Manipulation of starch bioaccessibility in wheat endosperm to regulate starch digestion, postprandial glycemia, insulinemia, and gut hormone responses: a randomized controlled trial in healthy ileostomy participants

A- and B-type wheat starch granules: The multiscale structural evolution during digestion and the distinct digestion mechanisms

The digestive characteristics of wheat starch are closely related to human health. However, the digestive mechanisms of distinct wheat starch granules are not well understood. To address this problem, A- and B-type wheat starch granules (AWS and BWS, respectively) were digested in vitro and the structural evolution of the digestive remnants was compared. After stomach-intestinal digestion of AWS, its crystallinity decreased from 12.75 % to 6.65 %, its fractal dimension decreased from 3.12 to 2.35, and the median particle size decreased from 20.613 to 10.135 μm. Additionally, the number of short chains (polymerization degree<14) and thermodynamic stability decreased after digestion. For BWS, Fourier transform infrared ratio of 1047/1022 cm-1 and 995/1022 cm-1 increased from 0.665 and 0.725 to 0.990 and 0.800, respectively. The median particle size decreased from 5.480 to 4.769 μm. An enzyme-resistant scattering peak was observed in the 1.35 nm-1 lamellar structure. Additionally, the number of B2 and B3 chains and the thermodynamic stability increased after digestion. Our study confirmed that BWS is more likely than AWS to form enzyme-resistant structures during digestion. These findings provide insights into the distinct digestion mechanisms of AWS and BWS, and serve as a foundation for modifying wheat starch to increase its nutritional value.

The particle sizes of milled wheat fractions affect the in vitro starch digestibility and quality parameters of wire-cut cookies made thereof

Slow digestion of starch is linked to various health benefits. The impact of wheat particle size on in vitro starch digestibility and quality of wire-cut cookies was here evaluated by including four soft wheat fractions [i.e. flour (average diameter, 83 μm), fine farina (643 μm), coarse farina (999 μm) and bran (1036 μm)] in the recipe. The susceptibility of starch in these fractions to in vitro digestion decreased with increasing particle size, resulting in a 76% lower digestion rate for coarse farina than for flour as found with the single first-order kinetic model. Starch was protected from hydrolysis likely due to delayed diffusion of pancreatic α-amylase through the intact farina cell walls. When 20-65% starch in flour for the control cookie recipe was substituted with the same percentages in fine and coarse farina, the starch digestion rate decreased when substitution levels increased. A 62% lower digestion rate was found at 65% substitution with coarse farina. Cell wall intactness was largely preserved in the cookies and most of the starch appeared as ungelatinised granules. Further, the cookie spread ratio during baking was 48% and 33% higher and the cookies were 63% and 57% less hard than control cookies when made with 65% fine farina and 65% coarse farina, respectively. The relatively low specific surface area of large wheat particles resulted in low water absorption and less dense packing. In conclusion, encapsulation of starch by intact cell walls in coarse wheat fractions makes them promising ingredients when developing starchy food products for controlled energy release.

Strategic exploration of whole grain cereals in modulating the glycaemic response

In the current context, diabetes presents itself as a widespread and complex global health issue. This study explores the significant influence of food microstructure and food matrix components interaction (protein, lipid, polyphenols, etc.) on the starch digestibility and the glycaemic response of post-prandial glycemia, focusing on the potential effectiveness of incorporating bioactive components from whole grain cereals into dietary strategies for the management and potential prevention of diabetes. This study aims to integrate the regulation of postprandial glycaemic homeostasis, including the complexities of starch digestion, the significant potential of bioactive whole grain components and the impact of food processing, to develop a comprehensive framework that combines these elements into a strategic approach to diabetes nutrition. The convergence of these nutritional strategies is analyzed in the context of various prevalent dietary patterns, with the objective of creating an accessible approach to mitigate and prevent diabetes. The objective remains to coalesce these nutritional paradigms into a coherent strategy that not only addresses the current public health crisis but also threads a preventative approach to mitigate future prevalence and impact.

Impact of chickpea hummus on postprandial blood glucose, insulin and gut hormones in healthy humans combined with mechanistic studies of food structure, rheology and digestion kinetics

Slowing the rate of carbohydrate digestion leads to low postprandial glucose and insulin responses, which are associated with reduced risk of type 2 diabetes. There is increasing evidence that food structure plays a crucial role in influencing the bioaccessibility and digestion kinetics of macronutrients. The aims of this study were to compare the effects of two hummus meals, with different degrees of cell wall integrity, on postprandial metabolic responses in relation to the microstructural and rheological characteristics of the meals. A randomised crossover trial in 15 healthy participants was designed to compare the acute effect of 27 g of starch, provided as hummus made from either intact chickpea cells (ICC) or ruptured chickpea cells (RCC), on postprandial metabolic responses. In vitro starch digestibility, microstructural and rheological experiments were also conducted to evaluate differences between the two chickpea hummus meals. Blood insulin and GIP concentrations were significantly lower (P < 0.02, P < 0.03) after the consumption of the ICC meal than the meal containing RCC. In vitro starch digestion for 90 min was slower in ICC than in RCC. Microscopic examination of hummus samples digested in vitro for 90 min revealed more intact chickpea cells in ICC compared to the RCC sample. Rheological experiments showed that fracture for ICC hummus samples occurred at smaller strains compared to RCC samples. However, the storage modulus for ICC was higher than RCC, which may be explained by the presence of intact cells in ICC. Food structure can affect the rate and extent of starch bioaccessibility and digestion and may explain the difference in the time course of metabolic responses between meals. The rheological properties were measured on the two types of meals before ingestion, showing significant differences that may point to different breakdown mechanisms during subsequent digestion. This trial was registered at clinicaltrial.gov as NCT03424187.

