.M.-C.)
- High Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (N.M.); (A.A.-F.); (J.D.K.); (M.F.)
- Riddet Institute, Massey University, Palmerston North 4442, New Zealand
- Department of Medicine, University of Auckland, Auckland 1023, New Zealand
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Skurk T, Bosy-Westphal A, Grünerbel A, Kabisch S, Keuthage W, Kronsbein P, Müssig K, Nussbaumer H, Pfeiffer AFH, Simon MC, Tombek A, Weber KS, Rubin D. Dietary Recommendations for Persons with Type 2 Diabetes Mellitus. Exp Clin Endocrinol Diabetes 2024; 132:182-215. [PMID: 38286422 DOI: 10.1055/a-2166-6772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Affiliation(s)
- Thomas Skurk
- ZIEL Institute for Food & Health, Technical University of Munich, Freising, Germany
| | - Anja Bosy-Westphal
- Institute of Human Nutrition, Faculty of Agriculture and Nutritional Sciences, Christian-Albrechts University of Kiel, Kiel, Germany
| | | | - Stefan Kabisch
- German Institute of Human Nutrition Potsdam-Rehbrücke, Potsdam, Germany
- German Center for Diabetes Research (DZD), Munich, Germany
| | - Winfried Keuthage
- Specialist Practice for Diabetes and Nutritional Medicine, Münster, Germany
| | - Peter Kronsbein
- Faculty of Nutrition and Food Sciences, Niederrhein University of Applied Sciences, Mönchengladbach Campus, Mönchengladbach, Germany
| | - Karsten Müssig
- Department of Internal Medicine, Gastroenterology and Diabetology, Niels Stensen Hospitals, Franziskus Hospital Harderberg, Georgsmarienhütte, Germany
| | | | - Andreas F H Pfeiffer
- Department of Endocrinology, Diabetes and Nutritional Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Marie-Christine Simon
- Institute of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Astrid Tombek
- Diabetes Centre Bad Mergentheim, Bad Mergentheim, Germany
| | - Katharina S Weber
- Institute for Epidemiology, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Diana Rubin
- Vivantes Hospital Spandau, Berlin, Germany
- Vivantes Humboldt Hospital, Berlin, Germany
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7
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Bohl M, Gregersen S, Zhong Y, Hebelstrup KH, Hermansen K. Beneficial glycaemic effects of high-amylose barley bread compared to wheat bread in type 2 diabetes. Eur J Clin Nutr 2024; 78:243-250. [PMID: 37940671 DOI: 10.1038/s41430-023-01364-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Cereals foods with a high content of dietary fibres or amylose have potential to lower postprandial glucose levels. Optimisation of cereal foods may improve management of type 2 diabetes (T2D). METHODS We investigated the impact on 4 h postprandial glucose responses given as incremental area under curve (iAUC) of bread made of either 50% RNAi-based (genetically modified) amylose-only barley flour (AmOn) (and 50% wheat flour), 50% hulless barley flour (and 50% wheat flour) or 75% hulless barley (and 25% wheat flour) in subjects with T2D compared with 100% wheat flour bread. DESIGN Twenty adults with T2D were randomly allocated to one of four breads at four separate visits. We measured fasting and 4 h postprandial responses of glucose, insulin, glucagon, triacylglycerol (TG), free fatty acids (FFA), glucagon-like peptide-1 (GLP-1) and gastric inhibitory polypeptide (GIP). Mixed model ANOVA was used to examine the differences. RESULTS Bread made from 50% AmOn lowered the 4 h postprandial glucose by 34%, 27%, 23% (P < 0.05) compared with 100% wheat, 50% or 75% hulless barley, respectively. Bread made from 75% hulless barley reduced the postprandial glucose response (iAUC) by 11% (P < 0.05) compared to 100% wheat bread. Postprandial insulin responses (iAUC) were reduced for 50% AmOn compared with 100% wheat and 50% hulless barley and for 75% hulless compared to 50% hulless barley bread (P < 0.05). 4 h postprandial glucagon (tAUC) did not differ between the four bread types (P > 0.05). Lower postprandial GIP (iAUC) was observed after all barley breads compared to 100% wheat (P < 0.05), whereas no difference was seen in postprandial GLP-1. Postprandial TG and FFA (tAUC) were difficult to judge due to differences in fasting values. CONCLUSIONS Bread made by replacing wheat flour with either 50% high-amylose or 75% hulless barley flour lowered postprandial glucose responses compared to 100% wheat bread indicating a beneficial impact on glucose regulation in T2D subjects. This trial was registered at clinicaltrials.gov as NCT04646746.
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Affiliation(s)
- Mette Bohl
- Steno Diabetes Centre Aarhus, Aarhus University Hospital, 8200, Aarhus N, Denmark.
- Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, 8600, Silkeborg, Denmark.
| | - Søren Gregersen
- Steno Diabetes Centre Aarhus, Aarhus University Hospital, 8200, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8200, Aarhus N, Denmark
| | - Yuyue Zhong
- Department of Plant and Environmental Sciences, University of Copenhagen, 1871, Frederiksberg C, Denmark
| | - Kim Henrik Hebelstrup
- Department of Agroecology, Section for Crop Genetics and Biotechnology, Aarhus University, 4200, Slagelse, Denmark
- Plantcarb Aps, 2970, Hørsholm, Denmark
| | - Kjeld Hermansen
- Department of Clinical Medicine, Aarhus University, 8200, Aarhus N, Denmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, 8200, Aarhus N, Denmark
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Strydom H, Delport E, Muchiri J, White Z. The Application of the Food Insulin Index in the Prevention and Management of Insulin Resistance and Diabetes: A Scoping Review. Nutrients 2024; 16:584. [PMID: 38474713 DOI: 10.3390/nu16050584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/08/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
The food insulin index (FII) is a novel algorithm used to determine insulin responses of carbohydrates, proteins, and fats. This scoping review aimed to provide an overview of all scientifically relevant information presented on the application of the FII in the prevention and management of insulin resistance and diabetes. The Arksey and O'Malley framework and the PRISMA Extension for Scoping Reviews 22-item checklist were used to ensure that all areas were covered in the scoping review. Our search identified 394 articles, of which 25 articles were included. Three main themes emerged from the included articles: 1. the association of FII with the development of metabolic syndrome, insulin resistance, and diabetes, 2. the comparison of FII with carbohydrate counting (CC) for the prediction of postprandial insulin response, and 3. the effect of metabolic status on the FII. Studies indicated that the FII can predict postprandial insulin response more accurately than CC, and that a high DII and DIL diet is associated with the development of metabolic syndrome, insulin resistance, and diabetes. The FII could be a valuable tool to use in the prevention and management of T1DM, insulin resistance, and T2DM, but more research is needed in this field.
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Affiliation(s)
- Hildegard Strydom
- Department of Human Nutrition, University of Pretoria, Pretoria 0084, South Africa
| | - Elizabeth Delport
- GI Foundation of South Africa, Nelspruit, Mbombela 1201, South Africa
| | - Jane Muchiri
- Department of Human Nutrition, University of Pretoria, Pretoria 0084, South Africa
| | - Zelda White
- Department of Human Nutrition, University of Pretoria, Pretoria 0084, South Africa
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9
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Haxhari F, Savorani F, Rondanelli M, Cantaluppi E, Campanini L, Magnani E, Simonelli C, Gavoci G, Chiadò A, Sozzi M, Cavallini N, Chiodoni A, Gasparri C, Barrile GC, Cavioni A, Mansueto F, Mazzola G, Moroni A, Patelli Z, Pirola M, Tartara A, Guido D, Perna S, Magnaghi R. Endosperm structure and Glycemic Index of Japonica Italian rice varieties. FRONTIERS IN PLANT SCIENCE 2024; 14:1303771. [PMID: 38250450 PMCID: PMC10796725 DOI: 10.3389/fpls.2023.1303771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/08/2023] [Indexed: 01/23/2024]
Abstract
Introduction Given that rice serves as a crucial staple food for a significant portion of the global population and with the increasing number of individuals being diagnosed with diabetes, a primary objective in genetic improvement is to identify and cultivate low Glycemic Index (GI) varieties. This must be done while ensuring the preservation of grain quality. Methods 25 Italian rice genotypes were characterized calculating their GI "in vivo" and, together with other 29 Italian and non-Italian genotypes they were studied to evaluate the grain inner structure through Field Emission Scanning Electron Microscopy (FESEM) technique. Using an ad-hoc developed algorithm, morphological features were extracted from the FESEM images, to be then inspected by means of multivariate data analysis methods. Results and Discussion Large variability was observed in GI values (49 to 92 with respect to glucose), as well as in endosperm morphological features. According to the percentage of porosity is possible to distinguish approximately among rice varieties having a crystalline grain (< 1.7%), those intended for the preparation of risotto (> 5%), and a third group having intermediate characteristics. Waxy rice varieties were not united by a certain porosity level, but they shared a low starch granules eccentricity. With reference to morphological features, rice varieties with low GI (<55) seem to be characterized by large starch granules and low porosity values. Our data testify the wide variability of Italian rice cultivation giving interesting information for future breeding programs, finding that the structure of the endosperm can be regarded as a specific characteristic of each variety.
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Affiliation(s)
- Filip Haxhari
- Centro Ricerche sul Riso, Ente Nazionale Risi, Castello D’Agogna, Italy
| | - Francesco Savorani
- Department of Applied Science and Technology (DISAT), Polytechnic University of Turin, Torino, Italy
| | - Mariangela Rondanelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Enrico Cantaluppi
- Centro Ricerche sul Riso, Ente Nazionale Risi, Castello D’Agogna, Italy
| | - Luigi Campanini
- Centro Ricerche sul Riso, Ente Nazionale Risi, Castello D’Agogna, Italy
| | - Edoardo Magnani
- Centro Ricerche sul Riso, Ente Nazionale Risi, Castello D’Agogna, Italy
| | - Cinzia Simonelli
- Centro Ricerche sul Riso, Ente Nazionale Risi, Castello D’Agogna, Italy
| | - Gentian Gavoci
- Department of Applied Science and Technology (DISAT), Polytechnic University of Turin, Torino, Italy
| | - Alessandro Chiadò
- Department of Applied Science and Technology (DISAT), Polytechnic University of Turin, Torino, Italy
| | - Mattia Sozzi
- Department of Applied Science and Technology (DISAT), Polytechnic University of Turin, Torino, Italy
| | - Nicola Cavallini
- Department of Applied Science and Technology (DISAT), Polytechnic University of Turin, Torino, Italy
| | - Angelica Chiodoni
- Center for Sustainable Future Technologies @Polito, Istituto Italiano di Tecnologia, Torino, Italy
| | - Clara Gasparri
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, Pavia, Italy
| | - Gaetan Claude Barrile
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, Pavia, Italy
| | - Alessandro Cavioni
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, Pavia, Italy
| | - Francesca Mansueto
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, Pavia, Italy
| | - Giuseppe Mazzola
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, Pavia, Italy
| | - Alessia Moroni
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, Pavia, Italy
| | - Zaira Patelli
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, Pavia, Italy
| | - Martina Pirola
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, Pavia, Italy
| | - Alice Tartara
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, Pavia, Italy
| | - Davide Guido
- Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Simone Perna
- Department of Biology, College of Science, University of Bahrain, Zallaq, Bahrain
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Mela DJ, Boers HM, Kadam T, Hiemstra H, Kalathil R, Seijen Ten Hoorn JWM. Effect of mulberry fruit extract on post-prandial glycaemic and insulinemic responses to different rice types: a randomised trial in healthy adults. Br J Nutr 2023; 130:2088-2094. [PMID: 37272629 DOI: 10.1017/s0007114523001319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We previously reported that the addition of a specified mulberry fruit extract (MFE) to rice consistently reduces post-prandial glycaemic (PPG) and post-prandial insulinemic (PPI) responses. This research tested whether this effect generalises to a broad range of rice types, reflecting the wide variation in rice characteristics known to influence glycaemic responses. In a randomised, balanced, partial factorial crossover design, Sona Masoori (SM), Bora Saul (BS), Gobindobogh (Gb) and Banskati (Bn) rices were tested with and without 0·37 g MFE. Healthy, normal-weight Indian adults (N 120) each consumed four of the eight possible boiled rice meals, all containing about 50 g available carbohydrate. The primary outcome was the effect of MFE on PPG, expressed as the percentage change in the positive, incremental AUC over 2 h. The mean effect of MFE on PPG for all rice types combined was -11·4 % (P < 0·003). The reduction in PPG was in a qualitatively similar range for all rice types (-9·8 to -15·1 %), and this was statistically significant for Bn. MFE also reduced the corresponding PPI response to all rice types combined by a mean of 10·1 % (P < 0·001; range -6·1 to -13·4 %), and the reduction in PPI was statistically significant for SM, Gb and BS. In conclusion, addition of 0·37 g MFE modestly reduced PPG and PPI responses to rices in general, and the effects were statistically significant for specific rice types.
