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Strydom H, Muchiri J, Delport E, White Z. Adherence to Personalised Nutrition Education Based on Glycemic and Food Insulin Index Principles and Their Association with Blood Glucose Control in Individuals with Type 2 Diabetes Mellitus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2025; 22:925. [PMID: 40566351 PMCID: PMC12193543 DOI: 10.3390/ijerph22060925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2025] [Revised: 06/06/2025] [Accepted: 06/10/2025] [Indexed: 06/28/2025]
Abstract
Personalised nutrition education (PNE) can enhance blood glucose control (BGC). We determined whether patients with type 2 diabetes (T2DM) adhered to PNE based on glycemic index (GI), glycemic load (GL), and food insulin index (FII) principles and whether adherence was associated with improved BGC. This retrospective cohort included 67 files for patients who received PNE. The patients completed 3-day food and blood glucose records at three points over 90 days. HbA1c values were compared between time points. An adherence score sheet (ASS) was used to determine their adherence to PNE and the main meal adherence classification (MMAC). A one-way repeated measures ANOVA was used to assess the changes over time. A chi-square test determined the association between the MMAC and blood glucose levels falling within the targeted ranges. Correlations between dietary adherence and BGC indicators were examined using Pearson's product-moment correlation. Adherence ranged from 88 to 95%. MMAC score was significantly associated with blood glucose being within the targeted ranges (p = 0.028). Mean blood glucose decreased over time, but the correlations with adherence were only significant at time point 1 (p = 0.029). HbA1c levels decreased significantly over time (p = 0.003), but their correlation with adherence was not significant (p > 0.05). In patients with T2DM, high adherence to PNE based on GI, GL, and FII principles was associated with improved BGC.
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Affiliation(s)
- Hildegard Strydom
- Department of Human Nutrition, University of Pretoria, Pretoria 0084, South Africa; (J.M.); (Z.W.)
| | - Jane Muchiri
- Department of Human Nutrition, University of Pretoria, Pretoria 0084, South Africa; (J.M.); (Z.W.)
| | | | - Zelda White
- Department of Human Nutrition, University of Pretoria, Pretoria 0084, South Africa; (J.M.); (Z.W.)
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Li X, Wainwright A, Fio CZ, Brodie S, Alexander K, McGill M, Duke SA, Fulcher G, Twigg S, Wong J, Brand-Miller J, Steil GM, Bell KJ. Do the Types of Dietary Carbohydrate and Protein Affect Postprandial Glycemia in Type 1 Diabetes? Nutrients 2025; 17:1868. [PMID: 40507137 PMCID: PMC12158204 DOI: 10.3390/nu17111868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2025] [Revised: 05/23/2025] [Accepted: 05/27/2025] [Indexed: 06/16/2025] Open
Abstract
Background/Objectives: Dietary protein and carbohydrate affect postprandial glycemia in individuals with type 1 diabetes (T1D). This paper aimed to determine the relationship between the types of dietary protein (Study 1) and carbohydrate (glycemic index; GI, Study 2) and postprandial glycemia. Methods: Two acute randomized crossover trials were conducted in adults with T1D comparing postprandial glycemia for test meals varying by protein type (n = 16 adults; 5 meals: egg, beef, chicken, salmon or whey (all 30 g protein), each served with fried rice (45 g carbohydrate) or GI (n = 8 adults, high or low GI bread, GI 52% vs. 76%) with peanut butter (19 g protein, 30 g fat). Insulin was dosed based on usual individualized insulin: carbohydrate ratio and capillary blood glucose levels (BGL) measured from 30 min pre- to 5 h postprandially in 15-30 min intervals. Results: Study 1: Postprandial glycemia varied over an almost 2-fold range, however responses were highly variable and there were no significant differences between sources (iAUCglucose Chicken: 203 ± 66 mmol·min/L, Egg: 263 ± 100 mmol·min/L, Beef: 309 ± 89 mmol·min/L, Salmon: 338 ± 83 mmol·min/L and Whey: 397 ± 115 mmol·min/L respectively, p > 0.05). Hypoglycemia (≤3.5 mmol/L) occurred at least once per protein type (chicken: 6/16 participants, egg 2/16, beef 3/16, salmon 1/16, whey 2/16). However, there were no statistically significant differences in the risk of hypoglycemia between protein sources (p > 0.05). Study 2: Postprandial glucose response curves were virtually identical for high GI and low GI, and the incremental area under the curve (iAUC) for glucose was not statistically significant after 1 h (p = 0.185), 3 h (p = 0.538) or 5 h (p = 0.694) following the meal. Conclusions: Clinical practice guidelines and insulin dosing algorithms likely do not need to consider differences in protein sources or in GI in the context of a high fat, high protein meals, for individuals with T1D.
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Affiliation(s)
- Xinyi Li
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia
- The Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia
| | - Alice Wainwright
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia
- The Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia
| | - Chantelle Z. Fio
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia
- The Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia
| | - Shannon Brodie
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia
- The Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia
| | - Kylie Alexander
- Royal North Shore Hospital Diabetes Centre, Sydney 2065, Australia
| | - Margaret McGill
- Royal Prince Alfred Hospital Diabetes Centre, Sydney 2050, Australia
| | - Sally-Anne Duke
- Royal North Shore Hospital Diabetes Centre, Sydney 2065, Australia
| | - Gregory Fulcher
- Royal North Shore Hospital Diabetes Centre, Sydney 2065, Australia
| | - Stephen Twigg
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia
- Royal Prince Alfred Hospital Diabetes Centre, Sydney 2050, Australia
| | - Jencia Wong
- Royal Prince Alfred Hospital Diabetes Centre, Sydney 2050, Australia
| | | | - Garry M. Steil
- Harvard Medical School, Boston, MA 02115, USA
- Boston Children’s Hospital, Boston, MA 02115, USA
| | - Kirstine J. Bell
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia
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Chen D, Deng F, Sun H. Impact of a Culturally Targeted Lifestyle Course on Dietary and Weight Outcomes of Chinese Americans in Texas. Am J Health Promot 2025; 39:581-588. [PMID: 39625455 DOI: 10.1177/08901171241304702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2025]
Abstract
PurposeThis study aimed to assess the impact of a culturally targeted lifestyle course on the dietary and weight outcomes of Asian Americans.DesignThis was an observational study of participants for a culturally targeted lifestyle course taught online by a Nutrition Scientist and Board-Certified Holistic Health Practitioner.SettingFrom 2021 to 2022, 284 participants were recruited through 4 community organizations in Texas and completed the informed consent.Subjects140 Chinese Americans finished 3 surveys before, after, and 6 months after the course.MeasuresParticipants' fruit and vegetable consumption was assessed using the questionnaire from the Behavioral Risk Factor Surveillance System and their physical activities were evaluated by the Godin-Shephard Leisure-Time Exercise Questionnaire.AnalysisWe conducted repeated measures ANOVA to compare participants' dietary and weight outcomes before, after, and 6 months after the course. Paired t-tests were performed to investigate how the outcomes differed from the baseline.ResultsThe participants' weights and BMI values at the 6-month follow-up were significantly lower than the baseline, though the changes were not significant immediately after the course. Rice consumption dropped significantly both after the class and at the 6-month follow-up. Participants also significantly reduced their intake of 100% juice and fried potatoes immediately after the class.ConclusionCommunity-based Participatory Approaches might be used to improve the dietary and weight outcomes of Asian Americans.
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Affiliation(s)
- Danhong Chen
- School of Agricultural Sciences, Sam Houston State University, Huntsville, TX, USA
| | - Furjen Deng
- Department of Sociology, Sam Houston State University, Huntsville, TX, USA
| | - Helen Sun
- Light and Salt Association, Houston, TX, USA
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Pratama SA, Kurniawan R, Chiu HY, Kuo HJ, Ekpor E, Kung PJ, Al Baqi S, Hasan F, Romadlon DS. Glycemic fluctuations, fatigue, and sleep disturbances in type 2 diabetes during ramadan fasting: A cross-sectional study. PLoS One 2025; 20:e0312356. [PMID: 40043024 PMCID: PMC11882071 DOI: 10.1371/journal.pone.0312356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2024] [Accepted: 12/17/2024] [Indexed: 05/13/2025] Open
Abstract
BACKGROUND This study aimed to assess the prevalence of glycemic fluctuations, fatigue, and sleep disturbances during Ramadan, and to identify factors associated with hypoglycemia and hyperglycemia events in this period. METHODS A cross-sectional study of 88 individuals with type 2 diabetes during Ramadan fasting from (08/03/2024) until (20/04/2024) was conducted. HbA1c levels before Ramadan were obtained from medical records. Participants monitored blood glucose twice daily (during the day and two hours after breaking fast). Blood glucose under 70 mg/dl was considered hypoglycemia, and over 200 mg/dl was hyperglycemia. Fatigue was thoroughly assessed using the Indonesian Multidimensional Fatigue Inventory-20 (IMFI-20), while the Pittsburgh Sleep Quality Index (PSQI) was utilized to evaluate sleep quality. In addition, data on sleep duration, as well as dietary habits during Ramadan, were also collected. RESULTS A total of 88 patients with type 2 diabetes (mean age, 52.7 years) participated, predominantly female (68.2%) and married (63.6%). The study found a prevalence of 21.6% for hypoglycemia and 30.6% for hyperglycemia. Additionally, 30.7% of participants experienced fatigue, and 40.9% reported poor sleep quality. HbA1c levels before Ramadan and fatigue were significantly associated with both hypoglycemia and hyperglycemia (p < 0.05). Sleep quality was also significantly associated with hyperglycemia events (p < 0.05). Furthermore, sleep duration was significantly related to hyperglycemia events (p = 0.01). Meal timing, frequency, and dietary patterns during Ramadan were also found to be significantly associated with both hypoglycemia and hyperglycemia (both p < 0.05). CONCLUSION Hypoglycemia and hyperglycemia are common among people with type 2 diabetes during Ramadan. Fatigue and poor sleep quality were also widespread. Key factors linked to these glycemic fluctuations were pre-Ramadan HbA1c levels and fatigue, while sleep quality was particularly associated with hyperglycemia. These results highlight the need for personalized care to manage blood sugar levels and improve overall health during Ramadan. We recommend that healthcare providers advise patients with type 2 diabetes to aim for 7-8 hours of sleep per night to help control blood glucose levels. Additionally, having three meals a day (Suhoor, Iftar, and a post-Iftar snack) with low glycemic index foods can help maintain stable blood glucose and prevent both hypoglycemia and hyperglycemia during Ramadan.
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Affiliation(s)
- Satwika Arya Pratama
- Department of Nutrition, Faculty of Sport and Health Sciences, Universitas Negeri Surabaya, Surabaya, Indonesia
| | - Rudy Kurniawan
- Diabetes Connection Care, Eka Hospital Bumi Serpong Damai, Tangerang, Indonesia
| | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan
- Research Center of Sleep Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Hsuan-Ju Kuo
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | | | - Po-Jen Kung
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States
| | - Safiruddin Al Baqi
- Faculty of Education and Teaching Sciences, State Islamic Institute of Ponorogo, Ponorogo, Indonesia
| | - Faizul Hasan
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
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Odeniran OM. Exploring the Potential of Bambara Groundnut Flour as an Alternative for Diabetic and Obese Patients in the USA: A Comprehensive Review. Cureus 2025; 17:e78258. [PMID: 40026940 PMCID: PMC11871983 DOI: 10.7759/cureus.78258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2025] [Indexed: 03/05/2025] Open
Abstract
Bambara groundnut flour (BGNF), derived from Vigna subterranea, is a nutrient-dense, low-glycemic alternative to traditional flours, making it beneficial for diabetes and obesity management. Rich in protein (18-24%) and fiber (12-19%), it promotes satiety, regulates blood sugar, and supports muscle preservation during weight loss. Its complex carbohydrates and resistant starch allow for gradual glucose release, reducing blood sugar spikes in diabetics. BGNF also contains antioxidants and anti-inflammatory compounds that may help mitigate diabetes-related complications. Compared to almond, coconut, and chickpea flours, it offers a balanced nutrient profile suitable for glycemic control and weight management. However, challenges such as limited production, high costs, and low public awareness hinder its accessibility, particularly in the U.S. To fully realize its potential, research, including clinical trials, is needed to validate its health benefits, while efforts to scale production and raise awareness could help position BGNF as a sustainable, functional food for managing chronic health conditions.
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Aminianfar A, Zolfaghari H, Soltani S, Hajianfar H, Azadbakht L, Shahshahan Z, Esmaillzadeh A. Dietary insulin load and index in relation to incident gestational diabetes mellitus: a prospective cohort study. Sci Rep 2024; 14:31571. [PMID: 39738065 PMCID: PMC11685760 DOI: 10.1038/s41598-024-68125-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 07/19/2024] [Indexed: 01/01/2025] Open
Abstract
No study has examined the association between dietary insulin load (DIL) and insulin index (DII) with developing gestational diabetes mellitus (GDM) during pregnancy. This study aimed to investigate the association between DIL and DII and risk of GDM in a group of pregnant women in Iran. In this prospective cohort study, 812 pregnant in their first trimester were recruited and followed. Usual dietary intakes were measured using a validated 117-item semi-quantitative food frequency questionnaire at weeks 8-16 of gestations. DIL and DII were calculated based on earlier publications. GDM was diagnosed based on the results of a 50 g, 1 h oral glucose tolerance test at 24-28 weeks of gestation. Cox proportional hazards model was used to compute relative risks ratios (RRs) and 95% confidence intervals (CI) for GDM. Mean ± SD of age and BMI of study participants was 29.4 ± 4.84 y and 25.14 ± 4.08 kg/m2, respectively at study baseline. Mean ± SD of DIL was 80,629 ± 29,328 and mean ± SD of DII was 40.23 ± 4.93. Overall, 28.4% (n = 231) of study population developed GDM at weeks 24-28 of pregnancy. After adjustment for potential confounding variables, we found that women in the highest quartile of DIL had 53% elevated risk of GDM (95% CI 1.003, 2.34; P-trend = 0.14) compared with those in the lowest quartile. Additional adjustment for weight gain during pregnancy did not alter the association (RR = 1.53; 95% CI 1.003, 2.34; P-trend = 0.14). Women with the greatest DII had a 23% non-significant elevated risk of GDM (95% CI 0.84, 1.82; P-trend = 0.55) compared to those with the lowest DII. We found that women with the highest DIL were at greater risk of developing GDM during pregnancy. No significant association was seen between DII and risk of GDM.
