The concept of low glycemic index and glycemic load foods as panacea for type 2 diabetes mellitus; prospects, challenges and solutions

The properties of the rice resistant starch processing and its application in skimmed yogurt

Extrusion is typically employed to prepare resistant starch (RS). However, the process is complicated. In this study, the effects of twin-screw extrusion on the crystallinity, thermal properties, and functional properties of starch formed in different extrusion zones were investigated. The effects of this process on the rheological properties and microstructure of RS-added skimmed yogurt were also studied. According to the results, the RS content increased from 7.40 % in the raw material to 33.79 % in the extrudate. The A-type crystal structure of the starch was not observed. The dissociation temperature of the extruded starch ranged from 87.76 °C to 100.94 °C. The glycemic index (GI) of skimmed yogurt fortified with 0.4 % RS was 48.7, and the viscosity was also improved. The microstructure exhibited a uniform network of the starch-protein structure. The findings may serve as a theoretical basis for the application of RS in the food industry.

Chronic and immediate refined carbohydrate consumption and facial attractiveness

The Western diet has undergone a massive switch since the second half of the 20th century, with the massive increase of the consumption of refined carbohydrate associated with many adverse health effects. The physiological mechanisms linked to this consumption, such as hyperglycaemia and hyperinsulinemia, may impact non medical traits such as facial attractiveness. To explore this issue, the relationship between facial attractiveness and immediate and chronic refined carbohydrate consumption estimated by glycemic load was studied for 104 French subjects. Facial attractiveness was assessed by opposite sex raters using pictures taken two hours after a controlled breakfast. Chronic consumption was assessed considering three high glycemic risk meals: breakfast, afternoon snacking and between-meal snacking. Immediate consumption of a high glycemic breakfast decreased facial attractiveness for men and women while controlling for several control variables, including energy intake. Chronic refined carbohydrate consumption had different effects on attractiveness depending on the meal and/or the sex. Chronic refined carbohydrate consumption, estimated by the glycemic load, during the three studied meals reduced attractiveness, while a high energy intake increased it. Nevertheless, the effect was reversed for men concerning the afternoon snack, for which a high energy intake reduced attractiveness and a high glycemic load increased it. These effects were maintained when potential confounders for facial attractiveness were controlled such as age, age departure from actual age, masculinity/femininity (perceived and measured), BMI, physical activity, parental home ownership, smoking, couple status, hormonal contraceptive use (for women), and facial hairiness (for men). Results were possibly mediated by an increase in age appearance for women and a decrease in perceived masculinity for men. The physiological differences between the three meals studied and the interpretation of the results from an adaptive/maladaptive point of view in relation to our new dietary environment are discussed.

Effect of Alchornea cordifolia on Glycemic Indices of Varieties of Fufu Among Healthy Subjects

Background

Glycemic index (GI) is a measure of the ability of carbohydrate food to raise blood glucose concentration. The GI of a food and its negative effects has caused an adverse increase in the prevalence of diabetes and other metabolic diseases.

Objective

This study aimed to determine the effect of Alchornea cordifolia on glycemic indices of varieties of fufu.

Methods

The research was a crossover experimental study involving 10 healthy individuals. A 50-g measure of pure glucose was served on 2 separate occasions and, subsequently, a measured amount of the test foods containing 50 g of available carbohydrates. The GI values were determined by the measure of the blood glucose concentrations of the subjects at fasting and after ingestion of the glucose and the test foods (fufu) within 2 h. Collection of capillary blood for blood glucose measurement started 30 min after consumption and was subsequently taken at 60, 90, and 120 min for both noncomposited and composited fufu GI determination. The phytoconstituents of the A. cordifolia were also determined.

Results

For the noncomposited fufu, plantain fufu had the least glycemic response (46%), followed by cassava fufu (50%) and cassava-plantain fufu (53%); however, all were in the low-GI category. For the composited fufu, plantain fufu had the least response (12%), followed by cassava-plantain fufu (14%) and cassava fufu (14%), with all in the low-GI category. A multiple comparison of GI on the various foods by analysis of variance revealed a significant difference between the GI of cassava-plantain fufu and composite cassava-plantain fufu (P = 0.001); cassava fufu and composite cassava fufu (P = 0.004); and plantain fufu and composite plantain fufu (P = 0.006). The phytochemical screening of the A. cordifolia revealed the presence of flavonoids and tannins.

Conclusions

Composited A. cordifolia fufu affects the glycemic response.