A review of endogenous non-starch components in cereal matrix: spatial distribution and mechanisms for inhibiting starch digestion

As compared with exogenous components, non-starch components (NSCS), such as proteins, lipids, non-starch polysaccharides (NSPs), and polyphenols, inherently present in cereals, are more effective at inhibiting starch digestibility. Existing research has mostly focused on complex systems but overlooked the analysis of the in-situ role of the NSCS. This study reviews the crucial mechanisms by which endogenous NSCS inhibit starch digestion, emphasizing the spatial distribution-function relationship. Starch granules are filled with pores/channels-associated proteins and lipids, embedding in the protein matrix, and maintained by endosperm cell walls. The potential starch digestion inhibition of endogenous NSCS is achieved by altering starch gelatinization, molecular structure, digestive enzyme activity, and accessibility. Starch gelatinization is constrained by endogenous NSCS, particularly cell wall NSPs and matrix proteins. The stability of the starch crystal structure is enhanced by the proteins and lipids distributed in the starch granule pores and channels. Endogenous polyphenols greatly inhibit digestive enzymes and participate in the cross-linking of NSPs in the cell wall space, which together constitute a physical barrier that hinders amylase diffusion. Additionally, the spatial entanglement of NSCS and starch under heat and non-heat processing conditions reduces starch accessibility. This review provides novel evidence for the health benefits of whole cereals.

Diet shapes the metabolite profile in the intact human ileum, which affects PYY release

The human ileum contains a high density of enteroendocrine L-cells, which release the appetite-suppressing hormones glucagon-like peptide-1 (GLP-1) and peptide tyrosine tyrosine (PYY) in response to food intake. Recent evidence highlighted the potential role of food structures in PYY release, but the link between food structures, ileal metabolites, and appetite hormone release remains unclear owing to limited access to intact human ileum. In a randomized crossover trial (ISRCTN11327221; isrctn.com), we investigated the role of human ileum in GLP-1 and PYY release by giving healthy volunteers diets differing in fiber and food structure: high-fiber (intact or disrupted food structures) or low-fiber disrupted food structures. We used nasoenteric tubes to sample chyme from the intact distal ileum lumina of humans in the fasted state and every 60 min for 480 min postprandially. We demonstrate the highly dynamic, wide-ranging molecular environment of the ileum over time, with a substantial decrease in ileum bacterial numbers and bacterial metabolites after food intake. We also show that high-fiber diets, independent of food structure, increased PYY release compared with a low-fiber diet during 0 to 240 min postprandially. High-fiber diets also increased ileal stachyose, and a disrupted high-fiber diet increased certain ileal amino acids. Treatment of human ileal organoids with ileal fluids or an amino acid and stachyose mixture stimulated PYY expression in a similar profile to blood PYY concentrations, confirming the role of ileal metabolites in PYY release. Our study demonstrates the diet-induced changes over time in the metabolite environment of intact human ileum, which play a role in PYY release.

Presence of digestible starch impacts in vitro fermentation of resistant starch

Starch is an important energy source for humans. Starch escaping digestion in the small intestine will transit to the colon to be fermented by gut microbes. Many gut microbes express α-amylases that can degrade soluble starch, but only a few are able to degrade intrinsic resistant starch (RS), which is insoluble and highly resistant to digestion (≥80% RS). We studied the in vitro fermentability of eight retrograded starches (RS-3 preparations) differing in rapidly digestible starch content (≥70%, 35-50%, ≤15%) by a pooled adult faecal inoculum and found that fermentability depends on the digestible starch fraction. Digestible starch was readily fermented yielding acetate and lactate, whereas resistant starch was fermented much slower generating acetate and butyrate. Primarily Bifidobacterium increased in relative abundance upon digestible starch fermentation, whereas resistant starch fermentation also increased relative abundance of Ruminococcus and Lachnospiraceae. The presence of small fractions of total digestible starch (±25%) within RS-3 preparations influenced the fermentation rate and microbiota composition, after which the resistant starch fraction was hardly fermented. By short-chain fatty acid quantification, we observed that six individual faecal inocula obtained from infants and adults were able to ferment digestible starch, whereas only one adult faecal inoculum was fermenting intrinsic RS-3. This suggests that, in contrast to digestible starch, intrinsic RS-3 is only fermentable when specific microbes are present. Our data illustrates that awareness is required for the presence of digestible starch during in vitro fermentation of resistant starch, since such digestible fraction might influence and overrule the evalution of the prebiotic potential of resistant starches.

Salt adopted in soaking solution controls the yield and starch digestion kinetics of intact pulse cotyledon cells

Intact cellular powders have gained attention as a functional ingredient due to their lower glycemic response and potential benefits in colon. The isolation of intact cells in the laboratory and pilot plant settings is mainly achieved through thermal treatment with or without the use of limited salts. However, the effects of salt type and concentration on cell porosity, and their impact on the enzymic hydrolysis of encapsulated macro-nutrients such as starch, have been overlooked. In this study, different salt-soaking solutions were used to isolate intact cotyledon cells from white kidney beans. The use of Na₂CO₃ and Na₃PO₄ soaking treatments, with high pH (11.5-12.7) and high amount of Na ion (0.1, 0.5 M), greatly improved the yield of cellular powder (49.6-55.5 %), due to the solubilization of pectin through β-elimination and ion exchange. Intact cell walls serve as a physical barrier, significantly reducing the susceptibility of cell to amylolysis when compared to white kidney bean flour and starch counterparts. However, the solubilization of pectin may facilitate enzyme access into the cells by enlarging cell wall permeability. These findings provide new insights into the processing optimization to improve the yield and nutritional value of intact pulse cotyledon cells as a functional food ingredient.

