Effect of consumption of micronutrient enriched
wheat steamed bread on postprandial plasma
glucose in healthy and type 2 diabetic subjects
Lan Su-Que1,4†, Meng Ya-Ning1†, Li Xing-Pu1,3*, Zhang Ye-Lun1,3, Song Guang-Yao2*and Ma Hui-Juan2
Background: Steamed wheat bread have previously been shown to induce comparatively high postprandial plasma
glucose responses, on the contrary, buckwheat products induced lower postprandial plasma glucose. The present
study was to assess the effects of micronutrient enriched bread wheat variety Jizi439 and buckwheat on postprandial
plasma glucose in healthy and diabetic subjects comparing with buckwheat and other bread wheat varieties.
Methods: Two experiments were conducted to study the effects of bread wheat variety Jizi439 on the postprandial
plasma glucose levels of the randomly selected subjects. The first experiment involved three types of steamed bread
with equivalent of 50g available carbohydrate fed to 10 normal weight young healthy subjects. Two types of steamed
bread were made from two purple-grain bread wheat varieties, Jizi439 and Chu20, respectively, and the third type was
made from the mixture of different white grain wheat varieties. Plasma glucose levels of each subject were measured
at 15, 30, 45, 60, 120 min after eating. Glucose was used as a reference, the total area under curve (AUC) and glycemic
index (GI) was calculated for test meal. The second experiment was performed among ten type 2 diabetics who were
served equivalent of 50g available carbohydrate of steamed bread made from Jizi 439, the mixture of white grain
bread wheat and buckwheat, respectively. The plasma glucose increment was determined two hours thereafter.
Results: In the first experiment, consumption of the steamed bread made from Jizi439 resulted in the least increase in
plasma glucose and the GI was significantly lower than that of Chu20 and the mixture. In the second experiment, the
average of postprandial 2h plasma glucose increment of Jizi439 was 2.46mmol/L which was significantly lower than
that of the mixture of white wheat but was not significantly different from buckwheat.
Conclusions: The results indicated that consumption of Jizi439 steamed bread resulted in significantly lower plasma
glucose in both healthy and diabetic subjects, compared with other types of test foods, except buckwheat bread. The
steam bread made from Jizi439 would be an ideal food for preventing and treatment of diabetes.
Keywords: Diabetes, Glycaemic index, Food choice, Functional foods, Health eating
Type-2 diabetes (Diabetes mellitus) is a common chronic
disease caused by a fault in the insulin production in the
body. Insulin resistance is an important underlying factor.
The disease has inheritable tendency. The World Health
Organization reported that diabetes has become a major
non-infectious disease threatening human health in the
world after malignant tumor, Cardiovascular and cerebro-
vascular disease . It was estimated that 30 million
people suffered from diabetes in the world in 1985.
By 2000, the number of global diabetics had reached
171 million. And based on this trend, it may reach
366 million in 2030 . Extensive studies have indi-
cated that uncontrolled diabetes may cause serious
complications including retinopathy, nephropathy,
and neuropathy [3-5]. However, these complications
are preventable through the glycemic control [2,6].
* Correspondence: firstname.lastname@example.org; email@example.com
1Institute of Cereal and Oil Crops, Hebei Academy of Agriculture and
Forestry Sciences, no. 162 Hengshan Street, Gaoxinqu, Shijiazhuang 050035,
P. R. China
2Hebei General Hospital, Shijiazhuang, P. R. China
Full list of author information is available at the end of the article
© 2013 Su-Que et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.
Su-Que et al. Nutrition Journal 2013, 12:64
It is well known that diabetes is highly correlated with
the life style and diet. Proper diet can control plasma glu-
cose level and help to prevent the development of type 2
diabetes. Postprandial hyperglycemia was increasingly rec-
ognized as an independent risk factor for cardiovascular
disease . Postprandial glycemia can be reliably controlled
by considering both the amount and types of carbohydrate.