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Affiliation(s)
- Azadeh Aminianfar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
- Research Center for Biochemistry and Nutrition in Metabolic Disease, Kashan University of Medical Sciences, Kashan, Iran.
| | - Hamid Zolfaghari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanaz Soltani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Department of Nutritional Sciences, School of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Hajianfar
- Food Safety Research Center (Salt), Semnan University of Medical Sciences, Semnan, Iran
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Shahshahan
- Department of Gynecology, School of Medicine Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran.
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular -Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Park JG, Ye SJ, Oh SM, Shin JS, Bae JE, Choi HW, Baik MY. Quality Characteristics and In Vitro Digestibility of Starch Gel in White Noodles Prepared with Short-Chain Glucan Aggregates (SCGA). Gels 2024; 11:6. [PMID: 39851977 PMCID: PMC11765410 DOI: 10.3390/gels11010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2024] [Revised: 12/24/2024] [Accepted: 12/25/2024] [Indexed: 01/26/2025] Open
Abstract
Short-chain glucan aggregates (SCGA), a type of resistant starch (RS) Ⅲ, is produced by debranching amylopectin with pullulanase and inducing self-assembly. Despite its low digestibility and high RS content, SCGA has not been applied to real food systems, especially noodles. The objective of this study was to determine the feasibility of low-digestible noodles using SCGA and to evaluate their quality characteristics and in vitro digestibility of starch gel. SCGA-noodles (SN) were prepared by substituting 0, 10, 20, and 25% of wheat flour with SCGA, and non-digestible maltodextrin (NMD) replaced 7% of the flour for comparison. Adding SCGA increased L- and b-values of the dough, resulting in a brighter appearance, while the NMD increased a-values. The substitution with SCGA weakened the gluten network, reducing dough and texture properties. Notably, cooked SN25 broke immediately in the tensile test, indicating substitution up to 20% is feasible in noodles. NMD7 formed sticky dough and showed extensive elongation without breaking. SN20 and SN25 significantly increased RS content and decreased the estimated glycemic index (eGI) compared to the control. However, NMD7 did not significantly reduce in vitro starch digestibility. In conclusion, this research confirmed the potential of SCGA as a low-digestible ingredient for noodles and other food applications.
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Affiliation(s)
- Jae-Geun Park
- Department of Food Science and Biotechnology, Institute of Life Science and Resources, Graduate School of Biotechnology, Kyung Hee University, Yongin 17104, Republic of Korea; (J.-G.P.); (S.-J.Y.); (S.-M.O.); (J.-S.S.); (J.-E.B.)
| | - Sang-Jin Ye
- Department of Food Science and Biotechnology, Institute of Life Science and Resources, Graduate School of Biotechnology, Kyung Hee University, Yongin 17104, Republic of Korea; (J.-G.P.); (S.-J.Y.); (S.-M.O.); (J.-S.S.); (J.-E.B.)
| | - Seon-Min Oh
- Department of Food Science and Biotechnology, Institute of Life Science and Resources, Graduate School of Biotechnology, Kyung Hee University, Yongin 17104, Republic of Korea; (J.-G.P.); (S.-J.Y.); (S.-M.O.); (J.-S.S.); (J.-E.B.)
- Food Processing Research Group, Korea Food Research Institute, Wanju-gun, Jeonju 55365, Republic of Korea
| | - Jae-Sung Shin
- Department of Food Science and Biotechnology, Institute of Life Science and Resources, Graduate School of Biotechnology, Kyung Hee University, Yongin 17104, Republic of Korea; (J.-G.P.); (S.-J.Y.); (S.-M.O.); (J.-S.S.); (J.-E.B.)
| | - Ji-Eun Bae
- Department of Food Science and Biotechnology, Institute of Life Science and Resources, Graduate School of Biotechnology, Kyung Hee University, Yongin 17104, Republic of Korea; (J.-G.P.); (S.-J.Y.); (S.-M.O.); (J.-S.S.); (J.-E.B.)
| | - Hyun-Wook Choi
- Department of Food and Nutrition, Jeonju University, Jeonju 55069, Republic of Korea
| | - Moo-Yeol Baik
- Department of Food Science and Biotechnology, Institute of Life Science and Resources, Graduate School of Biotechnology, Kyung Hee University, Yongin 17104, Republic of Korea; (J.-G.P.); (S.-J.Y.); (S.-M.O.); (J.-S.S.); (J.-E.B.)
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Gerontiti E, Shalit A, Stefanaki K, Kazakou P, Karagiannakis DS, Peppa M, Psaltopoulou T, Paschou SA. The role of low glycemic index and load diets in medical nutrition therapy for type 2 diabetes: an update. Hormones (Athens) 2024; 23:655-665. [PMID: 38750304 PMCID: PMC11519289 DOI: 10.1007/s42000-024-00566-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 04/29/2024] [Indexed: 09/11/2024]
Abstract
The increasing prevalence of type 2 diabetes mellitus (T2DM) and its microvascular and macrovascular complications necessitate an optimal approach to prevention and management. Medical nutrition therapy serves as the cornerstone of diabetes care, reducing reliance on diabetic medications for glycemic control and mitigating cardiovascular risk. The broadening field of research in the effect of low glycemic index (GI) and/or glycemic load (GL) diets on individuals with T2DM has yielded promising results in the existing literature. Adopting low-GI and GL dietary patterns contributes to minimizing fluctuations in blood glucose levels, thus presenting a good strategy for achieving enhanced glycemic control. Furthermore, the above dietary practices may offer a viable alternative and practical approach to weight management in individuals with T2DM. However, clinical practice guidelines for diabetes dietary management show inconsistency regarding the certainty of evidence supporting the implementation of low-GI/GL nutritional patterns. This review aims to thoroughly evaluate the available data on the effectiveness of low-GI and low-GL diets in managing glycemic control and reducing cardiovascular risk factors.
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Affiliation(s)
- Eleni Gerontiti
- Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Almog Shalit
- Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Section of Integrative Physiology and Metabolism, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
| | - Katerina Stefanaki
- Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Paraskevi Kazakou
- Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios S Karagiannakis
- Academic Department of Gastroenterology, Laiko Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Melpomeni Peppa
- Endocrine Unit, Second, Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, Athens, Greece
- Third Department of Internal Medicine, Sotiria General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodora Psaltopoulou
- Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavroula A Paschou
- Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
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Adjuik TA, Boi-Dsane NAA, Kehinde BA. Enhancing dietary analysis: Using machine learning for food caloric and health risk assessment. J Food Sci 2024; 89:8006-8021. [PMID: 39366774 DOI: 10.1111/1750-3841.17421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 08/12/2024] [Accepted: 09/09/2024] [Indexed: 10/06/2024]
Abstract
In the wake of growing concerns regarding diet-related health issues, this study investigates the application of machine learning methods to estimate the energy content and classify the health risks of foods based on the USDA National Nutrient Database. The caloric content of foods was estimated using the nutritional composition (i.e., carbohydrates, protein, total lipid, and total sugar content) and classified based on their weighted health risks, considering their carbohydrate, lipid, and glycemic index levels. The algorithms used for modeling include multiple linear regression (MLR), K-nearest neighbors, support vector machine, random forest regression (RFR), gradient-boosted regression, decision trees (DT), and deep neural networks. The MLR model demonstrated high accuracy on the training dataset (R2 = 0.99, mean absolute error [MAE] = 7.71 kcal, and root mean squared error [RMSE] = 17.89 kcal) and testing dataset (R2 = 0.99, MAE = 7.75 kcal, and RMSE = 18 kcal) in energy estimation, indicating its effectiveness in dietary assessment. The RFR and DT models were useful in categorizing foods into low-health-risk foods, but their performance was reduced in medium and high-health-risk groups. This research contributes to developing tools that could aid in personalized dietary planning and public health interventions to mitigate diet-related health risks. PRACTICAL APPLICATION: This study applies machine learning to estimate how many calories are in food and to understand the health risks different foods might have. By investigating the fats, cholesterol, and sugars in food items listed in a public database, we can better plan diets or develop apps that help people make healthier eating choices. This work aims to improve public access to nutritional information, supporting efforts to combat diet-related diseases through educational materials and applications that guide dietary choices in various settings.
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Affiliation(s)
- Toby A Adjuik
- Department of Agronomy, Iowa State University, Ames, Iowa, USA
| | | | - Bababode A Kehinde
- Department of Food Science, The Pennsylvania State University, University Park, Pennsylvania, USA
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Alaofè H, Mahdavimanshadi M, Mizéhoun-Adissoda C, Okechukwu A, Hounkpatin WA, Bedrick EJ, Gninkoun J, Fan N, Ehiri J. Precision nutrition for type 2 diabetes in Benin: leveraging linear goal programming to optimize diets with emphasis on adequacy, affordability, accessibility, and culture. Front Nutr 2024; 11:1400594. [PMID: 39176027 PMCID: PMC11338894 DOI: 10.3389/fnut.2024.1400594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 07/18/2024] [Indexed: 08/24/2024] Open
Abstract
Background Nutrition and diet are critical to managing Type 2 diabetes (T2D). Low-income households often face challenges maintaining a healthy and balanced diet due to food insecurity, availability, and cost. To address this issue, we used a linear goal programming (LGP) model to develop nutritionally adequate, affordable, accessible, and culturally acceptable diets for persons with T2D in Benin, a French-speaking sub-Saharan country. The goal was to help persons with T2D manage their condition more effectively. Methods We compiled a robust list of local commonly consumed foods in Benin, and calculated their nutritional value using West African food composition tables and food costs per serving from a market survey. Using mathematical optimization techniques, we designed dietary plans that meet the daily nutrient intake recommended by the World Health Organization (WHO) to prevent chronic diseases in normal adults. While adhering to dietary constraints of T2D, we developed optimized diet plans with varying energy levels that meet all nutrient requirements while considering availability, acceptability, and budgetary constraints. Results Fifty-two food items and recipes were evaluated to create six low-cost daily menus. Menu 1 was the most affordable at CFA 1,127 (USD 1.88), providing 1890 kcal of energy, while Menu 6 was the most expensive at CFA 1,227 (USD 2.05), providing 1749 kcal. All the menus met the daily WHO minimum requirements for carbohydrates, fat, cholesterol, and fiber content, while other nutrients such as protein, vitamin C, and iron reached the upper limits of the acceptable value range. Conclusion Linear goal programming can be an effective tool in helping to obtain optimized adequate, accessible, and culturally acceptable diets at minimal cost by interpreting and translating dietary recommendations into a nutritional model, based on local market prices.
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Affiliation(s)
- Halimatou Alaofè
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Mahdi Mahdavimanshadi
- Department of Systems and Industrial Engineering, University of Arizona, Tucson, AZ, United States
| | - Carmelle Mizéhoun-Adissoda
- School of Nutrition and Dietetics, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - Abidemi Okechukwu
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Waliou Amoussa Hounkpatin
- School of Nutrition and Food Science and Technology, Faculty of Agricultural Sciences of the University of Abomey-Calavi, Calavi, Benin
| | - Edward John Bedrick
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Jules Gninkoun
- Faculty of Health Sciences, University of Abomey Calavi, Cotonou, Benin
| | - Neng Fan
- Department of Systems and Industrial Engineering, University of Arizona, Tucson, AZ, United States
| | - John Ehiri
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
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11
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Temkov M, Rocha JM, Rannou C, Ducasse M, Prost C. Influence of baking time and formulation of part-baked wheat sourdough bread on the physical characteristics, sensory quality, glycaemic index and appetite sensations. Front Nutr 2024; 11:1370086. [PMID: 38887499 PMCID: PMC11180745 DOI: 10.3389/fnut.2024.1370086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 05/14/2024] [Indexed: 06/20/2024] Open
Abstract
Raw materials and process parameters in bread production can modulate the glycemic index, which on itself has been linked with provision of better hunger satisfaction and maintaining better satiation. The objective of this research was to investigate if using unrefined wheat flour or the addition of intact cereals in formulation or alternating the baking time would have an effect on physical characteristics, sensory quality, glycaemic index and appetite sensations in wheat sourdough bread. In the study, three types of commercial part-baked frozen sourdough bread, baked to the final baking for two different times (long and short baking time) were used. A randomized controlled crossover trial was performed with 10 healthy adults who consumed sufficient quantity of bread to ingest 50 g available carbohydrates. Participants self-reported appetite sensations (desire to eat, hunger, fullness, satisfaction, appetite) on a 10 cm visual analog scale (VAS) scale in a course of 180 min. In addition, bread products were subjected to overall acceptability and different sensory attributes were examined on JAR "just about right" scale. Different bread formulations (refined flour, unrefined wheat flour, cereal flour or intact cereals) and different length of baking time significantly influenced (p < 0.005) physical, textural and sensory features of products. The alternation of aforementioned parameters decreased the glycemic index, but not significantly (p > 0.005). No correlation was found between lower GI, satiety and satiation. Liking score and incremental area under the curve (iAUC) of satiety and satiation were calculated as highest in sourdough bread with added cereals.
