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January – March, 2024
AcTion:
Aceh N u t rition Journal
Original Article
Pages: 182 – 193
p-issn 2527-3310; e-issn 2548-5741
DOI: http://dx.doi.org/10.30867/action.v9i1.1514
Aceh. Nutri. J. 2024; 9(1)
https://ejournal.poltekkesaceh.ac.id/index.php/an/article/view/1514
Optimizing healthy snacks for diabetics: Study of fiber and starch
digestibility of glucomannan-modified Growol cookies
Optimasi snack sehat untuk diabetesi: Kajian serat dan daya cerna pati
cookies Growol modifikasi glukomanan
Desty Ervira Puspaningtyas1*, Puspita Mardika Sari2, Silvia Dewi Styaningrum3,
Adi Sucipto4, Dwita Mukti Rahmawati5, Getha Puji Lestari6
1 Program Studi Gizi Program Sarjana,
Fakultas Ilmu Kesehatan, Universitas
Respati Yogyakarta, Yogyakarta,
Indonesia.
E-mail: desty_puspaningtyas@respati.ac.id
2 Program Studi Gizi Program Sarjana,
Fakultas Ilmu Kesehatan, Universitas
Respati Yogyakarta, Yogyakarta,
Indonesia.
E-mail: puspitamardika@respati.ac.id
3 Program Studi Gizi Program Sarjana,
Fakultas Ilmu Kesehatan, Universitas
Respati Yogyakarta, Yogyakarta,
Indonesia.
E-mail: silviadewi_s@respati.ac.id
4 Program Studi Keperawatan Program
Sarjana, Fakultas Ilmu Kesehatan,
Universitas Respati Yogyakarta,
Yogyakarta, Indonesia.
E-mail: adisucipto@respati.ac.id
5 Program Studi Gizi Program Sarjana,
Fakultas Ilmu Kesehatan, Universitas
Respati Yogyakarta, Yogyakarta,
Indonesia.
E-mail: 20120102@respati.ac.id
6 Program Studi Gizi Program Sarjana,
Fakultas Ilmu Kesehatan, Universitas
Respati Yogyakarta, Yogyakarta,
Indonesia.
E-mail: 20120103@respati.ac.id
*Correspondence Author:
Program Studi Gizi Pr ogram Sarjana,
Fakultas Ilmu Kesehatan, Un iversitas
Respati Yogyakarta, Jalan Raya Tajem
Km 1,5, M aguwoharjo, Depok, Sleman ,
Yog yakarta, 55282, Indon esia.
E-mail: desty_puspaningtyas@respati.ac.id
Article History:
Received: November 07, 2023; Revised:
January 31, 2024; Accepted: February 13,
2024; Published: March 15, 2024.
Publisher:
© The Author(s). 2024 Open Access
This article has been distributed under the
terms of the License Internasional Creative
Commons Attribution 4.0
Abstract
Diabetes mellitus (DM) is an emergency health problem in the 21st century.
High dietary fiber and resistant starch foods with low starch digestibility are
solutions for DM. The addition of glucomannan to food can optimize the
levels of dietary fiber, resistant starch, and starch digestibility. This study
aimed to examine the optimization of dietary fiber, resistant starch, and
starch digestibility in Growol cookies supplemented with glucomannan.
Laboratory observations were conducted at the Universitas Respati
Yogyakarta and Chemmix Pratama Yogyakarta Laboratory between July and
September 2023. Cookies consisted of cookies A (negative control), B
(positive control), C (modified 10-gram inulin), D (modified glucomannan
3%), and E (modified glucomannan 7%). Dietary fiber and resistant starch
analyses were performed using the multi-enzyme method. Starch
digestibility was determined by comparing the starch content obtained using
the enzymatic method with that obtained using the acid hydrolysis method.
Statistical analyses were performed using ANOVA and Kruskal-Wallis tests.
