ArticlePDF Available

A Study of Blood Glucose Response Following Temperate and Tropical Fruit Ingestion in Healthy Adults

Authors:
INTRODUCTION
Different carbohydrate-foods produce
different blood glucose responses (Otto
and Niklas, 1980). Considerable interest
has been raised in the effects of various
carbohydrate-containing foods on post-
prandial blood glucose response. Results
obtained have been a basis for dietary rec-
ommendations for diabetic patients
(Crapo, Reaven & Olesky, 1976; Bantle et
al., 1983). These findings led to a method
of classification of carbohydrate-contain-
ing food based on their acute blood
Mal J Nutr 11(1): 47-57, 2005
A Study of Blood Glucose Response Following Temperate
and Tropical Fruit Ingestion in Healthy Adults
Barakatun Nisak Mohd Yusof, Ruzita Abd. Talib & Norimah A. Karim
Department of Nutrition & Dietetics, Faculty of Allied Health Sciences, Universiti Kebangsaan
Malaysia, Jalan Raja Muda Abd. Aziz, Kuala Lumpur 50300.
ABSTRACT
Fruits are well known to have high nutritional values. However, the
response in blood glucose level varies with different fruits. To date, data
has not been compiled to rank local fruits according to their blood glu-
cose response. Therefore, this randomised experimental study was car-
ried out to determine the blood glucose response after consuming ten
types of tropical fruits (mango, rambutan,longan,sapodilla, jackfruit,
watermelon,papaya and banana of three varieties, brangan,rastali and
mas)and four types of temperate fruits (red apple, orange, grape and
green pear). A total of 72 healthy subjects randomly divided into groups
of 12 to 20 subjects (mean age: 21.5+0.6 years, mean BMI: 21.13+1.49
kgm-2)were requested to consume test fruits or reference food (glucose)
after an overnight fasting on separate occasions. Each test fruit and the
glucose contained 50g of carbohydrates. Finger-prick blood samples
were obtained at 0 (fasting), 15, 30 60, 90 and 120 min after consuming
each fruit. The blood glucose response was obtained by calculating area
under the curve (AUC). The AUC ranged between 57.59+10 mmol.min/L
and 313.2 mmol.min/L, with glucose showing the highest AUC (p<0.05)
compared to all fruits tested. Banana gives the highest blood glucose
response while green pear showed the lowest. The fruits ranked in
descending order based on the AUC values were longan,followed by
rambutan,grapes, watermelon, orange, papaya, jackfruit, sapodilla,
mango and red apple. Tropical fruits had significantly higher AUC than
temperate fruits (p<0.05). Overall, bananas demonstrated the largest rise
in postprandial blood glucose response (62%) when compared to glucose
while green pear showed the lowest response (18%). This preliminary
data could be used as a recommendation to diabetic patients for optimum
blood glucose control.
____________________
Correspondence author: Barakatun Nisak Mohd Yusof, email: bnisakmy@yahoo.com
glucose response known as glycaemic
index (Jenkins et al., 1981). Foods that con-
tain carbohydrate are digested and
absorbed at a slower rate, resulting in
lower blood glucose. Hence, these foods
may have metabolic benefits in relation to
diabetic control (Ludwig, 2000). However,
little attention has been given to fruits
(Guevarra & Panlasigui, 2000).
Fruits consist mainly of carbohydrates
and are known to have high nutritional
values specifically in terms of micronutri-
ents (Fatema et al., 2003). Nevertheless, the
compositions vary greatly (Hoover-Plow,
Savesky & Dailey, 1987). Studies have
shown that high intake of fruits and veg-
etables may have a protective effect
against cardiovascular disease (CVD) (Liu
et al., 2000) and decrease the risk of devel-
oping diabetes (Ford & Mokdad, 2001).
The type and amount of fruits to be
included in daily diets of diabetics has
always been a concern (Guevarra &
Panlasigui, 2000). Fatema et al.(2003) has
reported that it is important to know the
composition of fruits and their biological
responses in order to rationalise the advice
of including fruits in the diet of diabetic
patients. In addition, Brand-Miller,
Olagiuri & Foster-Powell (1997) have doc-
umented that tropical fruits may produce
higher responses of postprandial blood
glucose than temperate fruits.
Therefore, the objectives of this study
are to determine the blood glucose
response for some tropical and temperate
fruits in healthy adults compared to glu-
cose itself. This novel data could be used
by dietitians and nutritionists in recom-
mending the most suitable fruits for
patients, especially individuals with dia-
betes.
Methods
Subjects
Four groups (A, B, C, D) consisting of
12 to 20 healthy volunteers were derived
from a total of 72 subjects to participate in
this study (Table 1). There were 32 males
and 40 females with mean age and body
mass index (BMI) of 21.5+0.6 years and
21.1+1.5 kgm-2 respectively. Subjects were
non-smokers and not on any medication.
Subjects were requested to maintain their
usual daily food intake and activity
throughout the study period. The purpose
and protocol of the study were explained
to the subjects and written consent was
obtained.
Test Fruits
Subjects were grouped accordingly. 14
fruits consisting of 10 tropical fruits
[mango (Mangifera Indica), rambutan
(Nephelium lappaceum), longan (Nephelium
malaiense), sapodilla (Manilkara achras),
jackfruits (Artocarpus heterophullus),
papaya (Carica papaya), watermelon
(Citrullus vulgaris) and three varieties of
banana (Musa paradisiacal)i.e. Brangan,
Rastali and Mas]and four temperate fruits
[red apple (Pyrus malus), orange (Citrus
reticula), grape (Vitis vinifera) and green
pear (Pyrus communis)] were tested in this
study. Glucose (Glucolin™) dissolved in
500 ml of water was given as a reference
food to compare with the test fruits. Both
test fruits and glucose consisted of 50g car-
bohydrates. The amount of carbohydrate
and the crude fibre content for each fruit
was calculated using the Food
Composition Table (Tee et al., 1997). Table
2shows the amount of the tested fruits
which had to be consumed to provide 50g
carbohydrates. All subjects managed to
consume the test fruits given despite the
more than average portion size.