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Affiliation(s)
- Mishela Temkov
- Department of Food Technology and Biotechnology, Faculty of Technology and Metallurgy, Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia
| | - João Miguel Rocha
- CBQF—Centro de Biotecnologia e Química Fina—Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Porto, Portugal
- LEPABE – Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto (FEUP), Porto, Portugal
- ALiCE – Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto (FEUP), Porto, Portugal
| | - Cécile Rannou
- ONIRIS, VETAGROBIO, UMR GEPEA CNRS 6144, Nantes, France
| | | | - Carole Prost
- ONIRIS, VETAGROBIO, UMR GEPEA CNRS 6144, Nantes, France
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12
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Wei X, Zou H, Zhang T, Huo Y, Yang J, Wang Z, Li Y, Zhao J. Gestational Diabetes Mellitus: What Can Medical Nutrition Therapy Do? Nutrients 2024; 16:1217. [PMID: 38674907 PMCID: PMC11055016 DOI: 10.3390/nu16081217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/12/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is one of the common complications during pregnancy. Numerous studies have shown that GDM is associated with a series of adverse effects on both mothers and offspring. Due to the particularity of pregnancy, medical nutrition treatment is considered to be the first choice for the treatment of GDM. This contribution reviews the research progress of medical nutrition treatment in GDM, summarizes the international recommendations on the intake of various nutrients and the influence of nutrients on the prevalence of GDM, and the improvement effect of nutritional intervention on it, in order to provide references for research in related fields of GDM and the targeted development of enteral nutrition.
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Affiliation(s)
- Xiaoyi Wei
- CAS Engineering Laboratory for Nutrition, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200031, China; (X.W.); (H.Z.); (T.Z.); (Y.H.); (Y.L.)
| | - Hong Zou
- CAS Engineering Laboratory for Nutrition, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200031, China; (X.W.); (H.Z.); (T.Z.); (Y.H.); (Y.L.)
| | - Tingting Zhang
- CAS Engineering Laboratory for Nutrition, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200031, China; (X.W.); (H.Z.); (T.Z.); (Y.H.); (Y.L.)
| | - Yanling Huo
- CAS Engineering Laboratory for Nutrition, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200031, China; (X.W.); (H.Z.); (T.Z.); (Y.H.); (Y.L.)
| | - Jianzhong Yang
- Sunline Research Laboratories, Jiangsu Sunline Deep Sea Fishery Co., Ltd., Lianyungang 222042, China; (J.Y.); (Z.W.)
| | - Zhi Wang
- Sunline Research Laboratories, Jiangsu Sunline Deep Sea Fishery Co., Ltd., Lianyungang 222042, China; (J.Y.); (Z.W.)
| | - Yu Li
- CAS Engineering Laboratory for Nutrition, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200031, China; (X.W.); (H.Z.); (T.Z.); (Y.H.); (Y.L.)
| | - Jiuxiang Zhao
- CAS Engineering Laboratory for Nutrition, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200031, China; (X.W.); (H.Z.); (T.Z.); (Y.H.); (Y.L.)
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13
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Skurk T, Bosy-Westphal A, Grünerbel A, Kabisch S, Keuthage W, Kronsbein P, Müssig K, Nussbaumer H, Pfeiffer AFH, Simon MC, Tombek A, Weber KS, Rubin D. Dietary Recommendations for Persons with Type 2 Diabetes Mellitus. Exp Clin Endocrinol Diabetes 2024; 132:182-215. [PMID: 38286422 DOI: 10.1055/a-2166-6772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Affiliation(s)
- Thomas Skurk
- ZIEL Institute for Food & Health, Technical University of Munich, Freising, Germany
| | - Anja Bosy-Westphal
- Institute of Human Nutrition, Faculty of Agriculture and Nutritional Sciences, Christian-Albrechts University of Kiel, Kiel, Germany
| | | | - Stefan Kabisch
- German Institute of Human Nutrition Potsdam-Rehbrücke, Potsdam, Germany
- German Center for Diabetes Research (DZD), Munich, Germany
| | - Winfried Keuthage
- Specialist Practice for Diabetes and Nutritional Medicine, Münster, Germany
| | - Peter Kronsbein
- Faculty of Nutrition and Food Sciences, Niederrhein University of Applied Sciences, Mönchengladbach Campus, Mönchengladbach, Germany
| | - Karsten Müssig
- Department of Internal Medicine, Gastroenterology and Diabetology, Niels Stensen Hospitals, Franziskus Hospital Harderberg, Georgsmarienhütte, Germany
| | | | - Andreas F H Pfeiffer
- Department of Endocrinology, Diabetes and Nutritional Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Marie-Christine Simon
- Institute of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Astrid Tombek
- Diabetes Centre Bad Mergentheim, Bad Mergentheim, Germany
| | - Katharina S Weber
- Institute for Epidemiology, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Diana Rubin
- Vivantes Hospital Spandau, Berlin, Germany
- Vivantes Humboldt Hospital, Berlin, Germany
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14
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Otoo ET, Tandoh MA, Mills-Robertson FC. Effect of Alchornea cordifolia on Glycemic Indices of Varieties of Fufu Among Healthy Subjects. Curr Dev Nutr 2024; 8:102076. [PMID: 38328775 PMCID: PMC10847058 DOI: 10.1016/j.cdnut.2024.102076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/29/2023] [Accepted: 01/04/2024] [Indexed: 02/09/2024] Open
Abstract
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.
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Affiliation(s)
- Eunice T Otoo
- Department of Biochemistry and Biotechnology (Human Nutrition and Dietetics), College of Science, PMB, KNUST, Kumasi, Ghana
| | - Marina A Tandoh
- Department of Biochemistry and Biotechnology (Human Nutrition and Dietetics), College of Science, PMB, KNUST, Kumasi, Ghana
| | - Felix C Mills-Robertson
- Department of Biochemistry and Biotechnology (Microbiology), College of Science, PMB, KNUST, Kumasi, Ghana
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15
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Yang Y, Liu Q, Yue F. Glycemic Response in Nonhuman Primates Fed Gluten-Free Rice Cakes Enriched with Soy, Pea, or Rice Protein and Its Correlation with Nutrient Composition. Nutrients 2024; 16:234. [PMID: 38257126 PMCID: PMC10818726 DOI: 10.3390/nu16020234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/01/2024] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
Celiac disease (CD) is a chronic disease caused by the consumption of gluten foods and is closely related to type 1 diabetes (T1D). Adherence to a gluten-free (GF) diet is the cornerstone of treating CD, and certain plant proteins added to GF foods affect blood glucose to varying degrees. The aim of this study was to analyze and compare the changes in glycemic index (GI) and incremental area under the postprandial glucose tolerance curve (IAUC) of various foods through consumption of GF foods supplemented with certain plant proteins in non-human primates. The test foods were GF rice cakes with 5%, 10%, and 15% added single plant proteins (rice protein, soy protein, and pea protein) mixed with rice flour, as well as 5%, 10%, and 15% gluten rice cakes, and rice flour alone, for a total of 13 food items, and 12 healthy cynomolgus monkeys were examined for their glucose levels in the blood after fasting and after eating each test food (50 g) for 15, 30, 45, 60, 90, and 120 min after fasting and eating each test food. Fingertip blood glucose levels were measured, and the nutrient content of each food, including protein, fat, starch, ash, and amino acids, was examined. All foods tested had a low GI (<50) when analyzed using one-way ANOVA and nonparametric tests. Postprandial IAUC was significantly lower (p < 0.05) for GF rice cakes with 15% pea protein (499.81 ± 34.46) compared to GF rice cakes with 5% pea protein (542.19 ± 38.78), 15% soy protein (572.94 ± 72.74), and 15% rice protein (530.50 ± 14.65), and GF rice cakes with 15% wheat bran protein (533.19 ± 34.89). A multiple regression analysis showed that glycine was negatively associated with IAUC in GF rice cakes with 5%, 10%, and 15% pea protein added (p = 0.0031 < 0.01). Fat was negatively correlated with IAUC in GF rice cakes supplemented with 5%, 10%, and 15% soy protein (p = 0.0024 < 0.01). In this study, GF rice cakes made with added pea protein were superior to other gluten and GF rice cakes and had a small effect on postprandial glucose.
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Affiliation(s)
- Yong Yang
- State Key Laboratory of Digital Medical Engineering, School of Biomedical Engineering, Hainan University, Sanya 572025, China;
- Collaborative Innovation Center of One Health, Hainan University, Haikou 570228, China
| | - Qingsu Liu
- Food, Water, Waste Research Group, Faculty of Engineering, The University of Nottingham, University Park Campus, Nottingham NG7 2RD, UK;
| | - Feng Yue
- State Key Laboratory of Digital Medical Engineering, School of Biomedical Engineering, Hainan University, Sanya 572025, China;
- Collaborative Innovation Center of One Health, Hainan University, Haikou 570228, China
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16
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Wong MMH, Yuen-Man Chan M, Ng TP, Louie JCY. Impact of carbohydrate quantity and quality on maternal and pregnancy outcomes in gestational diabetes mellitus: A systematic review and meta-analysis. Diabetes Metab Syndr 2024; 18:102941. [PMID: 38218096 DOI: 10.1016/j.dsx.2024.102941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 12/14/2023] [Accepted: 01/01/2024] [Indexed: 01/15/2024]
Abstract
OBJECTIVE To evaluate the impact of carbohydrate quantity and quality on maternal and pregnancy outcomes in gestational diabetes mellitus. METHODS Using a pre-defined search strategy, two researchers systematically searched MEDLINE, CINAHL Plus, and PubMed for randomized controlled trials comparing low-carbohydrate, low-glycaemic index, or low-glycaemic load diets with usual care in gestational diabetes mellitus. Mean differences and risk ratios were extracted. RESULTS Thirteen studies with 877 participants were included. Low-carbohydrate diet did not significantly differ from usual care for fasting blood glucose (3 studies; mean difference: 1.60 mmol/L; 95 % confidence interval: -1.95, 5.15), insulin requirement (2 studies; risk ratio: 1.01; 95 % confidence interval: 0.31, 3.05), birthweight (4 studies; mean difference: -0.23 kg; 95 % confidence interval: -1.90, 1.45), caesarean delivery (5 studies; risk ratio: 1.11; 95 % confidence interval: 0.66, 1.85), macrosomia (3 studies; risk ratio: 0.35; 95 % confidence interval: 0.00, 2130.64), large-for-gestational-age (2 studies; risk ratio: 0.46; 95 % confidence interval: 0.03, 7.20), and small-for-gestational-age infants (2 studies; risk ratio: 0.94; 95 % confidence interval: 0.00, 231.18). Low-glycaemic index diet did not significantly differ from usual care for the above outcomes either. However, low-glycaemic load diet reduced macrosomia risk (2 studies; risk ratio: 0.51; 95 % confidence interval: 0.43, 0.59). CONCLUSIONS Low-carbohydrate and low-glycaemic index diets do not differ from usual care for most maternal and foetal outcomes in gestational diabetes mellitus. But low-glycaemic load diet may reduce macrosomia risk.
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Affiliation(s)
- Martin Ming Him Wong
- School of Professional and Continuing Education, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Mandy Yuen-Man Chan
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Tsoi Pan Ng
- School of Biological Sciences, Faculty of Science, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Jimmy Chun Yu Louie
- School of Biological Sciences, Faculty of Science, The University of Hong Kong, Hong Kong Special Administrative Region, China; Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia.
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Guo J, Ellis A, Zhang Y, Kong L, Tan L. Starch-ascorbyl palmitate inclusion complex, a type 5 resistant starch, reduced in vitro digestibility and improved in vivo glycemic response in mice. Carbohydr Polym 2023; 321:121289. [PMID: 37739525 DOI: 10.1016/j.carbpol.2023.121289] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 07/19/2023] [Accepted: 08/09/2023] [Indexed: 09/24/2023]
Abstract
The prevalence of type 2 diabetes (T2D) has become a major public health concern worldwide. Slowly digested or indigestible carbohydrates such as resistant starch (RS) are associated with a low glycemic index (GI) and the decreased risk of developing T2D. Recently, starch inclusion complexes (ICs) have raised attention due to their thermally stable structure and high RS content. In this study, starch-ascorbyl palmitate (AP) ICs were produced using two different methods with hydrothermal treatments performed, and their in vitro digestion kinetics and in vivo glycemic response in C57BL/6J mice were investigated to determine their potential as a new type of RS, i.e., RS5. After treatments of annealing followed by acid hydrolysis (ANN-ACH), IC samples produced by both methods retained V-type crystalline structure. Either in their raw or treated conditions, V6h-AP ICs prepared using the "empty" V-type method exhibited a more favorable hydrolysis pattern as compared to its counterpart produced by the DMSO method in terms of a lower hydrolysis rate and equilibrium concentration (C∞) (p < 0.05). From the in vitro results, the ANN-ACH treated V6h-AP IC exhibited an estimated GI (eGI) value of 54.83, falling within the range of low GI foods and was the lowest among all tested samples (p < 0.05). Consistent with the in vitro digestion kinetics, the in vivo results showed that mice fed with ANN-ACH V6h-AP IC exhibited a modest glycemic response as evidenced by the lowest increase in postprandial blood glucose and AUC blood glucose (p < 0.05). In addition, the in vivo GI of the ANN-ACH V6h-AP IC (39.53) was the lowest among all the sample treatments and was even lower than that of the RS2 comparison (56, p < 0.05), indicating its more pronounced effect in modulating the postprandial glycemic response in mice and great potential as a new RS5.