The Impact of Using Carbohydrate Counting on Managing Diabetic Patients: A Review

Carbohydrate counting (CC) is a meal planning practice for diabetic patients, focusing on tracking the amount of carbohydrates in grams consumed at meals to manage blood glucose (BG) levels. The purpose of this narrative review is to evaluate the impact of CC in helping people with diabetes manage their condition. It reveals that CC offers superior glycemic control and flexibility compared to other food planning techniques. Specifically, when applied to children and teenage patients diagnosed with type 1 diabetes mellitus (T1DM), CC demonstrates the potential for substantial improvements in metabolic control without any adverse effects on weight or increased insulin requirements. In the context of T1DM, the combination of CC and the use of automated bolus calculators (ABCs) contributes to lowering glycated hemoglobin (HbA1c) levels. Furthermore, the study highlights that CC also holds promise in the management of type 2 diabetes mellitus (T2DM). In T2DM patients, adhering to a low glycemic index (GI) diet has proven to be more effective in controlling HbA1c and fasting BG levels compared to a higher GI diet or standard dietary control. This research underscores the evolving significance of CC as a pivotal component in diabetes management, attributed to increased awareness and education among patients. CC emerges as a versatile tool that can benefit individuals with various forms of diabetes by enhancing their glycemic control and overall quality of life. The findings affirm the impact of CC in improving patient outcomes, solidifying its status as a vital strategy in the multifaceted landscape of diabetes care.

Glycemic index of a nutritional supplement designed for people with chronic kidney disease

The study was carried out to measure the glycemic index (GI) of an oral food supplement for people with CKD as well as on patients on maintenance dialysis. The study was conducted as per international protocols for testing GI, was approved by the local institutional ethics committee, and was registered with the Clinical Trial Registry of India (CTRI). This was a crossover randomized controlled study which enrolled 15 participants between the ages of 18 and 45 years. The participants were randomly allotted to one group that consumed either the reference food (27.5 g of glucose monohydrate) or 118 g of the nutritional supplement which contained 25 g of available carbohydrates. Fasting capillary blood samples as well as blood samples at different time intervals as per the GI protocol, after consumption of either the supplement or the reference food were taken from the participants. Each testing day was separated by a 3-day washout period. GI was calculated from the incremental area under the blood glucose response elicited by the nutritional supplement as a percentage of the response after the consumption of 25 g of glucose (27.5 g of glucose monohydrate) by the same participant using a standard formula. The GI of the nutritional supplement was calculated to be 10.3 ± 2.0 which is considered to be low as per international GI testing standards. The product was created to supplement the diet of people with CKD at different stages and to help prevent the progression from CKD to ESRD as well as the risk for CVD. This product was found to have a low GI which is desirable for people with CKD as well as diabetics in general who are at risk for developing CKD.

Pumpkin and Pumpkin Byproducts: Phytochemical Constitutes, Food Application and Health Benefits

Nowadays, agricultural waste byproducts are exploited in the food industry rather than discarded. Pumpkin is one of the most significant vegetable crops that is widely consumed in farmland and certain urban regions. The current study was designed to measure the phytochemical constituents, food application, health benefits, and toxicity of pumpkin and pumpkin byproducts. Pumpkins and pumpkin byproducts (seeds, leaf, and skin/peel) can be utilized as functional ingredients. Different parts of the pumpkin contain bioactive compounds including carotenoids, lutein, zeaxanthin, vitamin E, ascorbic acid, phytosterols, selenium, and linoleic acid. Pumpkin is used in various food sectors as a functional food, including baking, beverages, meat, and dairy industries. Furthermore, the leaves and pulp of the pumpkin are used to produce soups, purees, jams, and pies. Different parts of pumpkins have several health benefits such as antidiabetic, antioxidant, anticancer, and anti-inflammatory effects. Therefore, this review paper elaborates on the pumpkins and pumpkin byproducts that can be used to develop food products and may be valuable against various diseases.

Exploring the underutilized novel foods and starches for formulation of low glycemic therapeutic foods: a review

Rising incidences of life-style disorders like obesity, diabetes and cardiovascular diseases are a matter of concern coupled with escalated consumption of highly refined and high energy foods with low nutrient density. Food choices of consumers have witnessed significant changes globally with rising preference to highly processed palatable foods. Thus, it calls food scientists, researchers and nutritionists' attention towards developing and promoting pleasant-tasting yet healthy foods with added nutritional benefits. This review highlights selected underutilized and novel ingredients from different food sources and their by-products that are gaining popularity because of their nutrient density, that can be employed to improve the nutritional quality of conventionally available empty-calorie foods. It also emphasizes on the therapeutic benefits of foods developed from these understudied grains, nuts, processing by-products of grains, fruits- and vegetable-byproducts and nutraceutical starches. This review aims to draw attention of food scientists and industrialists towards popularizing the utilization of these unconventional, yet nutrient rich foods sources in improving the nutritional profile of the conventional foods lacking in nutrient density.

