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Carbohydrates and carbohydrate foods and postprandial glycemic control in healthy or diabetic individuals
Source publication
Abstract Nutritional management of blood glucose levels is a strategic target in the prevention and management of type 2 diabetes mellitus (T2DM). To implement such an approach it is essential to understand the effect of food on glycaemic regulation and on the underlying metabolic derangements. This comprehensive review summarises the results from...
Contexts in source publication
Context 1
... and quality of evidence was assigned according to guidelines from Oxford Centre for Evidence Based Medicine available at http://www.cebm.net/?oD1116. Strategy for identifying data for extraction and summarizing study findings are detailed in Tables 1-9 and include: Type of Study, Food source (including physical characteristics and delivery), Control, Population Group, Methodology, Study Duration, Primary and Secondary Outcomes, and References. In addi- tion to inclusion of data regarding PPG, outputs considering impact of dietary components on blood glucose regulation were also included, as this was considered to be relevant. ...
Context 2
... trials on fiber foods and supplements: Recently, an obvious reappearance in the research interest on the role of DF in the regulation of glycemic and insulinemic responses in individuals with T2DM has emerged. Until now, a large number of postprandial studies involving different fiber types, either in the form of unprocessed foods or as isolated DF supplements, have been carried out in people with T2DM (Table 1 & 2). Additionally, data are derived from a few lon- ger-term dietary interventions in which either modified total diets or individual fiber products were served to individuals with T2DM for periods from two weeks up to one year ( Table 2). ...
Context 3
... randomized short-term trials clearly indicate that espe- cially soluble fibers with viscous properties (e.g., gluco- mannan, guar gum, psyllium, b-glucan) exert acute improvements in glucose and insulin responses in individuals with T2DM (Table 1). Guar gum (GG), an example of such a water-soluble nonstarch polysaccharide, has shown both glu- cose and insulin lowering properties ( Ellis et al., 1991;Golay et al., 1995), and psyllium fiber administered to NIDDM patients immediately before breakfast and dinner lowered postprandial glucose by 14% at breakfast and 20% at dinner compared to placebo. ...
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Citations
... Dietary treatments have a crucial role in glycemic control, particularly for diabetics and those at risk of getting the disease [3]. Seeking natural, accessible, and cost-effective solutions for regulating blood glucose levels has drawn attention to the potential health benefits of various meals and food components [4]. This includes red beetroot, which is a nutrient-dense vegetable, and it has attracted interest for its potential contribution to glycemic management [5]. ...
Purpose of review
Low-glycemic diets are crucial, particularly for individuals with diet-related diseases such as obesity and diabetes. Therefore, observing the impact of multiple forms of red beetroot-based products on the glycemic profiles of humans under various health conditions has arguably become significant due to beetroot's high fiber content, antioxidants, inorganic nitrates, etc., which this review aims to summarize.
Recent findings
The relevant articles published between 2000 and 2022 were obtained from PubMed, Scopus, and ScienceDirect by following the PRISMA-P 2020 statement. This systematic review included 18 randomized controlled trials (RCTs), one non-randomized clinical trial (non-RCT), and one quasi-experimental (QE) study, and they covered different health conditions, e.g., type-2 diabetes mellitus (T2DM), obesity, hypertension, etc. The studies produced conflicting results, likely due to differences in the study design, dosage, duration, and population. The risk of bias in most of the RCTs and QE studies included in the review was assessed as low or moderate, and only one non-RCT was assessed as having a high risk of bias.
Summary
Red beetroot may help maintain the blood sugar levels of humans under different health conditions. However, the existing results on beetroot's potential for glycemic management are unclear due to varied outcomes across studies. Further intervention studies with standardized protocols and diverse participant groups are necessary to assess the role of beetroot products in regulating blood sugar levels before making a definitive judgment.
... These results may be explained by the fact that white kidney bean crackers have greater dietary fibre content than cashew nut crackers, which have higher fat content. The comprehensive review by Russell et al. (2016) revealed that the type and amount of fibre play a key role in slowing the rate of carbohydrate digestion and absorption, as well as gastric emptying, resulting in beneficial effects on postprandial glycaemic control and insulinemic response. Likewise, as aforementioned, consuming oil/fat could slow the gastric-emptying rate and delay a rise in blood glucose, insulin, and glucose-dependent insulinotropic polypeptide levels in people with type 2 diabetes (Gentilcore et al., 2006). ...