The ileal and total tract digestibility fibre and nutrients in pigs fed high-fibre cereal-based diets provided without and with a carbohydrase complex

The effect of carbohydrase can be variable according to the complexity of cereal grains and co-products. Studies on the effect of carbohydrase on cereal diets varying in complexity are scarce. This study was conducted to investigate the apparent ileal (AID) and total tract digestibility (ATTD) of energy, fibre and nutrients in pigs fed diets based on cereal grains and co-products without and with supplementation with a carbohydrase complex in the form of xylanase, arabinofuranosidase and β-glucanase. The experiment was carried out as an 8 × 4 Youden Square design (eight diets and four periods by two blocks) using 16 growing pigs (33.3 ± 0.8 kg) surgically fitted with a T-cannula in the terminal ileum. The pigs were fed eight experimental diets based on either - maize, wheat, rye, or a wheat and rye mix that were provided with or without enzyme supplementation. The AID and ATTD of DM, organic matter, energy, CP, fat, starch, and soluble and insoluble non-starch polysaccharides (NSPs) were studied using titanium dioxide as an indigestible marker. There was a cereal type effect (P < 0.05) of the AID of most of the nutrients investigated but ash and NSP and some of its constituents but with no interactions between cereal types and carbohydrase supplementation (P > 0.05). The ATTD of nutrients in the large intestine was mainly influenced by the fibre composition and was significantly lower (P < 0.001) for NSP, protein and energy for the Maize than the other diets. Supplementation of the cereal diets with the carbohydrase complex partially degrades arabinoxylan (AX) and β-glucan giving rise to a generally higher AID of high-molecular weight arabinoxylan (P = 0.044), starch (P = 0.042), a tendency (P < 0.10) of higher AID of non-cellulosic polysaccharide glucose residue (β-glucan) and soluble arabinoxylan (AX) whereas none of the other components were affected (P > 0.05). Collectively, the results indicate that the carbohydrase complex degrades AX in the stomach and small intestine, leading to a higher AID but with no influence on the ATTD of fibres, nutrients, and energy.

Structural basis for rice starch multi-digestible fractions revealed by consecutive reaction kinetics model

BACKGROUND

Starch-based foods (e.g. rice) usually contain multiple starch fractions with distinct digestion rate constants, although their nature is currently unknown. The present study applied the recently developed consecutive reaction kinetics model to fit the in vitro digestion curves for starch fractions deconvoluted from the overall digestograms to differentiate their binding and catalysis rates to starch digestive enzymes. The fitting parameters were then correlated with starch molecular structures obtained from published data to understand starch structural features determining the binding and catalytic rate constants.

RESULTS

Binding and catalysis rates for the rapidly (RDF) and slowly digestible starch fraction (SDF) were controlled by distinct starch structural features. Typically, (i) the binding rate constant for RDF was negatively correlated with the amount of amylose short to intermediate chains, whereas it was positively correlated with the relative length of amylopectin intermediate chains; (ii) the catalysis rate constant for RDF was negatively correlated with the amount of amylose short to intermediate chains, relative length of amylose intermediate chains and amount of amylopectin long chains, whereas it was positively correlated with starch molecular size as well as relative length of amylopectin intermediate chains; (iii) and the catalysis rate constant for SDF was negatively correlated with the amount of amylopectin long chains, whereas it was positively correlated with starch molecular size.

CONCLUSION

These results provide a better understanding of the nature of different starch digestible fractions and the development of foods such as rice with slow starch digestibility. © 2023 Society of Chemical Industry.

Purple red rice bran anthocyanins reduce the digestibility of rice starch by forming V-type inclusion complexes

Purple red rice bran, a by-product of the rice polishing process, contained abundant anthocyanins. However, most of them were discarded resulting in a waste of resources. This study investigated the effects of purple red rice bran anthocyanin extracts (PRRBAE) on the physicochemical properties and digestive properties of rice starch and its mechanism of action. Infrared spectroscopy and X-ray diffraction indicated that PRRBAE could interact with rice starch through non-covalent bonds to form intrahelical V-type complexes. The DPPH and ABTS⁺ assays showed that PRRBAE could confer better antioxidant activity on rice starch. In addition, the PRRBAE could increase the resistant starch content and decrease the enzyme activities by changing the tertiary and secondary structure of starch-digesting enzymes. Further, molecular docking suggested that aromatic amino acids play a key role in the interaction of starch-digesting enzymes with PRRBAE. These findings will contribute to a better understanding of the mechanism of PRRBAE reducing starch digestibility, and to the development of high value-added products and low glycemic index (GI) foods.

A comparison of the effects of resistant starch types on glycemic response in individuals with type 2 diabetes or prediabetes: A systematic review and meta-analysis

Background

Type 2 diabetes (T2D) diagnoses are predicted to reach 643 million by 2030, increasing incidences of cardiovascular disease and other comorbidities. Rapidly digestible starch elevates postprandial glycemia and impinges glycemic homeostasis, elevating the risk of developing T2D. Starch can escape digestion by endogenous enzymes in the small intestine when protected by intact plant cell walls (resistant starch type 1), when there is a high concentration of amylose (resistant starch type 2) and when the molecule undergoes retrogradation (resistant starch type 3) or chemical modification (resistant starch type 4). Dietary interventions using resistant starch may improve glucose metabolism and insulin sensitivity. However, few studies have explored the differential effects of resistant starch type. This systematic review and meta-analysis aims to compare the effects of the resistant starch from intact plant cell structures (resistant starch type 1) and resistant starch from modified starch molecules (resistant starch types 2-5) on fasting and postprandial glycemia in subjects with T2D and prediabetes.

Methods

Databases (PubMed, SCOPUS, Ovid MEDLINE, Cochrane, and Web of Science) were systematically searched for randomized controlled trials. Standard mean difference (SMD) with 95% confidence intervals (CI) were determined using random-effects models. Sub-group analyses were conducted between subjects with T2D versus prediabetes and types of resistant starch.

Results

The search identified 36 randomized controlled trials (n = 982), 31 of which could be included in the meta-analysis. Resistant starch type 1 and type 2 lowered acute postprandial blood glucose [SMD (95% CI) = -0.54 (-1.0, -0.07)] and [-0.96 (-1.61, -0.31)]. Resistant starch type 2 improved acute postprandial insulin response [-0.71 (-1.31, -0.11)]. In chronic studies, resistant starch type 1 and 2 lowered postprandial glucose [-0.38 (-0.73, -0.02), -0.29 (-0.53, -0.04), respectively] and resistant starch type 2 intake improved fasting glucose [-0.39 (-0.66, -0.13)] and insulin [-0.40 (-0.60, -0.21)].