There were differences in dietary fiber and resistant starch among the
variants (p<0,001) with the highest being cookies E. There was no difference
in starch digestibility between the variants (p=0,104) with the lowest being
cookies E. In conclusion, glucomannan addition can optimize dietary fiber
and resistant starch levels, as well as the starch digestibility of Growol
cookies as a healthy snack for diabetics.
Keywords: Diabetes, dietary fiber, glucomannan, resistant starch
Abstrak
Diabetes mellitus (DM) merupakan darurat masalah kesehatan pada abad ke-
21. Makanan tinggi serat pangan dan pati resisten serta rendah daya cerna
pati merupakan solusi penanganan DM. Penambahan glukomanan pada
produk makanan mampu mengoptimalkan kadar serat pangan, pati resisten,
dan daya cerna pati. Penelitian bertujuan untuk mengkaji optimasi serat
pangan, pati resisten, dan daya cerna pati pada cookies Growol dengan
penambahan glukomanan. Penelitian berdesain observatori laboratorium
dilakukan di Universitas Respati Yogyakarta dan Laboratorium Chemmix
Pratama Yogyakarta pada Juli–September 2023. Cookies terdiri atas cookies A
(kontrol negatif), cookies B (kontrol positif), cookies C (modifikasi inulin 10
gram), cookies D (modifikasi glukomanan 3%), dan cookies E (modifikasi
glukomanan 7%). Analisis serat pangan dan pati resisten dilakukan dengan
metode multienzim. Daya cerna pati diperoleh dari perbandingan kadar pati
metode enzimatis dengan metode hidrolisis asam. Analisis statistik
menggunakan ANOVA dan Kruskal-Wallis. Terdapat perbedaan kadar serat
pangan dan pati resisten di antara varian cookies (p<0,001) dengan serat
pangan dan pati resisten tertinggi adalah cookies E. Tidak terdapat perbedaan
daya cerna pati di antara varian cookies (p=0,104) dengan daya cerna pati
terendah adalah cookies E. Kesimpulan, penambahan glukomanan mampu
Aceh. Nut r i. J. Vol: 9, No: 1, 2024
183
mengoptimalkan kadar serat pangan dan pati resisten serta daya cerna pati
cookies Growol sebagai snack sehat untuk diabetes.
Kata Kunci: Diabetes, glukomanan, pati resisten, serat pangan
Introduction
The International Diabetes Federation (IDF)
emphasizes that diabetes mellitus (DM) is an
emergency health problem of the 21st century,
considering that more than half a billion people
worldwide live with diabetes. The IDF estimates
that there will be a global increase of 46 % %in
diabetes cases from 2021 (around 537 million)
to 2030 (643 million) and a sharp increase in
2024 (783 million). The largest increase
occurred in Africa (134%), Southeast Asia
(68%), and America (50%). The emergence of
diabetes is evident in the increasing number of
children and teenagers living with diabetes
every year. More than 1,2 million children and
adolescents have diabetes with 184 thousand
new cases diagnosed each year (International
Diabetes Federation, 2021b).
In fact, in 2021, as many as 537 million
adults aged 20-79 years live with diabetes, and
three of the four adults living with diabetes
come from low-to middle-income countries.
Moreover, diabetes contributes to 6,7 million
deaths in 2021, namely one death every five
seconds. Diabetes has also caused an increase in
state spending on health by 966 million dollars,
with an increase in spending of 316% over the
last 15 years. Evidence of diabetes emergencies
can also be seen from the increasing number of
adults who experience impaired glucose
tolerance (541 million), which places them at a
high risk of developing type 2 diabetes mellitus
(International Diabetes Federation, 2021c).
In Indonesia, the prevalence of DM in the
population aged 20-79 years reached 6, 2% in
2020. Indonesia is predicted to become the 6th
largest country in the world with a prevalence of
DM aged 20-79 years of 14,1 million people in
2035 (Forouhi & Wareham, 2014). Periodic
reports contained in Indonesia Diabetes Report
from 2000 to 2021 shows that the incidence of
diabetes in adults aged 20-79 years has
increased from 5,7 million (2000) to 7,3 million
(2011) and increased drastically to 19,5 million
(2021) with the number of people with diabetes
who do not diagnosed at 14,3 million and the
death rate due to diabetes was 235.711 (6,5%).