Introduction: Crackers, one of the most consumed baked products, primarily contain refined wheat flour and have a moderate glycaemic index (GI). Nut and legume powders are used in baked goods to help regulate postprandial glycaemia; however, their glycaemic responses remain controversial. Our study aimed to compare the postprandial glycaemic responses between crackers with 30% wheat flour substitution by white kidney beans, cashew nuts, and almonds versus standard wheat crackers. Methods: Twelve adults were recruited for a five-session randomised controlled crossover study. In each session, they were randomly assigned to receive 50g carbohydrates from either a glucose solution or one of the four crackers. Plasma glucose levels were measured at baseline and 15, 30, 45, 60, 90, and 120 minutes after consumption. Satiety and hunger were evaluated using 100mm visual analogue scales at baseline and every 30 minutes until 120 minutes. Results: Mean incremental area under the curve (IAUC) for plasma glucose did not differ between the alternatives and wheat crackers, but was lowest for almond crackers. Compared with GI value of glucose solution, that of wheat, cashew nut, white kidney bean, and almond crackers were 39.97±23.13, 37.66±24.66, 35.85±10.86, and 28.09±17.92, respectively. Almond cracker consumption resulted in the highest mean IAUC for satiety and lowest for hunger, though non-significant. Conclusion: Crackers with 30% wheat flour substitution by nut and legume powders tended to improve postprandial glycaemia more than the standard crackers; however, acute responses on insulin and glucagon-like peptide-1 require further examination.
... Most prior studies examined the association between diabetes status and SMI, but limited evidence exists examining the association between FG in either the diabetic or prediabetic range or assessing the dose-response between FG and incidence of SMI. Moreover, FG is not a stable variable and could be influenced by factors such as age [11], BMI [12], diet [13], the use of oral anti-diabetic medication, and insulin. Given the variability of FG and this uncertain relationship, it is essential to evaluate the association of longitudinal glucose across the full range of values and SMI in a large population. ...
Background
Fasting glucose (FG) demonstrates dynamic fluctuations over time and is associated with cardiovascular outcomes, yet current research is limited by small sample sizes and relies solely on baseline glycemic levels. Our research aims to investigate the longitudinal association between FG and silent myocardial infarction (SMI) and also delves into the nuanced aspect of dose response in a large pooled dataset of four cohort studies.
Methods
We analyzed data from 24,732 individuals from four prospective cohort studies who were free of myocardial infarction history at baseline. We calculated average FG and intra-individual FG variability (coefficient of variation), while SMI cases were identified using 12-lead ECG exams with the Minnesota codes and medical history. FG was measured for each subject during the study’s follow-up period. We applied a Cox regression model with time-dependent variables to assess the association between FG and SMI with adjustment for age, gender, race, Study, smoking, longitudinal BMI, low-density lipoprotein level, blood pressure, and serum creatinine.
Results
The average mean age of the study population was 60.5 (sd: 10.3) years with median fasting glucose of 97.3 mg/dL at baseline. During an average of 9 years of follow-up, 357 SMI events were observed (incidence rate, 1.3 per 1000 person-years). The association between FG and SMI was linear and each 25 mg/dL increment in FG was associated with a 15% increase in the risk of SMI. This association remained significant after adjusting for the use of lipid-lowering medication, antihypertensive medication, antidiabetic medication, and insulin treatment (HR 1.08, 95% CI 1.01–1.16). Higher average FG (HR per 25 mg/dL increase: 1.17, 95% CI 1.08–1.26) and variability of FG (HR per 1 sd increase: 1.23, 95% CI 1.12–1.34) over visits were also correlated with increased SMI risk.
Conclusions
Higher longitudinal FG and larger intra-individual variability in FG over time were associated in a dose–response manner with a higher SMI risk. These findings support the significance of routine cardiac screening for subjects with elevated FG, with and without diabetes.