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Boers HM, van Dijk TH, Duchateau GS, Mela DJ, Hiemstra H, Hoogenraad AR, Priebe MG. Effect of mulberry fruit extract on glucose fluxes after a wheat porridge meal: a dual isotope study in healthy human subjects. Eur J Clin Nutr 2023; 77:741-747. [PMID: 36944719 DOI: 10.1038/s41430-023-01282-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 03/04/2023] [Accepted: 03/09/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Previous research has shown the efficacy of mulberry extracts for lowering post-prandial glucose (PPG) responses. The postulated mechanism is slowing of glucose absorption, but effects on glucose disposal or endogenous production are also possible. This research assessed the effect of a specified mulberry fruit extract (MFE) on these three glucose flux parameters. METHODS The study used a double-blind, randomized, controlled, full cross-over design. In 3 counter-balanced treatments, 12 healthy adult male subjects, mean (SD) age 24.9 (2.50) years and body mass index 22.5 (1.57) kg/m2, consumed porridge prepared from 13C-labelled wheat, with or without addition of 0.75 g MFE, or a solution of 13C-glucose in water. A co-administered 2H-glucose venous infusion allowed for assessment of glucose disposal. Glucose flux parameters, cumulative absorption (time to 50% absorption, T50%abs), and PPG positive incremental area under the curve from 0 to 120 min (+iAUC0-120) were determined from total and isotopically labelled glucose in plasma. As this exploratory study was not powered for formal inferential statistical tests, results are reported as the mean percent difference (or minutes for T50%abs) between treatments with 95% CI. RESULTS MFE increased mean T50%abs by 10.2 min, (95% CI 3.9-16.5 min), and reduced mean 2 h post-meal rate of glucose appearance by 8.4% (95% CI -14.9 to -1.4%) and PPG + iAUC0-120 by 11% (95% CI -26.3 to -7.3%), with no significant changes in glucose disposal or endogenous production. CONCLUSIONS The PPG-lowering effect of MFE is primarily mediated by a reduced rate of glucose uptake.
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Affiliation(s)
- Hanny M Boers
- Unilever Foods Innovation Centre, 6708 WH, Wageningen, The Netherlands.
| | - Theo H van Dijk
- Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ, Groningen, The Netherlands
| | - Guus S Duchateau
- Unilever Foods Innovation Centre, 6708 WH, Wageningen, The Netherlands
| | - David J Mela
- Unilever Foods Innovation Centre, 6708 WH, Wageningen, The Netherlands.
| | - Harry Hiemstra
- Unilever Foods Innovation Centre, 6708 WH, Wageningen, The Netherlands
| | | | - Marion G Priebe
- Center for Medical Biomics, University Medical Center Groningen, University of Groningen, 9713 AV, Groningen, The Netherlands
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Della Corte K, Jalo E, Kaartinen NE, Simpson L, Taylor MA, Muirhead R, Raben A, Macdonald IA, Fogelholm M, Brand-Miller J. Longitudinal Associations of Dietary Sugars and Glycaemic Index with Indices of Glucose Metabolism and Body Fatness during 3-Year Weight Loss Maintenance: A PREVIEW Sub-Study. Nutrients 2023; 15:2083. [PMID: 37432216 DOI: 10.3390/nu15092083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/21/2023] [Accepted: 04/22/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Dietary sugars are often linked to the development of overweight and type 2 diabetes (T2D) but inconsistencies remain. OBJECTIVE We investigated associations of added, free, and total sugars, and glycaemic index (GI) with indices of glucose metabolism (IGM) and indices of body fatness (IBF) during a 3-year weight loss maintenance intervention. DESIGN The PREVIEW (PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World) study was a randomised controlled trial designed to test the effects of four diet and physical activity interventions, after an 8-week weight-loss period, on the incidence of T2D. This secondary observational analysis included pooled data assessed at baseline (8), 26, 52, 104 and 156 weeks from 514 participants with overweight/obesity (age 25-70 year; BMI ≥ 25 kg⋅m-2) and with/without prediabetes in centres that provided data on added sugars (Sydney and Helsinki) or free sugars (Nottingham). Linear mixed models with repeated measures were applied for IBF (total body fat, BMI, waist circumference) and for IGM (fasting insulin, HbA1c, fasting glucose, C-peptide). Model A was adjusted for age and intervention centre and Model B additionally adjusted for energy, protein, fibre, and saturated fat. RESULTS Total sugars were inversely associated with fasting insulin and C-peptide in all centres, and free sugars were inversely associated with fasting glucose and HbA1c (Model B: all p < 0.05). Positive associations were observed between GI and IGM (Model B: fasting insulin, HbA1c, and C-peptide: (all p < 0.01), but not for added sugars. Added sugar was positively associated with body fat percentage and BMI, and GI was associated with waist circumference (Model B: all p < 0.01), while free sugars showed no associations (Model B: p > 0.05). CONCLUSIONS Our findings suggest that added sugars and GI were independently associated with 3-y weight regain, but only GI was associated with 3-y changes in glucose metabolism in individuals at high risk of T2D.
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Affiliation(s)
- Karen Della Corte
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, 00014 Helsinki, Finland
| | - Niina E Kaartinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
| | - Liz Simpson
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham NG7 2RD, UK
| | - Moira A Taylor
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham NG7 2RD, UK
| | - Roslyn Muirhead
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, 1958 Copenhagen, Denmark
- Clinical Research, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, 2730 Herlev, Denmark
| | - Ian A Macdonald
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham NG7 2RD, UK
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, 00014 Helsinki, Finland
| | - Jennie Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia
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Dose-response efficacy of mulberry fruit extract for reducing post-prandial blood glucose and insulin responses: randomised trial evidence in healthy adults. Br J Nutr 2023; 129:771-778. [PMID: 35272722 DOI: 10.1017/s0007114522000824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Extracts of mulberry have been shown to reduce post-prandial glucose (PPG) and insulin (PPI) responses, but reliability of these effects and required doses and specifications are unclear. We previously found that 1·5 g of a specified mulberry fruit extract (MFE) significantly reduced PPG and PPI responses to 50 g carbohydrate as rice porridge, with no indications of intolerance. The trials reported here aimed to replicate that work and assess the efficacy of lower MFE doses, using boiled rice as the carbohydrate source. Two separate randomised controlled intervention studies were carried out with healthy Indian males and females aged 20-50 years (n 84 per trial), with PPG area under the curve over 2 h as the primary outcome. Trial 1 used doses of 0, 0·37, 0·75, 1·12 and 1·5 g MFE in boiled rice and 0 or 1·5 g MFE in rice porridge. Trial 2 used doses of 0, 0·04, 0·12, 0·37 g MFE in boiled rice. In trial 1, relative to control, all MFE doses significantly decreased PPG (-27·2 to -22·9 %; all P ≤ 0·02) and PPI (-34·6 to -14·0 %, all P < 0·01). Breath hydrogen was significantly increased only at 1·5 g MFE (in rice porridge), and self-reported gastrointestinal symptoms were uniformly low. In trial 2, only 0·37 g MFE significantly affected PPG (-20·4 %, P = 0·002) and PPI (-17·0 %, P < 0·001). Together, these trials show that MFE in doses as low as 0·37 g can reliably reduce PPG and PPI responses to a carbohydrate-rich meal, with no apparent adverse effects.
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Cui Z, Wu M, Liu K, Wang Y, Kang T, Meng S, Meng H. Associations between Conventional and Emerging Indicators of Dietary Carbohydrate Quality and New-Onset Type 2 Diabetes Mellitus in Chinese Adults. Nutrients 2023; 15:647. [PMID: 36771355 PMCID: PMC9919288 DOI: 10.3390/nu15030647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/23/2023] [Accepted: 01/23/2023] [Indexed: 01/31/2023] Open
Abstract
Dietary glycemic index (GI), carbohydrate to fiber ratio (CF) and carbohydrate quality index (CQI) are conventional and emerging indicators for carbohydrate quality. We aimed to investigate the associations between these indicators and new-onset type 2 diabetes mellitus (T2DM) risk among Chinese adults. This prospective cohort study included 14,590 adults from the China Health and Nutrition Survey without cardiometabolic diseases at baseline. The associations between dietary GI, CF and CQI and T2DM risk were assessed using Cox proportional hazard regression analysis and dose-response relationships were explored using restricted cubic spline and threshold analysis. After a mean follow-up duration of 10 years, a total of 1053 new-onset T2DM cases occurred. There were U-shaped associations between dietary GI and CF and T2DM risk (both P-nonlinear < 0.0001), and T2DM risk was lowest when dietary GI was 72.85 (71.40, 74.05) and CF was 20.55 (17.92, 21.91), respectively (both P-log likelihood ratio < 0.0001). Inverse associations between CQI and T2DM risk specifically existed in participants < 60 y or attended middle school or above (both P-trend < 0.05). These findings indicated that moderate dietary GI and CF range and a higher dietary CQI score may be suggested for T2DM prevention in Chinese adults.
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Affiliation(s)
- Zhixin Cui
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen 518107, China
- Shenzhen Health Development Research and Data Management Center, Shenzhen 518028, China
| | - Man Wu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen 518107, China
| | - Ke Liu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen 518107, China
| | - Yin Wang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen 518107, China
| | - Tong Kang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen 518107, China
| | - Shuangli Meng
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen 518107, China
| | - Huicui Meng
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen 518107, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou 510080, China
- Guangdong Province Engineering Laboratory for Nutrition Translation, Guangzhou 510080, China
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Siqueira JH, Pereira TSS, Moreira AD, Diniz MFHS, Velasquez-Melendez G, Fonseca MJM, Barreto SM, Benseñor IM, Mill JG, Molina MCB. Consumption of sugar-sweetened soft drinks and risk of metabolic syndrome and its components: results of the ELSA-Brasil study (2008-2010 and 2012-2014). J Endocrinol Invest 2023; 46:159-171. [PMID: 35963981 DOI: 10.1007/s40618-022-01895-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/04/2022] [Indexed: 01/12/2023]
Abstract
AIM To estimate the association between consumption of sugar-sweetened soft drinks and unsweetened fruit juice with metabolic syndrome (MetS) and its components in participants of the Brazilian Longitudinal Adult Health Study (ELSA-Brasil) after 4 years of follow-up. METHODS We used data from ELSA-Brasil cohort (N = 15,105). The sample consisted of 6,124 civil servants free of the MetS at baseline (35 to 74 years, both sexes). The consumption of sugar-sweetened soft drinks and unsweetened fruit juice was estimated by a food frequency questionnaire previously validated. The outcome was MetS and its components (Joint Interim Statement criteria). To test the association between beverage consumption at baseline (2008-2010) and MetS and its components at follow-up (2012-2014), we used Poisson regression models with robust variance adjusting for potential confounders. RESULTS After 4-year follow-up, the higher consumption of sugar-sweetened soft drinks (≥ 1 serving/day = 250 mL/day) increased the relative risk of MetS (RR = 1.22; 95% CI 1.04-1.45), high fasting glucose (RR = 1.23; 95% CI 1.01-1.48), and high blood pressure (RR = 1.23; 95% CI 1.00-1.54). Moderate consumption of this beverage (0.4 to < 1 serving/day) increased the relative risk of high waist circumference (WC) (RR = 1.21; 95% CI 1.02-1.42). After adjustment for confounding variables, the consumption of unsweetened fruit juice was not associated with the MetS and its components. CONCLUSION Higher sugar-sweetened soft drinks consumption was associated with a higher risk relative of MetS, high fasting glucose, and high blood pressure, while moderate consumption of this beverage increased the relative risk of high WC in Brazilian adults.
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Affiliation(s)
- J H Siqueira
- Postgraduate Program in Public Health, Universidade Federal Do Espírito Santo, Marechal Campos Avenue, MaruípeVitória, Espírito Santo, 146829042-755, Brazil
| | - T S Silva Pereira
- Health Sciences Department, Universidad de Las Américas Puebla, Cholula, Puebla, México
| | - A D Moreira
- Department of Maternal and Child Nursing and Public Health, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - M F H S Diniz
- Internal Medicine Department, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - G Velasquez-Melendez
- Department of Maternal and Child Nursing and Public Health, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - M J M Fonseca
- Department of Epidemiology and Quantitative Methods in Health, National School of Public Health, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - S M Barreto
- Postgraduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - I M Benseñor
- Clinical and Epidemiological Research Center, University Hospital, University of São Paulo, São Paulo, Brazil
| | - J G Mill
- Postgraduate Program in Public Health, Universidade Federal Do Espírito Santo, Marechal Campos Avenue, MaruípeVitória, Espírito Santo, 146829042-755, Brazil
| | - M C B Molina
- Postgraduate Program in Public Health, Universidade Federal Do Espírito Santo, Marechal Campos Avenue, MaruípeVitória, Espírito Santo, 146829042-755, Brazil.