Experimental procedures
Subjects were requested to consume
test fruits or reference food (glucose) on
separate occasions in the morning (0800)
after 10-12 hours overnight fast. Fasting
blood sample was taken by finger-pricking
48 Barakatun Nisak MY, Ruzita AT & Norimah AK
at time 0 and the subjects were requested
to consume the test fruits with 250 ml
plain water or glucose in 500ml water
within 15 minutes. Further blood samples
were taken at 15, 30, 60, 90 and 120 min-
utes after initial intake. The blood samples
were obtained and analysed using glucose
oxidase method (Accutrend™ - Roche
Diagnostics GmbH, D-68298 Mannheim,
Germany).
Data Analysis
The blood glucose values for every
point of time over two hours were used to
calculate the area under the curve (AUC)
for each subject and each test individually
by encoding in Lotus software (123; CA
USA). The AUC calculation used was as
described by the Food and Agriculture
Organization of the United Nations (FAO,
1998). The blood glucose responses of test
fruits were then calculated as follows:
Blood Glucose Response
=AUC of test fruits x100
AUC of glucose
Results were expressed as mean +
SEM. Blood glucose value at each time,
AUC and blood glucose response were
subjected to repeated measure ANOVA
followed by Tukey’s multiple range test.
RESULTS
There was no significant difference in
terms of BMI and age between each subject
in the group (Table 1). Table 3 shows the
mean blood glucose at different time
points, the AUC values and blood glucose
response observed after consuming the
fruits. There was a significant increase in
fasting blood glucose after ingestion of all
fruits and glucose (p<0.01). The three tem-
perate fruits (grapes, orange and red
apple) and the two tropical fruits (papaya
and watermelon) reached peak blood glu-
cose values at 15 min while the rest of the
fruits including glucose peaked at 30 min.
The AUC ranged between 57.59mmol.
min/L and 313.2mmol.min/L, and was
significantly highest for glucose (p<0.05)
compared to all fruits tested. Among the
test fruits, the mean AUC was highest for
banana while the lowest was green pear.
The AUC value for banana was signifi-
cantly higher than green pear, red apple,
mango and sapodilla (p<0.05) while not
significantly different compared to the rest
of the fruits tested (Figure 1).
When comparing different varieties of
banana, Brangan has the highest AUC, fol-
lowed by Mas and Rastali (Figure 2).
However, the differences in AUC and
blood glucose response was insignificant
between the three types of bananas
(p>0.05). Nevertheless, banana showed
the largest rise of blood glucose response,
which was 62% when compared to glucose
(100%), while green pear showed the low-
est increment of only 18%. The blood glu-
cose response of other fruits tested was
longan,60% followed by rambutan and
grapes; (59%), watermelon (54%), orange
(47%), papaya (45%), jackfruit (41%),
sapodilla and mango (35%) and red apple
(27%) respectively (Figure 3).
Tropical fruits had significantly higher
AUC values and blood glucose responses
than temperate fruits (p<0.05) and both
were significantly lower than glucose
(p<0.05) (Figure 4). The crude fibre content
of the test fruits was not correlated with
the AUC value (r=-0.126, p>0.05) or blood
glucose response (r=-0.035, p>0.05) respec-
tively.
DISCUSSION
This study showed that the blood glu-
cose response produced after consuming
the test fruits was significantly lower
when compared with glucose (p<0.05).
Several researchers have reported similar
results and their results were attributed to
Blood glucose response following temperate and tropical fruit ingestion 49
the type of carbohydrate content of the
fruits which mainly consisted of fructose
(Wolever et al., 1993; Lunetta et al., 1995;
Guevarra & Panlasigui, 2000). Fructose is
slowly absorbed and is less likely to
increase blood glucose levels when com-
pared to other monosaccharides such as
glucose and lactose (Uusitupa, 1994).
Fructose is rapidly cleared and
metabolised by the liver in both normal
and type 2 diabetic patients (Wolever &
Brand-Miller, 1995). Moreover, the gly-
caemic index (GI) of fructose is significant-
ly lower than that of glucose and is found
to elicit lower blood glucose response (Lee
&Wolever, 1998).
Our results also demonstrated that the
tested fruits gave varying effects on blood
glucose responses. Wolever and Brand-
Miller (1995) noted that the glycaemic
index of fresh fruits vary over a threefold
range from 22 for cherries to 72 for water-
melon. There are several factors that may
affect the digestion and absorption of
fruits and thus the blood glucose response.
Factors such as the degree of ripeness, the
type of sugars present, the presence of
fibre and antinutrients and the physical
state of the fruits have contributed to the
response of glucose level (Guevarra &
Panlasigui, 2000).