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Affiliation(s)
- Jiayue Guo
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa, AL 35487, USA
| | - Amy Ellis
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa, AL 35487, USA
| | - Yanqi Zhang
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa, AL 35487, USA
| | - Lingyan Kong
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa, AL 35487, USA.
| | - Libo Tan
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa, AL 35487, USA.
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Zanini AC, Santos HD, Celes APM, Giuntini EB, Franco BDGDM. Determination of glycaemic response to the consumption of two specialised formulas for glycaemic control. Br J Nutr 2023; 130:1137-1143. [PMID: 36690581 DOI: 10.1017/s0007114523000144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
To assess the glycaemic response after ingestion of two specialised oral and enteral nutrition formulas for glycaemic control. The participants were sixteen healthy volunteers, aged 21-49 years, with normal glucose tolerance. The volunteers attended the tests fasting for 10 h, for 5 weeks, and consumed the reference food - glucose solution - for 3 weeks, and the two formulas DiamaxO and DiamaxIG in the following weeks, in amounts equivalent to 25 g of available carbohydrates. During the period of 120 min, seven blood samples were taken through capillary blood sampling to determine the glycaemic response. The glycaemic index (GI) was calculated according to the trapezoidal rule, ignoring areas below the fasting line. The glycaemic load (GL) was determined by the formula GL = ((GI(glucose = reference) × 'g' of available carbohydrate per serving]/100. The formulas showed low GI and GL. GI = 37·8 and GL = 6·6 for DiamaxO and GI = 21·5 and GL = 3·5 for DiamaxIG. The peak of the glycaemic response occurred 30 min after ingestion, with a marked difference in blood glucose between the Diamax products in relation to glucose. Differences were also significant at times 15, 45, 60 and 90 min in relation to glucose (ANOVA with post hoc Bonferroni, P < 0·005), but not between the two products. However, the AUC and the GI of DiamaxIG are significantly smaller than that of the DiamaxO second t test (P = 0·0059). The glycaemic response to the products is quite reduced, presenting a curve with a little accentuated shape, without high peak, especially in the modified product.
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Jing T, Zhang S, Bai M, Chen Z, Gao S, Li S, Zhang J. Effect of Dietary Approaches on Glycemic Control in Patients with Type 2 Diabetes: A Systematic Review with Network Meta-Analysis of Randomized Trials. Nutrients 2023; 15:3156. [PMID: 37513574 PMCID: PMC10384204 DOI: 10.3390/nu15143156] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Dietary patterns play a critical role in diabetes management, while the best dietary pattern for Type 2 diabetes (T2DM) patients is still unclear. The aim of this network meta-analysis was to compare the impacts of various dietary approaches on the glycemic control of T2DM patients. METHODS Relevant studies were retrieved from PubMed, Embase, Web of Knowledge, Cochrane Central Register of Controlled Trials (CENTRAL), and other additional records (1949 to 31 July 2022). Eligible RCTs were those comparing different dietary approaches against each other or a control diet in individuals with T2DM for at least 6 months. We assessed the risk of bias of included studies with the Cochrane risk of bias tool and confidence of estimates with the Grading of Recommendations Assessment, Development, and Evaluation approach for network meta-analyses. In order to determine the pooled effect of each dietary approach relative to each other, we performed a network meta-analysis (NMA) for interventions for both HbA1c and fasting glucose, which enabled us to estimate the relative intervention effects by combing both direct and indirect trial evidence. RESULTS Forty-two RCTs comprising 4809 patients with T2DM were included in the NMA, comparing 10 dietary approaches (low-carbohydrate, moderate-carbohydrate, ketogenic, low-fat, high-protein, Mediterranean, Vegetarian/Vegan, low glycemic index, recommended, and control diets). In total, 83.3% of the studies were at a lower risk of bias or had some concerns. Findings of the NMA revealed that the ketogenic, low-carbohydrate, and low-fat diets were significantly effective in reducing HbA1c (viz., -0.73 (-1.19, -0.28), -0.69 (-1.32, -0.06), and -1.82 (-2.93, -0.71)), while moderate-carbohydrate, low glycemic index, Mediterranean, high-protein, and low-fat diets were significantly effective in reducing fasting glucose (viz., -1.30 (-1.92, -0.67), -1.26 (-2.26, -0.27), -0.95 (-1.51, -0.38), -0.89 (-1.60, -0.18) and -0.75 (-1.24, -0.27)) compared to a control diet. The clustered ranking plot for combined outcomes indicated the ketogenic, Mediterranean, moderate-carbohydrate, and low glycemic index diets had promising effects for controlling HbA1c and fasting glucose. The univariate meta-regressions showed that the mean reductions of HbA1c and fasting glucose were only significantly related to the mean weight change of the subjects. CONCLUSIONS For glycemic control in T2DM patients, the ketogenic diet, Mediterranean diet, moderate-carbohydrate diet, and low glycemic index diet were effective options. Although this study found the ketogenic diet superior, further high-quality and long-term studies are needed to strengthen its credibility.
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Affiliation(s)
- Tiantian Jing
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.J.)
| | - Shunxing Zhang
- Department of Global Public Health/Media, Culture, and Communication, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY 10016, USA
| | - Mayangzong Bai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.J.)
| | - Zhongwan Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.J.)
| | - Sihan Gao
- School of Public Health, University of Washington Seattle Campus, Seattle, WA 98105, USA
| | - Sisi Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.J.)
| | - Jing Zhang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.J.)
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20
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Wasana KGP, Attanayake AP, Weerarathna TP, Amarasekera DABN, Jayatilaka KAPW. Association of dietary intake with body mass index and glycemic profile among newly diagnosed patients with type 2 diabetes mellitus. Am J Hum Biol 2023; 35:e23870. [PMID: 36695499 DOI: 10.1002/ajhb.23870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/25/2022] [Accepted: 01/10/2023] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Dietary intake plays an important role in determining body mass index (BMI) and glycemic profile in patients with type 2 diabetes mellitus (T2DM). Our aim was to describe habitual dietary intake and its associations with BMI and glycemic profile in a cohort of patients with newly diagnosed T2DM in Sri Lanka. METHODS A cross-sectional study was carried out among 158 patients with newly diagnosed T2DM in Galle, Sri Lanka. Data on demographic, lifestyle, and family history of diabetes mellitus, and clinical measures were collected. The dietary information was collected using a 24-h dietary recall. RESULTS Among the total number of study subjects, only 12.0%, 5.7% and 1.3% met the recommended daily consumption value of protein, fat, and fiber, respectively, whereas 99.4% of subjects had taken carbohydrates that exceeded the recommended consumption. There was a positive association between carbohydrate intake and BMI (0.004, [0.002], p = .048) and carbohydrate intake and glycated hemoglobin (HbA1C ) (0.001, [0.000], p = .049). Fat intake showed positive associations with BMI (0.029, [0.011], p = .006) and HbA1C (0.005, [0.002], p = .050). Protein intake showed a positive association with HbA1C (0.006, [0.003], p = .023). The aforementioned associations were observed after adjusting for demographic, lifestyle, and history of diabetes among the first-degree family members. The carbohydrate intake was positively associated with BMI (0.010, [0.003], p = .003) and HbA1C (0.001, [0.000], p = .050) with further adjustment in nutrient intake (except when used as an independent variable). Furthermore, the fat intake was associated with BMI (0.031, [0.011], p = .004) and HbA1C (0.005 [0.002], p = .050) with additional adjustments. CONCLUSIONS The diet of the majority of newly diagnosed T2DM patients in this cohort consisted of a higher carbohydrate intake than the recommended level. However, they did not meet the recommended daily intake of protein, fat, and fiber. Both carbohydrate and fat intake were significantly and positively associated with BMI and HbA1C in patients with newly diagnosed T2DM.
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21
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Silva ML, Rita K, Bernardo MA, Mesquita MFD, Pintão AM, Moncada M. Adansonia digitata L. (Baobab) Bioactive Compounds, Biological Activities, and the Potential Effect on Glycemia: A Narrative Review. Nutrients 2023; 15:2170. [PMID: 37432337 DOI: 10.3390/nu15092170] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/25/2023] [Accepted: 04/27/2023] [Indexed: 07/12/2023] Open
Abstract
Adansonia digitata L. fruit, also known as baobab, has been used traditionally throughout the world for its medicinal properties. Ethnopharmacological uses of various plant parts have been reported for hydration, antipyretic, antiparasitic, antitussive, and sudorific properties and also in the treatment of diarrhea and dysentery in many African countries. Several studies have revealed that in addition to these applications, baobab has antioxidant, anti-inflammatory, analgesic, and antimicrobial activities. The health benefits of baobab have been attributed to its bioactive compounds, namely phenols, flavonoids, proanthocyanins, tannins, catechins, and carotenoids. Baobab fruit is also an important source of vitamin C and micronutrients, including zinc, potassium, magnesium, iron, calcium, and protein, which may reduce nutritional deficiencies. Despite scientific studies revealing that this fruit has a wide diversity of bioactive compounds with beneficial effects on health, there is a gap in the review of information about their mechanisms of action and critical analysis of clinical trials exploring, in particular, their effect on glycemia regulation. This work aims to present a current overview of the bioactive compounds, biological activities, and effects of A. digitata fruit on blood glucose, highlighting their potential mechanisms of action and effects on glycemia regulation, evaluated in recent animal and human trials.
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Affiliation(s)
- Maria Leonor Silva
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511 Caparica, Portugal
| | - Keyla Rita
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511 Caparica, Portugal
| | - Maria Alexandra Bernardo
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511 Caparica, Portugal
| | - Maria Fernanda de Mesquita
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511 Caparica, Portugal
| | - Ana Maria Pintão
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511 Caparica, Portugal
| | - Margarida Moncada
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511 Caparica, Portugal
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22
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Khadem A, Shiraseb F, Mirzababaei A, Noori S, Mirzaei K. Association of Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and metabolically unhealthy overweight/obesity phenotypes among Iranian women: a cross sectional study. BMC Endocr Disord 2023; 23:84. [PMID: 37076804 PMCID: PMC10114364 DOI: 10.1186/s12902-023-01333-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 04/05/2023] [Indexed: 04/20/2023] Open
Abstract
PURPOSE Paradoxes have been found in obesity, including individuals with metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO), and diet may be one of the reasons for the creation of these metabolic phenotypes. Hence, the purpose of the present study was to investigate the association of the Mediterranean-DASH intervention for neurodegenerative delay (MIND) diet with metabolically unhealthy overweight/obesity (MUHOW/O) phenotypes. METHODS In this cross-sectional study, 229 overweight and obese women (body mass index (BMI) ≥ 25 kg/m2) aged 18-48 years were examined. Anthropometric measures and biochemical parameters were collected from all participants. The body composition of each participant was assessed using a bioelectrical impedance analyzer (BIA). The MIND diet score was determined based on 15 components using a valid and reliable food frequency questionnaire (FFQ) containing 147 items. Karelis criteria was used to determine metabolically healthy/unhealthy phenotype (MH/MUH). RESULTS Among the participants, 72.5% of individuals were identified as MUH and 27.5% as MH, with a mean ± standard deviation (SD) age of 36.16 (8.33) years. The results of our analysis showed that after controlling for age, energy intake, BMI, and physical activity, there was no significant association observed between overweight/obesity phenotypes with tertile 2 (T2) (OR: 2.01, 95% CI: 0.86-4.17, P-value = 0.10), T3 (OR: 1.89, 95% CI: 0.86-4.17, P-value = 0.11) of MIND score, and only the odds of MUH relative to MH with a marginal significant decreasing trend was observed from the second to the third tertile (1.89 vs. 2.01) (P - trend = 0.06). Also, after additional adjustment for marital status, the nonsignificant association between overweight/obesity phenotypes with tertile 2 (T2) (OR: 2.13, 95% CI: 0.89-5.10, P-value = 0.08), T3 (OR: 1.87, 95% CI: 0.83-4.23, P-value = 0.12) of MIND score remained, and the odds of MUH relative to MH with a significant decreasing trend was observed with increasing tertiles (P-trend = 0.04). CONCLUSIONS In conclusion, no significant associations were found between adherence to MIND diet with MUH, and only a significant downward trend in the odds of MUH was observed with increasing tertiles. We suggest further studies in this field.
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Affiliation(s)
- Alireza Khadem
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sahar Noori
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
- Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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23
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Arora N, Pulimamidi S, Yadav H, Jain S, Glover J, Dombrowski K, Hernandez B, Sarma AK, Aneja R. Intermittent fasting with ketogenic diet: A combination approach for management of chronic diseases. Clin Nutr ESPEN 2023; 54:166-174. [PMID: 36963859 DOI: 10.1016/j.clnesp.2023.01.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/21/2023] [Indexed: 01/30/2023]
Abstract
Intermittent Fasting (IF) is the consumption of food and drinks within a defined time, while the ketogenic diet (KD) switches the metabolism from glucose to fats. Continuation of intermittent fasting leads to the generation of ketones, the exact mechanism for a ketogenic diet. This article discusses the types of IF and KD, the monitoring required, and the mechanisms underlying IF and KD, followed by disorders in which the combination strategy could be applied. The strategies for successfully applying combination therapy are included, along with recommendations for the primary care physicians (PCP) which could serve as a handy guide for patient management. This opinion article could serve as the baseline for future clinical studies since there is an utmost need for developing new wholesome strategies for managing chronic disorders.