Conclusion

Resistant starch types 1 and 2 may influence glucose homeostasis via discrete mechanisms, as they appear to influence glycemia differently. Further research into resistant starch types 3, 4, and 5 is required to elucidate their effect on glucose metabolism. The addition of resistant starch as a dietary intervention for those with T2D or prediabetes may prevent further deterioration of glycemic control.

A procedure for determining the number and pattern of digestible starch fractions in multiphasic food digestograms

BACKGROUND

Plant-based foods are frequently heterogenous systems, containing multiple starch fractions with distinct digestion rate constants. An unbiased determination of the number and digestion pattern of these fractions is a prerequisite for understanding the digestive characteristics of food.

RESULTS

A non-linear least-squares procedure based on a conditional selection of simple first-order kinetics or a combination of parallel and sequential kinetics models was developed. The procedure gave robust results fitting manually generated data, and was applied to in vitro experimental digestion data of retrograded rice starches. By correlating fitting parameters with starch structural parameters, it showed that rice starches with a lower amylose content, longer amylose chains, and amylopectin intermediate chains had more digestible starch fractions after long-term retrogradation.

CONCLUSION

This procedure enables the structural basis of starch digestibility and the development of food products with slow starch digestibility to be better understood. © 2022 Society of Chemical Industry.

The microbiota and metabolites during the fermentation of intact plant cells depend on the content of starch, proteins and lipids in the cells

Intact cells, as the smallest unit of whole foods, were isolated from three legume crops and fermented with human faecal inoculum to elucidate the effect of food macro-nutrients compositional difference (starch, proteins and lipids) on in vitro colonic fermentation profiles. After 48 h of fermentation, the highest production of short-chain fatty acids (SCFAs) were observed for the pea cells, abundance in starch (64.9 %, db). In contrast, branch chain fatty acids (BCFAs) were the major metabolites for protein-enriched soybean cells (protein content 56.9 %, db). The peanut cells rich in lipids (49.2 %, db) has the lowest fermentation rate among the three varieties. Correspondingly, pea cells favoured the growth of Bifidobacterium, whereas soybean and peanut cells promoted an abundance of Bacteroides and Shigella, respectively. Furthermore, except the intact pea cells promoting the abundance of butyrate producer Roseburia, a similar fermentation pattern was found between intact and broken cells suggesting that macro-nutrient types, rather than structure, dominate the production of metabolites in colonic fermentation. The findings elucidate how the food compositional difference can modulate the gut microbiome and thus provide the knowledge to design whole food legumes-based functional foods.

Mining the A.E. Watkins Wheat Landrace Collection for Variation in Starch Digestibility Using a New High-Throughput Assay

Breeding for less digestible starch in wheat can improve the health impact of bread and other wheat foods. The application of forward genetic approaches has lately opened opportunities for the discovery of new genes that influence the digestibility of starch, without the burden of detrimental effects on yield or on pasta and bread-making quality. In this study we developed a high-throughput in vitro starch digestibility assay (HTA) for use in forward genetic approaches to screen wheat germplasm. The HTA was validated using standard maize and wheat starches. Using the HTA we measured starch digestibility in hydrothermally processed flour samples and found wide variation among 118 wheat landraces from the A. E. Watkins collection and among eight elite UK varieties (23.5 to 39.9% and 31.2 to 43.5% starch digested after 90 min, respectively). We further investigated starch digestibility in fractions of sieved wholemeal flour and purified starch in a subset of the Watkins lines and elite varieties and found that the matrix properties of flour rather than the intrinsic properties of starch granules conferred lower starch digestibility.

Influence of oral processing behaviour and bolus properties of brown rice and chickpeas on in vitro starch digestion and postprandial glycaemic response

PURPOSE

Oral processing behaviour may contribute to individual differences in glycaemic response to foods, especially in plant tissue where chewing behaviour can modulate release of starch from the cellular matrix. The aim of this study was to assess the impact of chewing time of two starch based foods (brown rice and chickpeas) on bolus properties, in vitro starch digestion and postprandial glycaemic excursion in healthy subjects.

METHODS

In a cross-over trial participants (n = 26) consumed two carbohydrates-identical test meals (brown rice: 233 g; chickpeas: 323 g) with either long (brown rice: 41 s/bite; chickpeas: 37 s/bite) or short (brown rice: 23 s/bite; chickpeas: 20 s/bite) chewing time in duplicate while glycaemic responses were monitored using a continuous glucose monitoring device. Expectorated boli were collected, then bolus properties (number, mean area, saliva amylase activity) and in vitro starch digestion were determined.

RESULTS

Longer chewing resulted in significantly (p < 0.05) more and smaller bolus particles, higher bolus saliva uptake and higher in vitro degree of intestinal starch hydrolysis (DH_Schewing time%) than shorter chewing for both foods (brown rice: DH_S%23 s = 84 ± 4% and DH_%S41s = 90 ± 6%; chickpeas: DH_S%20 s = 27 ± 3% and DH_%S37s = 34 ± 5%, p < 0.001). No significant effect of chewing time on glycaemic response (iAUC) (p > 0.05) was found for both meals. Brown rice showed significantly and considerably higher in vitro degree of intestinal starch hydrolysis and glycaemic response (iAUC) than chickpeas regardless of chewing time. No significant correlations were observed between bolus properties and in vitro starch hydrolysis or glycaemic response (p > 0.05).

CONCLUSION

Differences in the innate structure of starch based foods (brown rice compared to chickpeas) have a larger effect on postprandial glucose response than differences in mastication behaviour although oral processing behaviour showed consistent effects on bolus properties and in vitro starch digestion. Trial registration ClinicalTrials.gov identifier: NCT04648397 (First posted: December 1, 2020).

The influence of dough kneading time and flour particle size distribution on white bread structure, glycemic response and aspects of appetite

BACKGROUND & AIMS

White bread is widely consumed in many countries despite being a high-glycemic index (GI) food. It has been shown that the "food matrix effect" may help with diabetes and obesity management through lowering GI and appetite. This study aimed at investigating the effects of dough kneading time and flour particle size on white bread structure, glycemic response, and aspects of appetite.