In this study, banana has the largest
rise of blood glucose response while green
pear showed the lowest. A possible reason
for this is due to the carbohydrate content
of banana which is approximately twice
the amount of carbohydrate in apple, pear
or orange (Hermansen et al., 1992). The
degree of ripeness of banana may also
influence the postprandial blood glucose
response (Lintas et al., 1995). Over-ripe
banana has been found to be digested by a-
amylase at the highest rate, converting car-
bohydrate to free sugar (Englyst &
Cumming, 1986). However, no difference
was found in blood glucose response for
50 Barakatun Nisak MY, Ruzita AT & Norimah AK
Table 1. Characteristics of human subjects according to groups given each test fruit
Group Test Fruits n Age (years) BMI (kgm-2)
A Mango
Rambutan 20 21.2 + 0.5 20.8 + 1.4
Longan
B Sapodilla
Jackfruits 20 21.8 + 0.8 20.5 + 1.5
Green pear
C Banana
-Brangan
- Rastali 20 21.5 + 1.2 21.3 + 1.2
-Mas
D Watermelon
Papaya
Red apple 12 21.4 + 1.5 21.0 + 0.8
Orange
Grape
Total / Mean + SD (Range) 72 21.5 + 1.0 20.9 + 1.2
(21- 23) (19- 22)
p> 0.05 no significant difference of age and BMI between the groups
Blood glucose response following temperate and tropical fruit ingestion 51
Table 2. Amount of test fruits to be consumed
Test fruits Amount (g) Crude fibre (g)
containing 50 g CHO per 50 g CHO Origin
Mango (Mangifera Indica) 354 1.4 Local
(2 whole fruits)
Rambutan (Nephelium 361 1.3 Local
lappaceum) (12 whole fruits)
Longan (Nephelium malaiense) 313 1.2 Thailand
(24 whole fruits)
Sapodilla (Manilkara achras) 271 2.5 Local
(5 whole fruits without
skin/seeds)
Jackfruits (Artocarpus heterophullus) 686
(18 fruits 38.4 Local
without seeds)
Watermelon (Citrullus vulgaris) 835
(6 slices without skin;
LxWxT, 23.3x10x3 cm) 1.9 Local
Papaya (Carica papaya)703
(4½ slices;
LxWxT, 28x3x2.8 cm) 3.5 Local
Banana (Musa paradisiacal)
-Brangan 207 (3½ fruits) 1.0 Local
- Rastali 230 (7 fruits) 2.3
-Mas 219 (5 fruits) 3.7
Red apple (Pyrus malus)382 1.0 Fuji (Shandong,
(3½ whole fruits) Ltd China)
Orange (Citrus reticula) 552 3.2 Navel
(3½ whole fruits) (Australian
3107)
Grape (Vitis vinifera) 323 3.1 Top Brand
(27 whole fruits) (California)
Green pear (Pyrus communis) 310 5.6 China
(1½ whole fruits)
different types of bananas, indicating that
all varieties of bananas have the same
impact on blood glucose response.
Apple and green pear have been
reported to contain more fructose and less
glucose, thus demonstrating the lowest
blood glucose response (Lunetta et al.,
1995). In this study, sapodilla and mango
showed low glucose response and these
results are in agreement with those shown
by Guevarra & Panlasigui (2000). The
presence of antinutrients such as phytic
acid, tannins, lectins and saponin have
been known to delay the rate of digestion
and absorption (Brand-Miller et al., 1997).
Sapodilla contains saponin that has the
properties of foaming in water while
mango contains tannin and phytic acids
that are found to inhibit intestinal
enzymes lowering the rate of absorption
thus, producing low glucose response
(Guevarra & Panlasigui, 2000).
In addition, Bolton, Heaton &
Burroughs (1981) and Oettle, Emmett &
Heaton (1987) hypothesised that the rate
of the sugar entering the bloodstream
52 Barakatun Nisak MY, Ruzita AT & Norimah AK
Table 3. The mean blood glucose, AUC and blood glucose response (%) of fruits
under study
Test fruits 0 15 30 60 90 120 AUC BGR
(min) (min) (min) (min) (min) (min) (mmol.min/L) (%)
Tropical Fruits
Mango 3.7+0.2 4.6+0.3* 5.8+0.4 4.9+0.3 4.2+0.3 3.7+0.2 110.40+14** 35
Rambutan 4.2+0.2 5.8+0.2* 7.6+0.4 6.0+0.4 5.0+0.3 4.3+0.2 184.56+18** 59
Longan 3.8+0.2 5.6+0.2* 7.5+0.5 5.5+0.4 4.5+0.2 3.9+0.2 189.66+24** 60
Sapodilla 3.8+0.1 4.6+0.2* 5.8+0.2 5.2+0.3 3.6+0.2 3.8+0.2 110.92+15** 35
Jackfruits 3.6+0.1 4.6+0.2* 5.7+0.1 5.3+0.3 3.8+0.2 3.7+0.2 127.94+15** 41
Papaya 4.9+0.2 7.9+0.3* 7.7+0.3 5.7+0.2 5.0+0.2 4.8+0.2 140.32+24** 45
Watermelon 5.0+0.2 8.4+0.3* 7.8+0.2 6.1+0.2 5.5+0.2 5.0+0.1 170.46+23** 54
Various type of Bananas
-Brangan 4.6+0.1 7.6+0.1* 8.1+0.1 6.6+0.1 5.7+0.1 4.9+0.1 214.45+12** 68
-Rastali 4.9+0.1 6.5+0.1* 8.5+0.2 6.6+0.1 5.3+0.2 5.1+0.2 183.34+15** 59
-Mas 4.8+0.1 6.8+0.3* 7.5+0.4 6.6+0.4 6.0+0.3 5.1+0.2 189.45+32** 60
Mean 4.8+0.1 7.1+0.2 8.1+0.2 6.6+0.2 5.6+0.2 5.0+0.2 195.42+18** 62
Temperate Fruits
Grapes 5.2+0.6 9.4+1.1* 8.8+1.5 6.3+1.0 5.0+0.6 4.7+0.4 183.60+21** 59
Orange 4.7+0.4 8.4+1.7* 7.6+1.5 5.5+1.0 4.8+0.7 4.5+0.5 148.17+21** 47
Red apple 4.6+0.3 6.8+0.8* 6.4+0.6 4.8+0.5 4.7+0.3 4.5+0.2 84.27+8** 27
Green pear 3.3+0.2 3.7+0.2* 4.5+0.2 3.6+0.1 3.2+0.1 3.0+0.1 57.59+10** 18
Reference Food
Glucose 4.4+0.1 6.9+0.1* 8.9+0.1 8.0+0.1 6.1+0.1 5.6+0.1 313.20+10 100
(Glucolin®
* p<0.01
**p<0.05 significantly less than glucose
Values in bold determined the peaked blood glucose response. BGR= blood glucose response
Blood glucose response following temperate and tropical fruit ingestion 53
Mean Area Under the Curve
(
AUC
)
for Blood Glucose Response
over 2hr
84.27
110.4
110.92
127.94
140.32
148.17
183.63
184.56
189.66
195.42
313.2
57.59
170.46
0
50
100
150
200
250
300
350
Green pear
Red apple
Mango
Sapodilla
Jack fruits
Papaya
Orange
Watermelon
Grape
Rambutan
Longan
*Banana
Glucose
AUC value (mmol.min/L)