... For example, AgNPs have exhibited promise in regulating glucose levels, presenting therapeutic advantages in diabetes management. Research suggests that AgNPs can modulate insulin signaling pathways, potentially enhancing insulin sensitivity and cellular glucose uptake, thus offering a novel approach for treating diabetes 63,64 . AgNPs also demonstrate significant antiviral properties by disrupting viral attachment and entry into host cells. ...
This research explores the eco-friendly synthesis of silver nanoparticles (AgNPs) using Cassia occidentalis L. seed extract. Various analytical techniques, including UV–visible spectroscopy, transmission electron microscopy (TEM), scanning electron microscopy (SEM), X-ray diffraction (XRD), and energy dispersive X-ray spectroscopy (EDX), were employed for comprehensive characterization. The UV–visible spectra revealed a distinct peak at 425 nm, while the seed extract exhibited peaks at 220 and 248 nm, indicating the presence of polyphenols and phytochemicals. High-resolution TEM unveiled spherical and oval-shaped AgNPs with diameters ranging from 6.44 to 28.50 nm. The SEM exhibiting a spherical shape and a polydisperse nature, thus providing insights into the morphology of the AgNPs. EDX analysis confirmed the presence of silver atoms at 10.01% in the sample. XRD results unequivocally confirm the crystalline nature of the AgNPs suspension, thereby providing valuable insights into their structural characteristics and purity. The antioxidant properties of AgNPs, C. occidentalis seed extract, and butylated hydroxytoluene (BHT) were assessed, revealing IC50 values of 345, 500, and 434 μg/mL, respectively. Antibacterial evaluation against Bacillus subtilis, Staphylococcus aureus, and Escherichia coli demonstrated heightened sensitivity of bacteria to AgNPs compared to AgNO3. Standard antibiotics, tetracycline, and ciprofloxacin, acting as positive controls, exhibited substantial antibacterial efficacy. The green-synthesized AgNPs displayed potent antibacterial activity, suggesting their potential as a viable alternative to conventional antibiotics for combating pathogenic bacterial infections. Furthermore, potential biomedical applications of AgNPs were thoroughly discussed.
... Conversely, the diabetic control rats given rat chaw had a statistically significantly higher percentage change in blood glucose levels than the diabetic rats fed HPD. The present findings are consistent with the review conducted by Russell et al. (53) , which posits that a variety of dietary factors influences the effect of carbohydrates and fats on blood glucose levels. Nevertheless, it is important to remember that individuals with diabetes or other conditions involving impaired blood glucose regulation should not be advised to consume higher amounts due to possible negative consequences (53) . ...
... The present findings are consistent with the review conducted by Russell et al. (53) , which posits that a variety of dietary factors influences the effect of carbohydrates and fats on blood glucose levels. Nevertheless, it is important to remember that individuals with diabetes or other conditions involving impaired blood glucose regulation should not be advised to consume higher amounts due to possible negative consequences (53) . Diets high in protein had been reported to be beneficial in weight loss, improving body composition, and lowering blood sugar levels (53,54) , and better weight loss with high-protein diets has been linked to the satiating effects of dietary protein, a smaller selection of foods, and an aversion against dietary fat in the absence or smaller quantity of carbohydrates (53,55) , this further support the idea that consuming more dietary protein may aid in lowering calorie intake and thus blood sugar level. ...
... Nevertheless, it is important to remember that individuals with diabetes or other conditions involving impaired blood glucose regulation should not be advised to consume higher amounts due to possible negative consequences (53) . Diets high in protein had been reported to be beneficial in weight loss, improving body composition, and lowering blood sugar levels (53,54) , and better weight loss with high-protein diets has been linked to the satiating effects of dietary protein, a smaller selection of foods, and an aversion against dietary fat in the absence or smaller quantity of carbohydrates (53,55) , this further support the idea that consuming more dietary protein may aid in lowering calorie intake and thus blood sugar level. ...