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Wenzel DM, Olivier-Van Stichelen S. The O-GlcNAc cycling in neurodevelopment and associated diseases. Biochem Soc Trans 2022; 50:1693-1702. [PMID: 36383066 PMCID: PMC10462390 DOI: 10.1042/bst20220539] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 11/18/2022]
Abstract
Proper neuronal development is essential to growth and adult brain function. Alterations at any step of this highly organized sequence of events, due to genetic mutations or environmental factors, triggers brain malformations, which are leading causes of diseases including epilepsy, intellectual disabilities, and many others. The role of glycosylation in neuronal development has been emphasized for many years, notably in studying human congenital disorders of glycosylation (CDGs). These diseases highlight that genetic defects in glycosylation pathways are almost always associated with severe neurological abnormalities, suggesting that glycosylation plays an essential role in early brain development. Congenital disorders of O-GlcNAcylation are no exception, and all mutations of the O-GlcNAc transferase (OGT) are associated with X-linked intellectual disabilities (XLID). In addition, mouse models and in vitro mechanistic studies have reinforced the essential role of O-GlcNAcylation in neuronal development and signaling. In this review, we give an overview of the role of O-GlcNAcylation in this critical physiological process and emphasize the consequences of its dysregulation.
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Affiliation(s)
- Dawn M Wenzel
- Department of Biochemistry, Medical College of Wisconsin, Milwaukee, WI 53226, U.S.A
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17
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Goletzke J, Weber KS, Kössler T, Zaharia OP, Bódis K, Müssig K, Szendroedi J, Burkart V, Stutz B, Nöthlings U, Buyken AE, Roden M. Relative validity of a glycemic index extended food-frequency questionnaire. Nutr Metab Cardiovasc Dis 2022; 32:2310-2320. [PMID: 35973887 DOI: 10.1016/j.numecd.2022.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/15/2022] [Accepted: 07/11/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS The dietary glycemic index (GI) and glycemic load (GL) are increasingly recognized as important for the prevention and management of diabetes mellitus. To extend the portfolio of assessment methods for large-scale epidemiological studies, we propose a GI-specific addition to an already established FFQ. METHODS AND RESULTS The German version of the EPIC-FFQ was extended by GI-specific questions for major carbohydrate sources varying notably in GI (breakfast cereals, bread, pasta, rice, potato etc.). We performed relative validation analyses comparing the GI-extended FFQ to three to four 3-day weighted dietary records (3-d WDR) in 100 middle-aged individuals with diabetes mellitus participating in the German Diabetes Study (GDS). Level of agreement between the two methods was assessed by correlation and cross-classification analyses as well as Bland-Altman-Plots, conducted separately for women and men. Spearman correlation analysis for female participants suggested good agreement between the GI-extended FFQ and 3-d WDRs for energy adjusted dietary GL (r = 0.52, p = 0.0004). For both women and men, agreement with the estimations of dietary GI, GL (for men) and carbohydrates from low and higher-GI food sources from the GI-extended FFQ was acceptable (r: 0.28-0.45). Classification of the dietary GI and GL in the opposite quartile was <10% comparing the GI-extended FFQ and 3-d WDR. Bland-Altman plots suggested a tendency for an overestimation of the dietary GI from the GI-extended FFQ in the lower GI-ranges, particularly for men. CONCLUSION Compared to the 3-d WDR, the GI-extended FFQ showed a moderate to good relative validity for parameters of carbohydrate quality.
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Affiliation(s)
- Janina Goletzke
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, 33098 Paderborn, Germany
| | - Katharina S Weber
- Institute of Epidemiology, Kiel University, Kiel, Germany; Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
| | - Theresa Kössler
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Oana-Patricia Zaharia
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Kálmán Bódis
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Karsten Müssig
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Department of Internal Medicine, Gastroenterology and Diabetology, Niels Stensen Hospitals, Franziskus Hospital Harderberg, Georgsmarienhütte, Germany
| | - Julia Szendroedi
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Clinic for Endocrinology, Diabetology, Metabolic Diseases and Clinical Chemistry at Heidelberg University Hospital, Germany
| | - Volker Burkart
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
| | - Bianca Stutz
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, 33098 Paderborn, Germany
| | - Ute Nöthlings
- Institute of Nutrition and Food Sciences, Faculty of Agriculture, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Anette E Buyken
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, 33098 Paderborn, Germany.
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Short-term effects of sugar-free apricot jam, cocoa powder and dried cranberry cereal bar on glycaemic responses in healthy adults: a randomised clinical trial. J Nutr Sci 2022; 11:e77. [PMID: 36304830 PMCID: PMC9574874 DOI: 10.1017/jns.2022.74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/02/2022] [Indexed: 12/14/2022] Open
Abstract
High sugar intake has been associated with adverse effects on health, with some types of breakfast being highly linked to overweight and obesity. The aim was to compare the effects of four sugar-free breakfast items, apricot jam with white bread (JWB), white bread (WB), cocoa with fat-free milk (CM), and dried cranberry cereal bar (CB), compared to d-glucose on the glycaemic responses. Using a cross-over design, twelve healthy individuals (25 ± 4 years; BMI 22 ± 2 kg/m2) received isoglucidic test meals (25 g of available carbohydrate) and 25 g glucose reference, in random order. Glycaemic index/load (GI/GL) were calculated, and capillary blood glucose samples were collected at 0–120 min after meal consumption. Subjective appetite was assessed with visual analogue scales. Sugar-free apricot jam and cocoa powder contained traces of available carbohydrates and were consumed along with bread and fat-free milk, respectively. JWB and WB were classified as medium GI, low-to-medium GL; CM as medium GI, low GL; and CB as high GI, low-to-medium GL. Subjective hunger was lower after JWB, fullness was higher after CM and pleasure was higher after CB (P for all < 0⋅05). In conclusion, sugar-free apricot jam with and without WB and cocoa powder with fat-free milk are suitable healthy breakfast options leading to improved glycaemic and subjective appetite responses.
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Kong H, Yu L, Li C, Ban X, Gu Z, Liu L, Li Z. Perspectives on evaluating health effects of starch: Beyond postprandial glycemic response. Carbohydr Polym 2022; 292:119621. [DOI: 10.1016/j.carbpol.2022.119621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/22/2022] [Accepted: 05/10/2022] [Indexed: 11/02/2022]
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20
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Wang X, Wu G, Shen D, Zhang X, Yang W. Unmet Needs of Glycaemic Control and Risk Factors of Residual Hyperglycaemia in a Chinese Population with Type 2 Diabetes Initiating Basal Insulin: A Post Hoc Analysis of the FPG GOAL Study. Adv Ther 2022; 39:2820-2830. [PMID: 35430674 PMCID: PMC9123059 DOI: 10.1007/s12325-022-02128-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/14/2022] [Indexed: 11/28/2022]
Abstract
Introduction To aim of this analysis was to investigate the extent and evaluate risk factors of residual hyperglycaemia in Chinese individuals with type 2 diabetes (T2D) initiating basal insulin. Methods FPG GOAL was a 24-week, open-label, treat-to-target randomised controlled trial in Chinese individuals with T2D inadequately controlled with oral anti-hyperglycaemic drugs initiating treatment with basal insulin. This analysis categorised participants into the following glycaemic control categories: hyperglycaemia [glycated haemoglobin (HbA1c) ≥ 53 mmol/mol (≥ 7%), fasting plasma glucose (FPG) ≥ 7.0 mmol/L], residual hyperglycaemia [HbA1c ≥ 53 mmol/mol (≥ 7%), FPG < 7.0 mmol/L], discordant [HbA1c < 53 mmol/mol (< 7%), FPG ≥ 7.0 mmol/L] and at target [HbA1c < 53 mmol/mol (< 7%), FPG < 7.0 mmol/L]. The proportion of participants in each glycaemic control category was assessed at weeks 12 and 24. Multivariable regression analyses were conducted to evaluate risk factors for residual hyperglycaemia. Results Of the 914 participants included, 22.1% had residual hyperglycaemia, 31.9% had hyperglycaemia, 11.1% were discordant and 29.3% were at target at week 24. More participants who were randomised to a fasting blood glucose (FBG) target of > 3.9 to ≤ 5.6 mmol/L had residual hyperglycaemia compared with participants randomised to a FBG target of > 3.9 to ≤ 6.1 mmol/L or > 3.9 to ≤ 7.0 mmol/L. Multivariable analysis indicated that higher HbA1c and lower FPG levels at baseline were associated with greater proportion of residual hyperglycaemia. Conclusion Some Chinese individuals with T2D may have residual hyperglycaemia 3–6 months after initiating basal insulin treatment and require further intensified treatment. Higher HbA1c and lower FPG levels could be risk factors for residual hyperglycaemia. Trial Registration ClinicalTrials.gov identifier NCT02545842. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-022-02128-y.
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Affiliation(s)
- Xin Wang
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, 100029, China
| | | | - Dan Shen
- Sanofi Real-World Evidence, Shanghai, China
| | | | - Wenying Yang
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, 100029, China.
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21
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Messina M, Sievenpiper JL, Williamson P, Kiel J, Erdman JW. Perspective: Soy-based Meat and Dairy Alternatives, Despite Classification as Ultra-processed Foods, Deliver High-quality Nutrition on Par with Unprocessed or Minimally Processed Animal-based Counterparts. Adv Nutr 2022; 13:726-738. [PMID: 35325028 PMCID: PMC9156366 DOI: 10.1093/advances/nmac026] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 01/13/2022] [Accepted: 03/18/2022] [Indexed: 01/16/2023] Open
Abstract
In many non-Asian countries, soy is consumed via soy-based meat and dairy alternatives, in addition to the traditional Asian soyfoods, such as tofu and miso. Meat alternatives are typically made using concentrated sources of soy protein, such as soy protein isolate (SPI) and soy protein concentrate (SPC). Therefore, these products are classified as ultra-processed foods (UPFs; group 4) according to NOVA, an increasingly widely used food-classification system that classifies all foods into 1 of 4 groups according to the processing they undergo. Furthermore, most soymilks, even those made from whole soybeans, are also classified as UPFs because of the addition of sugars and emulsifiers. Increasingly, recommendations are being made to restrict the consumption of UPFs because their intake is associated with a variety of adverse health outcomes. Critics of UPFs argue these foods are unhealthful for a wide assortment of reasons. Explanations for the proposed adverse effects of UPFs include their high energy density, high glycemic index (GI), hyper-palatability, and low satiety potential. Claims have also been made that UPFs are not sustainably produced. However, this perspective argues that none of the criticisms of UPFs apply to soy-based meat and dairy alternatives when compared with their animal-based counterparts, beef and cow milk, which are classified as unprocessed or minimally processed foods (group 1). Classifying soy-based meat and dairy alternatives as UPFs may hinder their public acceptance, which could detrimentally affect personal and planetary health. In conclusion, the NOVA classification system is simplistic and does not adequately evaluate the nutritional attributes of meat and dairy alternatives based on soy.
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Affiliation(s)
- Mark Messina
- Soy Nutrition Institute Global, Washington, DC, USA
| | - John L Sievenpiper
- Departments of Nutritional Sciences and Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Endocrinology and Metabolism, Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Patricia Williamson
- Scientific and Regulatory Affairs, Research and Development, Cargill, Wayzata, MN, USA
| | - Jessica Kiel
- Scientific and Clinical Affairs, Medifast, Inc., Baltimore, MD, USA
| | - John W Erdman
- Department of Food Science and Human Nutrition, Division of Nutritional Sciences and Beckman Institute, University of Illinois at Urbana/Champaign, Urbana, IL, USA
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22
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Skurk T, Bosy-Westphal A, Grünerbel A, Kabisch S, Keuthage W, Kronsbein P, Müssig K, Pfeiffer AFH, Simon MC, Tombek A, Weber KS, Rubin D. Dietary recommendations for persons with type 2 diabetes mellitus. Exp Clin Endocrinol Diabetes 2022; 130:S151-S184. [PMID: 35359013 DOI: 10.1055/a-1624-5095] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Thomas Skurk
- ZIEL Institute for Food & Health, Technical University of Munich, Freising, Germany.,Else Kröner-Fresenius-Center for Nutritional Medicine, Technical University of Munich, Freising, Germany
| | - Anja Bosy-Westphal
- Institute for Human Nutrition, Faculty of Agricultural and Nutritional Sciences, Christian-Albrechts-University of Kiel, Kiel, Germany
| | | | - Stefan Kabisch
- German Institute of Human Nutrition Potsdam-Rehbrücke, Potsdam, Germany.,Department of Endocrinology, Diabetes and Nutritional Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany.,German Center for Diabetes Research (DZD), Munich, Germany
| | - Winfried Keuthage
- Focus Practice for Diabetes and Nutritional Medicine, Münster, Germany
| | - Peter Kronsbein
- Department of Ecotrophology, Niederrhein University of Applied Sciences, Mönchengladbach Campus, Germany
| | - Karsten Müssig
- Department of Internal Medicine, Gastroenterology and Diabetology, Niels Stensen Hospitals, Franziskus Hospital Harderberg, Georgsmarienhütte, Germany
| | - Andreas F H Pfeiffer
- Department of Endocrinology, Diabetes and Nutritional Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Marie-Christine Simon
- Institute of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | | | - Katharina S Weber
- Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Diana Rubin
- Vivantes Hospital Spandau, Berlin, Germany.,Vivantes Humboldt Hospital, Berlin, Germany
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23
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Lu LW, Chen JH. Seaweeds as Ingredients to Lower Glycemic Potency of Cereal Foods Synergistically-A Perspective. Foods 2022; 11:714. [PMID: 35267347 PMCID: PMC8909722 DOI: 10.3390/foods11050714] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 02/24/2022] [Accepted: 02/26/2022] [Indexed: 12/12/2022] Open
Abstract
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.