Moreover, 700 new cases of type 1 diabetes in
children and adolescents aged 0-14 years were
found, with a prevalence of 4.700 cases. The
number of diabetic complications also tends to
increase, including microvascular complications
such as nephropathy (7,7%), neuropathy
(17,6%), retinopathy (2,7%), and macrovascular
complications such as cerebrovascular disease
(5,4%), heart failure (5%), and coronary artery
disease (5,4%) (International Diabetes
Federation, 2021a). Ironically, the total medical
costs incurred by Indonesia reached $576
million, with 56% spent on hospitalization, 38%
on specialist visits, and 4% on other treatments
(Hidayat et al., 2022). The Yogyakarta Special
Region is one of the provinces with a higher
diabetes prevalence (4,5%) than the national
prevalence (2,4%) (Dinas Kesehatan DIY, 2021).
The prevention and treatment of diabetes must
be performed as early as possible. Optimal
management of diabetes can prevent
complications and reduce costs (Hidayat et al.,
2022).
One solution for managing DM is to
regulate simple sugar intake and increase the
intake of dietary fiber and resistant starch
(Abbas, 2021; Kosupa & Utama, 2020; Masrukan,
2020; Tuaño et al., 2021; Walsh et al., 2022).
Consuming foods high in fiber and resistant
starch can reduce postprandial glucose
concentrations and increase insulin sensitivity
(Pugh et al., 2023; Srimiati & Harsanti, 2023;
Volpe, 2016). In addition, resistant starch has
the potential to be used as a prebiotic, which is
the main substrate for gastrointestinal
microbiota (Bimo et al., 2015).
Furthermore, increasing the levels of
dietary fiber and resistant starch in food
products reduces the starch digestibility of a
product. The lower the digestibility of food
starch, the less glucose is produced, which
causes a slight increase in the blood glucose
levels. Foods with low starch digestibility are
suitable for consumption by people with
diabetes (Noviasari et al., 2015). A food product
with good fiber and resistant starch contents
was grown.
Growol is a traditional fermented food
made from cassava from Yogyakarta. This
fermentation occurs naturally and involves lactic
acid bacteria, which are beneficial for health
(Afrianto & Wariyah, 2020; Wicaksono et al.,
184
Optimizing healthy snacks for diabetics …
Puspaningtyas et al.
2022). Growol can support the growth of
bacteria such as Lactobacillus, which affects the
balance of the gastrointestinal microbiota
(Puspaningtyas et al., 2018; Sari &
Puspaningtyas, 2019).
Growol has been developed in the form of
Growol cookies, and then Growol cookies has
been modified by adding inulin to increase the
effectiveness of the fiber cookies. Growol
cookies have a lower glycemic index (87) than
glucose cookies (100). After the addition of
inulin, the glycemic index of the Growol cookies
decreased to 41 (low) (Puspaningtyas et al.,
2020; Puspaningtyas et al., 2022). However, the
addition of inulin has weaknesses in terms of
texture, in which cookies tend to be more fragile
and easy to break (Puspaningtyas, Sari, et al.,
2022). Inulin can be substituted by
glucomannan.
Glucomannan, a water-soluble fiber, has
the potential to be used as a substitute for inulin
in the development of growth cookies.
Glucomannan can be used as an emulsifier,
thickener, binder, and surfactant (Mura, 2021).
In addition, in terms of physiological effects,
glucomannan can improve lipid profiles and
glycemic status (Keithley et al., 2013; Keithley &
Swanson, 2005). Preclinical studies using
glucomannan from konjac flour showed
improvements in blood glucose control and
insulin sensitivity in diabetic test groups
(Susanti et al., 2015). A study in obese
individuals showed that glucomannan has an
inhibitory effect on glucose and increases insulin
(Mashudi et al., 2022).