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Affiliation(s)
- Niraj Arora
- Department of Neurology, University of Missouri, Columbia, MO, United States.
| | - Shruthi Pulimamidi
- Department of Neurology, University of Missouri, Columbia, MO, United States
| | - Hariom Yadav
- USF Center for Microbiome Research, Microbiomes Institute, University of South Florida, Tampa, FL, United States
| | - Shalini Jain
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, United States
| | - Jennifer Glover
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, United States
| | - Keith Dombrowski
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, United States
| | - Beverly Hernandez
- Clinical Nutrition Services, Tampa General Hospital, Tampa, FL, United States
| | - Anand Karthik Sarma
- Department of Neurology, Atrium Health Wake Forest Baptist, Winston-Salem, NC, United States
| | - Rachna Aneja
- Department of Neurology, University of Missouri, Columbia, MO, United States
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24
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Qiu M, Zhang Y, He Y. Reply to Henschel et al. Comment on "Qiu et al. Effect of Protein-Rich Breakfast on Subsequent Energy Intake and Subjective Appetite in Children and Adolescents: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2021, 13, 2840". Nutrients 2023; 15:1656. [PMID: 37049498 PMCID: PMC10096911 DOI: 10.3390/nu15071656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/13/2023] [Indexed: 04/03/2023] Open
Abstract
We want to thank Henschel et al. [...].
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Affiliation(s)
- Meijuan Qiu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Yu Zhang
- Department of Clinical Nutrition and Department of Health Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China
| | - Yuna He
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Xicheng District, Beijing 100050, China
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25
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Association of low-carbohydrate diet score and carbohydrate quality with visceral adiposity and lipid accumulation product. Br J Nutr 2023; 129:843-853. [PMID: 35570588 DOI: 10.1017/s000711452200143x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The present study examined the association between low-carbohydrate diet (LCD) score, glycemic index (GI), and glycemic load (GL) with visceral fat level (VFL) and lipid accumulation product (LAP). This cross-sectional study was conducted on 270 adults (118 men and 152 women) aged between 18-45 living in Tehran, Iran, between February 2017 and December 2018. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire (FFQ). Body composition were also assessed. We used analyses of covariance and binary logistic regression to explore associations after controlling for age, energy intake (model 1), education, smoking status, physical activity, occupation, marriage and metabolic diseases. There were no significant differences between tertiles of GI, GL and LCD for means of anthropometric measures, LAP and VFL index in men, while women in the highest tertile of GI and GL had significantly higher mean LAP in the crude model (P = 0·02) and model 1(P = 0·04), which disappeared after controlling for other confounders (P = 0·12). Moreover, the OR and CIs for having high LAP and VFL was not associated with dietary GI, GL and LCD in crude and adjusted models. However, chance of high VFL reduced by 65% and 57% among women with high adherence to LCD score (OR = 0·35, 95% CI = 0·16-0·78, P = 0·01) and model 1 (OR = 0·43, 95% CI = 0·18-1, P = 0·05), respectively. However, this significant association disappeared after controlling for other confounders (P = 0·07). Overall, we found carbohydrate quality and LCD score are not associated with LAP and VFL index. However, gender-specific relationship should not be neglect and warrants further investigation.
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26
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Zarasvand SA, Mullins AP, Arjmandi B, Haley-Zitlin V. Antidiabetic properties of mango in animal models and humans: A systematic review. Nutr Res 2023; 111:73-89. [PMID: 36841190 DOI: 10.1016/j.nutres.2023.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 11/25/2022] [Accepted: 01/21/2023] [Indexed: 01/30/2023]
Abstract
Mango has long been an attractive source of nutrition and pharmacological therapeutics. The mango plant (Mangifera indica L.) contains bioactive compounds that may have antidiabetic properties. This systematic review investigated the evidence for antidiabetic properties of the different parts of the mango plant in managing type 2 diabetes mellitus in animal models and humans. The electronic databases PubMed, FSTA, Web of Science, CINAHL, MEDLINE, and Cochrane Library were systematically searched to identify articles with clear objectives and methodologies available in the English language with publication date limits up to December 2020. Twenty-eight of 1001 animal and human studies met the inclusion criteria that investigated antidiabetic properties of mango from leaf (31%), flesh (38%), seed-kernel (7%), peel (14%), stem-bark (7%), and by-product (3%). Results support the glucose-lowering properties of mango in both animals and human. Proposed antidiabetic mechanisms of action include inhibition of α-amylase and α-glucosidase, improved antioxidant status, improved insulin sensitivity, facilitated glucose uptake, and gene regulation of glucose transporter type 4, insulin receptor substrate 1, and phosphoinositide 3-kinase. The animal and randomized control trial findings suggest that mango may be beneficial as an antidiabetic agent. Although these studies hold promise, additional observational studies and randomized control trials are required because human studies are significantly fewer in number, use mango flesh almost exclusively, and had modest blood glucose effects. Additional research gaps include identifying the mechanisms of action for the different components of the mango plant.
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Affiliation(s)
| | - Amy P Mullins
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL 32306, USA; Department of Family and Consumer Sciences-Leon County Extension Services, University of Florida Institute of Food and Agricultural Sciences, Tallahassee, FL 32301, USA.
| | - Bahram Arjmandi
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL 32306, USA.
| | - Vivian Haley-Zitlin
- Department of Food, Nutrition, and Packaging Sciences, Clemson University, Clemson, SC 29634-0316, USA.
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27
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Perler BK, Friedman ES, Wu GD. The Role of the Gut Microbiota in the Relationship Between Diet and Human Health. Annu Rev Physiol 2023; 85:449-468. [PMID: 36375468 DOI: 10.1146/annurev-physiol-031522-092054] [Citation(s) in RCA: 123] [Impact Index Per Article: 61.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The interplay between diet, the gut microbiome, and host health is complex. Diets associated with health have many similarities: high fiber, unsaturated fatty acids, and polyphenols while being low in saturated fats, sodium, and refined carbohydrates. Over the past several decades, dietary patterns have changed significantly in Westernized nations with the increased consumption of calorically dense ultraprocessed foods low in fiber and high in saturated fats, salt, and refined carbohydrates, leading to numerous negative health consequences including obesity, metabolic syndrome, and cardiovascular disease. The gut microbiota is an environmental factor that interacts with diet and may also have an impact on health outcomes, many of which involve metabolites produced by the microbiota from dietary components that can impact the host. This review focuses on our current understanding of the complex relationship between diet, the gut microbiota, and host health, with examples of how diet can support health, increase an individual's risk for disease, and be used as a therapy for specific diseases.
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Affiliation(s)
- Bryce K Perler
- Division of Gastroenterology and Hepatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA;
| | - Elliot S Friedman
- Division of Gastroenterology and Hepatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA;
| | - Gary D Wu
- Division of Gastroenterology and Hepatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA;
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28
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Ribet L, Dessalles R, Lesens C, Brusselaers N, Durand-Dubief M. Nutritional benefits of sourdoughs: A systematic review. Adv Nutr 2023; 14:22-29. [PMID: 36811591 PMCID: PMC10103004 DOI: 10.1016/j.advnut.2022.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 09/14/2022] [Accepted: 10/05/2022] [Indexed: 12/23/2022] Open
Abstract
Food fermentation using sourdough-i.e., consortia of lactic bacteria and yeasts-is increasingly considered among the public as a natural transformation yielding nutritional benefits; however, it is unclear whether its alleged properties are validated by science. The aim of this study was to systematically review the clinical evidence related to the effect of sourdough bread on health. Bibliographic searches were performed in 2 different databases (The Lens and PubMed) up to February 2022. Eligible studies were randomized controlled trials involving adults, healthy or not, given any type of sourdough bread compared with those given any type of yeast bread. A total of 573 articles were retrieved and investigated, of which 25 clinical trials met the inclusion criteria. The 25 clinical trials included a total of 542 individuals. The main outcomes investigated in the retrieved studies were glucose response (N = 15), appetite (N = 3), gastrointestinal markers (N = 5), and cardiovascular markers (N = 2). Overall, it is currently difficult to establish a clear consensus with regards to the beneficial effects of sourdough per se on health when compared with other types of bread because a variety of factors, such as the microbial composition of sourdough, fermentation parameters, cereals, and flour types potentially influence the nutritional properties of bread. Nonetheless, in studies using specific strains and fermentation conditions, significant improvements were observed in parameters related to glycemic response, satiety, or gastrointestinal comfort after bread ingestion. The reviewed data suggest that sourdough has great potential to produce a variety of functional foods; however, its complex and dynamic ecosystem requires further standardization to conclude its clinical health benefits.
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Affiliation(s)
- Léa Ribet
- Baking Science, Lesaffre Institute of Science & Technology, Lesaffre, Marcq-en-Barœul, France
| | | | - Corinne Lesens
- Baking Science, Lesaffre Institute of Science & Technology, Lesaffre, Marcq-en-Barœul, France
| | - Nele Brusselaers
- Global Health Institute, Antwerp University, Antwerp, Belgium; Centre for Translational Microbiome Research (CTMR), Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, Karolinska Hospital, Stockholm, Sweden; Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Mickaël Durand-Dubief
- Discovery & Front End Innovation, Lesaffre Institute of Science & Technology, Lesaffre, Marcq-en-Barœul, France.
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29
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Gluten-Free Diet in Co-Existent Celiac Disease and Type 1 Diabetes Mellitus: Is It Detrimental or Beneficial to Glycemic Control, Vascular Complications, and Quality of Life? Nutrients 2022; 15:nu15010199. [PMID: 36615856 PMCID: PMC9824312 DOI: 10.3390/nu15010199] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/03/2023] Open
Abstract
Celiac disease (CeD) is associated with type 1 diabetes mellitus (T1DM), and both have the same genetic background. Most patients with T1DM who develop CeD are either asymptomatic or have mild CeD-related gastrointestinal symptoms. Therefore, children affected by T1DM should undergo screening for asymptomatic CeD. The aim of this review is to highlight the influence of a gluten-free diet (GFD) on glycemic control, growth rate, microvascular complications, and quality of life in patients with T1DM and CeD. PubMed, Google Scholar, Web of Science, and Cochrane Central databases were searched. Reports reviewed were those published from 1969 to 2022 that focused on the interplay of T1DM and CeD and examined the effect of diet on glycemic control, growth rate, and quality of life. The most challenging aspect for a child with T1DM and CeD is that most GFD foods have a high glycemic index, while low glycemic index foods are recommended for T1DM. Interestingly, dietary therapy for CeD could improve the elevated HbA1c levels. Avoiding gluten added to a diabetic dietary regimen in T1DM patients might impose practical limitations and lead to important restrictions in the lifestyle of a young patient. Consequently, non-adherence to GFD in patients with T1DM and CeD is common. GFD in patients with T1DM and CeD seems to lower the incidence of micro- and macrovascular complications, but this requires further investigation. It seems that adherence to GFD in young patients with T1DM and CeD leads to regular growth and a stable body mass index without any negative effect on HbA1c or insulin requirements. Furthermore, the lipid profile and quality of life seem to have improved with the introduction of GFD.
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30
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Self-Reported Dietary Management Behaviors and Dietary Intake among Chinese Adults with Diabetes: A Population-Based Study. Nutrients 2022; 14:nu14235178. [PMID: 36501208 PMCID: PMC9740534 DOI: 10.3390/nu14235178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/25/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
Few studies have analyzed the implementation of dietary management in Chinese adults with diabetes. Thus, we assessed and compared dietary intake and diet quality between diabetic patients with and without dietary management behaviors (DPDM vs. NDPDM), and evaluated the adherence to dietary guidelines in both groups of patients. The data were obtained from the 2002, 2010-2013, and 2015 China National Nutrition Survey. A total of 69,583, 67,177, and 96,631 subjects participated in the 2002, 2010-2013, and 2015 survey rounds, respectively. The dietary intake data were measured using 3-day 24 h dietary recalls and weighed records of household condiments. The China Healthy Diet Index (CHDI) was used to evaluate diet quality. The study included 6229 patients with diabetes, of which 78% had dietary management behaviors. The diabetic patients with dietary management behaviors showed higher percentages of energy from high-quality carbohydrates, animal protein, saturated fatty acids, and unsaturated fatty acids and lower percentages from low-quality carbohydrates and plant protein than NDPDM. The diabetic patients with dietary management behaviors also had lower intakes of cereals and tubers and higher intakes of vegetables than NDPDM. The total CHDI score of DPDM was higher than NDPDM (56.3 ± 12.7 vs. 54.1 ± 12.3). The proportion of DPDM meeting the recommended intake for different food items ranged from 3.3% to 42.8% and from 3.0% to 39.2% in NDPDM. The diabetic patients with dietary management behaviors showed better adherence to dietary guidelines and higher diet quality scores than NDPDM, while the overall adherence was poor in both groups of patients. Our findings suggested that measures are needed to promote and refine dietary management behaviors, which can help to improve disease management in diabetic patients.