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Affiliation(s)
- Louise Weiwei Lu
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland 1024, New Zealand
- High Value Nutrition, National Science Challenge, Auckland 1010, New Zealand
| | - Jie-Hua Chen
- Institute for Innovative Development of Food Industry, Shenzhen University, Shenzhen 518060, China
- Shenzhen Key Laboratory of Marine Microbiome Engineering, Institute for Advanced Study, Shenzhen University, Shenzhen 518060, China
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Dwivedi AK, Dubey P, Reddy SY, Clegg DJ. Associations of Glycemic Index and Glycemic Load with Cardiovascular Disease: Updated Evidence from Meta-analysis and Cohort Studies. Curr Cardiol Rep 2022; 24:141-161. [PMID: 35119682 DOI: 10.1007/s11886-022-01635-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2021] [Indexed: 02/01/2023]
Abstract
PURPOSE OF REVIEW Diet and lifestyle patterns are considered major contributory factors for cardiovascular disease (CVD) and mortality. In particular, consuming a diet higher in carbohydrates (not inclusive of fruits and vegetables, but more processed carbohydrates) has been associated with metabolic abnormalities that subsequently may increase the risk of CVD and related mortality. Glycemic index (GI) and glycemic load (GL) are values given to foods based on how fast the body converts carbohydrates into glucose also referred to as the glycemic burden of carbohydrates from foods. Conflicting associations of how high GI and GL influence CVDs have been observed even in high-quality meta-analysis studies. We synthesize and report the associations of high GI and GL with various CVDs by sex, obesity, and geographical locations using an updated review of meta-analysis and observational studies. RECENT FINDINGS We identified high GI or high GL is associated with an increased risk of CVD events including diabetes (DM), metabolic syndrome (MS), coronary heart disease (CHD), stroke, and stroke mortality in the general population, and the risk of CVD outcomes appears to be stratified by sex, obesity status, and preexisting CVD. Both high GI and GL are associated with DM and CHD in the general population. However, high GI is strongly associated with DM/MS, while high GL is strongly associated with an increased risk of CHD in females. In addition, high GL is also associated with incident stroke, and appears to be associated with CVD mortality in subjects with preexisting CVD or high BMI and all-cause mortality in non-obese DM subjects. However, high GI appears to be associated with CVD or all-cause mortality only in females without CVD. High GI/GL is an important risk factor for CVD outcomes in the general population. High GI seems to be markedly associated with DM/MS, and it may enhance the risk of CVD or all-cause mortality in both sexes and predominately females. Although both high GI and high GL are risk factors for CHD in females, high GL is associated with CVD outcomes in at-risk populations for CVD. These data suggest that while high GI increases the propensity of CVD risk factors and mortality in healthy individuals, high GL contributes to the risk of severe heart diseases including CVD or all-cause mortality, particularly in at-risk populations. These data indicate dietary interventions designed for focusing carbohydrate quality by lowering both GI and GL are recommended for preventing CVD outcomes across all populations.
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Affiliation(s)
- Alok Kumar Dwivedi
- Division of Biostatistics & Epidemiology, Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, 5001 El Paso Drive, TX, 79905, USA.
| | - Pallavi Dubey
- Department of Obstetrics & Gynecology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, 4800 Alberta Avenue, El Paso, TX, 79905, USA
| | - Sireesha Y Reddy
- Department of Obstetrics & Gynecology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, 4800 Alberta Avenue, El Paso, TX, 79905, USA
| | - Deborah J Clegg
- Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, 4800 Alberta Avenue, El Paso, TX, 79905, USA
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Arrieta F, Pedro-Botet J, Iglesias P, Obaya JC, Montanez L, Maldonado GF, Becerra A, Navarro J, Perez JC, Petrecca R, Pardo JL, Ribalta J, Sánchez-Margalet V, Duran S, Tébar FJ, Aguilar M. Diabetes mellitus and cardiovascular risk: an update of the recommendations of the Diabetes and Cardiovascular Disease Working Group of the Spanish Society of Diabetes (SED, 2021). CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2022; 34:36-55. [PMID: 34330545 DOI: 10.1016/j.arteri.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/05/2021] [Indexed: 06/13/2023]
Abstract
This document is an update to the clinical practice recommendations for the management of cardiovascular risk factors (CVRF) in diabetes mellitus. The consensus has been developed by a multidisciplinary team made up of members of the Cardiovascular Risk Group of the Spanish Diabetes Society (SED). The work is a necessary update as, since the last review three years ago, there have been many clinical trials that have studied the cardiovascular outcomes of numerous drugs in the diabetic population. We believe that this guideline update may be of interest to all clinicians treating patients with diabetes.
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Affiliation(s)
- Francisco Arrieta
- Servicio de Endocrinología y Nutrición, Hospital Ramón y Cajal, Madrid, España.
| | - Juan Pedro-Botet
- Unidad de Lípidos y Riesgo Vascular, Hospital del Mar, Barcelona, España
| | - Pedro Iglesias
- Servicio de Endocrinología y Nutrición, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, España
| | - Juan Carlos Obaya
- Centro de Salud CHOPERA, Atención Primaria Alcobendas, Gdt Enfermedades Cardiovasculares Semfyc, Madrid, España
| | - Laura Montanez
- Servicio de Endocrinología y Nutrición, Hospital Ramón y Cajal, Madrid, España
| | | | - Antonio Becerra
- Servicio de Endocrinología y Nutrición, Hospital Ramón y Cajal, Madrid, España
| | - Jorge Navarro
- Hospital Clínico Universitario de Valencia, Gdt Diabetes Semfyc, Valencia, España
| | - J C Perez
- Centro de Salud Rincón de la Victoria, Atención Primaria, Málaga, España
| | - Romina Petrecca
- Unidad de Nutrición y dietética, Hospital de la Princesa, Madrid, España
| | - José Luis Pardo
- Centro de Salud Orihuela I. Médico de Familia, Atención Primaria Alicante, Alicante, España
| | - Josep Ribalta
- Universidad Rovira i Vigili, IISPV, CIBERDEM, Tarragona, España
| | | | - Santiago Duran
- Servicio de Endocrinología y Nutrición, Hospital Virgen de Valme, Sevilla, España
| | - Francisco Javier Tébar
- Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen de la Arrixaca, Murcia, España
| | - Manuel Aguilar
- Servicio de Endocrinología y Nutrición, Hospital Puerta del Mar, Cádiz, España
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Skurk T, Bosy-Westphal A, Grünerbel A, Kabisch S, Keuthage W, Kronsbein P, Müssig K, Pfeiffer AFH, Simon MC, Tombek A, Weber KS, Rubin D. Empfehlungen zur Ernährung von Personen mit Typ-2-Diabetes mellitus. DIABETOL STOFFWECHS 2021. [DOI: 10.1055/a-1543-1293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Thomas Skurk
- ZIEL- Institute for Food & Health, Technische Universität München, Freising
- Else Kröner-Fresenius-Zentrum für Ernährungsmedizin, Technische Universität München, Freising
| | - Anja Bosy-Westphal
- Institut für Humanernährung, Agrar- und Ernährungswissenschaftliche Fakultät, Christian-Albrechts-Universität zu Kiel, Kiel
| | | | - Stefan Kabisch
- Abt. Endokrinologie, Diabetes und Ernährungsmedizin, Charité Universitätsmedizin Berlin, Berlin
- Deutsche Zentrum für Diabetesforschung (DZD), München
| | | | - Peter Kronsbein
- Fachbereich Oecotrophologie, Hochschule Niederrhein, Campus Mönchengladbach
| | - Karsten Müssig
- Klinik für Innere Medizin und Gastroenterologie, Niels-Stensen-Kliniken, Franziskus-Hospital Harderberg, Georgsmarienhütte
| | - Andreas F. H. Pfeiffer
- Abt. Endokrinologie, Diabetes und Ernährungsmedizin, Charité Universitätsmedizin Berlin, Berlin
| | - Marie-Christine Simon
- Institut für Ernährungs- und Lebensmittelwissenschaften, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn
| | | | - Katharina S. Weber
- Institut für Epidemiologie, Christian-Albrechts-Universität zu Kiel, Kiel
| | - Diana Rubin
- Vivantes Klinikum Spandau, Berlin
- Vivantes Humboldt Klinikum, Berlin
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Siqueira JH, Santana NMT, Pereira TSS, Moreira AD, Benseñor IM, Barreto SM, Velasquez-Melendez G, Molina MDCB. Consumption of alcoholic and non-alcoholic beverages: ELSA-Brasil results. CIENCIA & SAUDE COLETIVA 2021; 26:3825-3837. [PMID: 34468676 DOI: 10.1590/1413-81232021269.2.30682019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 02/07/2020] [Indexed: 11/22/2022] Open
Abstract
The study aims to describe the consumption of alcoholic and non-alcoholic beverages according to sociodemographic, health and location variables. Cross-sectional study with ELSA-Brasil data (2008-2010). A questionnaire was used to collect sociodemographic, food, health data and anthropometry. Descriptive analysis and association with variables of interest were carried out. In the sample, 8% of the total caloric value comes from non-alcoholic beverages (5.6%: sugary drinks), and 4% from alcoholic beverages (2.7%: beer). Consumers of unsweetened and artificially sweetened beverages reported moderate/strong physical activity, former smokers and higher education. The opposite was true for sugary drinks. Eutrophic people reported higher consumption of sugary drinks and those obese, artificially sweetened and beer. Alcohol consumption varied with age (young: beer; elderly: wine/spirits) and education (low education: beer/spirits; higher education: wine). Coffee, natural juice and soda were the most consumed non-alcoholic beverages and beer was the most prevalent alcoholic beverage. Consumption variation was observed according to geographic location. The consumption of sugary and alcoholic beverages is high in Brazil and public health strategies are required.
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Affiliation(s)
- Jordana Herzog Siqueira
- Programa de Pós-Graduação em Saúde Coletiva. Universidade Federal do Espírito Santo. Av. Marechal Campos 1468, Bonfim. 29047-105 Vitória ES Brasil.
| | | | | | - Alexandra Dias Moreira
- Escola de Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | - Isabela Martins Benseñor
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade de São Paulo. São Paulo SP Brasil
| | - Sandhi Maria Barreto
- Faculdade de Medicina, Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | - Gustavo Velasquez-Melendez
- Escola de Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | - Maria Del Carmen Bisi Molina
- Programa de Pós-Graduação em Saúde Coletiva. Universidade Federal do Espírito Santo. Av. Marechal Campos 1468, Bonfim. 29047-105 Vitória ES Brasil.
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Dietary potato intake and risks of type 2 diabetes and gestational diabetes mellitus. Clin Nutr 2021; 40:3754-3764. [PMID: 34130021 DOI: 10.1016/j.clnu.2021.04.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 04/17/2021] [Accepted: 04/21/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND & AIMS Evidence regarding associations between potato consumption and type 2 diabetes (T2D) and gestational diabetes mellitus (GDM) risks is accumulating. This study aims to synthesize the evidence by conducting a meta-analysis of available studies. METHODS PubMed, Web of Science, EMBASE and Cochrane Library were searched (up to August 2020) to retrieve all eligible studies on the associations of interest. The risk estimates with 95% confidence intervals (CIs) were summarized using random- or fixed-effects model based on heterogeneity. Meta-analyses were performed for East and West regions separately. Dose-response relationship was assessed using data from all intake categories in each study. RESULTS A total of 19 studies (13 for T2D; 6 for GDM) were identified, including 21,357 T2D cases among 323,475 participants and 1516 GDM cases among 29,288 pregnancies. Meta-analysis detected a significantly positive association with T2D risk for total potato (RR: 1.19 [1.06, 1.34]), baked/boiled/mashed potato (RR: 1.08 [1.00, 1.16]), and French fries/fried potato (RR: 1.33 [1.03, 1.70]) intakes among Western populations. Dose-response meta-analysis demonstrated a significantly increased T2D risk by 10% (95% CI: 1.07, 1.14; P for trend<0.001), 2% (95% CI: 1.00, 1.04; P for trend = 0.02) and 34% (95% CI: 1.24, 1.46; P for trend<0.001) for each 80 g/day (serving) increment in total potato, unfried potato, and fried potato intakes, respectively. As for GDM, summarized estimates also suggested a higher though non-significant GDM risk for total potato (RR: 1.19 [0.89, 1.58]), and French fries/fried potato (RR: 1.03 [0.97, 1.09]) intakes in Western countries. In the dose-response meta-analysis, a significantly increased GDM risk was revealed for each daily serving (80 g) intakes of total potato (RR: 1.22; 95% CI: 1.06, 1.42; P for trend = 0.007) and unfried potato (RR: 1.26; 95% CI: 1.07, 1.48; P for trend = 0.006). CONCLUSIONS This study suggests that higher potato intake is associated with higher T2D risk among Western populations. The positive relationship presents a significant dose-response manner. Wisely controlled potato consumption may confer potential glucometabolic benefits.