ap<0.05; significantly different from glucose
bp<0.05; significantly different from banana
* Mean AUC of three types of Banana
Figure 1. Mean area under the curve (AUC) for blood glucose response over 2 hours for
test fruits and glucose
Mean AUC and blood glucose responseafter consuming different
varieties of bananas
189.45 183.34
313.2
68 60 59
100
214.45
0
50
100
150
200
250
300
350
Brangan Mas Rastali Glucose
Type of banana
AUC (mmol.min/L)
AUC
Blood Glucose Re sponse
Figure 2. Comparison of AUC and blood glucose response between different varieties of
bananas
54 Barakatun Nisak MY, Ruzita AT & Norimah AK
18
27
35
35
41
45
47
54
59
59
60
62
100
0 20 40 60 80 100
Blood Glucose Response (%)
green pear
red appl e
mango
sapodilla
jackfruits
papaya
orange
wat ermelon
grapes
rambut an
longan
banana
glucose
Tes t Fruits
TheBloodGlucoseResponse (BGR)of TestFruits w hen Compare
with Glucose
Figure 3. Mean blood glucose response (BGR) of test fruits when compared with glucose
(reference food)
Mean of Blood Glucose Area Under the Curve (AUC) betw een
Tropical, Temperate & Glucose
149.8
81.52
313.2
0
50
100
150
200
250
300
350
AUC (mmo l .mi n/L)
Tropical fruits
Temperate fruits
Gl u co s e
a
a,
b
Figure 4. Mean of blood glucose area under the curve (AUC) between tropical, temperate
&glucose
ap<0.05; significantly different from from glucose
bp<0.05; significantly different from tropical fruits
varies with the physical state of the fruit.
Grapes, rambutan,longan,papaya and
watermelon are easily chewed and thus
elicit a high glucose response. Sapodilla,
mango, red apple and green pear, howev-
er, require some effort in chewing due to
their grainy texture. This might also con-
tribute to its low glucose response
(Guevarra & Panlasigui, 2000).
The tropical fruits demonstrated the
largest rise in mean AUC value when com-
pared to temperate fruits (Brand-Miller et
al., 1997). Differences among the fruits
may arise because of variations, particu-
larly in monosaccharide composition and
the nature of fibre (Wolever & Brand-
Miller, 1995).
No significant relationship was seen
between the crude fibre content of the
AUC values and blood glucose response in
this study despite the fact that fibre has
been repeatedly shown to decrease the
postprandial blood glucose (Stevens et al.,
2002). However, our findings were in
agreement with the study by Jenkins et al.,
(1981) and Lunetta et al., (1995). This was
probably due to the types of fibre that dif-
fer within fruits. The total dietary fibres in
fruits consist of soluble and insoluble
fibre. The insoluble fibres such as cellulose
and hemi-cellulose are rigid materials, and
give the structure to plants (Anderson &
Akanji, 1991). Soluble fibre like pectin,
present abundantly in fruits, may form a
viscous solution which has the capacity to
bind to carbohydrate. This could limit the
accessibility to a-amylase and reduce the
blood glucose response (Goni, Valdivieso
&Garcia-Alonso, 2000). Soluble fibre has
been shown to be active on plasma glucose
metabolism and consequently, demon-
strate the lowering effect of blood glucose
response (Riccardi & Rivellese, 1991).
CONCLUSION
Our results showed that there is a dif-
ference in blood glucose response among
tropical and temperate fruits tested. Based
on these results, the most suitable temper-
ate fruits to be recommended for diabetic
patients without significantly increasing
the blood glucose response are green pear
and red apple, while the most suitable
tropical fruits are sapodilla and mango.
Banana can only be eaten in moderate
amounts provided that fruits are within
the carbohydrate allowance. Dose-
response study with various amounts of
fruits for example 15 g of carbohydrate
should be carried out to determine the
most appropriate portion size of the fruits.
Acknowledgments
The authors would like to thank all the
young-committed researchers; Khairil
Shazmin Kamarudin, Noor ul-Aziha
Muhammad, Nubairi Adha Yusof and Tan
Poi Szie from the Department of Nutrition
&Dietetics, UKM, KL who coordinated
the research project and provided the orig-
inal data to allow calculation the area
under the curve (AUC) for each blood glu-
cose value.
REFERENCES
Anderson JW & Akanji AO (1991). Dietary
fiber- an overview. Diabetes Care
14:1126-1131.
Bantle JP, Laine DC, Castle GW, Thomas
JW, Hoogwerf BJ & Goetz FC (1983).
Postprandial glucose and insulin
responses to meals containing differ-
ent carbohydrates in normal and dia-
betic subjects. N Engl J Med 309:7-12.
Bolton RP, Heaton KW & Burroughs LF
(1981). The role of dietary fiber in sati-
ety, glucose, and insulin: Studies with
fruit and fruit juice. Am J Clin Nutr
34:211-217.
Brand-Miller J, Olagiuri MJV & Foster-
Powell K (1997). The GI factor.
Blood glucose response following temperate and tropical fruit ingestion 55
McPhersons Printing Group, Sydney.
Crapo PA, Reaven GM & Olesky JM
(1976). Plasma glucose and insulin
responses to orally administered sim-
ple and complex carbohydrate.
Diabetes 25:741-747.
Englyst HN & Cummings JH (1986).
Digestion of the carbohydrate of
banana (Musa paradisiaca sapientum) in
the human small intestine. Am J Clin
Nutr 44:42-50.
FAO/WHO Expert Consultation (1998).
Carbohydrate in human nutrition.