Carbohydrates consist of sugars (e.g., fructose vs glucose),
starches (e.g., amylose vs amylopectin) and fibers (e.g.,
soluble vs insoluble). Fibers are not converted to glucose,
cannot be broken down by digestive enzymes and pass
relatively intact into the large intestine.It was reported that
the Glycemic Index (GI) of a food is influenced by many
different factors including the type of sugar, the type of
starch, the type of fiber, the processing of a food, and the
presence of fat or protein in a mixed meal .
There is a large amount of evidence that consumption
of low GI foods could have a significant impact on the
amelioration of metabolic disturbances [9-11]. The GI is
defined as the incremental area under the plasma glu-
cose response curve of a 50g available carbohydrates
portion of a test food, expressed as a percentage of the
same amount of available carbohydrate from a reference
food (either white bread or glucose) taken by the same
subject . The GI can be used to classify foods based
on their plasma glucose raising potential. Bread wheat
is one of the most consumed food staples globally. In
Northern China, steamed bread is a popular daily food.
Some studies have evaluated the glycemic response of
different wheat bread and reported that was influenced
by cereal fibre, baking process and the bread fermenta-
tion [12-14]. Several studies have evaluated the glycemic
response of steamed wheat bread, and reported that it
was normally with high GI (88.1-98.3) [15,16].
In present study, the objective was to find the best
bread wheat variety which can be used to make steamed
bread with low GI. A purple-grain wheat variety named
Jizi439 developed by ourselves, with riched micronutriton
especially organic chromium which may be effective in at-
tenuating insulin resistance and lowering plasma choles-
terol levels , and with high amylase (Table 1), was
used to see if it is the suitable variety for making low GI
steam bread. Firstly, steamed wheat breads were made
from, purple-grain wheat variety Jizi439, purple-grain
variety Chu 20 (micronutriton not riched), the mixture of
white grain wheat varieties. They were served with the
equivalent of 50g available carbohydrate of the different
breads to ten healthy young volunteers. The postprandial
plasma glucose response and the GI value of the products
were determined. After chosen the lowest GI value variety,
the second experiment was arranged. The effects of differ-
ent steamed breads on postprandial glucose responses
among ten diabetic type 2 subjects were studied by serving
three types of foods made from the lowest GI value
variety, buckwheat and the mixture of white grain wheat
varieties, respectively. The aim was to assess the effect of
wheat variety Jizi439 on postprandial plasma glucose in
different subjects comparing with buckwheat. In total,
twenty participants (10 healthy subjects and 10 type 2 dia-
betic subjects) were randomly cruited for the study. Ten
healthy subjects were normal glucose tolerance, and no
overweight and obesity were indicated, there were not dia-
betes and other historical metabolic diseases.
Materials and methods
Four types of wheat sources, purple-grain wheat variety
Jizi439 with riched micronutriton and high amylose
(Table 1), purple-grain variety Chu 20 (organic chromium
not riched), the mixture (normally high GI) of white grain
wheat varieties Shi4185 and Shixin733 (50:50) and buck-
wheat collected from commercial fields which could ef-
fectively reduce diabetes symptom , were used in the
study. Jizi439 and chu20 were developed by authors .
The white wheat varieties were provided by Shijiazhuang
Academy of Agriculture and Forestry Sciences. Wheat
flour was in a powder form made by removal of 15% bran.
Steamed breads were made from 1kg wheat flour, 500g
water and 6g dry yeast, The ingredients were mixed and
kneaded for 8-10min, The dough then was fermented for
60 min at 32°C and 75% relative humidity. Then the dough
was divided into pieces (50g available carbohydrate),
Table 1 Nutritional composition per 100 g of the tested
Nutrition type Wheat variety names Buckwheat
Jizi439 Chu20 Mixed white
Water (g)49.248.5 47.2 48.6
Ash (g)0.58 0.550.610.60
protein (g) 10.6 9.8 8.56.4
37.3 38.9 41.539.0
Fibre (g) 1.411.38 1.243.73
Amylose (g) 18.64 16.839.62-
Resistant starch (g) 1.000.85 0.61 0.86
Magnesium (mg)85.6 82.1 32.9172.0
aThe portion size of each test was adjusted to contain 50 g
Su-Que et al. Nutrition Journal 2013, 12:64
Page 2 of 7
dough pieces were placed in steamer, the water should be
boiling and its cover should not be opened during
steaming. Steaming takes 20 minutes. The nutrition con-
tents of one piece of steamed bread for each meal were
shown in Table 1.