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Annan SF, Higgins LA, Jelleryd E, Hannon T, Rose S, Salis S, Baptista J, Chinchilla P, Marcovecchio ML. ISPAD Clinical Practice Consensus Guidelines 2022: Nutritional management in children and adolescents with diabetes. Pediatr Diabetes 2022; 23:1297-1321. [PMID: 36468223 DOI: 10.1111/pedi.13429] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 09/30/2022] [Indexed: 12/07/2022] Open
Affiliation(s)
- S Francesca Annan
- Paediatric Division, University College London Hospitals, London, UK
| | - Laurie A Higgins
- Pediatric, Adolescent and Young Adult Section, Joslin Diabetes Center, Boston, Massachusetts, USA
| | - Elisabeth Jelleryd
- Medical Unit Clinical Nutrition, Karolinska University Hospital, Stockholm, Sweden
| | - Tamara Hannon
- School of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Shelley Rose
- Diabetes & Endocrinology Service, MidCentral District Health Board, Palmerston North, New Zealand
| | - Sheryl Salis
- Department of Nutrition, Nurture Health Solutions, Mumbai, India
| | | | - Paula Chinchilla
- Women's and Children's Department, London North West Healthcare NHS Trust, London, UK
| | - Maria Loredana Marcovecchio
- Department of Paediatrics, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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32
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Fiore G, Magenes VC, DI Profio E, Milanta C, Calcaterra V, Diamanti A, Campoy C, Zuccotti G, Verduci E. Gut microbiota in obesity and related comorbidities in children and adolescents: the role of biotics in treatment. Minerva Pediatr (Torino) 2022; 74:632-649. [PMID: 35708037 DOI: 10.23736/s2724-5276.22.06964-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Obesity is a complex pathology, globally spread, with a multifactorial pathogenesis, strictly linked with lifestyle, hormones, genetic and epigenetic factors. Evidence supports that obesity, and its comorbidities, are related to changes in gut microbiota, partially responsible of the modulation of energy metabolism. EVIDENCE ACQUISITION Pediatric obesity has been associated with lower bacterial diversity and differences in composition of the gut microbiota, also varying according to the metabolic status of obese subjects. Indeed, differences in distributions and activity of microorganisms in the gut of metabolically healthy and unhealthy obese children have been highlighted. EVIDENCE SYNTHESIS Based on human studies, this review aims to discuss gut microbiota alterations in obese children and adolescents and its role in obese-related complications. Moreover, the role of biotics (probiotics, prebiotics, synbiotics and -marginally- postbiotics) has been analyzed as modulator of obesity-related dysbiosis. CONCLUSIONS As a conclusion, a deeper knowledge about biotic mechanisms of action would be of great interest to implement the clinical care of children and adolescents with obesity and related comorbidities.
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Affiliation(s)
- Giulia Fiore
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Vittoria C Magenes
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Elisabetta DI Profio
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Chiara Milanta
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Valeria Calcaterra
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, Pavia, Italy
| | - Antonella Diamanti
- Unit of Hepatology Gastroenterology and Nutrition, Bambino Gesù Children's Hospital, Rome, Italy
| | - Cristina Campoy
- Centre of Excellence for Pediatric Research EURISTIKOS, Department of Pediatrics, University of Granada, Granada, Spain
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
- L. Sacco Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- Pediatric Clinical Research Center Fondazione Romeo ed Enrica Invernizzi, University of Milan, Milan, Italy
| | - Elvira Verduci
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy -
- Department of Health Sciences, University of Milan, Milan, Italy
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Influence of Some Spaghetti Processing Variables on Technological Attributes and the In Vitro Digestion of Starch. Foods 2022; 11:foods11223650. [PMID: 36429241 PMCID: PMC9689111 DOI: 10.3390/foods11223650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/07/2022] [Accepted: 11/13/2022] [Indexed: 11/18/2022] Open
Abstract
Durum semolina spaghetti is known to have a low-moderate glycaemic index but the impact of various processing variables during the manufacture and cooking of pasta does affect pasta structure and potentially could alter starch digestion. In this study, several process variables were investigated to see if they can impact the in vitro starch digestion in spaghetti while also monitoring the pasta’s technological quality. Cooking time had a large impact on pasta starch digestion and reducing cooking from fully cooked to al dente and using pasta of very high protein content (17%), reduced starch digestion extent. The semolina particle size distribution used to prepare pasta impacted pasta quality and starch digestion to a small extent indicating a finer semolina particle size (<180 µm) may promote a more compact structure and help to reduce starch digestion. The addition of a structural enzyme, Transglutaminase in the pasta formulae improved overcooking tolerance in low protein pasta comparable to high protein pasta with no other significant effects and had no effect on starch digestion over a wide protein range (8.6−17%). While cold storage of cooked pasta was expected to increase retrograded starch, the increase in resistant starch was minor (37%) with no consequent improvement in the extent of starch digestion. Varying three extrusion parameters (die temperature, die pressure, extrusion speed) impacted pasta technological quality but not the extent of starch digestion. Results suggest the potential to subtly manipulate the starch digestion of pasta through some processing procedures.
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Bilgic H, Sensoy I. Effect of psyllium and cellulose fiber addition on the structure and the starch digestibility of bread and crackers. FOOD STRUCTURE 2022. [DOI: 10.1016/j.foostr.2022.100302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Intake of Sugar Substitute Gummy Candies Benefits the Glycemic Response in Healthy Adults: A Prospective Crossover Clinical Trial. Gels 2022; 8:gels8100642. [PMID: 36286143 PMCID: PMC9601933 DOI: 10.3390/gels8100642] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 11/26/2022] Open
Abstract
Sugar reduction in food has attracted great health concerns worldwide. Gummies have been one of the most popular and highly favored candies due to their chewable properties, simplicity to swallow, and delicious taste. The general perception is that gummies raise blood sugar levels, but the truth is that gummies with the right formula can control glycemic response. The purpose of this study is to investigate the effects of the gummy dosage form and sugar types on the glycemic response control. Maltitol and erythritol as sweetener alternatives were applied in gummy candies (total and partial sugar substitutes gummy, T-SG and P-SG), with sucrose-based gummies used as comparisons (CG). A prospective crossover study was then conducted on 17 healthy adults. The effects of different types of gummies on glycemic response in healthy adults were evaluated on the basis of the participants’ glycemic index (GI) and glycemic load (GL) values. Every three-day interval, participants took CG, P-SG, T-SG, and glucose solution, respectively, and the theoretical glucose conversion content was kept the same in all groups for each trial. Each participant performed four tests with each sample and recorded the changes in blood glucose after food consumption. It was found that all three types of gummies slowed down subjects’ glycemic response when not taken in excess, and the improvement effect was in the trend of T-SG > P-SG > CG. Both P-SG and T-SG were low-GI candies (54.1 and 49.9). CG that was not consumed in excess of 17.2 g had a high GI (81.9) but a low GL (<10). Texture analysis and in vitro digestion were used to explore the effect of gummy matrix on glucose release. T-SG and P-SG retained a higher hardness and were less hydrolyzed to release glucose during digestion compared with CG. Additionally, experiments have revealed that gummies can reverse the poor glucose tolerance in women. In conclusion, gummies are a good carrier for dietary supplements due to their sustained-release characteristic of available carbohydrates and provide healthier options for people in control of glucose homeostasis.
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Camplain R, Teufel-Shone NI, Jiang L, Chang J, Manson SM. Change in physical activity, food choices and hemoglobin A1c among American Indians and Alaska Natives with type 2 diabetes. Prev Med Rep 2022; 29:101945. [PMID: 36161132 PMCID: PMC9502664 DOI: 10.1016/j.pmedr.2022.101945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/14/2022] [Accepted: 08/05/2022] [Indexed: 12/03/2022] Open
Abstract
At baseline, physically active participants with higher healthy food scores had lower HbA1c levels than non-active participants. Over the three-year period, women who increased physical activity and/or healthy food consumption had slightly decreased HbA1c. Changes in physical activity and HbA1c differed by gender. The prevalence of diabetes among American Indian and Alaska Native (AI/AN) adults is the highest of all United States racial/ethnic groups. Health behaviors, including regular physical activity and healthy food choices, are important components in the management of diabetes. We estimated the cross-sectional association between physical activity and healthy food scores, separately, and combined (PAHF) with hemoglobin A1c (HbA1c) over three years of the Special Diabetes Program for Indians-Healthy Heart demonstration project (SDPI-HH) intervention. The relationship between physical activity and food choices was also examined. Among 3,039 SDPI-HH participants at baseline, those reporting being physically active and having high healthy food scores had statistically significant lower HbA1c (mean = 7.67 ± 2.01) compared to inactive participants with low healthy food scores (7.90 ± 1.92). Among the 1,150 SDPI-HH participants who attended the three-year follow-up visit, participants who increased physical activity, consumption of healthy foods, or both had a larger decrease in HbA1c (β = -0.29, P = 0.03) over the study period compared to participants with no improvement in physical activity or increase in consuming healthy foods. This association was statistically significant among women (β = -0.35, P = 0.04) but not among men (β = -0.08, P = 0.70). Our findings indicated that an increase in healthier behaviors, including physical activity and healthy food choices, was associated with a small improvement in HbA1c in the subset of women who participated in the SDPI-HH through the three-year follow up. Although the decrease in HbA1c was small, physical activity and healthy food choices are important behaviors to incorporate into everyday life among AI/AN adults, particularly those with diabetes.
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Affiliation(s)
- Ricky Camplain
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, United States
- Corresponding author at: PO Box 4065, Northern Arizona University, Flagstaff 86011-4065, AZ.
| | - Nicolette I. Teufel-Shone
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, United States
| | - Luohua Jiang
- Department of Epidemiology, University of California, Irvine, CA, United States
| | - Jennifer Chang
- Department of Epidemiology, University of California, Irvine, CA, United States
| | - Spero M Manson
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Center, Aurora, CO, United States
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Goletzke J, Weber KS, Kössler T, Zaharia OP, Bódis K, Müssig K, Szendroedi J, Burkart V, Stutz B, Nöthlings U, Buyken AE, Roden M. Relative validity of a glycemic index extended food-frequency questionnaire. Nutr Metab Cardiovasc Dis 2022; 32:2310-2320. [PMID: 35973887 DOI: 10.1016/j.numecd.2022.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/15/2022] [Accepted: 07/11/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS The dietary glycemic index (GI) and glycemic load (GL) are increasingly recognized as important for the prevention and management of diabetes mellitus. To extend the portfolio of assessment methods for large-scale epidemiological studies, we propose a GI-specific addition to an already established FFQ. METHODS AND RESULTS The German version of the EPIC-FFQ was extended by GI-specific questions for major carbohydrate sources varying notably in GI (breakfast cereals, bread, pasta, rice, potato etc.). We performed relative validation analyses comparing the GI-extended FFQ to three to four 3-day weighted dietary records (3-d WDR) in 100 middle-aged individuals with diabetes mellitus participating in the German Diabetes Study (GDS). Level of agreement between the two methods was assessed by correlation and cross-classification analyses as well as Bland-Altman-Plots, conducted separately for women and men. Spearman correlation analysis for female participants suggested good agreement between the GI-extended FFQ and 3-d WDRs for energy adjusted dietary GL (r = 0.52, p = 0.0004). For both women and men, agreement with the estimations of dietary GI, GL (for men) and carbohydrates from low and higher-GI food sources from the GI-extended FFQ was acceptable (r: 0.28-0.45). Classification of the dietary GI and GL in the opposite quartile was <10% comparing the GI-extended FFQ and 3-d WDR. Bland-Altman plots suggested a tendency for an overestimation of the dietary GI from the GI-extended FFQ in the lower GI-ranges, particularly for men. CONCLUSION Compared to the 3-d WDR, the GI-extended FFQ showed a moderate to good relative validity for parameters of carbohydrate quality.
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Affiliation(s)
- Janina Goletzke
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, 33098 Paderborn, Germany
| | - Katharina S Weber
- Institute of Epidemiology, Kiel University, Kiel, Germany; Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
| | - Theresa Kössler
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Oana-Patricia Zaharia
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Kálmán Bódis
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Karsten Müssig
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Department of Internal Medicine, Gastroenterology and Diabetology, Niels Stensen Hospitals, Franziskus Hospital Harderberg, Georgsmarienhütte, Germany
| | - Julia Szendroedi
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Clinic for Endocrinology, Diabetology, Metabolic Diseases and Clinical Chemistry at Heidelberg University Hospital, Germany
| | - Volker Burkart
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
| | - Bianca Stutz
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, 33098 Paderborn, Germany
| | - Ute Nöthlings
- Institute of Nutrition and Food Sciences, Faculty of Agriculture, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Anette E Buyken
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, 33098 Paderborn, Germany.
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Papakonstantinou E, Galanopoulos K, Kapetanakou AE, Gkerekou M, Skandamis PN. Short-Term Effects of Traditional Greek Meals: Lentils with Lupins, Trahana with Tomato Sauce and Halva with Currants and Dried Figs on Postprandial Glycemic Responses-A Randomized Clinical Trial in Healthy Humans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11502. [PMID: 36141773 PMCID: PMC9517682 DOI: 10.3390/ijerph191811502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/31/2022] [Accepted: 09/10/2022] [Indexed: 06/16/2023]
Abstract
Low glycemic index (GI) diets have been associated with decreased chronic disease risk. In a randomized, cross-over study we investigated the GI and glycemic response to three traditional Greek mixed meals: Lentils, Trahana, and Halva. Twelve healthy, fasting individuals received isoglucidic test meals (25 g available carbohydrate) and 25 g glucose reference, in random order. GI was calculated and capillary blood glucose (BG) samples were collected at 0-120 min after meal consumption. Subjective appetite ratings were assessed. All three tested meals provided low GI values. Lentils GI was 27 ± 5, Trahana GI was 42 ± 6, and Halva GI was 52 ± 7 on glucose scale. Peak BG values were lowest for Lentils, followed by Trahana and then by Halva (p for all <0.05). Compared to the reference food, BG concentrations were significantly lower for all meals at all time-points (p for all <0.05). Lentils provided lower glucose concentrations at 30 and 45 min compared to Trahana (p for all <0.05) and at 30, 45, and 60 min compared to Halva (p for all <0.05). BG concentrations did not differ between Trahana and Halva at all time points. No differences were observed for fasting BG, time to peak rise for BG, and subjective appetite ratings. In conclusion, all three mixed meals attenuated postprandial glycemic response in comparison to glucose, which may offer advantages to glycemic control.