Report of joint FAO/WHO Expert
Consultation paper 66. Rome: FAO
Food and Nutrition.
Fatema K, Ali L, Rahman MH, Parvin S &
Hassan Z (2003). Serum glucose and
insulin response to mango and papaya
in type 2 diabetic subjects. Nutr
Research 23:9-14.
Ford ES & Mokdad AH (2001). Fruit and
vegetable consumption and diabetes
mellitus incidence among U.S. Adults.
Preventive Medicine 32:33–39.
Goni I, Valdivieso L & Garcia-Alonso A
(2000). Nori seaweed consumption
modifies glycemic response in healthy
volunteers. Nutr Research 20:1367-
1375.
Guevarra MTB & Panlasigui LN (2000).
Blood glucose responses of diabetes
mellitus type II patients to some local
fruits. Asian Pacific J Clin Nutr 9:303-
308.
Hermansen K, Rasmussen O, Gregersen S
&Larsen S (1992). Influence of
ripeness of banana on the blood glu-
cose and insulin response in type 2
diabetic subjects. Diabet Med 9:730-
743.
Hoover-Plow J, Savesky J & Dailey G
(1987). The glycemic response to meals
with six different fruits in insulin-
dependent diabetics using a home
blood-glucose monitoring system. Am
JClin Nutr 45:92-97.
Jenkins DJA, Wolever TMS, Taylor, HR,
Barker H, Fielden H, Baldwin MJ,
Bowling AC, Newman HC, Jenkins
AL & Goff VD (1981). Glycemic index
of foods: A physiological basis for car-
bohydrate exchange. Am J Clin Nutr
34:362-366.
Lee BM & Wolever TMS (1998). Effect of
glucose, sucrose and fructose on plas-
ma glucose and insulin responses in
normal humans: comparison with
white bread. Eur J Clin Nutr 52:924-
928.
Lintas C, Cappelloni M, Adorisio S,
Clementi A & del-Toma E (1995).
Effect of ripening on resistant starch
and total sugars in musa paradisiaca
sapientum:glycemic and insulinemic
response in normal subjecs and
NIDDM patients. Euro J Clin Nutr
49:5303-5306.
Liu S, Manson JE, Lee IM, Cole SR,
Hennekens CH, Willett WC & Buring
JE (2000). Fruit and vegetable intake
and risk of cardiovascular disease: the
women’s health study. Am J Clin Nutr
79:922-928.
Ludwig DS (2002). The glycemic index:
Physiological mechanism relating to
obesity, diabetes and cardiovascular
disease. JAMA 287:2414-2423.
Lunetta M, Di Mauro M, Crimi S &
Mughini L (1995). No important dif-
ferences in glycemic responses to com-
mon fruits in type 2 diabetic patients.
Diabet Med 12:674-678.
56 Barakatun Nisak MY, Ruzita AT & Norimah AK
Oettle GJ, Emmett PM & Heaton KW
(1987). Glucose and insulin responses
to manufactured and whole-food
snacks. Am J Clin Nutr 47:86-91.
Otto H & Niklas L (1980). Different
glycemic responses to carbohydrate-
containing foods. Implications for the
dietary treatment of diabetes mellitus.
Hyg (Geneva) 38:3424-3429. (abst in
French).
Riccardi G & Rivellese AA (1991). Effect of
dietary fiber and carbohydrate on glu-
cose and lipoprotein metabolism in
diabetic patients. Diabetes Care
14:1115-1125.
Stevens J, Ahn K, Juhaeri, Houstan D,
Steffan L & Couper D (2002). Dietary
fiber intake and glycemic index and
incidence of Diabetes in African-
American and White adults. Diabetes
Care 25:1715-1721.
Tee ES, Mohd. Ismail Noor, Mohd. Nasir
Azudin & Khatijah Idris (eds) (1997).
Nutrient Composition of Malaysian
Foods. 4th Edition. Malaysian Food
Composition Database Programme,
Institute for Medical Research, Kuala
Lumpur; 310 p.
Uusitupa MIJ (1994). Fructose in the dia-
betic diet. Am J Clin Nutr 59:753-757.
Wolever TMS & Brand-Miller J (1995).
Sugars & blood glucose control. Am J
Clin Nutr 62:212-227.
Wolever TMS, Vuksan V, Relle L, Jenkins
A, Josse R, Wong G & Jenkins D
(1993). Glycemic index of fruits and
fruit products in patients with dia-
betes. Int J Food Sc Nutr 43:205-212
(Abstr).
Blood glucose response following temperate and tropical fruit ingestion 57
... The fruit is a good source of vitamin B 6 , vitamin C and potassium and also an important starchy staple along with wheat, rice or corn for populations in many developing countries (Steptoe et al. 2003). However, substantial scientific data on glycemic index (GI) and glycemic load (GL) values of tropical bananas are not available (Yusof et al. 2005, Atkinson et al. 2008. ...
... Insoluble fibers present in fruits increase the bulk of the portion and slow the passage of food in the upper gastrointestinal tract (Wong and Jenkins 2007). Soluble fibers such as pectin form a viscous solution limiting the accessibility of starch to a-amylase and reduce blood glucose response (Yusof et al. 2005). Resistant starch (RS) contents of Silk, Mysore and Gros Michel were higher than Pisang Awak. ...
... Foster Powell et al. (2002) have reported the mean GI values of bananas with different degrees of ripeness (raw, slightly ripe, fully ripe and over ripe) from Europe, Canada, the USA and South Africa (10 studies) to be 74^5 (range ¼ 43 -100 against bread and glucose as standards). GI values of 59, 60 and 62 (against glucose) were reported for three varieties of bananas from Malaysia (Yusof et al. 2005). ...