A total of twenty unrelated individuals were randomly
recruited by volunteer. They were divided into two
groups: Healthy and diabetic subject group.
In the first test, healthy subjects group consisted of 5
males and 5 females (were not in the menstrual cycle)
with ages between 23 and 26 years old were used for
selecting the lowest GI vareity. The subjects were ran-
domly recruited from Hebei normal universities (under-
graduate and postgraduate) based on the following
inclusion criteria: (1) normal glucose tolerance con-
firmed by a 75-g oral glucose tolerance test (OGTT)
according to the 1999 World Health Organization
criteria (fasting plasma glucose < 6.1 mmol/l and 2-h
plasma glucose < 7.8 mmol/l), (2) no family history of
T2DM and (3) the body mass index (BMI) ≤ 28.0 kg/m2.
Type 2 diabetic subject group consisted of 10 subjects
aged between 45 and 65 years old were used for the second
test to prove the effect of consumption of wheat steamed
bread made from Jizi439 on postprandial plasma glucose.
The subjects were randomly recruited from the Endocrin-
ology Department at Hebei General Hospital. Diabetes was
diagnosed in accordance with the 1999 World Health
Organization criteria (i.e., fasting plasma glucose ≥7.0 mmol/
l and/or 2-h plasma glucose ≥ 11.1 mmol/l). Patients diag-
nosed with T2DM before 30 years of age, with a body mass
index (BMI) > 28 kg/m2, or clinical findings consistent with
type 1 diabetes or other specific forms of diabetes (e.g., ma-
turity onset diabetes of the young) were excluded from this
study. Of these, eight subjects took metformin for lowering
glucose, while the others were on lifestyle intervention.
Height, weight, waist circumference, and blood pres-
sure were measured before glycemic response test. BMI
was calculated by height and weight. Blood samples were
collected to measure fasting plasma glucoseand glycated
hemoglobin A1c (HbA1c). For subjects without history
of diabetes, a 75-g OGTT test was also conducted to
confirm 2-h plasma glucoses were within normal range.
The clinical characteristics of the subjects are summa-
rized in Table 2. All participants provided written
informed consent, and the study protocol was approved
by the Ethics Committee of Hebei General Hospital.
Test of glycemic response of healthy subjects
This test was for choosing the low GI food from three test
foods made from Jizi439, chu20 and the mixture of white
grain bread wheat, respectively. All the ten Healthy subjects
were subjected to fasting 8–10 hours prior to the experi-
ment, and no eating or drinking was allowed. The subjects
were told to avoid food rich in DF the entire day before the
experiment day, and avoid alcohol, smoking and excessive
physical exercise on the day before each test and at the test
morning, and otherwise as far as possible to maintain their
regular life style throughout the entire study [20-23].
Fasting venous blood samples were collected prior to the
breakfast. The subjects were then provided with the test
foods, a piece of steam bread made from Jizi439 chu20, and
the mixture of white grain bread wheat, respectively, which
was equivalent of 50 g available carbohydrates or a 50 g
glucose in solution. Each subject was served for 250 ml of
drinking water. Thereafter the testing subjects were asked
to consume steam breads within 10 min and followed by
taking venous blood samples at 15, 30, 45, 60, 120 min after
meal. Timing for blood samples started with the first bite of
the test meal, the subjects were allowed to drink one bite of
water during the test interval. Each subject received four
tests: one for reference food and three tests for three differ-
ent test foods. The time interval between two tests was 3
day. Glucose was used as the reference food.
