Glycemic impact as a property of foods is accurately measured by an available carbohydrate method that mimics the glycemic response

The role of food structure in gastric-emptying rate, absorption and metabolism

The high levels of non-communicable diseases such as CVD and type 2 diabetes mellitus are linked to obesity and poor diet. This continuing emphasis on health in relation to food is proving a powerful driver for the development of cheap but palatable and more functional foods. However, the efficacy of such foods is often hard to prove in human subjects. Thus, a suite of tools has been developed including in silico and in vitro simulations and animal models. Although animal models offer physiologically relevant platforms for research, their use for experimentation is problematic for consumers. Thus, in vitro methods such as Infogest protocols have been developed to provide digestion endpoints or even an indication of the kinetics of digestion. These protocols have been validated for a range of food systems but they still miss the final absorption step. This review discusses the use of such in vitro models and what further steps need to be included to make the bioaccessibility determination more relevant to bioavailability and human health.

In Vitro Digestive Analysis of Digestible and Resistant Starch Fractions, with Concurrent Glycemic Index Determination, in Whole Grain Wheat Products Minimally Processed for Reduced Glycaemic Impact

Eight wheat products differing in texture (porridge vs. bread), grain fineness (fine, kibbled, intact), and cooking (raw vs. cooked), with pre-measured glycaemic indexes (GI), were analysed by in vitro amylolytic digestion to determine effects of processing to reduce GI on quantities of starch fractions differing in digestibility. The accuracy and precision of the in vitro analysis was assessed from its ability to concurrently predict clinical GI. In porridges, kernel intactness and lack of cooking reduced GI while increasing Type 1 (inaccessible) and Type 2 (ungelatinised) resistant starch. Porridge in vitro GI values (GI_iv), calculated from the area under in vitro digestion curves minus estimated blood glucose disposal, were: raw fine, 26.3; raw kibbled, 12.6; cooked fine, 63.9; cooked kibbled, 44.1; and correlated closely with clinical GI values (R² = 0.97). In bread, the negative association of kernel intactness and resistant starch with GI was seen in vitro but not in vivo. Bread GI_iv values were: roller milled flour, 67.4; stoneground flour 61.1; kibbled grain, 53.0; kibbled + intact kernel, 49.5; but correlation with clinical values was low (R² = 0.47), and variability in the clinical results was high (clinical CV = 72.5%, in vitro CV = 3.7%). Low glycaemic potency of wheat by minimal processing was achieved by maintaining particle size, avoiding hydrothermal treatment, avoiding crushing and using a food matrix requiring little chewing for ingestion. Use of in vitro digestive analysis for high precision measurement of starch fractions with potential secondary health benefits was validated by accurate concurrent prediction of the glycaemic index but needed to account for effects of chewing.

Effects of Xanthan Gum, Lambda-Carrageenan and Psyllium Husk on the Physical Characteristics and Glycaemic Potency of White Bread

White bread contains a high proportion of easily digestible starch, which contributes to an undesirable rapid increase in blood glucose concentration. This study investigated the effects of nonstarch polysaccharides (NSP) -xanthan gum, lambda-carrageenan and psyllium husk on the physical functionality and glycaemic potency of white bread. The amount of water for each formulation was adjusted based on DoughLab set at a target torque value of ~500 FU for sufficient dough development. Adding NSP generally resulted in significantly increased loaf volumes and decreased hardness. The glycaemic potency (glycaemic glucose equivalents (GGE) g) of bread was found to be reduced with the addition of NSP at all levels (1, 3 and 5% w/w based on flour weight). Increasing the concentration of xanthan gum and lambda-carrageenan did not show any further decrease in the glycaemic potency. Notably, adding 5% w/w psyllium husk significantly reduced the glycaemic potency from ~49 GGE/100 g in the reference bread to 32 GGE/100 g. The reduction in the glycaemic potency was attributed to viscosity effects (for xanthan) and starch–NSP interactions (for psyllium husk). Overall, the 5% w/w psyllium husk bread sample was most promising in terms of both physical characteristics and its effect on in vitro glucose release.