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Huang M, Lo K, Li J, Allison M, Wu WC, Liu S. Pasta meal intake in relation to risks of type 2 diabetes and atherosclerotic cardiovascular disease in postmenopausal women : findings from the Women's Health Initiative. BMJ Nutr Prev Health 2021; 4:195-205. [PMID: 34308127 PMCID: PMC8258098 DOI: 10.1136/bmjnph-2020-000198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 04/11/2021] [Accepted: 04/12/2021] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To evaluate the association between pasta meal intake and long-term risk of developing diabetes or atherosclerotic cardiovascular disease (ASCVD, including coronary heart disease (CHD) and stroke) in postmenopausal women. DESIGN Prospective cohort study. SETTING Women's Health Initiative (WHI) in the USA. PARTICIPANTS 84 555 postmenopausal women aged 50-79 in 1994, who were free of diabetes, ASCVD and cancer at baseline who were not in the dietary modification trial of the WHI, completed a validated food frequency questionnaire, and were evaluated for incident diabetes and ASCVD outcomes during the follow-up until 2010. MAIN OUTCOME MEASURE Diabetes and ASCVD. RESULTS Cox proportional hazards models were used to estimate the association (HR) between quartiles of pasta meal consumption (residuals after adjusting for total energy) and the risk of incidence diabetes, CHD, stroke or ASCVD, accounting for potential confounding factors, with testing for linear trend. We then statistically evaluated the effect of substituting white bread or fried potato for pasta meal on disease risk. When comparing the highest to the lowest quartiles of residual pasta meal intake, we observed significantly reduced risk of ASCVD (HR=0.89, 95% CI 0.83 to 0.96, p trend=0.002), stroke (HR=0.84, 95% CI 0.75 to 0.93, p trend=0.001), CHD (HR=0.91, 95% CI 0.83 to 1.00, p trend=0.058) and no significant alteration in diabetes risk (HR=1.02, 95% CI 0.96 to 1.07, p trend=0.328). Replacing white bread or fried potato with pasta meal was statistically associated with decreased risk of stroke and ASCVD. CONCLUSIONS Pasta meal intake did not have adverse effects on long-term diabetes risk and may be associated with significant reduced risk of stroke and ASCVD. The potential benefit of substituting pasta meal for other commonly consumed starchy foods on cardiometabolic outcomes warrants further investigation in additional high-quality and large prospective studies of diverse populations.
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Affiliation(s)
- Mengna Huang
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
- Center for Global Cardiometabolic Health, Brown University, Providence, Rhode Island, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Kenneth Lo
- Center for Global Cardiometabolic Health, Brown University, Providence, Rhode Island, USA
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Jie Li
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
- Center for Global Cardiometabolic Health, Brown University, Providence, Rhode Island, USA
- Center for International Health, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Matthew Allison
- Department of Family Medicine and Public Health, San Diego School of Medicine, University of California San Diego, La Jolla, California, USA
| | - Wen-Chih Wu
- Center for Long term Services and Support, Providence VA Medical Center, Alpert Medical School, Brown University School of Public Health and the Miriam Hospital Center for Cardiac Fitness, Providence, Rhode Island, USA
| | - Simin Liu
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
- Center for Global Cardiometabolic Health, Brown University, Providence, Rhode Island, USA
- Division of Endocrinology, Department of Medicine, and Division of Cardiothoracic Surgery, Department of Surgery, The Warren Alpert School of Medicine and Rhode Island Hospital, Providence, Rhode Island, USA
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Diabetes: is it time to flatten the curve? Br J Gen Pract 2021; 71:174. [PMID: 33771797 DOI: 10.3399/bjgp21x715481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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31
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Glenn AJ, Hernández-Alonso P, Kendall CWC, Martínez-González MÁ, Corella D, Fitó M, Martínez JA, Alonso-Gómez ÁM, Wärnberg J, Vioque J, Romaguera D, López-Miranda J, Estruch R, Tinahones FJ, Lapetra J, Serra-Majem JL, Bueno-Cavanillas A, Tur JA, Celada SR, Pintó X, Delgado-Rodríguez M, Matía-Martín P, Vidal J, Mas-Fontao S, Daimiel L, Ros E, Jenkins DJA, Toledo E, Sorlí JV, Castañer O, Abete I, Rodriguez AM, Barceló OF, Oncina-Canovas A, Konieczna J, Garcia-Rios A, Casas R, Gómez-Pérez AM, Santos-Lozano JM, Vazquez-Ruiz Z, Portolés O, Schröder H, Zulet MA, Eguaras S, Lete IS, Zomeño MD, Sievenpiper JL, Salas-Salvadó J. Longitudinal changes in adherence to the portfolio and DASH dietary patterns and cardiometabolic risk factors in the PREDIMED-Plus study. Clin Nutr 2021; 40:2825-2836. [PMID: 33933749 DOI: 10.1016/j.clnu.2021.03.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/16/2021] [Accepted: 03/12/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND & AIMS The Portfolio and Dietary Approaches to Stop Hypertension (DASH) diets have been shown to lower cardiometabolic risk factors in randomized controlled trials (RCTs). However, the Portfolio diet has only been assessed in RCTs of hyperlipidemic patients. Therefore, to assess the Portfolio diet in a population with metabolic syndrome (MetS), we conducted a longitudinal analysis of one-year data of changes in the Portfolio and DASH diet scores and their association with cardiometabolic risk factors in Prevención con Dieta Mediterránea (PREDIMED)-Plus trial. METHODS PREDIMED-Plus is an ongoing clinical trial (Trial registration: ISRCTN89898) conducted in Spain that includes 6874 older participants (mean age 65 y, 48% women) with overweight/obesity fulfilling at least three criteria for MetS. Data for this analysis were collected at baseline, six months and one year. Adherence to the Portfolio and DASH diet scores were derived from a validated 143-item food frequency questionnaire. We used linear mixed models to examine the associations of 1-SD increase and quartile changes in the diet scores with concomitant changes in cardiometabolic risk factors. RESULTS After adjusting for several potential confounders, a 1-SD increase in the Portfolio diet score was significantly associated with lower HbA1c (β [95% CI]: -0.02% [-0.02, -0.01], P < 0.001), fasting glucose (-0.47 mg/dL [-0.83, -0.11], P = 0.01), triglycerides (-1.29 mg/dL [-2.31, -0.28], P = 0.01), waist circumference (WC) (-0.51 cm [-0.59, -0.43], P < 0.001), and body mass index (BMI) (-0.17 kg/m2 [-0.19, -0.15], P < 0.001). A 1-SD increase in the DASH diet score was significantly associated with lower HbA1c (-0.03% [-0.04, -0.02], P < 0.001), glucose (-0.84 mg/dL [-1.18, -0.51], P < 0.001), triglycerides (-3.38 mg/dL [-4.37, -2.38], P < 0.001), non-HDL-cholesterol (-0.47 mg/dL [-0.91, -0.04], P = 0.03), WC (-0.69 cm [-0.76, -0.60 cm], P < 0.001), BMI (-0.25 kg/m2 [-0.28, -0.26 kg/m2], P < 0.001), systolic blood pressure (-0.57 mmHg [-0.81, -0.32 mmHg], P < 0.001), diastolic blood pressure (-0.15 mmHg [-0.29, -0.01 mmHg], P = 0.03), and with higher HDL-cholesterol (0.21 mg/dL [0.09, 0.34 mg/dL, P = 0.001]). Similar associations were seen when both diet scores were assessed as quartiles, comparing extreme categories of adherence. CONCLUSIONS Among older adults at high cardiovascular risk with MetS, greater adherence to the Portfolio and DASH diets showed significant favourable prospective associations with several clinically relevant cardiometabolic risk factors. Both diets are likely beneficial for cardiometabolic risk reduction.
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Affiliation(s)
- Andrea J Glenn
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Pablo Hernández-Alonso
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain; University Hospital of Sant Joan de Reus, Nutrition Unit, Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Cyril W C Kendall
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, Ontario, Canada; College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Miguel Ángel Martínez-González
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, IdiSNA, Pamplona, Spain; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Dolores Corella
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Montserrat Fitó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d`Investigació Médica (IMIM), Barcelona, Spain
| | - J Alfredo Martínez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, IdiSNA, Pamplona, Spain; Nutritional Control of the Epigenome. IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Ángel M Alonso-Gómez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area; Osakidetza Basque Health Service, Araba University Hospital; University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Julia Wärnberg
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Nursing. University of Málaga, Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain
| | - Jesús Vioque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigation Sanitaria y Biomédica de Alicante, ISABIAL-UMH, Alicante, Spain
| | - Dora Romaguera
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR). Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma de Mallorca, Spain
| | - José López-Miranda
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Ramon Estruch
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Francisco J Tinahones
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Virgen de la Victoria Hospital, Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA). University of Málaga, Málaga, Spain
| | - José Lapetra
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - J Luís Serra-Majem
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria & Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas de Gran Canaria, Spain
| | - Aurora Bueno-Cavanillas
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Josep A Tur
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS & IDISBA, Palma de Mallorca, Spain
| | | | - Xavier Pintó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, University of Barcelona, Hospitalet de Llobregat, Barcelona Spain
| | - Miguel Delgado-Rodríguez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Division of Preventive Medicine, Faculty of Medicine, University of Jaén, Jaén, Spain
| | - Pilar Matía-Martín
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Josep Vidal
- CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Endocrinology, Institut d` Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Sebastian Mas-Fontao
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Endocrinology and Nutrition, Hospital Fundación Jimenez Díaz. Instituto de Investigaciones Biomédicas IISFJD. University Autonoma, Madrid, Spain
| | - Lidia Daimiel
- Nutritional Control of the Epigenome. IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Emilio Ros
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - David J A Jenkins
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Estefania Toledo
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, IdiSNA, Pamplona, Spain
| | - José V Sorlí
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Olga Castañer
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d`Investigació Médica (IMIM), Barcelona, Spain
| | - Itziar Abete
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, IdiSNA, Pamplona, Spain
| | - Anai Moreno Rodriguez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area; Osakidetza Basque Health Service, Araba University Hospital; University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Olga Fernández Barceló
- Department of Nursing. University of Málaga, Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain
| | | | - Jadwiga Konieczna
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR). Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma de Mallorca, Spain
| | - Antonio Garcia-Rios
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Rosa Casas
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Ana Maria Gómez-Pérez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Virgen de la Victoria Hospital, Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA). University of Málaga, Málaga, Spain
| | - José Manuel Santos-Lozano
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Zenaida Vazquez-Ruiz
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, IdiSNA, Pamplona, Spain
| | - Olga Portolés
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Helmut Schröder
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d`Investigació Médica (IMIM), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Maria A Zulet
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, IdiSNA, Pamplona, Spain
| | - Sonia Eguaras
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, IdiSNA, Pamplona, Spain; Servicio Navarro de Salud, Pamplona, Spain
| | - Itziar Salaverria Lete
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area; Osakidetza Basque Health Service, Araba University Hospital; University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - María Dolores Zomeño
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d`Investigació Médica (IMIM), Barcelona, Spain; Servicio Navarro de Salud, Pamplona, Spain
| | - John L Sievenpiper
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - Jordi Salas-Salvadó
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain; University Hospital of Sant Joan de Reus, Nutrition Unit, Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
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Penlioglou T, Lambadiari V, Papanas N. The contribution of dietary glycemic index and glycemic load to the development of microvascular complications of diabetes. Nutrition 2021; 89:111234. [PMID: 33878554 DOI: 10.1016/j.nut.2021.111234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/24/2020] [Accepted: 03/01/2021] [Indexed: 01/19/2023]
Abstract
Lifestyle modification, including a healthy diet, is of paramount importance in the management of diabetes mellitus. To this end, diets have been proposed with low glycemic index (an index of carbohydrate food expressing how quickly this nutrient can increase blood glucose) and glycemic load (an index obtained by multiplying the glycemic index by the grams of carbohydrate, then dividing by 100). The aim of this review was to discuss the potential contribution of diets with low glycemic index and glycemic load in diabetic microvascular complications. Currently, their role to the prevention and delay of microvascular complications in diabetes mellitus remains unclear, and further knowledge is desirable.