Article
Full-text available
Chemical compositions and glycemic indices of four varieties of banana (Musa spp.) (kolikuttu-Silk AAB, embul-Mysore AAB, anamalu-Gros Michel AAA, seeni kesel-Pisang Awak ABB) were determined. Silk, Gros Michel, Pisang Awak and Mysore contained the highest percentages of starch (14%), sucrose (38%), free glucose (29%) and fructose (58%) as a percentage of the total available carbohydrate content respectively. Total dietary fiber contents of four varieties ranged from 2.7 to 5.3%. Glycemic indices of Silk, Mysore, Gros Michel and Pisang Awak were 61 ± 5, 61 ± 6, 67 ± 7, 69 ± 9 and can be categorized as low against white bread as the standard. A single banana of the four varieties elicited a low glycemic load. Thus, consumption of a banana from any of these varieties can be recommended as a snack for healthy or diabetic patients who are under dietary management or pharmacological drugs to regulate blood glucose responses in between meals.
... In order to analyse the starch digestibility rate, resistance starch, the hydrolysis index (HI) and glycemic index (GI) were estimated and tabulated in Table 4 Yusof et al. (2005). This is in accordance to the reduction in the starch upon ripening. ...
Article
Full-text available
Banana with different genomic groups has a greater varietal diversity. New varieties are also developed which have unique tastes, and tolerance to biotic or abiotic stresses. Eleven varieties belonging to different genomic groups are evaluated for their nutrients, secondary metabolites, techno‐functional characteristics, antioxidant activities, glycemic indices, and shelf life. Bioactive profiling was also carried out using Gas Chromatography–Mass Spectroscopy (GCMS). Results revealed that plantain and cooking bananas recorded higher fruit weight than dessert bananas. Pulp to peel ratio was higher in the dessert variety Ney Poovan and dual‐purpose variety Popoulu compared to cooking varieties indicating the presence of a thicker skin. Higher resistant starch (39% dry weight) and lower glycemic index (45%–50%) were observed in Kaveri Saba and Monthan. Total phenolics in ripe bananas were significantly higher than in unripe stages. GCMS results showed the predominance of esters and hydrocarbons among banana varieties and the presence of unique volatiles like linoelaidic acid, 9,12‐octadecadienoic acid in Kaveri Sugantham. PCA and cluster analysis indicated that the biochemical parameters also varied with the genomic groups. The study creates new business opportunities for varieties beyond cv. Grand Naine both in the domestic and export markets.
... In traditional Chinese medicines, longan is utilized to improve immunity, cure insomnia, neural pain and swelling, promote blood metabolism, and to enhance learning and memory . However, it has been demonstrated that the blood glucose response of longan in healthy adults is the second highest following the banana, in comparison with glucose as a reference (Yusof et al. 2005). The high quantity of sugars present in longan arils (sucrose 38.55-150.69 ...
Article
In this study, dried longan pulp (DLP) was subjected to fermentation using selected strains of lactic acid bacteria (Lactobacillus plantarum subsp. Plantarum and Leuconostoc mesenteroides). We then studied changes in the free and bound phytochemical profile, antioxidant activity, free amino acid, and organic acid composition. Fermentation exhibited a 17.4% and 5.7% increase in the amount of free and total phenolic contents of DLP. Phenolic composition determined by HPLC revealed significant changes due to fermentation that were primarily in the contents of gallic acid, vanillic acid, 4-methylcatechol and p-coumaric acid, resulting in a 37.9% and 25.7% increase in free gallic acid and 4-methylcatechol, respectively. Fermentation was also found to enhance the ferric reducing antioxidant power of both free and total and the oxygen radical absorbance capacity of free phenolic fraction by 18.3%, 11.8%, and 37.4%, respectively. In addition, fermentation was observed to reduce the contents of free amino acids with bitter taste (phenylalanine, tyrosine and leucine), and increase amino acids (taurine, aspartic acid, cysteine, cysteine thiazoline and γ-amino-butyric acid) having antioxidant potential. Therefore, this study provides basis for the production of fermented longan-based functional products with improved antioxidant activity.
... Raw jackfruit flesh is regarded as a good source of carbohydrate (25%), vitamin A and a fair source of protein (1.6%) [6]. The postprandial glycaemic response to raw and ripe jackfruit elicits low glycaemic index (GI) [7]. However, research has not focused on studying the nutritional parameters of cooked jackfruit meals. ...
Article
Full-text available
The mature jackfruit (Artocarpus heterophyllus) is consumed in Sri Lanka either as a main meal or a meal accompaniment. However, there is no scientific data on the nutrient compositions of cooked jackfruit meals. Thus, the objective of the study was to carry out a nutritional assessment of a composite jackfruit breakfast meal comprising seeds and flesh. A jackfruit meal comprising of flesh (80% available carbohydrate) and seeds (20% available carbohydrate) was included in the study. The study was carried out in a random cross over design. Setting University of Sri Jayewardenepura. Study participants Healthy individuals (n=10, age: 20-30 yrs). The macronutrient contents, rapidly and slowly available glucose (SAG) contents, water solubility index of the jackfruit meal were determined according to standard methods. The GI of the meal was calculated according to FAO/WHO guidelines. The moisture content of the boiled jackfruit flesh was high (82% FW). Jack seeds contained 4.7% protein (FW), 11.1% total dietary fibre (FW) and 8% resistant starch (FW). Jackfruit meal elicited a GI of 75. The Glycaemic Load (GL) of the normal serving size of the meal is medium. The slowly available glucose (SAG) percentage of jackfruit meal (30%) was twice that of the standard. The boiled jackfruit flesh contained disintegrated starch granules while seeds contained intact swollen and disintegrated granules. The jackfruit seeds are a good source of starch (22%) and dietary fibre. The meal is categorized as a low GI meal. The low GI could be dueto the collective contributions from dietary fibre, slowly available glucose and un-gelatinised (intact) starch granules in the seeds.