Table 2 Subjects clinical characteristics
N (male/female) 10(5/5)10(7/3)
25 ± 255±10
23.29 ± 3.28 24.31 ± 3.47
Waist circumference (cm) 80.82 ± 6.4583.31 ± 5.55
4.88 ± 0.417.84 ± 1.15
2-h plasma glucose (mmol/l)5.85 ± 0.98-
HbA1c (%)5.40 ± 0.30 6.60 ± 0.50
Table 3 Incremental area under the curve of plasma
glucose responses and GI value of test foods
Variety Incremental area under the
curve (iAUC) (0-120min)
index (GI) (%)
The mixture of
* Data are presented as mean±SD (n=10). Means with different superscript
letters different significantly (repeated measures analysis of variance, post hoc
Tukey test, P < 0.05). Glucose was used as the reference food.
Su-Que et al. Nutrition Journal 2013, 12:64
Page 3 of 7
Plasma glucose determination of diabetics
This test was for choosing the best food for control
plasma glucose increment from three test foods made
from Jizi439 with riched organic chromium which may
be effective in attenuating insulin resistance and lower-
ing plasma cholesterol levels , the mixture of white
grain bread wheat (normally high GI) and buckwheat
which could effectively reduce diabetes symptom ,
respectively. Ten diabetic type2 subjects consumed the
equivalent of 50g available Carbohydrates of different
steam bread made from wheat variety Jizi439, the mix-
ture of white bread wheat and buckwheat, respectively,
at breakfast. Each subject was served for 250 ml of
drinking water at the same the time. The tests were
performed 6 days apart and started at the same time in
the morning. Blood samples were taken for measuring
the plasma glucose of each subject 2 h after breakfast.
The test was repeated three days continuously in the
morning for each type of bread. The time interval
between two tests of different bread was 6 days. The first
three days was for Jizi439, and then for, the mixture of
white grain wheat, and buckwheat.
Analytical methods of blood samples
Plasma glucose was measured by the glucose oxidase
method with a glucose analyzer (Beckman, USA). All
samples were assayed in the same batch.
Chemical analysis of the test products
Starch is solubilized by boiling the sample in aqueous
calcium chloride. Interfering substances are removed by
preliminary extraction with aqueous alcohol, and treat-
ment of the calcium chloride extract with a suitable pre-
cipitant. Optical activity of the extract is measured with
a polarimeter, and starch content is calculated thereform
(automatic polarimeter WZZ-2, China). The resistant
starch content of the products was determined according
to Barry et al. . The amylose starch content of the
products was determined according to Scott et al. . Fat
is extracted with ethyl ether. Ethyl ether is heated and
volatilized, then is condensed above the sample. Solv-
ent continuously drips through the sample to extract
the fat. Fat content is measured by weight loss of sam-
ple or weight of fat removed (Soxhlet extractor, YG-2,
China). Protein content was determined by Kjeldahl
analysis (Kjeltec Auto 1030 Analyser, Tecator, Höganäs,
Sweden). Cr, Mg, Se in products was determined by
atomic absorbent spectrophotometry (atomic fluorescence
spectrometer, AFS-2201, China).
The data were analyzed with a general linear model
(ANOVA) followed by Tukey's multiple comparison test.
Values of p ≤0.05 were considered statistical significance.
All the statistical analyses were performed using the
SPSS software v19 (SPSS Inc, USA).
Postprandial plasma glucose responses of healthy
Before consuming the different test foods, basal fasting
plasma glucose were examined, which were 4.16±0.29,
4.18±0.30, 4.28±0.30, 4.33±0.18mmol/L for Jizi439, Chu20,
the mixture of bread wheat and glucose, respectively.
Which were comparable, the postprandial plasma glucose
responses curves of healthy subjects for Jizi439, Chu20 and
the mixture of white wheat were showed in Figure 1. Gen-
erally the plasma glucose level reached peak values in the
first 45 min for all the test foods, and decreased slowly
thereafter. The plasma glucose response curve showed that
glucose resulted the highest among all test foods, followed
by the mixture of white wheat, Chu20 and Jizi439. It indi-
cated that the consumption of Jizi439 led to the least
increase in plasma glucose at all time points from 15min
to 120min after the meal. Statistical analysis indicated that
the levels of plasma glucose after Jizi439 steamed bread
consumption were significantly lower than that of any
other testing foods at all the time points (P<0.05).