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Affiliation(s)
- Emilia Papakonstantinou
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 75 Iera Odos, 18855 Athens, Greece
| | - Konstantinos Galanopoulos
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 75 Iera Odos, 18855 Athens, Greece
- Laboratory of Food Quality Control and Hygiene, Department of Food Science and Human Nutrition, School of Food Science and Human Nutrition, 75 Iera Odos, 18855 Athens, Greece
| | - Anastasia E. Kapetanakou
- Laboratory of Food Quality Control and Hygiene, Department of Food Science and Human Nutrition, School of Food Science and Human Nutrition, 75 Iera Odos, 18855 Athens, Greece
| | - Maria Gkerekou
- Laboratory of Food Quality Control and Hygiene, Department of Food Science and Human Nutrition, School of Food Science and Human Nutrition, 75 Iera Odos, 18855 Athens, Greece
| | - Panagiotis N. Skandamis
- Laboratory of Food Quality Control and Hygiene, Department of Food Science and Human Nutrition, School of Food Science and Human Nutrition, 75 Iera Odos, 18855 Athens, Greece
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Dharmalingam M, Das R, Jain S, Gupta S, Gupta M, Kudrigikar V, Bachani D, Mehta S, Joglekar S. Impact of Partial Meal Replacement on Glycemic Levels and Body Weight in Indian Patients with Type 2 Diabetes (PRIDE): A Randomized Controlled Study. Diabetes Ther 2022; 13:1599-1619. [PMID: 35834107 PMCID: PMC9281377 DOI: 10.1007/s13300-022-01294-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/21/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Partial meal replacement (PMR) offers potential glycemic and weight control benefits in type 2 diabetes mellitus (T2DM) patients. We evaluated the clinical impact of PMR (diabetes-specific nutritional supplement [DSNS]) in overweight/obese Indian patients with T2DM. METHODS PRIDE, a 12-week, phase IV, open-label, multicenter study randomized (1:1) newly diagnosed T2DM patients (≤ 1 year) to either DSNS plus standard of care (SOC; diabetes treatment with dietary counseling) group (PMR) or SOC alone group (SOC). The primary endpoint was mean change in glycated hemoglobin (HbA1c) from baseline to week 12. Secondary endpoints were changes in glucose profiles, body weight, waist circumference, lipid profile, and factors impacting quality-of-life (QoL) at week 6 and 12 from baseline. Safety was assessed throughout the study. RESULTS Of the 176 patients enrolled, 171 (n = 85 in PMR group; n = 86 in SOC group) were included in the modified intent-to-treat population. The mean reduction in HbA1c at week 12 from baseline in PMR group was significant compared to the SOC group (- 0.59 vs. - 0.21%, p = 0.002). At week 12, the PMR group showed significant reduction in mean body weight (- 2.19 vs. - 0.22 kg; p = 0.001) and waist circumference (- 2.34 vs. - 0.48 cm; p = 0.001) compared to SOC group. Mean fasting plasma glucose and post-prandial glucose significantly reduced from baseline at week 6 and 12 in each group (p < 0.05). No significant change was observed in lipid profile. QoL parameters (treatment adherence, general well-being, and energy fulfilment) in the PMR were significantly better than SOC group (p < 0.05). Patients were satisfied with the taste of DSNS. No serious adverse events were reported. CONCLUSIONS DSNS is an encouraging option for PMR strategy, as it significantly improved HbA1c, body weight, waist circumference, and overall well-being among overweight/obese Indian T2DM patients. TRIAL IDENTIFICATION NO CTRI/2019/10/021595.
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Affiliation(s)
- Mala Dharmalingam
- Endocrinology and Diabetes Research Center and Laboratory, Bangalore, 560003, India
| | - Rupam Das
- Downtown Hospital, Guwahati, 781006, India
| | - Sandeep Jain
- Marudhar Hospital, Jaipur, Rajasthan, 302012, India
| | - Sachin Gupta
- Shubham Multispeciality Hospital, Amraiwadi, Ahmedabad, 380026, India
| | - Manoj Gupta
- Health Point Hospital, Kolkata, 700025, India
| | - Vinay Kudrigikar
- India Medical Affairs, Sun Pharma Laboratories Ltd., Sun House, Plot No. 201 8/1, Western Express Highway, Goregaon (E), Mumbai, Maharashtra, 400063, India.
| | - Deepak Bachani
- India Medical Affairs, Sun Pharma Laboratories Ltd., Sun House, Plot No. 201 8/1, Western Express Highway, Goregaon (E), Mumbai, Maharashtra, 400063, India
| | - Suyog Mehta
- India Medical Affairs, Sun Pharma Laboratories Ltd., Sun House, Plot No. 201 8/1, Western Express Highway, Goregaon (E), Mumbai, Maharashtra, 400063, India
| | - Sadhna Joglekar
- India Medical Affairs, Sun Pharma Laboratories Ltd., Sun House, Plot No. 201 8/1, Western Express Highway, Goregaon (E), Mumbai, Maharashtra, 400063, India
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Shorey S, Ng ED, Law EC, Wong JCM, Loke KY, Tam WWS. Physical Activity and Nutrition Interventions for Type 1 Diabetes: A Meta-analysis. Pediatrics 2022; 150:188758. [PMID: 35953465 DOI: 10.1542/peds.2022-056540] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Current evidence is lacking on physical activity and nutrition-based interventions focusing on the management of type 1 diabetes mellitus (T1DM) and health-related quality of life among children. To assess the effects of physical activity interventions and nutrition-based interventions for children with T1DM. METHODS Data sources include the Cochrane Central Register of Controlled Trials, Medline, clinicaltrials.gov, the World Health Organization International Clinical Trials Registry Platform, CINAHL through January 2022. Study selection includes randomized controlled trials of children aged 18 years and below with T1DM comparing either a physical activity intervention, a nutrition-based intervention, or hybrid physical activity and nutrition-based intervention with placebo or no-treatment control. Data were pooled using a random-effects model. Primary outcomes were hemoglobin A1c (HbA1c), and health-related quality of life. RESULTS Eighteen trials were included. Physical activity compared with the no-treatment group showed a lack of effect on HbA1c (mean difference = -0.58, 95% confidence interval -1.20 to 0.05; P value = .07). Nutrition-based intervention compared with no-treatment control for HbA1c level revealed a lack of effect (mean difference = -0.61, 95% confidence interval -1.48 to 0.26; P value = .17). Limitations include paucity of studies and low quality of evidence caused by the risk of bias. CONCLUSIONS Despite the lack of significant evidence, the generally favorable results highlight the potential of such interventions in enhancing glycemic control and health-related quality of life. Additionally, promising results from a single physical activity-nutrition-based hybrid intervention in terms of glycemic control indicate the plausible effectiveness of a mixed intervention.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Center for Nursing Studies.,National University Health System, Singapore
| | | | - Evelyn C Law
- Departments of Pediatrics.,National University Health System, Singapore.,Translational Neuroscience Program, Agency for Science, Technology, and Research, Singapore Institute for Clinical Sciences, Singapore
| | - John C M Wong
- Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Cimini A, Poliziani A, Antonelli G, Sestili F, Lafiandra D, Moresi M. Characterization of Fresh Pasta Made of Common and High-Amylose Wheat Flour Mixtures. Foods 2022; 11:foods11162510. [PMID: 36010510 PMCID: PMC9407497 DOI: 10.3390/foods11162510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/02/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
This study aims to assess the main biochemical, technological, and nutritional properties of a few samples of fresh pasta composed of commercial common wheat flour blended with increasing percentages, ranging from 0 to 100%, of high-amylose wheat flour. Although the technological parameters of such samples remained practically constant, fresh pasta samples including 50 to 100% of high-amylose wheat flour were classifiable as foods with a low in vitro glycemic index of about 43%. However, only fresh pasta made of 100% high-amylose wheat flour exhibited a resistant starch-to-total starch ratio greater than 14% and was therefore eligible to claim a physiological effect of improved glucose metabolism after a meal, as according to EU Regulation 432/2012.
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Affiliation(s)
- Alessio Cimini
- Dipartimento per l’Innovazione nei Sistemi Biologici, Agroalimentari e Forestali, Università della Tuscia, Via S. C. de Lellis, 01100 Viterbo, Italy
| | - Alessandro Poliziani
- Dipartimento per l’Innovazione nei Sistemi Biologici, Agroalimentari e Forestali, Università della Tuscia, Via S. C. de Lellis, 01100 Viterbo, Italy
| | - Gabriele Antonelli
- Dipartimento per l’Innovazione nei Sistemi Biologici, Agroalimentari e Forestali, Università della Tuscia, Via S. C. de Lellis, 01100 Viterbo, Italy
| | - Francesco Sestili
- Dipartimento di Scienze Agrarie e Forestali, Università della Tuscia, Via S. C. de Lellis, 01100 Viterbo, Italy
| | - Domenico Lafiandra
- Dipartimento di Scienze Agrarie e Forestali, Università della Tuscia, Via S. C. de Lellis, 01100 Viterbo, Italy
| | - Mauro Moresi
- Dipartimento per l’Innovazione nei Sistemi Biologici, Agroalimentari e Forestali, Università della Tuscia, Via S. C. de Lellis, 01100 Viterbo, Italy
- Correspondence: ; Tel.: +39-0761-357497
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Küpers LK, Fernández-Barrés S, Mancano G, Johnson L, Ott R, Vioque J, Colombo M, Landgraf K, Tobi EW, Körner A, Gaillard R, de Vries JHM, Jaddoe VWV, Vrijheid M, Sharp GC, Felix JF. Maternal Dietary Glycemic Index and Glycemic Load in Pregnancy and Offspring Cord Blood DNA Methylation. Diabetes Care 2022; 45:1822-1832. [PMID: 35708509 PMCID: PMC9346994 DOI: 10.2337/dc21-2662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 05/06/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Suboptimal nutrition in pregnancy is associated with worse offspring cardiometabolic health. DNA methylation may be an underlying mechanism. We meta-analyzed epigenome-wide association studies (EWAS) of maternal dietary glycemic index and load with cord blood DNA methylation. RESEARCH DESIGN AND METHODS We calculated maternal glycemic index and load from food frequency questionnaires and ran EWAS on cord blood DNA methylation in 2,003 mother-offspring pairs from three cohorts. Analyses were additionally stratified by maternal BMI categories. We looked-up the findings in EWAS of maternal glycemic traits and BMI as well as in EWAS of birth weight and child BMI. We examined associations with gene expression in child blood in the online Human Early Life Exposome eQTM catalog and in 223 adipose tissue samples. RESULTS Maternal glycemic index and load were associated with cord blood DNA methylation at 41 cytosine-phosphate-guanine sites (CpGs, P < 1.17 × 10-7), mostly in mothers with overweight/obesity. We did not observe overlap with CpGs associated with maternal glycemic traits, BMI, or child birth weight or BMI. Only DNA methylation at cg24458009 and cg23347399 was associated with expression of PCED1B and PCDHG, respectively, in child blood, and DNA methylation at cg27193519 was associated with expression of TFAP4, ZNF500, PPL, and ANKS3 in child subcutaneous adipose tissue. CONCLUSIONS We observed multiple associations of maternal glycemic index and load during pregnancy with cord blood DNA methylation, mostly in mothers with overweight/obesity; some of these CpGs were associated with gene expression. Additional studies are required to further explore functionality, uncover causality, and study pathways to offspring health.