In vascularized tissues, inflammation is a complex and dynamic defensive response to cell injury, infection by bacteria, trauma, or toxins. Inflammatory biomarkers are molecules that regulate the inflammatory response in all immune system cells. Numerous mediators are released from the attack site, and different host immune system cells infiltrate the area during inflammation. Without the combination of regulated leukocyte population migration, different inflammatory mediators, inflammatory biomarkers (acute or systemic inflammatory marker), and subsequent physiologic changes that carry inflammatory responses, it would be impossible to assemble and regulate inflammatory responses. This study focuses on the attenuating potential of modified diets on testicular inflammatory biomarkers in streptozotocin-induced diabetic Wistar rats. Ninety-six adults male Wistar rats were divided into four units, of four groups/unit and each group consisting of six rats. Unit 1 is non-diabetic unit, whereas Units 2, 3, and 4 were induced with type 2 diabetes. While the rats in group one in all the units were fed with standard rat chaw, group 2 received HFD, group three received HPD, while groups four received HCD. Alpha lipoic acid (200 mg/kg body weight) and metformin (50 mg/kg body weight) were also given to the rats in units three and four, respectively. After 12 weeks of treatment and feeding, each rat was euthanized and testes were excised for biochemical analysis. Data were examined using GraphPad Prism. Two-way analysis of variance (ANOVA) was used to examine the mean variations between groups. The Tukey post hoc test was then performed, with p-values of 0.05 being deemed statistically significant. According to the current study's findings, high-protein meals, both by themselves and in conjunction with ALA, reduce blood glucose levels and the inflammatory damage brought on by streptozotocin toxicity. For this reason, they may be utilized to treat diabetes mellitus and autoimmune-induced inflammation.
... In addition, high-protein plant foods promote satiety and fullness which can be useful in suppressing appetite. Therefore, the consumption of high-protein meals is adjudged to regulate blood glucose concentration, hence, may be a safe product for diabetic patients (Russell et al. 2016). It may not be out of place to project that the novel snack product would be relevant for diabetes control owing to its potential to provide valuable nutrients, promote satiety and slow down glycemic release. ...
Snack products are evolving as new carriers of functional ingredients with nutritional and health-promoting benefits. A blend of whole grains is increasingly being utilized to harness the functional potential of the grain mix. Amaranth, acha, and pearl millet grains flours were optimized using response surface methodology (RSM), to obtain optimum blends (90:5:5 and 47.98:26.68:25.34) with high protein content and low glycemic index. Snack bar products from the blends were labelled MBY and MBZ. A total of 40 diabetic and 10 non-diabetic subjects were recruited. Of the diabetic, about 42% were overweight while 40% were obese, the non-diabetic had normal weights. Each was allowed to consume snacks containing the equivalent of 50 g of carbohydrates. Finger prick was employed to evaluate the postprandial glucose response of snack products while venous blood was evaluated for antioxidant enzymes, carbohydrate-hydrolyzing activities, and insulin using standard methods. Consumption of the multigrain snacks elicited a stable postprandial response (133-141 mg/dL) with 16 and 24% postprandial decline. In addition, snacks had low to intermediate glycemic index (52 and 56) in diabetic and low glycemic index (43 and 45) in non-diabetics; likewise reduced α-amylase/α-glucosidase activities compared to control snacks. Similarly, glutathione level, glutathione peroxidase, superoxide dismutase, and catalase activities in serum from subjects that consumed multigrain snacks were upregulated compared to control and market sample groups. Moreso, snack products promoted a reduction in serum insulin levels in diabetic subjects (45 and 17% for MBY and MBZ respectively). Following the nutraceutical properties displayed by the formulated snack especially MBY, it can be promoted as a functional snack for the management of diabetes while solving the limited snack product choice of diabetes sufferers.
... Additionally, complex plant cell wall matrices in nuts have been proposed to limit the enzymatic degradation of nuts within the gastrointestinal tract, which leads to encapsulation of fat and thus a reduction in fat absorption, resulting in reduced energy availability (6,22) . Furthermore, regular nut consumption is proposed to promote glycaemic control due to their high fibre content (23) and fatty acid profile that been linked to better insulin sensitivity (24) . High amounts of monounsaturated fats (MUFA), protein and fibre in nuts delay gastric emptying which lowers postprandial glucose (25) . ...