METHODS

A two-phase randomized cross-over design was used in 10 healthy subjects over the course of 2 h. In phase 1, Texture Profile Analysis (TPA) attributes, Scanning Electron Microscope (SEM) image, glycemic response, and appetite aspects of white bread made with a 15-min dough kneading time (K15) were compared with white bread made with a 10-min dough kneading time (K10). In phase 2, TPA, SEM image, glycemic response, and satiety score of white bread made with coarse flour (CF) were compared to white bread made with fine flour (FF).

RESULT

With increasing hardness (force required to compress a food between the molars to a given deformation), total blood glucose IAUC in K15 (IAUC = 119 ± 12; GI = 66) was significantly (p < 0.05) lower than in K10 (IAUC = 154 ± 10; GI = 81). No marked difference was observed between K15 and K10 on aspects of appetite except for hunger. There was no significant (p > 0.05) difference in glycemic response between CF (IAUC = 126 ± 18; GI = 64) and FF (IAUC = 147 ± 12; GI = 81). Similarly, no discernible difference in satiety between CF and FF.

CONCLUSION

Changes in processing conditions can improve blood glucose response relalated to white bread consumption.

Culinary strategies to manage glycemic response in people with type 2 diabetes: A narrative review

Diet plays a critical role in the management of many chronic diseases. It is well known that individuals with type 2 diabetes (T2D) need to pay close attention to foods rich in carbohydrates to better manage their blood sugar. Usually, individuals are told to increase their dietary fiber intake which is associated with better glycemic control and limit their overall carbohydrate consumption. However, there are many other cooking strategies available to reduce the glycemic response to meals rich in carbohydrates and with a high glycemic index, such as adding fats, proteins, or vinegar, modifying the cooking or preparation processes, and even the selection and storage of foods consumed. The aim of the present narrative review is to summarize some of these existing strategies applied to the cooking process and their ability to modulate glycemic response to meals in individuals with T2D.

Monitoring the effect of cell wall integrity in modulating the starch digestibility of durum wheat during different steps of bread making

Reduction of starch digestibility in starchy foods is beneficial for lowering the risks for major non-communicable diseases. Preserving cell integrity is known to delay starch digestibility in flour but its effect in bread is not clear. In this study, the effect of increasing particle size on in vitro starch digestibility of durum wheat flour, dough, and bread was investigated. Cell integrity was retained during bread processing for medium (1000 µm-1800 µm), and large (>1800 µm) flour, whereas in small one cell walls were mostly damaged (<350 µm). In vitro starch digestibility of flour decreased increasing particle size, but no difference was found in dough. In bread, instead, a modest decrease of starch digestibility for the bread made by large particle was observed, likely due to its dense structure. In conclusion, a high particle size could limit starch digestibility in durum wheat flour but not in bread.

Matched whole grain wheat and refined wheat milled products do not differ in glycemic response or gastric emptying in a randomized, crossover trial

BACKGROUND

Epidemiologic and some clinical studies support the view that whole grain foods have lower glycemic response than refined grain foods. However, from the perspective of food material properties, it is not clear why whole grain cereals containing mostly insoluble and nonviscous dietary fibers (e.g., wheat) would reduce postprandial glycemia.

OBJECTIVES

We hypothesized that glycemic response for whole grain wheat milled products would not differ from that of refined wheat when potentially confounding variables (wheat source, food form, particle size, viscosity) were matched. Our objective was to study the effect of whole grain wheat compared with refined wheat milled products on postprandial glycemia, gastric emptying, and subjective appetite.

METHODS

Using a randomized crossover design, healthy participants (n = 16) consumed 6 different medium-viscosity porridges made from whole grain wheat or refined wheat milled products, all from the same grain source and mill: whole wheat flour, refined wheat flour, cracked wheat, semolina, reconstituted wheat flour with fine bran, and reconstituted wheat flour with coarse bran. Postprandial glycemia, gastric emptying, and appetitive response were measured using continuous glucose monitors, the 13C-octanoic acid (8:0) breath test, and visual analog scale (VAS) ratings. Bayes factors were implemented to draw inferences about null effects.

RESULTS

Little-to-no differences were observed in glycemic responses, with lower incremental AUC between 0 and 120 min glycemic responses only for semolina [mean difference (MD): -966 mg min/dL; 95% CI: -1775, -156 mg min/dL; P = 0.02) and cracked wheat (MD: -721 mg min/dL; 95% CI: -1426, -16 mg min/dL; P = 0.04) than for whole wheat flour porridge. Bayes factors suggested weak to strong evidence for a null effect (i.e., no effect of treatment type) in glycemic response, gastric emptying, and VAS ratings.

CONCLUSIONS

Although whole grain wheat foods provide other health benefits, they did not in their natural composition confer lower postprandial glycemia or gastric emptying than their refined wheat counterparts.This trial was registered at clinicaltrials.gov as NCT03467659.

Effect of high-amylose starch branching enzyme II wheat mutants on starch digestibility in bread, product quality, postprandial satiety and glycaemic response

High-amylose starch branching enzyme II (sbeII) mutant wheat has potential to be low-glycaemic compared to conventional wheat; however, the effects of bread made from sbeII wheat flour on glycaemic response and product quality require investigation. We report the impact of white bread made from sbeII wheat flour on in vitro starch digestibility and product quality, and on postprandial glycaemia in vivo, compared to an isoglucidic wild-type (WT) control white bread. Starch in sbeII bread was ∼20% less susceptible to in vitro amylolysis leading to ∼15% lower glycaemic response measured in vivo, compared to the WT control bread, without major effects on bread appearance or texture, measured instrumentally. Despite the early termination of the in vivo intervention study due to the COVID-19 outbreak (n = 8 out of 19), results from this study indicate that sbeII wheat produces bread with lower starch digestibility than conventional white bread.

Impact of white bread made from sbeII wheat flour on postprandial glycaemic response.