A mean GI and iAUC values for each steamed wheat
bread sample was presented in Table 3. Compared with
the reference food (glucose as a reference control), GI
and iAUC (15–120 min) values of Jizi439 were signifi-
cantly lower than that of any food (p<0.05). Although
the glucose response for the individual subjects varied to
some extent, the lowest GI for Jizi439-based food was
observed consistently in all healthy subjects. The GI
values of Jizi439 were 19.67% and 10.78% lower (p<0.05)
than that of the mixture of white wheat and Chu20,
2. Postprandial plasma glucose responses of diabetic
A similar test was conducted among ten diabetics. Each
diabetic subject consumed test foods (50 g available
Figure 1 Postprandial plasma glucose responses of healthy
subjects. Test foods were made from Jizi439, Chu20 and the
mixture of white wheat, respectively. Glucose was used as a control.
Values are means ±SD, n=10.
Su-Que et al. Nutrition Journal 2013, 12:64
Page 4 of 7
carbohydrates) made from Jizi439, the mixture of white
wheat and buckwheat, respectively. In comparison with
the mixture of white wheat, postprandial 2 h plasma ?
A3B2 show $132#?>glucose was significantly lower in all
diabetic subjects who consumed Ji439 (Figure 2). The
average value of postprandial 2h plasma glucose incre-
ment was 2.46, 7.88 and 4.01mmol/L in different foods
(Figure 3). Apparently, consumption of purple-grain bread
wheat Jizi439 resulted in the lowest postprandial 2h
plasma glucose, and it was significantly lower than that of
the mixture of white wheat. However, no difference was
observed between buckwheat and Jizi439 (Figure 3). It is,
therefore, concluded that the food made from Jizi439 is an
ideal food for diabetics as buckwheat.
GI is important parameter for the evaluation of the “Gly-
cemic potential” of a food. It provides a practical guide-
line for diabetic people for selecting foods. Foods are
categorized into three groups according to their GI .
Food with GI < 55 is considered to be low GI food while
high GI food is referred to the food with GI >70. Food
with GI ranging between 55 and 70 is usually classified
as medium GI food. Some studies suggested that whole-
grain foods may reduce the glycaemic response and
reduce the risk of diabetes [12,13]. That was apparently
due to cereal fiber intake. Other studies suggested that
the traditional baguette have lower GI in type 2 diabetes
subjects than other varieties (classic baguette, loaf of
wholemeal bread, loaf of bread fermented with yeast or
with leaven, sandwich). These differences might be
explained in bread processing and fermentation proced-
ure rather than fibre or resistant starch content .
Processing and fermentation procedure of the steamed
bread is different from that of the bread. Previous stud-
ies have showed that GI of steamed bread made from
bread wheat was 98.34, which was classified as high-GI
food , Yang et al.  reported that GI of steamed
bread was 88.1±20.2. Thus, white wheat bread is usually
defined as a high GI food . In this study, glucose was
Figure 2 Postprandial 2h plasma glucose responses of ten diabetics. Test foods were made from Jizi439, the mixture of white wheat and
Figure 3 The comparision of postprandial 2h plasma glucose of different test foods. Values are means±SD, n=10. Repeated measures
analysis of variance, post hoc Tukey test, P < 0.05, means with different letters different significantly.
Su-Que et al. Nutrition Journal 2013, 12:64
Page 5 of 7
used as the reference food (only one determination).
The GI of steamed bread made from Jizi439 were com-
pared with other varieties, and found that GI of Jizi439
was significantly lower than that of other wheat varieties.
The carbohydrate content of a food and its compos-
ition play a major role in influencing the postprandial
plasma glucose. Starch is an important carbohydrate
source in the human diet. Some studies showed that
higher amylose usually results in lower glucose re-
sponses [28,29]. Behall et al. reported that high amylose
(70% amylose) crackers were significantly lower than the
high amylopectin (70% amylopectin) crackers. The present
results demonstrated that Jizi439 contains 31.0% amylose
(amylose/total starch). Since most wheat cultivars contain
16.18-31.79% amylose in China , Jizi439 is considered
to be a high amylose wheat variety. This may be the one
of the reasons that GI of Jizi439 was lower.