Energy-restricted (ER) diets promote weight loss and improve body composition and glycaemic control. Nut consumption also improves these parameters. However, less is known about the combined benefit of these two strategies. This scoping review implemented a systematic search of Medline, Embase and Scopus to identify randomised controlled trials evaluating the effect of ER diets with or without nuts on body mass, body composition and glycaemic control in adults. After reviewing titles and abstracts, 29 full-text articles were screened, resulting in seven studies reported in eight papers that met the inclusion criteria. Energy restriction was achieved by prescribing a set energy target or reducing intake by 1,000-4,200 kJ from daily energy requirements. Interventions ranged from 4-52 weeks in duration and contained 42-84g/day of almonds, peanuts, pistachios or walnuts. While all studies reported that energy restriction resulted in significant weight loss, the addition of nuts to ER diets only demonstrated significantly greater weight loss in approximately half of the included studies (4/7 studies). There was limited evidence to support additional benefits from nuts for body composition measures or glycemic control. Although improvements in weight loss and glycemia were not consistent when nuts were included in ER diets, no study revealed an adverse effect of nut consumption on health outcomes. Future studies could explore the effect of consuming different types and amounts of nuts, combined with various levels of energy restriction on weight, body composition and glycaemic control.
... This disease is the main cause of death in developed countries and is expected to become an epidemic in newly industrialized countries. Uncontrolled diabetes is a major factor in several serious disorders including macrovascular disease, vision impairment, kidney failure, neuropathy, and amputation (Russell et al., 2016). Indeed, prolonged hyperglycemia has been associated with cardiovascular complications, although such complications are not criteria for the diagnosis of diabetes mellitus (Wu et al., 2016). ...
The exploration of Tectona grandis Linn. from Indonesia, especially its use as an anti-diabetes agent is still quite limited. This study aims to determine the antidiabetic activity of the fractions from Tectona grandis Linn. leaves in male Rattus norvegicus. The animal blood glucose level was measured first as T0, then the animals were injected with streptozotocin (STZ) 40 mg/Kg BW to induce diabetes mellitus (DM), and then the blood was collected to determine the blood glucose level (T1). The animal was divided into six groups, namely normal group (NC) without treatment, positive control (K+) (DM+glibenclamide 5 mg), negative control (K-) (DM+NaCMC 0.5%), fractions group (DM+nHexane fraction (P1), DM+chloroform fraction (P2), and DM+ethyl acetate fraction (P3), each dose 300 mg/kg BW). The duration of treatment was 7 days, and at the end of treatment, the blood glucose levels were determined. The T0, T1, and T2 are analyzed using One-Way ANOVA and post-hoc LSD. The results obtained that the K+, P3, P2, and P1 groups were able to reduce the animals' blood glucose levels significantly (p<0.05), with the blood glucose levels are 97.01; 110.96; 129.38; and 111.46 mg/dL, respectively. The percentage of reduction in blood glucose level shows that the K+ group has the highest percentage at 66.8%, followed by the P3 group at 64.0%. The n-hexane, chloroform, and ethyl acetate fractions showed similar effectiveness to glibenclamide in reducing blood glucose levels statistically (p>0.05). Consequently, Tectona grandis Linn ...
... Studies suggest that elevated blood glucose levels may contribute towards the development of type 2 diabetes mellitus [32]. High blood glucose levels promote an acute inflammatory response and contribute to endothelial Population weighted equivalence *n = 4,655,426, **n = 3,908,305, *** n = 747,121, ¶ n = 374,109, ¶ ¶ n = 373,012 a P-value to compare the variables between two groups in avocado consumption (avocado consumers and non-consumers) using chi-square analysis for categorical data and t-test for continuous data b P-value to compare the variables between two groups in avocado intakes (high and low) using chi-square analysis for categorical data and t-test for continuous data damage associated with increased risk of cardiovascular events [33]. Foods deliver nutrients and bioactive compounds that can have varying influences on cardiometabolic disease mechanisms. ...
... Foods deliver nutrients and bioactive compounds that can have varying influences on cardiometabolic disease mechanisms. Food-based management of blood glucose dysregulation, by potentially including avocado within patterns of eating, may be a cost-effective strategy for cardiometabolic disease risk reduction [33]. The findings of our study are consistent with the clinical evidence for avocado consumption and blood glucose regulation [34][35][36][37][38]. ...