Enzyme kinetic approach for mechanistic insight and predictions of in vivo starch digestibility and the glycaemic index of foods

BACKGROUND

Starch is a principal dietary source of digestible carbohydrate and energy. Glycaemic and insulinaemic responses to foods containing starch vary considerably and glucose responses to starchy foods are often described by the glycaemic index (GI) and/or glycaemic load (GL). Low GI/GL foods are beneficial in the management of cardiometabolic disorders (e.g., type 2 diabetes, cardiovascular disease). Differences in rates and extents of digestion of starch-containing foods will affect postprandial glycaemia.

SCOPE AND APPROACH

Amylolysis kinetics are influenced by structural properties of the food matrix and of starch itself. Native (raw) semi-crystalline starch is digested slowly but hydrothermal processing (cooking) gelatinises the starch and greatly increases its digestibility. In plants, starch granules are contained within cells and intact cell walls can limit accessibility of water and digestive enzymes hindering gelatinisation and digestibility. In vitro studies of starch digestion by α-amylase model early stages in digestion and can suggest likely rates of digestion in vivo and expected glycaemic responses. Reports that metabolic responses to dietary starch are influenced by α-amylase gene copy number, heightens interest in amylolysis.

KEY FINDINGS AND CONCLUSIONS

This review shows how enzyme kinetic strategies can provide explanations for differences in digestion rate of different starchy foods. Michaelis-Menten and Log of Slope analyses provide kinetic parameters (e.g., K m and k cat /K m ) for evaluating catalytic efficiency and ease of digestibility of starch by α-amylase. Suitable kinetic methods maximise the information that can be obtained from in vitro work for predictions of starch digestion and glycaemic responses in vivo.

New definition of resistant starch types from the gut microbiota perspectives - a review

Current definition of resistant starch (RS) types is largely based on their interactions with digestive enzymes from human upper gastrointestinal tract. However, this is frequently inadequate to reflect their effects on the gut microbiota, which is an important mechanism for RS to fulfill its function to improve human health. Distinct shifts of gut microbiota compositions and alterations of fermented metabolites could be resulted by the consumption of RS from the same type. This review summarized these defects from the current definitions of RS types, while more importantly proposed pioneering concepts for new definitions of RS types from the gut microbiota perspectives. New RS types considered the aspects of RS fermentation rate, fermentation end products, specificity toward gut microbiota and shifts of gut microbiota caused by the consumption of RS. These definitions were depending on the known outcomes from RS-gut microbiota interactions. The application of new RS types in understanding the complex RS-gut microbiota interactions and promoting human health should be focused in the future.

Color, Starch Digestibility, and In Vitro Fermentation of Roasted Highland Barley Flour with Different Fractions

Highland barley (HB) is commonly milled into flour for direct consumption or further processed with other food formulations. Nevertheless, the association between milling and HB flour properties remains lacking. This work studied the effect of particle sizes (coarse, 250–500 μm; medium, 150–250 μm; fine, <150 μm) on physicochemical and nutritional properties of raw and sand-roasted HB flour. Gelatinization enthalpy decreased with increasing particle sizes of raw HB flour, while no endothermic transitions were observed in sand-roasted flour. Sand roasting destroyed starch granules and decreased short-range molecular order. Starch digestibility increased while total short-chain fatty acids (SCFAs) production decreased with decreasing particle sizes in all samples. The relative crystallinity of sand-roasted HB flour decreased by 80–88% compared with raw samples. Sand roasting raised in vitro starch digestibility, while total SCFAs during in vitro fecal fermentation decreased. Sand-roasted HB flour with particle sizes <150 μm had the highest starch digestibility (94.0%) but the lowest production of total SCFAs (1.89–2.24 mM). Pearson’s correlation analysis confirmed the relationship between the nutritional qualities of HB flour and milling.

Evaluation of the physicochemical properties and in vitro digestibility of the complex formed between rice starch and a novel pigment from Vaccinium bracteatum Thunb. leaf

This study investigated the effect of Vaccinium bracteatum Thunb. leaf (VBTL) dark blue pigment on the physicochemical properties and in vitro digestibility of different rice starches. The results showed that glutinous rice starch (GRS) had a higher pigment loading capacity than indica rice starch (IRS) and japonica rice starch (JRS). Fourier transform infrared spectroscopy showed that these binary complexes between pigment and starch molecules bind through strong hydrogen bonds. All starch-pigment complexes displayed a lower gelatinization enthalpy than the controls. The addition of this pigment reduced the maximum starch in vitro digestion amount. Furthermore, the addition of pigment significantly increased the resistant starch and decreased the rapidly digestible starch in 'Wu mi', rice grains dyed by VBTL. This study provided important evidence of the digestion resistibility of VBTL dark blue pigment on 'Wu mi' to promote glycaemic regulation as a healthy cereal product.

The oral microbiome: Role of key organisms and complex networks in oral health and disease

States of oral health and disease reflect the compositional and functional capacities of, as well as the interspecies interactions within, the oral microbiota. The oral cavity exists as a highly dynamic microbial environment that harbors many distinct substrata and microenvironments that house diverse microbial communities. Specific to the oral cavity, the nonshedding dental surfaces facilitate the development of highly complex polymicrobial biofilm communities, characterized not only by the distinct microbes comprising them, but cumulatively by their activities. Adding to this complexity, the oral cavity faces near-constant environmental challenges, including those from host diet, salivary flow, masticatory forces, and introduction of exogenous microbes. The composition of the oral microbiome is shaped throughout life by factors including host genetics, maternal transmission, as well as environmental factors, such as dietary habits, oral hygiene practice, medications, and systemic factors. This dynamic ecosystem presents opportunities for oral microbial dysbiosis and the development of dental and periodontal diseases. The application of both in vitro and culture-independent approaches has broadened the mechanistic understandings of complex polymicrobial communities within the oral cavity, as well as the environmental, local, and systemic underpinnings that influence the dynamics of the oral microbiome. Here, we review the present knowledge and current understanding of microbial communities within the oral cavity and the influences and challenges upon this system that encourage homeostasis or provoke microbiome perturbation, and thus contribute to states of oral health or disease.