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Affiliation(s)
- Theano Penlioglou
- Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Vaia Lambadiari
- Second Department of Internal Medicine, Research Institute and Diabetes Centre, National and Kapodistrian University of Athens, Medical School, Attikon Hospital, Athens, Greece
| | - Nikolaos Papanas
- Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece.
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Effects of alpha-glucosidase-inhibiting drugs on acute postprandial glucose and insulin responses: a systematic review and meta-analysis. Nutr Diabetes 2021; 11:11. [PMID: 33658478 PMCID: PMC7930031 DOI: 10.1038/s41387-021-00152-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 06/11/2020] [Accepted: 02/03/2021] [Indexed: 12/15/2022] Open
Abstract
Background/objectives Despite considerable literature supporting the potential health benefits of reducing postprandial glucose (PPG), and insulin (PPI) exposures, the size of a clinically relevant reduction is currently unknown. We performed a systematic review and meta-analysis to quantify effects of alpha-glucosidase-inhibiting (AGI) drugs on acute PPG and PPI responses. Methods We searched EMBASE and MEDLINE until March 13, 2018 for controlled studies using AGI drugs together with a standardized carbohydrate load or mixed meal. The mean incremental PPG and PPI levels were calculated as outcomes. Meta-analyses, stratified by diabetes state, were performed by using random effects models. Results The 66 included publications comprised 127 drug-control comparisons for PPG, and 106 for PPI, mostly testing acarbose or miglitol. The absolute effects on PPG were larger among individuals with diabetes (−1.5 mmol/l mean PPG [95% CI −1.9, −1.1] by acarbose, and −1.6 [−1.9, −1.4] by miglitol) as compared to individuals without diabetes (−0.4 [95% CI −0.5, −0.3] by acarbose, and −0.6 [−0.8, −0.4] by miglitol). Relative reductions in PPG by both drugs were similar for diabetic and non-diabetic individuals (43−54%). Acarbose and miglitol also significantly reduced mean PPI, with absolute and relative reductions being largest among individuals without diabetes. Conclusions The present meta-analyses provide quantitative estimates of reductions of PPG and PPI responses by AGI drugs in diabetes and non-diabetic individuals. These data can serve as benchmarks for clinically relevant reductions in PPG and PPI via drug or diet and lifestyle interventions.
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Effect of a Low-Glycemic Load Diet Intervention on Maternal and Pregnancy Outcomes in Obese Pregnant Women. Nutrients 2021; 13:nu13030748. [PMID: 33652705 PMCID: PMC7996780 DOI: 10.3390/nu13030748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/20/2021] [Accepted: 02/22/2021] [Indexed: 11/30/2022] Open
Abstract
The increased prevalence of obese, pregnant women who have a higher risk of glucose intolerance warrants the need for nutritional interventions to improve maternal glucose homeostasis. In this study, the effect of a low-glycemic load (GL) (n = 28) was compared to a high-GL (n = 34) dietary intervention during the second half of pregnancy in obese women (body mass index (BMI) > 30 or a body fat >35%). Anthropometric and metabolic parameters were assessed at baseline (20 week) and at 28 and 34 weeks gestation. For the primary outcome 3h-glucose-iAUC (3h-incremental area under the curve), mean between-group differences were non-significant at every study timepoint (p = 0.6, 0.3, and 0.8 at 20, 28, and 34 weeks, respectively) and also assessing the mean change over the study period (p = 0.6). Furthermore, there was no statistically significant difference between the two intervention groups for any of the other examined outcomes (p ≥ 0.07). In the pooled cohort, there was no significant effect of dietary GL on any metabolic or anthropometric outcome (p ≥ 0.2). A post hoc analysis comparing the study women to a cohort of overweight or obese pregnant women who received only routine care showed that the non-study women were more likely to gain excess weight (p = 0.046) and to deliver large-for-gestational-age (LGA) (p = 0.01) or macrosomic (p = 0.006) infants. Thus, a low-GL diet consumed during the last half of pregnancy did not improve pregnancy outcomes in obese women, but in comparison to non-study women, dietary counseling reduced the risk of adverse outcomes.
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35
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Park HA. Fruit Intake to Prevent and Control Hypertension and Diabetes. Korean J Fam Med 2021; 42:9-16. [PMID: 33524250 PMCID: PMC7884895 DOI: 10.4082/kjfm.20.0225] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 10/11/2020] [Indexed: 01/10/2023] Open
Abstract
Fruits are considered healthy because of their high antioxidant, vitamin, mineral, fiber, and phytochemical contents. However, their high sugar content is a concern for glucose, lipid, and uric acid metabolism. We reviewed related articles published in the last 10 years and summarized evidence that relates fruit intake to the prevention and control of hypertension and diabetes mellitus. Clinicians should familiarize themselves with appropriate fruit intake to counsel at-risk patients on hypertension and diabetes.
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Affiliation(s)
- Hyun Ah Park
- Department of Family Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
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36
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Jayedi A, Soltani S, Jenkins D, Sievenpiper J, Shab-Bidar S. Dietary glycemic index, glycemic load, and chronic disease: an umbrella review of meta-analyses of prospective cohort studies. Crit Rev Food Sci Nutr 2020; 62:2460-2469. [PMID: 33261511 DOI: 10.1080/10408398.2020.1854168] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We aimed to present a comprehensive review of the association of dietary glycemic index (GI) and load (GL) with the risk of chronic disease. Published meta-analyses of prospective observational studies evaluating the association of dietary GI and GL with risk of chronic disease were identified by a search in PubMed and Scopus to November, 2020. Summary relative risks (SRRs) were recalculated using random-effects models. The certainty of evidence was rated by the GRADE approach. Eighteen meta-analyses of prospective cohort studies, reporting 19 SRRs for dietary GI and 17 SRRs for dietary GL were identified. There was a positive association between dietary GI and the risk of type 2 diabetes, coronary heart disease, and colorectal, breast, and bladder cancers, as well as between dietary GL and the risk of coronary heart disease, type 2 diabetes, and stroke. With regard to cancers at other sites, there was no significant association. The certainty of evidence ranged from very low to low. Although by GRADE classification no associations were rated stronger than low, they were classified as one grade higher when the NutriGrade system was used. Further research is needed to add evidence for the relation of dietary GI and GL with cancer risk.
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Affiliation(s)
- Ahmad Jayedi
- Food Safety Research Center (Salt), Semnan University of Medical Sciences, Semnan, Iran.,Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepideh Soltani
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - David Jenkins
- Faculty of Medicine, Departments of Nutritional Science and Medicine, University of Toronto, Toronto, Canada.,Clinical Nutrition & Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.,Division of Endocrinology & Metabolism, St. Michael's Hospital, Toronto, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - John Sievenpiper
- Faculty of Medicine, Departments of Nutritional Science and Medicine, University of Toronto, Toronto, Canada.,Clinical Nutrition & Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.,Division of Endocrinology & Metabolism, St. Michael's Hospital, Toronto, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Prpa EJ, Bajka BH, Ellis PR, Butterworth PJ, Corpe CP, Hall WL. A systematic review of in vitro studies evaluating the inhibitory effects of polyphenol-rich fruit extracts on carbohydrate digestive enzymes activity: a focus on culinary fruits consumed in Europe. Crit Rev Food Sci Nutr 2020; 61:3783-3803. [PMID: 32838552 DOI: 10.1080/10408398.2020.1808585] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Evidence shows that polyphenols can attenuate postprandial blood glucose responses to meals containing digestible carbohydrate. Polyphenol-rich plant extracts are emerging as potential ingredients in functional foods and/or beverages despite limited understanding of their physiological effects. Many studies have investigated the mechanisms of polyphenol-rich fruit extracts on inhibition of digestive enzymes. However, the evidence available has yet to be critically evaluated systematically. This report reviews the in vitro literature to quantify the effect of fruit polyphenol extracts on the activities of digestive carbohydrases. A systematic literature search was conducted using six science databases. Included studies, totaling 34 in number, were in vitro digestion models which quantified gut digestive enzyme(s) activity on starch digestion in the presence of fruit polyphenol extracts. Most studies assessed the effects of fruit extracts on either α-amylase (n = 30) or α-glucosidase (n = 30) activity. Studies were consistent overall in showing stronger inhibition of α-amylase compared to α-glucosidase by proanthocyanidin- and/or ellagitannin-rich fruit extracts. Recommendations are proposed for future reporting of this type of research to enable meaningful synthesis of the literature as a whole. Such knowledge could allow effective choices to be made for development of novel functional foods and beverages.
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Affiliation(s)
- E J Prpa
- Faculty of Life Sciences and Medicine, Department of Nutritional Sciences, King's College London, London, UK
| | - B H Bajka
- Faculty of Life Sciences and Medicine, Department of Biochemistry and Nutritional Sciences, Biopolymers Group, King's College London, London, UK
| | - P R Ellis
- Faculty of Life Sciences and Medicine, Department of Biochemistry and Nutritional Sciences, Biopolymers Group, King's College London, London, UK
| | - P J Butterworth
- Faculty of Life Sciences and Medicine, Department of Biochemistry and Nutritional Sciences, Biopolymers Group, King's College London, London, UK
| | - C P Corpe
- Faculty of Life Sciences and Medicine, Department of Nutritional Sciences, King's College London, London, UK
| | - W L Hall
- Faculty of Life Sciences and Medicine, Department of Nutritional Sciences, King's College London, London, UK
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Apple polyphenol-rich drinks dose-dependently decrease early-phase postprandial glucose concentrations following a high-carbohydrate meal: a randomized controlled trial in healthy adults and in vitro studies. J Nutr Biochem 2020; 85:108466. [PMID: 32739411 DOI: 10.1016/j.jnutbio.2020.108466] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 05/19/2020] [Accepted: 07/23/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Previous research demonstrated that a high dose of phlorizin-rich apple extract (AE) can markedly inhibit early-phase postprandial glycemia, but efficacy of lower doses of the AE is unclear. OBJECTIVE To determine whether lower AE doses reduce early-phase postprandial glycemia in healthy adults and investigate mechanisms. DESIGN In a randomized, controlled, double-blinded, cross-over acute trial, drinks containing 1.8 g (HIGH), 1.35 g (MED), 0.9 g (LOW), or 0 g (CON) of a phlorizin-rich AE were consumed before 75 g starch/sucrose meal. Postprandial blood glucose, insulin, C-peptide, glucose-dependent insulinotropic polypeptide (GIP) and polyphenol metabolites concentrations were measured 0-240 min, acetaminophen concentrations to assess gastric emptying rate, and 24 h urinary glucose excretion. Effects of AE on intestinal glucose transport were investigated in Caco-2/TC7 cells. RESULTS AE significantly reduced plasma glucose iAUC 0-30 min at all doses: mean differences (95% CI) relative to CON were -15.6 (-23.3, -7.9), -11.3 (-19.6, -3.0) and -8.99 (-17.3, -0.7) mmol/L per minute for HIGH, MEDIUM and LOW respectively, delayed Tmax (HIGH, MEDIUM and LOW 45 min vs. CON 30 min), but did not lower Cmax. Similar dose-dependent treatment effects were observed for insulin, C-peptide, and GIP. Gastric emptying rates and urinary glucose excretion did not differ. Serum phloretin, quercetin and epicatechin metabolites were detected postprandially. A HIGH physiological AE dose equivalent decreased total glucose uptake by 48% in Caco-2/TC7 cells. CONCLUSIONS Phlorizin-rich AE, even at a low dose, can slightly delay early-phase glycemia without affecting peak and total glycemic response.
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Lambadiari V, Korakas E, Tsimihodimos V. The Impact of Dietary Glycemic Index and Glycemic Load on Postprandial Lipid Kinetics, Dyslipidemia and Cardiovascular Risk. Nutrients 2020; 12:E2204. [PMID: 32722053 PMCID: PMC7468809 DOI: 10.3390/nu12082204] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/20/2020] [Accepted: 07/23/2020] [Indexed: 02/07/2023] Open
Abstract
Many recent studies have acknowledged postprandial hypetriglyceridemia as a distinct risk factor for cardiovascular disease. This dysmetabolic state is the result of the hepatic overproduction of very low-density lipoproteins (VLDLs) and intestinal secretion of chylomicrons (CMs), which leads to highly atherogenic particles and endothelial inflammation. Postprandial lipid metabolism does not only depend on consumed fat but also on the other classes of nutrients that a meal contains. Various mechanisms through which carbohydrates exacerbate lipidemia have been identified, especially for fructose, which stimulates de novo lipogenesis. Glycemic index and glycemic load, despite their intrinsic limitations, have been used as markers of the postprandial glucose and insulin response, and their association with metabolic health and cardiovascular events has been extensively studied with contradictory results. This review aims to discuss the importance and pathogenesis of postprandial hypertriglyceridemia and its association with cardiovascular disease. Then, we describe the mechanisms through which carbohydrates influence lipidemia and, through a brief presentation of the available clinical studies on glycemic index/glycemic load, we discuss the association of these indices with atherogenic dyslipidemia and address possible concerns and implications for everyday practice.