Factors Affecting the Nutritional, Health, and Technological Quality of Durum Wheat for Pasta-Making: A Systematic Literature Review

Durum wheat is one of the most important food sources in the world, playing a key role in human nutrition, as well as in the economy of the different countries in which its production areas are concentrated. Its grain also represents a staple and highly versatile ingredient in the development of health foods. Nonetheless, the aspects determining durum wheat's health quality and their interactions are many, complex, and not entirely known. Therefore, the present systematic literature review aims at advancing the understanding of the relationships among nutritional, health, and technological properties of durum wheat grain, semolina, and pasta, by evaluating the factors that, either positively or negatively, can affect the quality of the products. Scopus, Science Direct, and Web of Science databases were systematically searched utilising sets of keywords following the PRISMA guidelines, and the relevant results of the definitive 154 eligible studies were presented and discussed. Thus, the review identified the most promising strategies to improve durum wheat quality and highlighted the importance of adopting multidisciplinary approaches for such purposes.

Glycemic Responses of Milk and Plant-Based Drinks: Food Matrix Effects

The consumption of food items containing digestible carbohydrates in food products leads to postprandial increases in blood glucose levels and glycemic responses. The extent to which these occur depends on many factors, including concentration and type of carbohydrate, but also other physicochemical properties of the food matrix, which determine the rate of uptake of monosaccharides into the bloodstream, including product structure and factors affecting gastric emptying. For milk, control of postprandial glycemic responses appears to be multifaceted, including a controlled rate of gastric emptying, a rate of glucose and galactose uptake into the bloodstream controlled by enzymatic hydrolysis, as well as stimulated insulin secretion to enhance uptake of blood glucose from the bloodstream. Altogether, this allows milk to deliver comparatively high levels of carbohydrate with limited glycemic responses. For plant-based drinks positioned as milk alternatives, however, compositional differences (including carbohydrate type and concentration) as well as matrix factors limiting control over gastric emptying and insulin secretion can, in some cases, lead to much stronger glycemic responses, which are undesirable in relation to non-communicable diseases, such as type-2 diabetes. This review discusses glycemic responses to milk and plant-based drinks from this perspective, focusing on mechanistic insights and food matrix effects.

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.

Nutrient and popping characteristics of Wyoming-grown Peruvian popping beans

American consumers fall short of dietary fiber intake recommended by dietary guidelines. Beans provide protein and fiber, however, less than 14% of adults include them in their daily diets. Nuña beans (Phaseolus vulgaris L.), a class of common beans originated in South America and cultivated for growth in North America, possess a unique set of characteristics including flavor profile, popping ability, and nutrient content that may appeal to consumers. The purpose of this study was to evaluate a unique line of Wyoming-grown popping beans to (1) determine nutrient characteristics and (2) assess popping percentage and shelf stability. Crude protein content was determined for five lines grown in Wyoming utilizing the Dumas method for nitrogen quantification. Total fatty acid content and a fatty acid profile for one line (CO49957) was determined by gas-liquid chromatography. Popping percentage was assessed by heating beans in canola oil in a cast iron pan to induce popping. Storage duration impact on popping was evaluated on CO49957 at 6, 12, and 15 months after harvest. Crude protein content was significantly different between all five lines. Total fatty acid content of CO49957 averaged 2.90 g/100 g wet weight. Average fatty acid profile of CO49957 popped in canola oil comprised oleic acid (41.4%), linoleic acid (20.4%), α-linolenic acid (18.6%), palmitic acid (10.4%), and stearic acid (2.23%). Popping percentage was 90% (baseline), 100% (6 months), 87% (12 months), and 80% (15 months). Popping beans provide plant-based protein and fiber while maintaining adequate levels of popping percentage with prolonged storage.

Quality assessment of nutri-cereal bran rich fraction enriched buns and muffins

Millet bran, a by-product obtained during millet processing is rich in nutrients, fiber, antioxidants and phyto-nutrients, but remains underutilized. Consumption of bakery products have increased significantly among all age groups. Majority of the bakery products are calorie dense and lack nutrients. There are limited studies on utilization of minor millet brans and bran rich fractions (BRF) in development of bakery products. Thus, present study aimed at formulating designer buns and muffins using foxtail and kodo millet BRF respectively. It was observed that buns prepared with 20% foxtail and muffins prepared with 30% kodo BRF showed better acceptability. The nutritional profile of BRF enriched buns and muffins had significant increase in dietary fibre (2.73% and 2.79%), iron, calcium, zinc, antioxidant capacity and phytonutrient content. A reduction was observed in the available carbohydrates in both buns (51.11-47.85 g/100 g) and muffins (46.76-43.87 g/100 g). Buns and muffin exhibited moderate glycemic index (57.71, 56.42) and glycemic load (19.32, 14.85) respectively. Shelf life of buns and muffins was 3 and 7 days respectively at room temperature. In both the products moisture, water activity and microbial plate count increased during storage whereas sensory acceptability decreased. The study indicates that addition of minor millet BRF in baked products enhanced nutritional content and reduced glycemic index thereby exhibiting its potential as a functional ingredient in food processing.