Chewing differences in consumers affect the digestion and colonic fermentation outcomes: In vitro studies

It is important to understand variability in consumer chewing behavior for designing food products that deliver desired functionalities for target consumer segments. In this study, we selected 29 participants, representing...

Food Matrix Effects for Modulating Starch Bioavailability

As the prevalence of obesity and diabetes has continued to increase rapidly in recent years, dietary approaches to regulating glucose homeostasis have gained more attention. Starch is the major source of glucose in the human diet and can have diverse effects, depending on its rate and extent of digestion in the small intestine, on postprandial glycemic response, which over time is associated with blood glucose abnormalities, insulin sensitivity, and even appetitive response and food intake. The classification of starch bioavailability into rapidly digestible starch, slowly digestible starch, and resistant starch highlights the nutritional values of different starches. As starch is the main structure-building macroconstituent of foods, its bioavailability can be manipulated by selection of food matrices with varying degrees of susceptibility to amylolysis and food processing to retain or develop new matrices. In this review, the food factors that may modulate starch bioavailability, with a focus on food matrices, are assessed for a better understanding of their potential contribution to human health. Aspects affecting starch nutritional properties as well as production strategies for healthy foods are also reviewed, e.g., starch characteristics (different type, structure, and modification), food physical properties (food form, viscosity, and integrity), food matrix interactions (lipid, protein, nonstarch polysaccharide, phytochemicals, organic acid, and enzyme inhibitor), and food processing (milling, cooking, and storage).

Determining the glycaemic responses of foods: conventional and emerging approaches

A low-glycaemic diet is crucial for those with diabetes and cardiovascular diseases. Information on the glycaemic index (GI) of different ingredients can help in designing novel food products for such target groups. This is because of the intricate dependency of material source, composition, food structure and processing conditions, among other factors, on the glycaemic responses. Different approaches have been used to predict the GI of foods, and certain discrepancies exist because of factors such as inter-individual variation among human subjects. Besides other aspects, it is important to understand the mechanism of food digestion because an approach to predict GI must essentially mimic the complex processes in the human gastrointestinal tract. The focus of this work is to review the advances in various approaches for predicting the glycaemic responses to foods. This has been carried out by detailing conventional approaches, their merits and limitations, and the need to focus on emerging approaches. Given that no single approach can be generalised to all applications, the review emphasises the scope of deriving insights for improvements in methodologies. Reviewing the conventional and emerging approaches for the determination of GI in foods, this detailed work is intended to serve as a state-of-the-art resource for nutritionists who work on developing low-GI foods.

Equicarbohydrate partial exchange of kiwifruit for wheaten cereal reduces postprandial glycaemia without decreasing satiety

Kiwifruit is a carbohydrate food of low glycaemic potency which could potentially be exchanged for starch-based foods in management of postprandial glycaemia. The effect of equicarbohydrate partial exchange of kiwifruit varieties ‘Hayward’ green (GR) and ‘Zesy002’ (SunGold; SG) for a starchy wheat-based breakfast cereal (WB) on the characteristics of the postprandial glycaemic response and satiety was therefore determined. A total of twenty non-diabetic subjects (mean age 36 years; mean BMI 24·5 kg/m²) consumed four meals, each containing 40 g available carbohydrate, in random order, after an overnight fast. The meals were: (1) glucose; (2) 70·29 g breakfast cereal; (3) 200 g of GR plus breakfast cereal (30·93 g); and (4) 200 g of SG plus breakfast cereal (27·06 g). Throughout the 180 min postprandial period, capillary blood glucose concentrations were monitored, and satiety rated by a visual analogue scale. Partial kiwifruit substitution of WB significantly reduced postprandial glycaemic response amplitude (glucose, 3·91; WB, 3·66; WB + GR, 2·36; WB + SG, 2·31  mmol/l; least significant difference (LSD) 0·64; P < 0·001) and incremental area under the blood glucose response curve (0–120 min) (glucose, 228; WB, 180; WB + GR, 133; WB + SG, 134 mmol/l × min; LSD 22·7; P < 0·001). The area between baseline and response remained positive in kiwifruit-substituted meals but became negative after 120 min with glucose and WB, indicating that kiwifruit improved homeostatic control. Kiwifruit substitution of cereal did not significantly reduce satiety. We conclude that either ‘Hayward’ or ‘Zesy002’ kiwifruit may be used in equicarbohydrate partial substitution of starchy staple foods to reduce glycaemic response and improve glucose homeostasis without decreasing satiety.