The impact of starchy food structure on postprandial glycemic response and appetite: a systematic review with meta-analysis of randomized crossover trials

BACKGROUND

Starchy foods can have a profound effect on metabolism. The structural properties of starchy foods can affect their digestibility and postprandial metabolic responses, which in the long term may be associated with the risk of type 2 diabetes and obesity.

OBJECTIVES

This systematic review sought to evaluate the clinical evidence regarding the impact of the microstructures within starchy foods on postprandial glucose and insulin responses alongside appetite regulation.

METHODS

A systematic search was performed in the PUBMED, Ovid Medicine, EMBASE, and Google Scholar databases for data published up to 18 January 2021. Data were extracted by 3 independent reviewers from randomized crossover trials (RCTs) that investigated the effect of microstructural factors on postprandial glucose, insulin, appetite-regulating hormone responses, and subjective satiety scores in healthy participants.

RESULTS

We identified 745 potential articles, and 25 RCTs (n = 369 participants) met our inclusion criteria: 6 evaluated the amylose-to-amylopectin ratio, 6 evaluated the degree of starch gelatinization, 2 evaluated the degree of starch retrogradation, 1 studied starch-protein interactions, and 12 investigated cell and tissue structures. Meta-analyses showed that significant reductions in postprandial glucose and insulin levels was caused by starch with a high amylose content [standardized mean difference (SMD) = -0.64 mmol/L*min (95% CI: -0.83 to -0.46) and SMD = -0.81 pmol/L*min (95% CI: -1.07 to -0.55), respectively], less-gelatinized starch [SMD = -0.54 mmol/L*min (95% CI: -0.75 to -0.34) and SMD = -0.48 pmol/L*min (95% CI: -0.75 to -0.21), respectively], retrograded starch (for glucose incremental AUC; SMD = -0.46 pmol/L*min; 95% CI: -0.80 to -0.12), and intact and large particles [SMD = -0.43 mmol/L*min (95% CI: -0.58 to -0.28) and SMD = -0.63 pmol/L*min (95% CI: -0.86 to -0.40), respectively]. All analyses showed minor or moderate heterogeneity (I2 < 50%). Sufficient evidence was not found to suggest how these structural factors influence appetite.

CONCLUSIONS

The manipulation of microstructures in starchy food may be an effective way to improve postprandial glycemia and insulinemia in the healthy population. The protocol for this systematic review and meta-analysis was registered in the international prospective register of systematic reviews (PROSPERO) as CRD42020190873.

Application of first-order kinetics modeling to reveal the nature of starch digestion characteristics

Mathematical modeling of in vitro starch digestograms is essential to understand starch structure-digestibility relationships as it covers all detailed information of the starch digestograms with only a few kinetics-based parameters. However, many assumptions exist for these mathematical models, which are frequently overlooked by researchers and lead to inappropriate or even wrong interpretations of the fitted parameters. This review presents a critical evaluation of four mostly applied empirical first-order kinetics models including single first-order kinetics (SK), logarithm of slope (LOS) transformed kinetics, parallel first-order kinetics (PK) and the combination of parallel and sequential (CPS) kinetics models. For homogeneous food systems, the SK model is perfectly suitable, whereas the LOS, PK and CPS models were suitably developed for food systems containing multiple digestible fractions. For the digestion of starch containing multiple digestible fractions, the LOS model assumed a sequential digestion pattern, whereas the PK model assumed a parallel pattern. In the current review, there is also emphasis on the recently developed CPS model, which is able to differentiate the sequential and parallel digestion patterns for different starch digestible fractions existing in food systems. Understanding these assumptions enables a better selection of an appropriate mathematical model for improving the understanding of in vitro starch digestion characteristics. This review meets the growing interest of the food industry in terms of developing a new generation of foods with slower starch digestibility.

Glycaemic potency reduction by coarse grain structure in breads is largely eliminated during normal ingestion

The hypothesis that coarse grain particles in breads reduce glycaemic response only if the particles remain intact during ingestion was tested. Three breads were formulated: (1) White bread (WB – reference), (2) 75 % of kibbled purple wheat in 25 % white bread matrix (PB) and (3) a 1:1 mixture of 37·5 % kibbled soya beans and 37·5 % of kibble purple wheat in 25 % white bread matrix (SPB). Each bread was ingested in three forms: unchewed (U), as customarily consumed (C) and homogenised (H). Twelve participants ingested 40 g available carbohydrate portions of each bread in each form, with post-prandial blood glucose measured over 120 min. Glycaemic responses to WB were the same regardless of its form when ingested. Unchewed PB had significantly less glycaemic effect than WB, whereas the C and H forms were similar to WB. Based on a glycaemic index (GI) of 70 for WB, the GI values for the C, U and H breads, respectively, were WB: 70·0, 70 and 70, PB: 75, 42 and 61, SPB: 57, 48 and 55 (%) (Least significant difference = 17·43, P < 0·05, bold numbers significantly different from WB). The similar glycaemic response to the H and C forms of the breads, and their difference from the U form, showed that the glycaemia-moderating effect of grain structure on starch digestion was lost during customary ingestion of bread. We conclude that the kibbled-grain structure may not effectively retard starch digestion in breads as normally consumed because it is largely eliminated by ingestive processes including chewing.

Molecular-structure evolution during in vitro fermentation of granular high-amylose wheat starch is different to in vitro digestion

This study investigates the evolution of the distributions of whole molecular size and of chain length of granular wheat starches (37 ~ 93% amylose content), subjected to in vitro fermentation with a porcine faecal inoculum or digestion with pancreatic enzymes. The results showed that the molecular structures of high-amylose starch (HAS) unfermented residues largely remained unchanged during the fermentation process, while wild-type starch (37% amylose content) showed a preferential degradation of the amylopectin fraction. In contrast, under simulated digestion conditions, the undigested residues of HAS showed structural changes, including a decrease in amylose content, a shift of amylose peak position towards lower degrees of polymerisation, and an enzyme-resistant fraction. These changes of starch structure are likely to be dependent on the different starch-degrading enzyme activities present in pancreatic vs. microbial systems. Molecular changes in response to fermentation metabolism revealed by size-exclusion chromatography can help understand the microbial utilization of resistant starch.