Assessing Long-Term Impact of Dietary Interventions on Occurrence of Symptoms Consistent with Hypoglycemia in Patients without Diabetes: A One-Year Follow-Up Study

Background: A well-balanced nutritional diet pattern has a significant role in the management of diet-related disorders. Currently, there are no specific dietary guidelines to refer to when advising non-diabetic patients with symptoms attributed to hypoglycemia in the postprandial period or patients with confirmed reactive hypoglycemia (RH). The aim of this study was to investigate the impact of the dietary interventions, and their sustained outcome, on the severity of hypoglycemic-like symptoms occurring in non-diabetic patients. Methods: The study group included forty non-diabetic individuals with symptoms consistent with RH. At the baseline, each patient underwent RH diagnosis and complex dietary evaluation. Over a period of six months, each patient had four appointments with a dietitian. Two sessions were focused on a dietary education about low glycemic index diet (LGID) and Mediterranean diet (MD). The said diets were to be followed for a period of three months, with two additional dietary check-ups. Once dietary supervision was completed, patients had no imposed dietary patterns. The final follow-up appointment took place twelve months later and that is when each patient underwent a detailed assessment of their current dietary habits and evaluation of the frequency of symptoms consistent with hypoglycemia. Results: There was a statistically significant reduction in the severity in eight out of the ten analyzed hypoglycemic-like symptoms after the dietary interventions. The most significant change was observed in the following symptoms: hunger (η2 = 0.66), impaired concentration (η2 = 0.61), hand tremor (η2 = 0.55), and fatigue (η2 = 0.51). The outcomes were comparable for both recommended diets, the LGID and the MD. The reduction in hypoglycemic-like symptoms continued after the twelve-month period. The individualized dietary counselling significantly improved the patients’ eating habits in comparison to those present prior to intervention in terms of healthy diet index (F(2,78) = 27.30, p < 0.001, η2 = 0.41, 90%CI [0.26; 0.51]) and unhealthy diet index (F(2,78) = 433.39, p < 0.001, η2 = 0.91, 90%CI [0.89; 0.93]). Conclusions: Healthy modifications in dietary habits may improve patient’s well-being and reduce the severity of their postprandial symptoms attributed to hypoglycemia. Therefore, dietary intervention focused on appropriate nutritional management combined with follow-up consultations may be a beneficial step towards comprehensive treatment of non-diabetic patients who present with hypoglycemic-like symptoms in the postprandial period.

Low-Glycemic Index Diets as an Intervention in Metabolic Diseases: A Systematic Review and Meta-Analysis

We aimed to investigate the effects of a low-glycemic index (GI) diet on the body mass and blood glucose of patients with four common metabolic diseases by conducting a systematic review and meta-analysis of studies comparing a low-GI diet (LGID) and other types of diet. Search terms relating to population, intervention, comparator, outcomes, and study design were used to search three databases: PubMed, Embase, and the Cochrane Library. We identified 24 studies involving 2002 participants. Random-effects models were used for 16 studies in the meta-analysis and stratified analyses were performed according to the duration of the intervention. The systematic review showed that LGIDs slightly reduced body mass and body mass index (BMI) (p < 0.05). BMI improved more substantially after interventions of >24 weeks and there was no inter-study heterogeneity (I² = 0%, p = 0.48; mean difference (MD) = -2.02, 95% confidence interval (CI): -3.05, -0.98). Overall, an LGID had superior effects to a control diet on fasting blood glucose (FBG) and glycosylated hemoglobin. When the intervention exceeded 30 days, an LGID reduced FBG more substantially (MD = -0.34, 95% CI: -0.55, -0.12). Thus, for patients with metabolic diseases, an LGID is more effective at controlling body mass and blood glucose than a high-GI or other diet.

'Old Is Gold': How Traditional Indian Dietary Practices Can Support Pediatric Diabetes Management

Nutrition is crucial for maintaining normal growth, development, and glycemic control in young people with diabetes (PwD). Undue restrictions cause nutrient deficiencies as well as poor adherence to meal plans. Widespread availability of low-cost, ultra-processed, and hyperpalatable food is further damaging. Most families struggle to find ways to provide nutritious, yet attractive, food with a low glycemic index (GI). India is one of the oldest continuous civilizations with a rich and diverse cultural and culinary heritage. Traditional dietary practices, including the centuries-old 'Thali' (meaning plate) concept, emphasize combinations (grains, lentils, vegetables, dairy, spices, prebiotics and probiotics, and fats) of local, seasonal, and predominantly plant-based ingredients. These practices ensure that all of the necessary food groups are provided and fit well with current evidence-based recommendations, including the International Society for Pediatric and Adolescent Diabetes (ISPAD) 2018 Guidelines. Techniques for the preparation, cooking, and preservation of food further impact the GI and nutrient availability. These practices benefit nutrient density, diet diversity, and palatability and thus improve adherence to meal plans and glycemic control. This narrative review describes the ancient wisdom, food composition, and culinary practices from across India which are still valuable today. These may be of benefit worldwide to improve glycemic control as well as quality of life, especially in PwD.