The medical evidence showed that the organic chromium
was one of the essential microelements for human body, and
played a very important role in maintaining and regulating
proper levels of carbohydrate, lipid metabolism and enhan-
cing insulin signaling [26,31,32]. In vitro and in vivo studies
suggested that chromium supplements, particularly niacin-
bound chromium and/or chromium-nicotinate, may be ef-
fective in attenuating insulin resistance and lowering plasma
cholesterol levels . In contrast,a few of studies showed
that chromium supplementation did not improve glycemic
control in type 2 diabetes [33,34]. Nevertheless, most re-
search believed that supplemental Cr is beneficial to diabetes
patients [16,17,31,32]. Jizi439 could provide a microelement
supplement. This wheat variety offered medicational as well
as nutritional values, which made it an ideal food source to
prevent diabetes, cardiovascular diseases and enhancing
immunity. Therefor, it should be widely used as unique raw
material to make various wheat-based end-products, such as
bread, steamed bread and noodles.
It was reported that the intake of buckwheat could
effectively reduce diabetes symptom . A test that
compared the effect of whole buckwheat on plasma
glucose with the bread made from refined wheat flour
indicated that buckwheat significantly lowered plasma
glucose responses ; Skrabanja et al.  have found
that buckwheat may be beneficial to diabetes. In a
placebo (sucrose) -controlled study of streptozotocin-
diabetic rats, a single dose of buckwheat seed extract
lowered plasma glucose levels by 12-19% within 90 and
120 min after administration. In present study, post-
prandial 2 h plasma glucose level of Jizi439 was lower
than that of buckwheat. Therefore, Jizi439 should be
also beneficial to diabetes.
This study indicated that the GI of steamed bread made
from Jizi439 was lower than that of Chu20 and mixed
white wheat. Jizi439 steamed bread resulted in lower
plasma glucose compared with other types of test foods
in both healthy and diabetic subjects. So, it is an ideal
food source to making steam bread for diabetics.
GI: Glycemic index; iAUC: Incremental area under the curve; BMI: Body mass
index; OGTT: The oral glucose tolerance test; ANOVA: Analysis of variance.
The authors declare that they have no competing interests.
Xingpu Li contributed to the conception and design of this study, led the
implementation of the project, and contributed to the modifying of the
manuscript, She is the corresponding author. Suque Lan conducted majority
of the data collection and analysis and contributed to the writing of the
manuscript. Yaning Meng conducted majority of the data collection and
analysis and contributed to the writing of the manuscript. Suque Lan and
Yaning Meng contributed to the study equally. Yelun Zhang conducted the
part of data acquisition and modified the manuscript. Guangyao Song
contributed to the modifying of the manuscript, and conducted the part of
data acquisition and analysis. Huijuan Ma conducted the part of data
acquisition and analysis. All authors has read and approved the final
We thank Dr. B.B. Singh for his valuable comments on the manuscript. This
work was supported by National agriculture science technology
achievement transformation fund of China (2010GB2A200034), National
science and technology underpinning Project of China (2013BAD01B02-11),
and Provincial Natural Science Foundation of Hebei (C2008001198).
1Institute of Cereal and Oil Crops, Hebei Academy of Agriculture and Forestry
Sciences, no. 162 Hengshan Street, Gaoxinqu, Shijiazhuang 050035, P. R.
China.2Hebei General Hospital, Shijiazhuang, P. R. China.3Hebei Research
Station of Crop Gene Resource & Germplasm Enhancement, Ministry of
Agriculture, Shijiazhuang, P. R. China.4Key Laboratory of Genetics and
Breeding of Hebei Province, Shijiazhuang, P. R. China.
Received: 7 September 2012 Accepted: 3 May 2013
Published: 17 May 2013
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Cite this article as: Su-Que et al.: Effect of consumption of micronutrient
enriched wheat steamed bread on postprandial plasma glucose in
healthy and type 2 diabetic subjects. Nutrition Journal 2013 12:64.
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Su-Que et al. Nutrition Journal 2013, 12:64
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