Article
Full-text available
Glycaemic index (GI) testing provides a useful point of comparison between carbohydrate sources. For this comparison to be meaningful, the methods used to determine GI values need to be rigorous and consistent between testing events. This requirement has led to increasing standardization of the GI methodology, with an international standard developed in joint consultation with FAO/WHO (ISO 26642:2010) currently the most up to date document. The purpose of this review is to compare the international standard to methods of published studies claiming to have performed a GI test. This analysis revealed that the international standard permits a wide range of choices for researchers when designing a GI testing plan, rather than a single standardized protocol. It has also been revealed that the literature contains significant variation, both between studies and from the international standard for critical aspects of GI testing methodology. The primary areas of variation include; what glucose specification is used, which reference food is used, how much reference food is given, what drink is given during testing, the blood sampling site chosen and what assay and equipment is used to measure blood glucose concentration. For each of these aspects we have explored some of the methodological and physiological implications of these variations. These insights suggest that whilst the international standard has assisted with framing the general parameters of GI testing, further stan-dardization to testing procedures is still required to ensure the continued relevance of the GI to clinical nutrition.
Article
Objectives This study compared the effects of consuming different forms (bite size, puree) and two fruit types (guava, papaya) on glycemic response (GR) in elderly and young adults. DesignThis study was conducted using a randomized, crossover design. ParticipantsNineteen healthy participants (9 elderly, 10 young adults) were recruited from the general public in Singapore. Intervention: Participants consumed glucose (reference food) on three occasions and test fruits (guava bites, guava puree, papaya bites, and papaya puree) on one occasion each. MeasurementsBlood glucose was analyzed prior to consuming the test food, at 15, 30, 45, 60, 90 and 120 minutes after food consumption. ResultsThe incremental area under the blood glucose response curve (iAUC) over 120 minutes for all the treatments was significantly lower than glucose (all P < 0.001). All fruit forms and types studied were low glycemic index (GI) (guava bites: 29; papaya bites: 38; papaya puree: 42; guava puree: 47), albeit a significant difference in GI between the treatments was found (P = 0.003). Elderly exhibited significantly greater GR than young participants (P = 0.019). Conclusion Although fruit form influences GR in the elderly and young adults, all fruit types and forms studied were found to be low GI. This study indicates that fruits are a valuable source of nutrient irrespective of the form of delivery in elderly and young adults. This study was registered at www.anzctr.org.au as ACTRN12614000655640.
Article
Full-text available
To rank Bangladeshi Mango and Papaya in terms of their Glycemic Index (GI) and Insulinemic Index (II), which are useful measures of glucose and insulin responses to a dietary component, thirteen type 2 diabetic subjects consumed, under a cross-over design, equi-carbohydrate amounts of mango (250 g), papaya (602 g) and white bread (the reference food, 63 g). Blood sample was drawn 5 times between 0h and 3h. Serum C-peptide was measured to evaluate Insulinemic status. Mango and Papaya showed higher serum glucose responses compared to that of bread. The similar glycemic responses of Papaya and Mango were reflected in their GI values. Papaya showed higher insulin response compared to both Mango and Bread (p < 0.001). Papaya also showed significantly higher C-peptide–glucose ratio in comparison to that of Mango and Bread. The data suggest that equi-carbohydrate amount of Papaya and Mango produce higher glycemic response as compared to bread, but the two fruits are comparable regarding this property. The higher insulin response of papaya needs to be considered in case of therapeutic management of diabetic patients and in assessing the risk of atherogenesis due to hyperinsulinemia.
Article
Full-text available
Diabetes diets should aim at ensuring an ideal body weight with normoglycemia and normolipidemia. The consensus recommendations of various diabetes associations suggest that these goals are most likely to be achieved by diets high in complex carbohydrates and fiber and low in fat. A typical diabetes diet containing 55-60% energy as carbohydrate (at least 66% complex), less than 30% energy as fat, 0.8 g.kg-1 desirable body wt.day-1 protein, and approximately 40 g fiber/day, improves glycemic control, reduces levels of serum atherogenic lipids, decreases blood pressure in those with hypertension, and reduces body weight in the obese. This diet also reduces insulin requirements in the insulin-treated patient and can promote discontinuation of insulin therapy in those with non-insulin-dependent diabetes mellitus. This article presents our experience with high-fiber high-carbohydrate diets and reviews knowledge on the likely mechanisms of action of fiber, its long-term effectiveness, and the concerns about its long-term safety. We suggest that reports on the risk of hypertriglyceridemia from on the risk of hypertriglyceridemia from high-carbohydrate diets are inconsistent and invalidated if those diets are also high in fiber content. Similarly, we urge some caution in prescribing high-monounsaturated fat diets as an alternative to high-carbohydrate diets, at least until the long-term implications of the former are clearer. We believe that there is no compelling reason to change the current diabetes diets, which should continue to be high in carbohydrate and fiber content.
Article
Background: Prospective data relating fruit and vegetable intake to cardiovascular disease (CVD) risk are sparse, particularly for women. Objective: In a large, prospective cohort of women, we examined the hypothesis that higher fruit and vegetable intake reduces CVD risk. Design: In 1993 we assessed fruit and vegetable intake among 39876 female health professionals with no previous history of CVD or cancer by use of a detailed food-frequency questionnaire. We subsequently followed these women for an average of 5 y for incidence of nonfatal myocardial infarction (MI), stroke, percutaneous transluminal coronary angioplasty, coronary artery bypass graft, or death due to CVD. Results: During 195647 person-years of follow-up, we documented 418 incident cases of CVD including 126 MIs. After adjustment for age, randomized treatment status, and smoking, we observed a significant inverse association between fruit and vegetable intake and CVD risk. For increasing quintiles of total fruit and vegetable intake (median servings/d: 2. 6, 4.1, 5.5, 7.1, and 10.2), the corresponding relative risks (RRs) were 1.0 (reference), 0.78, 0.72, 0.68, and 0.68 (95% CI comparing the 2 extreme quintiles: 0.51, 0.92; P: for trend = 0.01). An inverse, though not statistically significant, trend remained after additional adjustment for other known CVD risk factors, with RRs of 1.0, 0.75, 0.83, 0.80, and 0.85 (95% CI for extreme quintiles: 0.61, 1.17). After excluding participants with a self-reported history of diabetes, hypertension, or high cholesterol at baseline, the multivariate-adjusted RR was 0.45 when extreme quintiles were compared (95% CI: 0.22, 0.91; P: for trend = 0.09). Higher fruit and vegetable intake was also associated with a lower risk of MI, with an adjusted RR of 0.62 for extreme quintiles (95% CI: 0.37, 1.04; P: for trend = 0.07). Conclusion: These data suggest that higher intake of fruit and vegetables may be protective against CVD and support current dietary guidelines to increase fruit and vegetable intake.