Resistant structure of extruded starch: Effects of fatty acids with different chain lengths and degree of unsaturation

This study investigated the formation mechanism of enzyme-resistant structures in extruded starch, specifically, fatty acid-starch complexes (FASCs). The effects of fatty acids (FAs) with different carbon-chain lengths (C12-C18) and degrees of unsaturation (C18:0-C18:2) on complex formation were evaluated, with fluorescence microscopy verifying complex formation. The complexed-lipid content and degree of relative crystallinity increased with the carbon-chain length and degree of FA unsaturation. FAs with fewer carbons were more likely to generate stable complexes (e.g., form II, melted at 100-120 °C), while FAs with more carbons tended to produce relatively unstable complexes (e.g., form I, melted at 80-100 °C). After reheating and cooling, a new amylose-lipid complex and an amylose-amylopectin network was formed in the unsaturated FASC samples, which restricted the penetration of enzymes into starch granules. A starch-linoleic acid complex exhibited the highest resistant starch content (15.7%) and lowest predicted glycaemic index (88.4).

Rice Bran Makes a Healthy and Tasty Traditional Indonesian Goat Meatball, 'Bakso'

Meatballs are popular in Asia and traditionally made from beef or chicken with tapioca (≈8% wt/wt) as filler. Tapioca has a high glycaemic index (GI); therefore, rice bran was evaluated as a substitute to create a healthier meatball of acceptable quality. Substitution of tapioca with rice bran (100:0; 75:25, 50:50; 25:75; 0:100% tapioca: % rice bran) decreased the starch content (7.8 to 3.3%) and GI (56.08 to 43.85) whilst increasing the protein (10.9 to 12.8%) and fibre (8.1 to 10.3%) contents. Although consistency (995 to 776 N/mm) was affected, firmness (90.6 to 90.5 N) and shear force (300 to 312 N) were only slightly affected by the ratio of tapioca to rice bran. Sensory analysis revealed that the goat meatball with the substitution of tapioca with up to 25% rice bran was deemed acceptable by 40 Indonesian consumers.

Glycemic index values of traditional Kenyan foods: the missing link in the effectiveness of dietary approach in the prevention and management of diabetes mellitus in Kenya

BACKGROUND

Glycemic index (GI) measures postprandial blood sugar after consumption of carbohydrate-rich foodstuff. Kenya is yet to fully embrace this concept in prevention and management of diabetes mellitus.

OBJECTIVE

To review and tabulate GIs of locally consumed foods in order to improve dietary management of diabetes mellitus.

METHODOLOGY

A literature search was conducted using Google scholar and PubMed databases which identified 7 articles on glycemic index values of Kenyan foods published between 2002 and 2020. Two articles failed to meet the inclusion criteria and five proceeded for review. Key search words used included GI, glycemic load and glycemic response combined with Kenya. The data was reported depending on whether the testing involved healthy individuals or patients suffering from diabetes mellitus.

RESULTS

Nine individual foods and 7 mixed meals were identified. Low GI foods included beans and whole maize ugali consumed alongside cowpea leaves. High GI foods included whole maize ugali eaten with beef, boiled rice, boiled cassava and cassava-sorghum ugali eaten with silver fish.

CONCLUSION

Proper meal mixing is important in diabetes management. Cowpea leaves and beans possess GI lowering potential. This information can be used to improve guidance on food choices for diabetes patients.

Medical nutrition therapy of pediatric type 1 diabetes mellitus in India: Unique aspects and challenges

Medical nutrition therapy (MNT) is a vital aspect of management of type 1 diabetes mellitus (T1DM) and should be tailored to ethnic and family traditions and the socioeconomic and educational status of the patient. In this article, we discuss the unique aspects of MNT in children and adolescents with T1DM in the Indian setting, with focus on the challenges faced by patients, dieticians and physicians and how these can be overcome. The authors reviewed the available literature on MNT in T1DM from India and prepared the document based on their vast collective clinical experience in treating patients with T1DM from different regions in India. Indian diets are predominantly carbohydrate-based with high glycemic index (GI) and low protein content. Various methods are available to increase the protein and fiber content and reduce the GI of food in order to limit glycemic excursions. Insulin regimens need to be tailored to the child's school timings, meal schedule, and the availability of a responsible adult to supervise/administer insulin. All patients, irrespective of economic and education background, should be taught the broad principles of healthy eating, balanced diet and carbohydrate counting. There are various barriers to dietary compliance, including joint family system, changing lifestyles, and other factors which need to be addressed. There is a need to customize dietary management according to patient characteristics and needs and develop standardized patient educational material on principles of healthy eating in various regional languages.

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.

Causal relations among starch fine molecular structure, lamellar/crystalline structure and in vitro digestion kinetics of native rice starch

Causal relations among starch fine molecular structures, lamellar/crystalline structures, and the in vitro digestion kinetics of native rice starches.