White bread enriched with polyphenol extracts shows no effect on glycemic response or satiety, yet may increase postprandial insulin economy in healthy participants

Extracts from different plant sources have been shown to modify starch digestion from carbohydrate-rich foods and lower resulting glycemia. It was hypothesized that extracts rich in polyphenols, added to white bread, would improve the glycemic response and insulin response and increase satiety in healthy participants. An in vitro dose-response analysis was performed to determine the optimal dose of a variety of extracts (baobab fruit extract, green tea extract, grape seed extract, and resveratrol) for reducing rapidly digestible starch in white bread. The 2 extracts with the greatest sugar reducing potential were then used for the human study in which 13 volunteers (9 female and 4 male) were recruited for a crossover trial of 3 different meals. On separate days, participants consumed a control white bread, white bread with green tea extract (0.4%), and white bread with baobab fruit extract (1.88%). Glycemic response, insulin response, and satiety were measured 3 hours postprandially. Although enriched breads did not reduce glycemic response or hunger, white bread with added baobab fruit extract significantly (P < .05) reduced the total (0-180 minutes) and segmental insulin area under the curve at 0 to 90, 0 to 120, and 0 to 150 minutes, and therefore reduced the amount of insulin needed for a given blood glucose response. This preliminary research suggests that there is potential for baobab fruit extract added into white bread to improve insulin economy in healthy adults.

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

BACKGROUND

Cereal crops, particularly wheat, are a major dietary source of starch, and the bioaccessibility of starch has implications for postprandial glycemia. The structure and properties of plant foods have been identified as critical factors in influencing nutrient bioaccessibility; however, the physical and biochemical disassembly of cereal food during digestion has not been widely studied.

OBJECTIVES

The aims of this study were to compare the effects of 2 porridge meals prepared from wheat endosperm with different degrees of starch bioaccessibility on postprandial metabolism (e.g., glycemia) and to gain insight into the structural and biochemical breakdown of the test meals during gastroileal transit.

DESIGN

A randomized crossover trial in 9 healthy ileostomy participants was designed to compare the effects of 55 g starch, provided as coarse (2-mm particles) or smooth (<0.2-mm particles) wheat porridge, on postprandial changes in blood glucose, insulin, C-peptide, lipids, and gut hormones and on the resistant starch (RS) content of ileal effluent. Undigested food in the ileal output was examined microscopically to identify cell walls and encapsulated starch.

RESULTS

Blood glucose, insulin, C-peptide, and glucose-dependent insulinotropic polypeptide concentrations were significantly lower (i.e., 33%, 43%, 40%, and 50% lower 120-min incremental AUC, respectively) after consumption of the coarse porridge than after the smooth porridge (P < 0.01). In vitro, starch digestion was slower in the coarse porridge than in the smooth porridge (33% less starch digested at 90 min, P < 0.05, paired t test). In vivo, the structural integrity of coarse particles (∼2 mm) of wheat endosperm was retained during gastroileal transit. Microscopic examination revealed a progressive loss of starch from the periphery toward the particle core. The structure of the test meal had no effect on the amount or pattern of RS output.

CONCLUSION

The structural integrity of wheat endosperm is largely retained during gastroileal digestion and has a primary role in influencing the rate of starch amylolysis and, consequently, postprandial metabolism. This trial was registered at isrctn.org as ISRCTN40517475.