Article
Seaweeds constitute sources of a great diversity in dietary fiber (DF). They contain a high proportion of soluble DF, which may be a barrier to starch digestion, and as a consequence seaweeds may modify glycemic response and may be beneficial in human health. The objective of this research was to evaluate the effect of Nori alga on postprandial glycemic response in healthy volunteers. This could offer a potential use of algae not only as a food but also as an ingredient rich in soluble dietary fiber. The effect of 3g Nori alga on the postprandial glycemic response to white bread was measured. Capillary blood samples were taken in the fasting state and then at 15, 30, 45, 60, 90, and 120 min. after each meal. Plasma glucose concentrations were analyzed and incremental areas under plasma glucose curves were calculated to determine the glycemic index (GI) of Nori + white bread with respect to white bread alone. Glycemic response to white bread was used as reference. In vitro kinetics of starch digestion were determined to estimate GI. In vitro and in vivo results were compared. Nori alga slowed down the degree of in vitro starch hydrolysis. Nori taken along with bread decreased the sharp glucose peacks found for bread at 30–60 min. After its ingestion, glucose levels until 120 min. were moderate. The intake of Nori alga decreased the glycemic response to white bread in healthy volunteers, from 100 to 68%. In vitro kinetic results provided an idea of in vivo behavior therefore preliminary in vitro assays are recommended before initiating in vivo experiments.
Article
To determine the glucose responses of diabetes mellitus type II subjects to fruits, four locally available fruits (containing 25 g of available carbohydrates per serving portion) of chico, mango, pineapple, and papaya were tested among ten type II diabetic subjects, using wheat bread as the control. Results of the in vivo test indicated that chico and mango had significantly lower (P≤ 0.05) blood glucose areas compared to wheat bread. Chico and mango also had a much lower glycemic index (GI), 57 and 59, respectively, compared to pineapple, 73 and papaya, 86. Differences in glucose responses to fruits and their varying GI are attributed to the amount of fiber, type and amount of sugars found, presence of antinutrients, acidity and physical characteristics of the fruits when chewed. The high fiber content of chico (7.9%), its fructose content (5.3%), its grainy texture when chewed and the presence of antinutrients (saponin, sapotin and achrasaponin) may contribute to its slow digestion and absorption. The low GI and blood glucose response of mango may be because of its fructose content (3.0%), acidity content (malic, citric and tartaric) and its phytic acid content (0.03%). Furthermore, starch, which is a possible factor contributing to low GI, is present in chico (0.8%) and mango (0.3%). Pineapple and papaya, the test fruits that elicited higher blood glucose responses and GI, have much lower fiber contents, less acids and contain glucose and sucrose sugars.
Article
We have studied the effects of glucose, sucrose, and various starches on postprandial plasma glucose and insulin responses in 19 subjects. All carbohydrate loads were calculated to contain 50 gm. of glucose, and the response to each carbohydrate was tested twice: when given alone in a drink or when given in combination with other nutrients as a meal. The data demonstrate: (1) Glucose and sucrose elicited similar plasma glucose response curves, but sucrose elicited a somewhat greater (20 per cent) plasma insulin response. (2) Raw starch ingestion resulted in a 44 per cent lower glucose response and a 35-65 per cent lower insulin response than did either glucose or sucrose ingestion. (3) When carbohydrate was given as a meal the plasma glucose responses were 40-60 per cent lower than when the same carbohydrate was given as a drink, while the insulin responses were generally similar, and (4) when different cooked starches were compared, the plasma glucose and insulin responses to rice were significantly lower (50 per cent) than to potato. In conclusion, the size of the carbohydrate molecule appears to influence the postprandial glucose and insulin responses such that more complex carbohydrates (starches) elicit lower responses. This effect may be related to differences in digestion rather than to differences in absorption.
Article
Banana is a popular and tasty fruit which often is restricted in the diet prescribed for diabetic patients owing to the high content of free sugars. However, in under-ripe bananas starch constitutes 80-90% of the carbohydrate content, which as the banana ripens changes into free sugars. To study the effect of ripening on the postprandial blood glucose and insulin responses to banana, 10 type 2 (non-insulin-dependent) diabetic subjects consumed three meals, consisting of 120 g under-ripe banana, 120 g over-ripe banana or 40 g white bread on separate days. The mean postprandial blood glucose response area to white bread (181 +/- 45 mmol l-1 x 240 min) was significantly higher compared with under-ripe banana (62 +/- 17 mmol l-1 x 240 min: p < 0.01) and over-ripe banana (106 +/- 17 mmol l-1 x 240 min: p < 0.01). Glycaemic indices of the under-ripe and over-ripe bananas differed (43 +/- 10 and 74 +/- 9: p < 0.01). The mean insulin response areas to the three meals were similar: 6618 +/- 1398 pmol l-1 x 240 min (white bread), 7464 +/- 1800 pmol l-1 x 240 min (under-ripe banana) and 8292 +/- 2406 pmol l-1 x 240 min (over-ripe banana). The low glycaemic response of under-ripe compared with over-ripe bananas may be ascribed to the high starch content, which has previously been found to be only hydrolysed slowly by alfa-amylase in humans.(ABSTRACT TRUNCATED AT 250 WORDS)