Anticancer and Immunomodulatory Benefits of Taro (Colocasia esculenta) Corms, an Underexploited Tuber Crop

Taro corms contain valuable bioactive molecules effective against cancer and cancer-related risk factors, such as carcinogens and biological agents, several pathophysiological conditions, including oxidative stress and inflammation, while controlling metabolic dysfunctions and boosting the immunological response. Such broad effects are achieved by the taro health-influencing compounds displaying antitumoral, antimutagenic, immunomodulatory, anti-inflammatory, antioxidant, anti-hyperglycemic, and anti-hyperlipidemic activities. Taro bioactivities are attributed to the combination of tarin, taro-4-I polysaccharide, taro polysaccharides 1 and 2 (TPS-1 and TPS-2), A-1/B-2 α-amylase inhibitors, monogalactosyldiacylglycerols (MGDGs), digalactosyldiacylglycerols (DGDGs), polyphenols, and nonphenolic antioxidants. Most of these compounds have been purified and successfully challenged in vitro and in vivo, proving their involvement in the aforementioned activities. Although these health-promoting effects have been recognized since ancient times, as well as other valuable features of taro for food profit, such as hypo-allergenicity, gluten-free, and carbohydrates with medium-glycemic index, taro crop remains underexploited. The popularization of taro intake should be considered a dietary intervention strategy to be applied to improve the overall health status of the organism and as supportive therapy to manage tumorigenesis.

Refined Carbohydrate Consumption and Facial Attractiveness

Since the second half of the 20th century, a massive increase in the consumption of refined carbohydrates has occurred, generating well-described detrimental health effects such as obesity, insulin resistance, type II diabetes, cardiovascular diseases and dental caries. Certain physiological mechanisms involved, particularly through chronic hyperglycaemia and hyperinsulinaemia, suggest that a non-medical trait such as facial attractiveness could also be affected. To explore this possibility, variation in facial attractiveness was evaluated relative to refined carbohydrate consumption. Attractiveness was assessed from facial pictures as judged by raters of the opposite sex. Estimates of refined carbohydrate consumption were based on the glycaemic load of three mealtimes at-higher glycaemic risk (breakfast, afternoon snack and between-meal snack). In the presence of several control variables, facial pictures of women and men with higher between-meal glycaemic loads were preferred by opposite-sex raters. Structural equation modeling suggests that this result is possibly mediated by an increase in apparent age for men and an increase in femininity for women. The different physiological ecologies of the three meals at-higher glycaemic risk are discussed as well as the interpretation of the results in terms of adaptation or maladaptation to the modern and unique dietary environment.

Peptides from Natural or Rationally Designed Sources Can Be Used in Overweight, Obesity, and Type 2 Diabetes Therapies

Overweight and obesity are among the most prominent health problems in the modern world, mostly because they are either associated with or increase the risk of other diseases such as type 2 diabetes, hypertension, and/or cancer. Most professional organizations define overweight and obesity according to individual body-mass index (BMI, weight in kilograms divided by height squared in meters). Overweight is defined as individuals with BMI from 25 to 29, and obesity as individuals with BMI ≥30. Obesity is the result of genetic, behavioral, environmental, physiological, social, and cultural factors that result in energy imbalance and promote excessive fat deposition. Despite all the knowledge concerning the pathophysiology of obesity, which is considered a disease, none of the existing treatments alone or in combination can normalize blood glucose concentration and prevent debilitating complications from obesity. This review discusses some new perspectives for overweight and obesity treatments, including the use of the new orally active cannabinoid peptide Pep19, the advantage of which is the absence of undesired central nervous system effects usually experienced with other cannabinoids.

In-Vitro Antioxidant, Hypoglycemic Activity, and Identification of Bioactive Compounds in Phenol-Rich Extract from the Marine Red Algae Gracilaria edulis (Gmelin) Silva

Obesity and diabetes are major metabolic disorders which are prevalent worldwide. Algae has played an important role in managing these disorders. In this study, Gracilaria edulis, a marine red algae, was investigated for antioxidant and hypoglycemic potential using in vitro models. De-polysaccharide methanol extract of G. edulis was sequentially partitioned with hexane, chloroform, ethyl acetate, and antioxidants, and hypoglycemic potentials were evaluated using multiple methods. High antioxidant potential was observed in the ethyl acetate fraction in terms of ferric reducing antioxidant power, iron chelating, and DPPH and ABTS radical scavenging activities, while the crude methanol extract exhibited potent oxygen radical-absorbance capacity. Potent α-amylase inhibitory activity was observed in the ethyl acetate fraction, while the ethyl acetate fraction was effective against α-glucosidase inhibition. Glucose diffusion was inhibited by the ethyl acetate fraction at 180 min, and the highest antiglycation activity was observed in both chloroform and ethyl acetate fractions. Additionally, gas chromatography-mass spectrometry analysis of the ethyl acetate fraction revealed the presence of several potent anti-diabetic compounds. In conclusion, G. edulis exhibited promising antidiabetic potential via multiple mechanisms. The ethyl acetate fraction exhibited the strongest hypoglycemic and antiglycation potential among the four fractions, and hence the isolation of active compounds is required to develop leads for new drugs to treat diabetes.