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Affiliation(s)
- Leanne K Küpers
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Sílvia Fernández-Barrés
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Giulia Mancano
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, U.K.,Bristol Medical School Population Health Sciences, University of Bristol, Bristol, U.K
| | - Laura Johnson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, U.K.,Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, U.K
| | - Raffael Ott
- Institute of Diabetes Research, Helmholtz Zentrum München, and Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Neuherberg, Germany.,Forschergruppe Diabetes e.V., Neuherberg, Germany
| | - Jesus Vioque
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universidad Miguel Hernandez, Sant Joan d'Alacant, Alicante, Spain.,Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), Alicante, Spain
| | - Marco Colombo
- University of Leipzig, Medical Faculty, University Hospital for Children and Adolescents, Center for Pediatric Research, Leipzig, Germany
| | - Kathrin Landgraf
- University of Leipzig, Medical Faculty, University Hospital for Children and Adolescents, Center for Pediatric Research, Leipzig, Germany
| | - Elmar W Tobi
- Periconceptional Epidemiology, Division of Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Antje Körner
- University of Leipzig, Medical Faculty, University Hospital for Children and Adolescents, Center for Pediatric Research, Leipzig, Germany
| | - Romy Gaillard
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Jeanne H M de Vries
- Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Martine Vrijheid
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gemma C Sharp
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, U.K.,Bristol Medical School Population Health Sciences, University of Bristol, Bristol, U.K
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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43
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Holder M, Kapellen T, Ziegler R, Bürger-Büsing J, Danne T, Dost A, Holl RW, Holterhus PM, Karges B, Kordonouri O, Lange K, Müller S, Raile K, Schweizer R, von Sengbusch S, Stachow R, Wagner V, Wiegand S, Neu A. Diagnosis, Therapy and Follow-Up of Diabetes Mellitus in Children and Adolescents. Exp Clin Endocrinol Diabetes 2022; 130:S49-S79. [PMID: 35913059 DOI: 10.1055/a-1624-3388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Martin Holder
- Klinikum Stuttgart, Olgahospital, Department of Pediatric Endocrinology and Diabetology, Germany
| | - Thomas Kapellen
- Department of Paediatrics and Adolescent Medicine, University Hospital, Leipzig, Germany
| | - Ralph Ziegler
- Practice for Paediatrics and Adolescent Medicine, Focus on Diabetology, Münster, Germany
| | - Jutta Bürger-Büsing
- Association of Diabetic Children and Adolescents, Diabetes Center, Kaiserslautern, Germany
| | - Thomas Danne
- Children's and Youth Hospital Auf der Bult, Hannover, Germany
| | - Axel Dost
- Department of Paediatrics and Adolescent Medicine, University Hospital Jena, Germany
| | - Reinhard W Holl
- Institute for Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Germany
| | - Paul-Martin Holterhus
- Department of General Paediatrics, University Hospital Schleswig-Holstein, Kiel Campus, Germany
| | - Beate Karges
- Endocrinology and Diabetology Section, University Hospital, RWTH Aachen University, Germany
| | - Olga Kordonouri
- Children's and Youth Hospital Auf der Bult, Hannover, Germany
| | - Karin Lange
- Department of Medical Psychology, Hannover Medical School, Hannover, Germany
| | | | - Klemens Raile
- Virchow Hospital, University Medicine, Berlin, Germany
| | - Roland Schweizer
- Department of Pediatrics and Adolescent Medicine, University Hospital Tübingen, Germany
| | - Simone von Sengbusch
- Department of Paediatrics and Adolescent Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
| | - Rainer Stachow
- Sylt Specialist Hospital for Children and Adolescents, Westerland, Germany
| | - Verena Wagner
- Joint Practice for Paediatrics and Adolescent Medicine, Rostock, Germany
| | | | - Andreas Neu
- Department of Pediatrics and Adolescent Medicine, University Hospital Tübingen, Germany
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44
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Jiang Y, Zhao Y, Milne G, Dai Q, Chen Q, Zhang X, Lan Q, Rothman N, Gao YT, Cai Q, Shu XO, Zheng W, Yang G. Quality of dietary carbohydrate is more important than its quantity in lipid peroxidation. Am J Clin Nutr 2022; 116:189-196. [PMID: 35170729 PMCID: PMC9257472 DOI: 10.1093/ajcn/nqac047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/10/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND High glycemic index (GI) diets have been linked to elevated risk of cardiometabolic diseases. One possible underlying mechanism comes from high GI diet's potential to promote lipid peroxidation. OBJECTIVES We aim to evaluate whether and to what extent dietary carbohydrate quality and quantity are associated with systemic levels of lipid peroxidation in females. METHODS In this cross-sectional analysis of 2163 middle-aged women, a subset of the Shanghai Women's Health Study, we measured lipid peroxidation biomarkers F2-isoprostanes (F2-IsoPs) and its metabolite, 2,3-dinor-5,6-dihydro-15-F2t-IsoP (F2-IsoP-M), in urine. The quality of carbohydrate was defined by dietary GI, assessed using a validated FFQ via in-person interviews. A multivariable linear regression model with restricted cubic spline functions was used to evaluate the association of measured biomarkers with carbohydrate intake and dietary GI. RESULTS After adjustment for potential confounding factors such as cigarette smoking, BMI, and comorbidities, among others, we found that F2-IsoP-M concentrations were positively associated with both carbohydrate intake and dietary GI. Carbohydrate intake and dietary GI were weakly correlated (r = 0.12). When further mutually adjusted for the 2 factors, the positive association with F2-IsoP-M remained statistically significant for GI (P = 0.004) but not for carbohydrate intake (P = 0.50). Compared with those in the 10th percentile of dietary GI, fold increases (95% CI) in F2-IsoP-M concentrations for those in the 30th, 50th, 70th, and 90th percentiles were 1.03 (1.00, 1.07), 1.06 (1.01, 1.10), 1.09 (1.03, 1.14), and 1.13 (1.05, 1.21), respectively. Moreover, there appeared a threshold regarding the association between dietary GI and F2-IsoP-M concentrations, with the dose-effect slope of GI being 2.3 times greater when GI was ≥75 relative to GI <75. CONCLUSIONS This study provides evidence that the quality of dietary carbohydrate may be more important than the quantity of the intake with regard to systemic lipid peroxidation.
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Affiliation(s)
- Yu Jiang
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yingya Zhao
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ginger Milne
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Qi Dai
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Qingxia Chen
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Qing Lan
- Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Yu-Tang Gao
- Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qiuyin Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Gong Yang
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, TN, USA
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45
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Yaregal Z, Baye K, Fardet A. Compared with fresh
injera
, stale
injera
increases satiety in healthy subjects, but does not decrease the glycemic index. Cereal Chem 2022. [DOI: 10.1002/cche.10556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Zemenu Yaregal
- Center for Food Science and Nutrition, College of Natural and Computational Sciences Addis Ababa University PO box 1176 Addis Ababa Ethiopia
| | - Kaleab Baye
- Center for Food Science and Nutrition, College of Natural and Computational Sciences Addis Ababa University PO box 1176 Addis Ababa Ethiopia
| | - Anthony Fardet
- INRAE, Université Clermont Auvergne, UNH Human Nutrition Unit, CRNH Auvergne F‐63000 Clermont‐Ferrand France
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46
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Complete nutrition drink with retrograded starch is low glycemic, and the individual glucose response to the low glycemic complete nutrition drink depends on fasting insulin levels and HOMA-IR in a randomized cross-over control trial. J Nutr Sci 2022; 11:e25. [PMID: 35462880 PMCID: PMC9003636 DOI: 10.1017/jns.2022.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 02/26/2022] [Accepted: 03/02/2022] [Indexed: 11/30/2022] Open
Abstract
Complete nutrition drinks with a low glycemic index (GI) provide nutritional support and prevent hyperglycaemia. The present study identified GI and factors predicting individual glucose response to a new complete nutrition drink. A randomised cross-over controlled trial was conducted in eighteen healthy volunteers (FPG < 100 mg/dl). Complete nutrition drinks containing retrograded starch, glucose solution and white bread were assigned in a random sequence with 14-day wash-out intervals. Plasma glucose and insulin levels were measured from baseline to 180 min after consuming each food. Results show the adjusted GIs of the drink was 48.2 ± 10.4 and 46.7 ± 12.7 with glucose and white bread as the reference, respectively. While the drink has low GI (<55), the individual glucose responses varied (GI: 7–149). Comparing characters in individual GI < 55 (n = 12) and GI ≥ 55 (n = 6) groups revealed significantly higher baseline insulin in the low GI group (14.86 ± 16.51 μIU/ml v. 4.9 ± 3.4 μIU/ml, P < 0·05). The correlation matrix confirms only two predictive factors for having individual GI <55 were baseline insulin (r = 0·5, P = 0·03) and HOMA-IR (r = 0·55, P = 0·02). ROC curve reveals fasting insulin above 1.6 μIU/ml and HOMA-IR above 1.05 as the cut-off values. The findings suggest that the complete nutrition drink has a low GI, but there was wide variability in individual responses partly explained by fasting insulin levels and HOMA-IR. Screening for fasting insulin and HOMA-IR may be encouraged to maximise the functional benefit of the drink.
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47
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Lew LC, Mat Ludin AF, Shahar S, Abdul Manaf Z, Mohd Tohit N. Efficacy and Sustainability of Diabetes-Specific Meal Replacement on Obese and Overweight Type-2 Diabetes Mellitus Patients: Study Approaches for a Randomised Controlled Trial and Impact of COVID-19 on Trial Progress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074188. [PMID: 35409872 PMCID: PMC8998339 DOI: 10.3390/ijerph19074188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/26/2022] [Accepted: 03/16/2022] [Indexed: 12/04/2022]
Abstract
Meal replacement (MR) is widely used in weight and diabetes management programs due to its ease of compliance and handling. However, little is known about its impact on outcomes other than glycaemic control and weight loss. Furthermore, not many studies evaluate its cost-effectiveness and sustainability. This study aimed to evaluate the efficacy of a diabetes-specific MR for the weight reduction and glycaemic controls of overweight and obese T2DM patients, as compared to routine dietary consultation. Other health outcomes, the cost effectiveness, and the sustainability of the MR will also be evaluated. Materials and Methods: This randomised controlled clinical trial will involve 156 participants who have been randomised equally into the intervention and control groups. As a baseline, both groups will receive diet consultation. Additionally, the intervention group will receive an MR to replace one meal for 5 days a week. The duration of intervention will be 12 weeks, with 36 weeks of follow-up to monitor the sustainability of the MR. The primary endpoints are weight and Hemoglobin A1c (HbA1c) reduction, while the secondary endpoints are anthropometry, biochemical measurements, satiety, hormone changes, quality of life, and cost-effectiveness. The impact of the COVID-19 pandemic on study design is also discussed in this paper. This study has obtained human ethics approval from RECUKM (JEP-2019-566) and is registered at the Thai Clinical Trials Registry (TCTR ID: TCTR20210921004).
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Affiliation(s)
- Leong Chen Lew
- Biomedical Science Programme, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
- Center for Healthy Ageing and Wellness, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (S.S.); (Z.A.M.)
| | - Arimi Fitri Mat Ludin
- Biomedical Science Programme, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
- Center for Healthy Ageing and Wellness, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (S.S.); (Z.A.M.)
- Correspondence: ; Tel.: +603-92898043
| | - Suzana Shahar
- Center for Healthy Ageing and Wellness, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (S.S.); (Z.A.M.)
- Dietetic Programme, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Zahara Abdul Manaf
- Center for Healthy Ageing and Wellness, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (S.S.); (Z.A.M.)
- Dietetic Programme, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Noorlaili Mohd Tohit
- Department of Family Medicine, University Kebangsaan Malaysia Medical Centre (UKMMC), Cheras, Kuala Lumpur 56000, Malaysia;
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48
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Rheological, pasting and textural properties of corn flour as influenced by the addition of rice and lentil flour. Lebensm Wiss Technol 2022. [DOI: 10.1016/j.lwt.2022.113231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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49
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Skurk T, Bosy-Westphal A, Grünerbel A, Kabisch S, Keuthage W, Kronsbein P, Müssig K, Pfeiffer AFH, Simon MC, Tombek A, Weber KS, Rubin D. Dietary recommendations for persons with type 2 diabetes mellitus. Exp Clin Endocrinol Diabetes 2022; 130:S151-S184. [PMID: 35359013 DOI: 10.1055/a-1624-5095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Thomas Skurk
- ZIEL Institute for Food & Health, Technical University of Munich, Freising, Germany.,Else Kröner-Fresenius-Center for Nutritional Medicine, Technical University of Munich, Freising, Germany
| | - Anja Bosy-Westphal
- Institute for Human Nutrition, Faculty of Agricultural and Nutritional Sciences, Christian-Albrechts-University of Kiel, Kiel, Germany
| | | | - Stefan Kabisch
- German Institute of Human Nutrition Potsdam-Rehbrücke, Potsdam, Germany.,Department of Endocrinology, Diabetes and Nutritional Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany.,German Center for Diabetes Research (DZD), Munich, Germany
| | - Winfried Keuthage
- Focus Practice for Diabetes and Nutritional Medicine, Münster, Germany
| | - Peter Kronsbein
- Department of Ecotrophology, Niederrhein University of Applied Sciences, Mönchengladbach Campus, Germany
| | - Karsten Müssig
- Department of Internal Medicine, Gastroenterology and Diabetology, Niels Stensen Hospitals, Franziskus Hospital Harderberg, Georgsmarienhütte, Germany
| | - Andreas F H Pfeiffer
- Department of Endocrinology, Diabetes and Nutritional Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Marie-Christine Simon
- Institute of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | | | - Katharina S Weber
- Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Diana Rubin
- Vivantes Hospital Spandau, Berlin, Germany.,Vivantes Humboldt Hospital, Berlin, Germany
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50
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Dietary Complex and Slow Digestive Carbohydrates Promote Bone Mass and Improve Bone Microarchitecture during Catch-Up Growth in Rats. Nutrients 2022; 14:nu14061303. [PMID: 35334960 PMCID: PMC8951765 DOI: 10.3390/nu14061303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 02/06/2023] Open
Abstract
Catch-up growth is a process that promotes weight and height gains to recover normal growth patterns after a transient period of growth inhibition. Accelerated infant growth is associated with reduced bone mass and quality characterized by poor bone mineral density (BMD), content (BMC), and impaired microarchitecture. The present study evaluated the effects of a diet containing slow (SDC) or rapid (RDC) digestible carbohydrates on bone quality parameters during the catch-up growth period in a model of diet-induced stunted rats. The food restriction period negatively impacted BMD, BMC, and microarchitecture of appendicular and axial bones. The SDC diet was shown to improve BMD and BMC of appendicular and axial bones after a four-week refeeding period in comparison with the RDC diet. In the same line, the micro-CT analysis revealed that the trabecular microarchitecture of tibiae and vertebrae was positively impacted by the dietary intervention with SDC compared to RDC. Furthermore, features of the cortical microstructure of vertebra bones were also improved in the SDC group animals. Similarly, animals allocated to the SDC diet displayed modest improvements in growth plate thickness, surface, and volume compared to the RDC group. Diets containing the described SDC blend might contribute to an adequate bone formation during catch-up growth thus increasing peak bone mass, which could be linked to reduced fracture risk later in life in individuals undergoing transient undernutrition during early life.
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