... Although avocados contain approximately 7.5% fibre [13], the estimated mean fibre intakes reported in our study were higher in the high avocado intake group when compared with the low avocado intake group. Higher intake of dietary fibre has a positive impact on postprandial glucose control [33]. As noted earlier, previous studies also suggested that avocado consumption is associated with favourable diet quality [8]. ...
Background
Avocados are a rich source of nutrients including monounsaturated fats, dietary fibre and phytochemicals. Higher dietary quality is reported in studies of consumers with higher avocado intakes. The present study aimed to examine avocado consumption and cardiometabolic risk measures in a representative sample of Australian adults.
Methods
A cross-sectional analysis was performed using Australian Health Survey 2011-2013 (n = 2,736 observations). Day 1 24-hour recall data was used to examine reported avocado intake (whole avocados and avocado-containing products excluding avocado oil) and cardiometabolic risk measures (LDL, HDL, and total cholesterol, triglycerides, apolipoprotein B, HbA1c, plasma glucose, systolic and diastolic blood pressure). T-tests and chi square analyses were conducted between low (5.21 [95% CI: 4.63, 5.79] grams/day) and high (44.11 [95% CI: 35.89, 52.33] grams/day) consumers of avocado.
Results
14.7% of Australians were ‘avocado consumers’ (n = 403 observations). Mean avocado intake was 24.63 (95% CI: 20.11, 29.15) grams per day, with a median intake of 10.40 (IQR: 4.49–26.00) grams per day for those considered ‘avocado consumers’. Consumers of avocados had a lower BMI and waist circumference (each, p ≤ 0.001), lower plasma glucose level (p = 0.03), and higher HDL cholesterol (p ≤ 0.001) when compared with non-consumers. A trend towards lower plasma glucose, HbA1c (each, p = 0.04) and higher dietary fibre intake (p = 0.05) was found between high and low consumers of avocado.
Conclusions
Our study suggests favourable outcomes for avocado intake and cardiometabolic characteristics of consumers. Future studies should explore glucose homeostasis using a clinical trial design to understand potential relationships between avocado intake and cardiometabolic risk factors.
... The limitations of our study are related to the small sample, thus leaving open the possibility that some minor effects were not detected; to the unbalanced number of obese and nonobese patients, which might have led to bias in the statistical analyses; and to the assessment of non-adherence by anamnestic information. Our sample also lacked data regarding the patients' dietary habits, which might have influenced metabolic parameters [61,62]. A strength of our study is that it is the first study to investigate the effects of obesity among unmedicated individuals with schizophrenia. ...
Aim of the study
We investigated the association between obesity and body mass index (BMI) with Positive and Negative Syndrome Scale (PANSS) psychopathology, age at disease onset, and parameters linked to the metabolic syndrome (fasting plasma lipid and glucose levels), among antipsychotic-naïve first-episode schizophrenia (AN-FES) patients and nonadherent chronic schizophrenia individuals.
Subject or material and methods
We recruited a total of 187 AN-FES patients or nonadherent chronic individuals for this study. Clinical and anthropometric data together with plasma lipid and glucose parameters were collected immediately after patients’ admission to the hospital. Patients were classified as obese with body mass index (BMI) ≥ 30, or as non-obese if overweight (BMI: 25 – 29.9) or of normal body weight (BMI: 18.5 – 24.9).
Results
After controlling for the possible confounders we found that only BMI significantly predicted clinical and metabolic variables. Among AN-FES patients, higher BMI values predicted lower levels of HDL cholesterol (HDL-c), and higher ratios for LDL cholesterol (LDL-c)/HDL-c and triglyceride/HDL-c, while among nonadherent individuals, higher BMI values predicted higher number of psychotic episodes, and lower PANSS general psychopathology scores. The contribution of BMI ranged from approximately 5.8% to 29.6%, with the lowest contribution observed for number of psychotic episodes, and the highest contribution for the LDL-c/HDL-c ratio.
Discussion
Our results indicate that AN-FES patients and nonadherent chronic patients differed in the effects of BMI.
Conclusions
Higher BMI contributes to an increased risk for dyslipidemia among AN-FES patients and to the higher number of psychotic episodes, and less severe clinical psychopathology among nonadherent chronic schizophrenia individuals.