The role of psychobiological and neuroendocrine mechanisms in appetite regulation and obesity

Obesity is a multifactorial disease. Among its causes are physical inactivity and overeating. In addition, other factors may play an important role in the development of overweight/obesity. For example, certain hormones including leptin, insulin and ghrelin, may influence appetite and consequently body weight. Obesity frequently co-exists with metabolic disorders including dyslipidemia, hypertension and insulin resistance, thus constituting the metabolic syndrome which is characterized by increased cardiovascular risk. Lack of comprehensive knowledge on obesity-related issues makes both prevention and treatment difficult. This review considers the psychobiological and neuroendocrine mechanisms of appetite and food intake. Whether these factors, in terms of obesity prevention and treatment, will prove to be relevant in clinical practice (including reducing the cardiovas-cular risk associated with obesity) remains to be established.

Characterizing kiwifruit carbohydrate utilization in vitro and its consequences for human faecal microbiota

It is well accepted that our gut bacteria have coevolved with us in relation to our genetics, diet and lifestyle and are integrated metabolically with us to affect our gut health adversely or beneficially. "Who is there" may vary quite widely between individuals, as might "how they do it", but "what they make" may be less variable. Many different individual species of bacteria can perform the same saccharolytic functions and so the availability of substrate (host or diet-derived) along with the degradative enzymes they possess may be key drivers of gut ecology. In this case study, we discuss detailed microbial ecology and metabolism analysis for three individuals following 48 h of in vitro faecal fermentation, using green kiwifruit as the substrate. In parallel, we have analyzed the chemical changes to the kiwifruit carbohydrates present in the fermenta to close the circle on substrate usage/degradative enzymes possessed/microbes present/microbial byproducts produced. In the absence of host carbohydrate, we see that kiwifruit carbohydrates were differentially utilized to drive microbial diversity, yet resulted in similar byproduct production. The starting ecology of each individual influenced the quantitative and qualitative microbial changes; but not necessarily the metabolic byproduct production. Thus, we propose that it is the consistent functional changes that are relevant for assessment of gut health benefits of any food. We recommend that in this era of large scale genotype/-omics studies that hypothesis-driven, bottom-up research is best placed to interpret metagenomic data in parallel with functional, phenotypic data.

Kiwifruit remnants from digestion in vitro have functional attributes of potential importance to health

The physicochemical properties of plant cell walls in the gut are important in modulating processes that influence health. We investigated the physicochemical properties of kiwifruit cell walls digested under gastric and gastroileal conditions in vitro. Soluble and insoluble undigested polymer fractions were measured, the hydration properties of the digested pulp, and the capacity to retard diffusion and mixing in a simulated small intestinal segment. Undigested polymer (dietary fibre) fractions differed little between "Hayward' ('Hayward') and 'Hort16A' (gold) kiwifruit cultivars in their relative proportions, although total dietary fibre was greater in 'Hayward' than in the 'Hort16A'. The polysaccharide composition of seed-free digestion-resistant polymer was similar in both cultivars and not affected by in vitro digestion. Indigestible remnants from kiwifruit had strong water retention and swelling capacities, also little affected by digesting, and retarded both glucose diffusion and mixing significantly, especially in the presence of low background viscosity. We conclude that the particulate cell wall remnants of digested kiwifruit retain substantial potential to influence the properties of gut contents.

Wholeness and primary and secondary food structure effects on in vitro digestion patterns determine nutritionally distinct carbohydrate fractions in cereal foods

Starchy foods of differing structure, including bakery products, breakfast cereals, pastas, and pulses were digested in vitro. Bakery products and processed breakfast cereals with little resilient structure yielded large amounts of rapidly available carbohydrate (RAC), less slowly digested starch (SDS) and little inaccessible digestible starch (IDS) (70:22:8%). Partially processed grains, such as rolled oats contained an increased proportion of SDS (55:38:7%). Pastas, being dense starch structures digested more gradually to completion by superficial erosion, yielding approximately equal proportions of RAC and SDS but little IDS (43:52:4%). Pulses, which retained their cellular morphology, digested more linearly yielding a lower proportion of RAC, a larger proportion of SDS and more IDS (9:69:22%). Preservation of native "primary" structure, and use of processing to create "secondary" structure, are both means by which wholeness, in the sense of intactness, can be used to influence carbohydrate digestion to make foods of lower glycaemic impact.