Abscisic Acid Standardized Fig (Ficus carica) Extracts Ameliorate Postprandial Glycemic and Insulinemic Responses in Healthy Adults

Abscisic acid (ABA) can improve glucose homeostasis and reduce inflammation in mammals by activating lanthionine synthetase C-like 2 (LANCL2). This study examined the effects of two fig fruit extracts (FFEs), each administered at two different ABA doses, on glycemic index (GI) and insulinemic index (II) to a standard glucose drink. In a randomized, double-blind crossover study, 10 healthy adults consumed 4 test beverages containing FFE with postprandial glucose and insulin assessed at regular intervals over 2 h to determine GI and II responses. Test beverages containing 200 mg FFE-50× and 1200 mg FFE-10× significantly reduced GI values by -25% (P = 0.001) and -24% (P = 0.002), respectively. Two lower doses of FFE also reduced GI values compared with the reference drink (by approximately -14%), but the differences did not reach statistical significance. Addition of FFE to the glucose solution significantly reduced II values at all dosages and displayed a clear dose-response reduction: FFE-50× at 100 mg and 200 mg (-14% (P < 0.05) and -24% (P = 0.01), respectively) and FFE-10× at 600 mg and 1200 mg (-16% (P < 0.05) and -24% (P = 0.01), respectively). FFE supplementation is a promising nutritional intervention for the management of acute postprandial glucose and insulin homeostasis, and it is a possible adjunctive treatment for glycemic management of chronic metabolic disorders such as prediabetes and type 2 diabetes mellitus.

Influence of Clitoria ternatea Flower Extract on the In Vitro Enzymatic Digestibility of Starch and Its Application in Bread

This study aimed to assess the effect of the Clitoria ternatea L. flower extract (CTE), on the inhibition of pancreatic α-amylase, in vitro starch hydrolysis, and predicted the glycemic index of different type of flours including potato, cassava, rice, corn, wheat, and glutinous rice flour. The application in a bakery product prepared from flour and CTE was also determined. The results demonstrated that the 1% and 2% (w/v) CTE inhibited the pancreatic α-amylase activity by using all flours as a substrate. Moreover, 0.5%, 1%, and 2% (w/v) CTE showed a significant reduction in the glucose release, hydrolysis index (HI), and predicted glycemic index (pGI) of flour. In glutinous rice flour, 1% and 2% (w/v) CTE had a significantly lower level of rapidly digestible starch (RDS) and slowly digestible starch (SDS) with a concomitant higher level of undigested starch. The statistical analysis demonstrated strong positive significant correlations between the percentage of CTE and the undigested starch of wheat and cassava. The addition of 5%, 10%, and 20% (w/w) CTE significantly reduced the rate of starch digestion of the wheat bread. The pGI of bread incorporated with 5% CTE (w/w) was significantly lower than that of the control bread. Our findings suggest that CTE could reduce the starch digestibility, the HI, and pGI of flour through the inhibition of carbohydrate digestive enzymes. Taken together, CTE may be a potent ingredient for the reduced glycemic index of flours.

Nutrition Therapy in Managing Pregnant Women With Gestational Diabetes Mellitus: A Literature Review

Objective: Gestational diabetes mellitus is the most common metabolic and endocrine perinatal complication and is a growing health problem worldwide. Considering the fetal programming and its contribution as one of the evolutionary origins of human diseases, it is very important to improve the glucose metabolism in pregnant women, determination of other nutrients, preventing excessive accumulation of fetal fats, emphasis on weight loss measures before pregnancy, dietary intake with low-fat healthy food and prevention of abundant weight loss. In this paper, we have provided a brief review on dietary intake and dietary interventions in GDM from the perspective of nutrition science attending the physiopathology and etiology of the disease. Materials and methods: Electronic search for English and Persian articles has been perform in databases, including Google Scholar, PubMed ,Scopus, Cochrane central ,Science direct, ISC, SID, Magiran, Iran Medex, and Med Libby key words: gestational diabetes, gestational diabetes mellitus, nutrition, macronutrient, micronutrient, Diabetes. All available articles (cross-sectional, descriptive-analytic, and clinical studies with desirable design and review quality studies were used. Reference books including Krause's Food and the Nutrition Care, The Williams Obstetrics editions of the 14^th (2017) and the 24^th edition (2014) were also reviewed. Results: Nutrition therapy and physical activity are the initial treatment of GDM. Proper and flexible methods of nutrition therapy that successfully regulate maternal glycaemia while improving expected fetal growth have extensive concepts. Meanwhile, dietary supplements with proven beneficial effects can play an important role in improving deficiencies and improving the metabolic profile of patients. Conclusion: Nutritional management is the main treatment for gestational diabetes mellitus and overweight/obesity is the principal contest in patient counseling and interventions during pregnancy. Despite extensive researches carried out, this field is an active research area and requires more clinical research to minimize maternal and fetal complications.