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Affiliation(s)
- Vaia Lambadiari
- Second Department of Internal Medicine and Research Institute, University General Hospital Attikon, 124 62 Haidari, Greece;
| | - Emmanouil Korakas
- Second Department of Internal Medicine and Research Institute, University General Hospital Attikon, 124 62 Haidari, Greece;
| | - Vasilios Tsimihodimos
- Department of Internal Medicine, School of Medicine, University of Ioannina, 451 10 Ioannina, Greece;
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40
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Mela DJ, Cao XZ, Dobriyal R, Fowler MI, Lin L, Joshi M, Mulder TJP, Murray PG, Peters HPF, Vermeer MA, Zhang Z. The effect of 8 plant extracts and combinations on post-prandial blood glucose and insulin responses in healthy adults: a randomized controlled trial. Nutr Metab (Lond) 2020; 17:51. [PMID: 32647531 PMCID: PMC7336677 DOI: 10.1186/s12986-020-00471-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 06/24/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Lower post-prandial glucose (PPG) and insulin (PPI) responses to foods are associated with reduced diabetes risk and progression. Several plant extracts have been proposed to reduce PPG or PPI by inhibiting enzymes or transporters involved in carbohydrate digestion and uptake. This study evaluates a range of such extracts, consumed with a carbohydrate load, for their effects on PPG, PPI and indicators of (gastrointestinal) tolerance. METHODS Interventions were extracts of mulberry fruit (MFE, 1.5 g), mulberry leaf (MLE, 1.0 g), white bean (WBE, 3.0 g), apple (AE, 2.0 g), elderberry (EE, 2.0 g), turmeric (TE, 0.18 g), AE + TE, and EE + TE. Each of these 8 individual extracts or combinations were added to a rice porridge containing ~ 50 g available carbohydrate (control). In a within-subject (randomised, balanced incomplete block) design, individual subjects received the control and a subset of 4 of the 8 extracts or combinations. Participants were 72 apparently healthy adults (mean [SD] age 31.2 [5.5] yr, body mass index 22.1 [2.0] kg/m2). The primary outcome was the percentage change in 2-h PPG (positive incremental area under the curve) relative to control. Secondary measures were the 2-h PPI response, 7-h breath hydrogen, measures of gastrointestinal discomfort, and urine glucose. RESULTS In the 65 subjects who completed the control and at least one intervention treatment, additions of AE, MFE and MLE produced statistically significant reductions in PPG vs control (p < 0.05; mean effect - 24.1 to - 38.1%). All extracts and combinations except TE and WBE significantly reduced PPI (p < 0.01; mean effect - 17.3% to - 30.4%). Rises in breath hydrogen > 10 ppm were infrequent, but statistically more frequent than control only for MLE (p = 0.02). Scores for gastrointestinal discomfort were extremely low and not different from control for any treatment, and no glucosuria was observed. CONCLUSIONS Additions of AE, MFE and MLE to rice robustly reduced PPG and PPI. EE significantly reduced only PPI, while TE and WBE showed no significant efficacy for PPG or PPI. Breath hydrogen responses to MLE suggest possible carbohydrate malabsorption at the dose used, but there were no explicit indications of intolerance to any of the extracts. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT04258501. Registered 6 February 2020 - Retrospectively registered.
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Affiliation(s)
| | | | | | | | - Li Lin
- Unilever R&D Shanghai, Shanghai, China
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Kazemi F, Danaei G, Farzadfar F, Malik V, Parsaeian M, Pouraram H, Zamaninour N, Rahmani J, Dorosty Motlagh AR. Glycemic Index (GI) Values for Major Sources of Dietary Carbohydrates in Iran. Int J Endocrinol Metab 2020; 18:e99793. [PMID: 33257904 PMCID: PMC7695225 DOI: 10.5812/ijem.99793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 05/09/2020] [Accepted: 05/10/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The glycemic index (GI) values of staple foods are not available in a standardized method in Iran. OBJECTIVES The aim of this study was to measure the GI values of the major carbohydrate sources in a typical Iranian diet. METHODS Using the international standard method, the GI values were determined for four wheat flatbreads, barley and rye bread, white and brown rice, as well as white and brown rice mixed with lentils. Twelve healthy adults were given 50 g anhydrous glucose three times (as the reference carbohydrate) and the test foods once each throughout the study. Using finger-prick blood samples, capillary blood glucose was measured using a reliable glucometer. The GI was calculated using the trapezoidal method. RESULTS The GI values of the following types of bread were: Barley 66, Lavash 72, Taftoon 79, Sangak 82, rye 84, and Barbari 99. The GI values for brown and white rice were 65 and 71, respectively. The mixture of brown rice with lentils had a GI value of 55, and the mixture of white rice with lentils had a GI of 79. CONCLUSIONS The most common types of bread and white rice consumed in Iran have high GI values. There is potential to reduce the overall GI values in the Iranian diet by encouraging the consumption of barley bread and brown rice.
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Affiliation(s)
- Fatemeh Kazemi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Goodarz Danaei
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Vasanti Malik
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Mahboubeh Parsaeian
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Pouraram
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Zamaninour
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Jamal Rahmani
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Dorosty Motlagh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding Author: Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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Fatty acids in the de novo lipogenesis pathway and incidence of type 2 diabetes: A pooled analysis of prospective cohort studies. PLoS Med 2020; 17:e1003102. [PMID: 32530938 PMCID: PMC7292352 DOI: 10.1371/journal.pmed.1003102] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 04/28/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND De novo lipogenesis (DNL) is the primary metabolic pathway synthesizing fatty acids from carbohydrates, protein, or alcohol. Our aim was to examine associations of in vivo levels of selected fatty acids (16:0, 16:1n7, 18:0, 18:1n9) in DNL with incidence of type 2 diabetes (T2D). METHODS AND FINDINGS Seventeen cohorts from 12 countries (7 from Europe, 7 from the United States, 1 from Australia, 1 from Taiwan; baseline years = 1970-1973 to 2006-2010) conducted harmonized individual-level analyses of associations of DNL-related fatty acids with incident T2D. In total, we evaluated 65,225 participants (mean ages = 52.3-75.5 years; % women = 20.4%-62.3% in 12 cohorts recruiting both sexes) and 15,383 incident cases of T2D over the 9-year follow-up on average. Cohort-specific association of each of 16:0, 16:1n7, 18:0, and 18:1n9 with incident T2D was estimated, adjusted for demographic factors, socioeconomic characteristics, alcohol, smoking, physical activity, dyslipidemia, hypertension, menopausal status, and adiposity. Cohort-specific associations were meta-analyzed with an inverse-variance-weighted approach. Each of the 4 fatty acids positively related to incident T2D. Relative risks (RRs) per cohort-specific range between midpoints of the top and bottom quintiles of fatty acid concentrations were 1.53 (1.41-1.66; p < 0.001) for 16:0, 1.40 (1.33-1.48; p < 0.001) for 16:1n-7, 1.14 (1.05-1.22; p = 0.001) for 18:0, and 1.16 (1.07-1.25; p < 0.001) for 18:1n9. Heterogeneity was seen across cohorts (I2 = 51.1%-73.1% for each fatty acid) but not explained by lipid fractions and global geographical regions. Further adjusted for triglycerides (and 16:0 when appropriate) to evaluate associations independent of overall DNL, the associations remained significant for 16:0, 16:1n7, and 18:0 but were attenuated for 18:1n9 (RR = 1.03, 95% confidence interval (CI) = 0.94-1.13). These findings had limitations in potential reverse causation and residual confounding by imprecisely measured or unmeasured factors. CONCLUSIONS Concentrations of fatty acids in the DNL were positively associated with T2D incidence. Our findings support further work to investigate a possible role of DNL and individual fatty acids in the development of T2D.
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The Effects of Carbohydrate-Restricted Dietary Patterns and Physical Activity on Body Weight and Glycemic Control. Curr Atheroscler Rep 2020; 22:20. [PMID: 32468247 DOI: 10.1007/s11883-020-00838-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW Carbohydrate (CHO)-restricted dietary patterns (very-low-CHO < 25-50 g CHO/day; low CHO 50-130 g CHO/day) and physical activity are used for weight loss and type 2 diabetes (T2D) prevention and management. This review discusses evidence for effects of these lifestyle therapies on body weight and glycemic control. RECENT FINDINGS Evidence supports the view that CHO-restricted interventions may be more effective than high-CHO, low-fat (HCLF) interventions in the short term for weight loss and glycemic control, but both produced similar levels of weight loss and glycemic control by 12 months. CHO-restricted dietary patterns resulted in a decreased use of diabetes medications. Benefits of CHO restriction were achieved at intakes that did not induce ketosis. Physical activity increases insulin sensitivity and reduces pancreatic beta-cell load, enhancing the effect of weight loss to delay or prevent T2D. A CHO-restricted dietary pattern may be a reasonable option for weight loss and T2D management for some individuals. Physical activity enhances weight management and cardiometabolic health.
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Feskens E, Brennan L, Dussort P, Flourakis M, Lindner LME, Mela D, Rabbani N, Rathmann W, Respondek F, Stehouwer C, Theis S, Thornalley P, Vinoy S. Potential Markers of Dietary Glycemic Exposures for Sustained Dietary Interventions in Populations without Diabetes. Adv Nutr 2020; 11:1221-1236. [PMID: 32449931 PMCID: PMC7490172 DOI: 10.1093/advances/nmaa058] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/23/2020] [Accepted: 04/28/2020] [Indexed: 12/15/2022] Open
Abstract
There is considerable interest in dietary and other approaches to maintaining blood glucose concentrations within the normal range and minimizing exposure to postprandial hyperglycemic excursions. The accepted marker to evaluate the sustained maintenance of normal blood glucose concentrations is glycated hemoglobin A1c (HbA1c). However, although this is used in clinical practice to monitor glycemic control in patients with diabetes, it has a number of drawbacks as a marker of efficacy of dietary interventions that might beneficially affect glycemic control in people without diabetes. Other markers that reflect shorter-term glycemic exposures have been studied and proposed, but consensus on the use and relevance of these markers is lacking. We have carried out a systematic search for studies that have tested the responsiveness of 6 possible alternatives to HbA1c as markers of sustained variation in glycemic exposures and thus their potential applicability for use in dietary intervention trials in subjects without diabetes: 1,5-anhydroglucitol (1,5-AG), dicarbonyl stress, fructosamine, glycated albumin (GA), advanced glycated end products (AGEs), and metabolomic profiles. The results suggest that GA may be the most promising for this purpose, but values may be confounded by effects of fat mass. 1,5-AG and fructosamine are probably not sensitive enough to the range of variation in glycemic exposures observed in healthy individuals. Use of measures based on dicarbonyls, AGEs, or metabolomic profiles would require further research into possible specific molecular species of interest. At present, none of the markers considered here is sufficiently validated and sensitive for routine use in substantiating the effects of sustained variation in dietary glycemic exposures in people without diabetes.