Using naso- and oro-intestinal catheters in physiological research for intestinal delivery and sampling in vivo: practical and technical aspects to be considered

Intestinal catheters have been used for decades in human nutrition, physiology, pharmacokinetics, and gut microbiome research, facilitating the delivery of compounds directly into the intestinal lumen or the aspiration of intestinal fluids in human subjects. Such research provides insights about (local) dynamic metabolic and other intestinal luminal processes, but working with catheters might pose challenges to biomedical researchers and clinicians. Here, we provide an overview of practical and technical aspects of applying naso- and oro-intestinal catheters for delivery of compounds and sampling luminal fluids from the jejunum, ileum, and colon in vivo. The recent literature was extensively reviewed, and combined with experiences and insights we gained through our own clinical trials. We included 60 studies that involved a total of 720 healthy subjects and 42 patients. Most of the studies investigated multiple intestinal regions (24 studies), followed by studies investigating only the jejunum (21 studies), ileum (13 studies), or colon (2 studies). The ileum and colon used to be relatively inaccessible regions in vivo. Custom-made state-of-the-art catheters are available with numerous options for the design, such as multiple lumina, side holes, and inflatable balloons for catheter progression or isolation of intestinal segments. These allow for multiple controlled sampling and compound delivery options in different intestinal regions. Intestinal catheters were often used for delivery (23 studies), sampling (10 studies), or both (27 studies). Sampling speed decreased with increasing distance from the sampling syringe to the specific intestinal segment (i.e., speed highest in duodenum, lowest in ileum/colon). No serious adverse events were reported in the literature, and a dropout rate of around 10% was found for these types of studies. This review is highly relevant for researchers who are active in various research areas and want to expand their research with the use of intestinal catheters in humans in vivo.

Interplay between grain digestion and fibre in relation to gastro-small-intestinal passage rate and feed intake in pigs

PURPOSE

The combined effects of grain digestibility and dietary fibre on digesta passage rate and satiety in humans are poorly understood. Satiety can be increased through gastric distention, reduced gastric emptying rate and when partially digested nutrients reach the terminal ileum to stimulate peptide release through the ileal/colonic brakes to slow the rate of digesta passage. This study determined the effects of grain digestibility and insoluble fibre on mean retention time (MRT) of digesta from mouth-to-ileum, feed intake (FI), starch digestion to the terminal ileum and faecal short chain fatty acids (SCFA) in a pig model.

METHOD

Twelve grain-based [milled sorghum (MS), steam-flaked-sorghum, milled wheat, and steam-flaked-wheat (SFW)] diets with different intrinsic rates of starch digestion, assessed by apparent amylase diffusion coefficient (ADC), and fibre from oat hulls (OH) at 0, 5 and 20% of the diet were fed to ileal-cannulated pigs.

RESULT

MRT was affected by grain-type/processing (P < 0.05) and fibre amount (P < 0.05). An approximate tenfold increase in ADC showed a limited decline in MRT (P = 0.18). OH at 20% increased MRT (P < 0.05) and reduced FI (P < 0.05). Ileal digestibility of starch increased and faecal SCFA concentration decreased with ADC; values for MS being lower (P < 0.001) and higher (P < 0.05), respectively, than for SFW.

CONCLUSIONS

Lower ileal digestibility of starch, higher faecal SCFA concentration and longer MRT of MS than SFW, suggest the ileal/colonic brakes may be operating. FI appeared to decrease with increasing MRT. MRT increased and intake decreased with grain-based foods/feeds that have low starch digestibility and substantial amounts of insoluble fibre.

α-Amylase action on starch in chickpea flour following hydrothermal processing and different drying, cooling and storage conditions

Starch is present in many prepared 'ready-meals' that have undergone processing and/or storage in frozen or chilled state. Hydrothermal processing greatly increases starch digestibility and postprandial glycaemia. Effects of different heating/drying and cooling regimes on amylolysis have received little attention. Hence, we examined the effects of different processing treatments on in vitro digestibility of starch in chickpea flour. Solid-state 13C NMR was used to estimate ordered double-helical structure in the starch. Native starch with 25 % double-helical content was the most resistant to digestion but hydrothermal processing (gelatinisation) resulted in >95 % loss of order and a large increase in starch digestibility. Air-drying of pre-treated flour produced slowly-digestible starch (C∞, 55.9 %). Refrigeration of gelatinised samples decreased ease of amylolysis coincident with increase in double-helical content. Freezing maintained the same degree of digestibility as freshly gelatinised material and produced negligible retrogradation. Chilling may be exploited to produce ready-meals with a lower glycaemic response.

The impact of replacing wheat flour with cellular legume powder on starch bioaccessibility, glycaemic response and bread roll quality: A double-blind randomised controlled trial in healthy participants

The global rise in obesity and type 2 diabetes has generated significant interest in regulating the glycaemic impact of staple foods. Wheat breads (white or wholemeal) are popular staples, but have a high-glycaemic index, due to the highly digestible wheat starch. Reducing the glycaemic potency of white bread is challenging because the bread-making conditions are mostly conducive to starch gelatinisation. Cellular legume powders are a new source of type 1 resistant starch, where the starch is encapsulated by dietary fibre in the form of intact plant cell walls. The starch in these cell powders is less susceptible to gelatinisation and digestion than starch in conventional legume flours. However, legume cell resilience to baking conditions and the effects of this ingredient on glycaemic responses and product quality are unknown. Here we show that the integrity of cell wall fibre in chickpea powder was preserved on baking and this led to a ~40% reduction in in vivo glycaemic responses (iAUC120) to white bread rolls (~50 g available carbohydrate and 12 g wheat protein per serving) when 30% or 60% (w/w) of the wheat flour was replaced with intact cell powder. Significant reductions in glycaemic responses were achieved without adverse effects on bread texture, appearance or palatability. Starch digestibility analysis and microscopy confirmed the importance of cell integrity in attenuating glycaemic responses. Alternative processing methods that preserve cell integrity are a new, promising way to provide healthier low glycaemic staple foods; we anticipate that this will improve dietary options for diabetes care.