Effect of ethanol extract of boiled breadfruit (Treculia Africana) seed on the oral glucose tolerance, lipid profile, and body weight of normoglycemic albino rats

The effect of ethanol extracts of boiled Treculia africana seed on the oral glucose tolerance (OGTT), lipid profile, and body weight of normoglycemic albino rats was determined. Fifteen male albino rats were used and were divided into three groups of five rats each. Groups 1 and 2 received 100 and 200 mg/kg of the extract, while group 3 (control group) received 1 ml/kg of normal saline. The experiment lasted for 28 days. The body weights of the rats were determined daily. OGTT was determined at week zero (before extract administration) and at weeks 2 and 4, respectively, following extract administration. Glycemic index (GI) of the extracts was calculated from the incremental area under the OGTT curve. The total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and very-low-density lipoprotein (VLDL) cholesterol levels in the sera of the rats were determined using standard techniques. Atherogenic index (AI) and coronary risk index (CRI) of the rats were expressed as ratios of LDL cholesterol to HDL cholesterol and total cholesterol to HDL cholesterol, respectively. Following 2 weeks of the extract administration, the blood glucose for groups 1 and 2 rats declined to values ≤100 mg/dl after oral glucose loading. GI for the standard rat feeds and the extracts at 100 and 200 mg/kg by the second week of experimentation were 100, 114, and 96.09, respectively. GI for the extract at 100 mg/kg decreased to 103.63 at the 4th week, while that for the extract at 200 mg/kg increased to 98.07. The extract at 100 mg/kg increased the LDL cholesterol, AI, and CRI of the rats, suggesting that consumption of boiled African breadfruit may expose an individual to the risk of development of cardiovascular diseases. Finally, the study suggested that consumption of T. africana seed by a nondiabetic subject may have no effect on the glucose tolerance of the individual, while it will negatively impact on the glycemic status of a diabetic subject.

Effect of domestic cooking on the starch digestibility, predicted glycemic indices, polyphenol contents and alpha amylase inhibitory properties of beans (Phaseolis vulgaris) and breadfruit (Treculia africana)

The effect of processing on starch digestibility, predicted glycemic indices (pGI), polyphenol contents and alpha amylase inhibitory properties of beans (Phaseolis vulgaris) and breadfruit (Treculia africana) was studied. Total starch ranged from 4.3 to 68.3g/100g, digestible starch ranged from 4.3 to 59.2 to 65.7g/100g for the raw and processed legumes; Resistance starch was not detected in most of the legumes except in fried breadfruit and the starches in both the raw and processed breadfruit were more rapidly digested than those from raw and cooked beans. Raw and processed breadfruit had higher hydrolysis curves than raw and processed beans with the amylolysis level in raw breadfruit close to that of white bread. Raw beans had a low glycemic index (GI); boiled beans and breadfruit had intermediate glycemic indices respectively while raw and fried breadfruit had high glycemic indices. Aqueous extracts of the food samples had weak α-amylase inhibition compared to acarbose. The raw and processed legumes contained considerable amounts of dietary phenols and flavonoids. The significant correlation (r=0.626) between α-amylase inhibitory actions of the legumes versus their total phenolic contents suggests the contribution of the phenolic compounds in these legumes to their α-amylase inhibitory properties.

Impact of High-Carbohydrate Diet on Metabolic Parameters in Patients with Type 2 Diabetes

In patients with type 2 diabetes mellitus (T2DM), whether dietary carbohydrates have beneficial or detrimental effects on cardiometabolic risk factors has drawn attention. Although a high-carbohydrate (HC) diet and a low-carbohydrate (LC) diet have gained popularity for several decades, there is scarce review focusing on the effects of HC diet on glucose, lipids and body weight in patients with T2DM. In this review, we examined recently-published literature on the effects of HC diets on metabolic parameters in T2DM. HC diets are at least as effective as LC diets, leading to significant weight loss and a reduction in plasma glucose, HbA1c and low density lipoprotein-cholesterol (LDL-C) levels. The major concern is that HC diets may raise serum triglyceride levels and reduce high density lipoprotein-cholesterol (HDL-C) levels, increasing the risk of cardiovascular disease. However, these untoward effects were not a persistent consequence and may be ameliorated with the consumption of a low glycemic index (GI)/low glycemic load (GL) and high fiber. Carbohydrate intake should be individualized, and low caloric intake remains a crucial factor to improve insulin sensitivity and reduce body weight; however, an HC diet, rich in fiber and with a low GI/GL, may be recommendable in patients with T2DM.