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Affiliation(s)
- Edith Feskens
- Department of Agrotechnology and Food Sciences, Wageningen University, Wageningen, The Netherlands
| | - Lorraine Brennan
- Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland
| | - Pierre Dussort
- International Life Sciences Institute-ILSI Europe a.i.s.b.l., Brussels, Belgium
| | - Matthieu Flourakis
- International Life Sciences Institute-ILSI Europe a.i.s.b.l., Brussels, Belgium,Address correspondence to MF (e-mail: )
| | - Lena M E Lindner
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany,German Center for Diabetes Research , Munich, Germany
| | | | - Naila Rabbani
- Department of Basic Medical Sciences, College of Medicine, Qatar University Health, Qatar University, Doha, Qatar,Clinical Sciences Research Laboratories, University of Warwick, Coventry, United Kingdom
| | - Wolfgang Rathmann
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany,German Center for Diabetes Research , Munich, Germany
| | | | - Coen Stehouwer
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands,School for Cardiovascular Diseases (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - Paul Thornalley
- Clinical Sciences Research Laboratories, University of Warwick, Coventry, United Kingdom,Diabetes Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Sophie Vinoy
- Nutrition Department, Mondelez Int R&D, Saclay, France
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Ruijgrok C, Blaak EE, Egli L, Dussort P, Vinoy S, Rauh SP, Beulens JW, Robertson MD, Alssema M. Reducing postprandial glucose in dietary intervention studies and the magnitude of the effect on diabetes-related risk factors: a systematic review and meta-analysis. Eur J Nutr 2020; 60:259-273. [PMID: 32277270 PMCID: PMC7867534 DOI: 10.1007/s00394-020-02240-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 03/25/2020] [Indexed: 11/20/2022]
Abstract
Purpose Reducing postprandial hyperglycemia has beneficial effects on
diabetes-related risk factors, but the magnitude of the reduction needed to achieve such
an effect is unknown. The purpose of the study was to quantify the relationship of acute
glucose and insulin postprandial responses with longer-term effects on diabetes-related
risk factors by performing a systematic review and meta-analysis of dietary intervention
studies. Methods We systematically searched EMBASE and MEDLINE. Dietary intervention studies
among any human population aiming to reduce postprandial glycemia, with actual measures of
postprandial glucose (PPG) and/or insulin (PPI) as acute exposures (incremental area under
the curve, iAUC) as well as markers of glucose metabolism (fasting glucose, HbA1c) and
insulin sensitivity (fasting insulin, HOMA-IR) after at least 4 weeks of diet intervention
as outcomes were included. Meta-analyses were performed for the effects on acute exposures
and on diabetes-related risk factors. The relationship between changes in acute exposures
and changes in risk factor outcomes was estimated by meta-regression analyses. Results Out of the 13,004 screened papers, 13 papers with 14 comparisons were
included in the quantitative analysis. The dietary interventions acutely reduced mean PPG
[mean difference (MD), − 0.27 mmol/l; 95% CI − 0.41 to − 0.14], but not mean PPI (MD
− 7.47 pmol/l; 95% CI − 16.79 to 1.86). There were no significant overall effects on
fasting glucose and insulin. HbA1c was reduced by − 0.20% (95% CI − 0.35 to − 0.05).
Changes in acute PPG were significantly associated with changes in fasting plasma glucose
(FPG) [per 10% change in PPG: β = 0.085 (95% CI 0.003,
0.167), k = 14], but not with fasting insulin
[β = 1.20 (95% CI − 0.32, 2.71), k = 12]. Changes in acute PPI were not associated with changes
in FPG [per 10% change in PPI: β = − 0.017 (95% CI
− 0.056, 0.022), k = 11]. Conclusions Only a limited number of postprandial glucose-lowering dietary intervention
studies measured acute postprandial exposures to PPG/PPI during the interventions. In this
small heterogeneous set of studies, an association was found between the magnitude of the
acute postprandial responses and the change in fasting glucose, but no other outcomes.
More studies are needed to quantify the relationship between acute postprandial changes
and long-term effects on risk factors. Electronic supplementary material The online version of this article (10.1007/s00394-020-02240-1) contains supplementary material, which is available to authorized
users.
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Affiliation(s)
- Carolien Ruijgrok
- Department of Epidemiology & Biostatistics, Amsterdam UMC - location VUmc, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Ellen E Blaak
- Department of Human Biology, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Léonie Egli
- Nestlé Institute of Health Sciences, Nestlé Research, Lausanne, Switzerland
| | - Pierre Dussort
- ILSI Europe a.I.S.B.L., Avenue E. Mounier 83, Box 6, 1200, Brussels, Belgium.
| | - Sophie Vinoy
- Nutrition Department, Mondelez International R&D, Saclay, France
| | - Simone P Rauh
- Department of Epidemiology & Biostatistics, Amsterdam UMC - location VUmc, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Joline W Beulens
- Department of Epidemiology & Biostatistics, Amsterdam UMC - location VUmc, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Marjan Alssema
- Department of Epidemiology & Biostatistics, Amsterdam UMC - location VUmc, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Unilever Research and Development, Vlaardingen, The Netherlands
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Lopez-Cepero A, Rosal MC, Frisard C, Person S, Ockene I, Tucker KL. Changes in Glycemic Load Are Positively Associated with Small Changes in Primary Stress Markers of Allostatic Load in Puerto Rican Women. J Nutr 2020; 150:554-559. [PMID: 31665370 PMCID: PMC7308622 DOI: 10.1093/jn/nxz260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/26/2019] [Accepted: 09/27/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Puerto Ricans experience a high prevalence of type 2 diabetes. Dietary glycemic load (GL) and allostatic load (AL) have been linked with diabetes. AL, the wear and tear on the body from chronic stress, starts with secretion of primary stress markers from activation of the hypothalamic-pituitary-adrenal (HPA) axis, sympathetic nervous system (SNS), and immune system. GL can act as a physiological stressor, contributing to the primary AL response. OBJECTIVE We examined the relation between GL and a composite score of primary stress markers of AL in Puerto Rican adults. METHODS Data were from the Boston Puerto Rican Health Study, a cohort study of Puerto Ricans, aged 45-75 y, including 262 men and 697 women with complete data at baseline and 2-y follow-up. GL was calculated from dietary intake obtained with an FFQ. Sex-specific composite primary AL scores included markers of the HPA axis (cortisol and dehydroepiandrosterone sulfate), SNS (epinephrine and norepinephrine), and immune system (C-reactive protein). Linear regression models were stratified by sex and adjusted for covariates. RESULTS Mean ± SD baseline GL score was 155 ± 28 for men and 135 ± 34 for women. Mean primary stress AL score was 1.25 ± 1.14 for men and 1.25 ± 1.06 for women. GL was not associated with AL score in men. In women, increasing GL from baseline to 2 y was significantly associated with increasing AL, after adjusting for sociodemographics, physical activity, smoking, BMI, menopause, and baseline AL score (β = 0.03; P = 0.049). Results became marginally significant after further adjustment for chronic diseases (P = 0.06) and intake of fats (P values: saturated fats = 0.08; trans fats = 0.06; unsaturated fats = 0.07), but the magnitude of the association remained unchanged. CONCLUSIONS Increasing GL over 2 y was positively associated with increasing composite score of primary markers of AL in Puerto Rican women. More studies are needed to confirm our findings.
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Affiliation(s)
- Andrea Lopez-Cepero
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Milagros C Rosal
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Christine Frisard
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Sharina Person
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Ira Ockene
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA
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Yari Z, Behrouz V, Zand H, Pourvali K. New Insight into Diabetes Management: From Glycemic Index to Dietary Insulin Index. Curr Diabetes Rev 2020; 16:293-300. [PMID: 31203801 DOI: 10.2174/1573399815666190614122626] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/05/2019] [Accepted: 05/03/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Despite efforts to control hyperglycemia, diabetes management is still challenging. This may be due to focusing on reducing hyperglycemia and neglecting the importance of hyperinsulinemia; while insulin resistance and resultant hyperinsulinemia preceded diabetes onset and may contribute to disease pathogenesis. OBJECTIVE The present narrative review attempts to provide a new insight into the management of diabetes by exploring different aspects of glycemic index and dietary insulin index. RESULTS The current data available on this topic is limited and heterogeneous. Conventional diet therapy for diabetes management is based on reducing postprandial glycemia through carbohydrate counting, choosing foods with low-glycemic index and low-glycemic load. Since these indicators are only reliant on the carbohydrate content of foods and do not consider the effects of protein and fat on the stimulation of insulin secretion, they cannot provide a comprehensive approach to determine the insulin requirements. CONCLUSION Selecting foods based on carbohydrate counting, glycemic index or glycemic load are common guides to control glycemia in diabetic patients, but neglect the insulin response, thus leading to failure in diabetes management. Therefore, paying attention to insulinemic response along with glycemic response seems to be more effective in managing diabetes.
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Affiliation(s)
- Zahra Yari
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahideh Behrouz
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Zand
- Department of Cellular and Molecular Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Katayoun Pourvali
- Department of Cellular and Molecular Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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The Mediterranean way: why elderly people should eat wholewheat sourdough bread-a little known component of the Mediterranean diet and healthy food for elderly adults. Aging Clin Exp Res 2020; 32:1-5. [PMID: 31721096 DOI: 10.1007/s40520-019-01392-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 10/16/2019] [Indexed: 12/25/2022]
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Merino B, Fernández-Díaz CM, Cózar-Castellano I, Perdomo G. Intestinal Fructose and Glucose Metabolism in Health and Disease. Nutrients 2019; 12:E94. [PMID: 31905727 PMCID: PMC7019254 DOI: 10.3390/nu12010094] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 12/26/2019] [Accepted: 12/26/2019] [Indexed: 02/06/2023] Open
Abstract
The worldwide epidemics of obesity and diabetes have been linked to increased sugar consumption in humans. Here, we review fructose and glucose metabolism, as well as potential molecular mechanisms by which excessive sugar consumption is associated to metabolic diseases and insulin resistance in humans. To this end, we focus on understanding molecular and cellular mechanisms of fructose and glucose transport and sensing in the intestine, the intracellular signaling effects of dietary sugar metabolism, and its impact on glucose homeostasis in health and disease. Finally, the peripheral and central effects of dietary sugars on the gut-brain axis will be reviewed.
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Affiliation(s)
- Beatriz Merino
- Instituto de Biología y Genética Molecular-IBGM (CSIC-Universidad de Valladolid), Valladolid 47003, Spain; (B.M.); (C.M.F.-D.); (G.P.)
| | - Cristina M. Fernández-Díaz
- Instituto de Biología y Genética Molecular-IBGM (CSIC-Universidad de Valladolid), Valladolid 47003, Spain; (B.M.); (C.M.F.-D.); (G.P.)
| | - Irene Cózar-Castellano
- Instituto de Biología y Genética Molecular-IBGM (CSIC-Universidad de Valladolid), Valladolid 47003, Spain; (B.M.); (C.M.F.-D.); (G.P.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid 28029, Spain
| | - German Perdomo
- Instituto de Biología y Genética Molecular-IBGM (CSIC-Universidad de Valladolid), Valladolid 47003, Spain; (B.M.); (C.M.F.-D.); (G.P.)
- Departamento de Ciencias de la Salud, Universidad de Burgos, Burgos 09001, Spain
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50
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Walther B, Lett AM, Bordoni A, Tomás‐Cobos L, Nieto JA, Dupont D, Danesi F, Shahar DR, Echaniz A, Re R, Fernandez AS, Deglaire A, Gille D, Schmid A, Vergères G. GutSelf: Interindividual Variability in the Processing of Dietary Compounds by the Human Gastrointestinal Tract. Mol Nutr Food Res 2019; 63:e1900677. [PMID: 31483113 PMCID: PMC6900003 DOI: 10.1002/mnfr.201900677] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/25/2019] [Indexed: 12/19/2022]
Abstract
Nutritional research is currently entering the field of personalized nutrition, to a large extent driven by major technological breakthroughs in analytical sciences and biocomputing. An efficient launching of the personalized approach depends on the ability of researchers to comprehensively monitor and characterize interindividual variability in the activity of the human gastrointestinal tract. This information is currently not available in such a form. This review therefore aims at identifying and discussing published data, providing evidence on interindividual variability in the processing of the major nutrients, i.e., protein, fat, carbohydrates, vitamins, and minerals, along the gastrointestinal tract, including oral processing, intestinal digestion, and absorption. Although interindividual variability is not a primary endpoint of most studies identified, a significant number of publications provides a wealth of information on this topic for each category of nutrients. This knowledge remains fragmented, however, and understanding the clinical relevance of most of the interindividual responses to food ingestion described in this review remains unclear. In that regard, this review has identified a gap and sets the base for future research addressing the issue of the interindividual variability in the response of the human organism to the ingestion of foods.
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Affiliation(s)
- Barbara Walther
- AgroscopeFederal Department of Economic AffairsEducation and Research EAER3003BerneSwitzerland
| | - Aaron M. Lett
- Section for Nutrition ResearchDepartment of MedicineImperial College LondonLondonUK
| | - Alessandra Bordoni
- Department of Agri‐Food Sciences and TechnologiesUniversity of Bologna47521CesenaItaly
| | | | | | - Didier Dupont
- UMR 1253Science et Technologie du Lait et de l'ŒufINRA35000RennesFrance
| | - Francesca Danesi
- Department of Agri‐Food Sciences and TechnologiesUniversity of Bologna47521CesenaItaly
| | - Danit R. Shahar
- Department of Public HealthThe S. Daniel Abraham International Center for Health and NutritionBen‐Gurion University of the Negev84105Beer‐ShevaIsrael
| | - Ana Echaniz
- Cambridge Food Science LtdCB23 5ABCambridgeUK
| | - Roberta Re
- Cambridge Food Science LtdCB23 5ABCambridgeUK
| | | | - Amélie Deglaire
- UMR 1253Science et Technologie du Lait et de l'ŒufINRA35000RennesFrance
| | - Doreen Gille
- AgroscopeFederal Department of Economic AffairsEducation and Research EAER3003BerneSwitzerland
| | - Alexandra Schmid
- AgroscopeFederal Department of Economic AffairsEducation and Research EAER3003BerneSwitzerland
| | - Guy Vergères
- AgroscopeFederal Department of Economic AffairsEducation and Research EAER3003BerneSwitzerland
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