To date, studies related to the initial
feasibility of glucomannan-modified Growol
cookies as a healthy snack for diabetics have not
been conducted, especially in terms of the levels
of dietary fiber, resistant starch, and starch
digestibility. This study supports the use of local
food as a dietary solution in disease therapy,
especially for diseases related to decreased body
function, such as diabetes (Nakamura & Omaye,
2012). The use of cassava as a raw material for
making Growols also supports Indonesia's food
diversification and food security (Khoerunisa,
2020; Putri et al., 2022).
This study aimed to provide an overview
of changes in the levels of dietary fiber, resistant
starch, and starch digestibility in various
modifications of Growol cookies. Ultimately, this
research aimed to examine the optimization of
dietary fiber, resistant starch, and starch
digestibility of Growol cookies with the addition
of glucomannan.
Methods
Research Design, Location, and Time
This was a laboratory observation of the
differences in the levels of dietary fiber, resistant
starch, and starch digestibility of glucomannan-
modified Growol cookies compared to control
Growol cookies and inulin-modified Growol
cookies, which have been developed in previous
research. This research consisted of several
stages, starting from making Growol, producing
Growol flour, manufacturing Growol cookies,
and laboratory testing.
This research was conducted at
Universitas Respati Yogyakarta, specifically in
the Culinary and Dietetics Laboratory, as a place
for making Growol, drying Growol, and making
cookies. The Chemmix Pratama Yogyakarta
Laboratory was used to analyze the food fiber
content, resistant starch, and starch digestibility.
This study was conducted from July to
September 2023. This research has received a
certificate of ethical suitability from the Health
Research Ethics Commission, Faculty of Health
Sciences, Universitas Respati Yogyakarta with
number 0146.3/FIKES/PL/VII/2023.
Process of Making Growol, Growol Flour, and
Growol Cookies
The cassava specifications used in making
Growols refer to previous studies, namely
Klentengan cassava (Manihot esculente or
Manihot utilisima) with light green stems, five–
nine finger leaves, 8-11 years old, long round
tubers, thin brown outer skin, and slightly thick
white or pink inner skin with white tubers inside
(Helsius et al., 2023b, 2023a; Puspaningtyas et
al., 2018).
Growol is made through a natural
fermentation process according to previous
studies (Puspaningtyas et al., 2018), starting
from selecting cassava by peeling the cassava
skin and removing the black or bluish parts.
Next, the cassava was cut into smaller pieces of
approximately 5 cm, followed by washing under
flowing water two to three times. Next, cassava
was soaked in water at a weight-to-volume ratio
of 1:3. The cassava was soaked for four days
Aceh. Nut r i. J. Vol: 9, No: 1, 2024
185
until a distinctive aroma appeared, and the
cassava became softer. The next step was
washing and filtering the cassava using mori
cloth seven times. The filtered cassava was then
squeezed and molded into raw Growol. The final
step was steaming the raw Growol into Growol.
The Growol-flouring process begins by
slicing the Growol into thin pieces, followed by
drying the Growol using a cabinet dryer at 80 °C
for six hours. The next step was to flour the
Growol using a grinder and sieve it with a 60-
mesh sieve.
Cookies were made after Growol flour was
available. Ingredients and the process of making
Growol cookies are described in a previous
study (Puspaningtyas et al., 2020; Puspaningtyas
et al., 2022). The developed cookies consisted of
negative control Growol cookies with granulated
sugar as the sweetener (cookies A), positive
control Growol cookies with non-calorie sugar
as the sweetener (cookies B), Growol cookies
with 10 g of inulin (cookies C), Growol cookies
with 3% glucomannan (cookies D), and Growol
cookies with 7% glucomannan (cookies E). The
percentage of inulin used was based on previous
studies (Puspaningtyas et al., 2022). The
percentage of glucomannan use refers to the
effective limit of glucomannan consumption of
1-4 grams per day (Keithley et al., 2013;
Keithley & Swanson, 2005; Mohammadpour et
al., 2020).
Dietary Fiber Testing
Dietary fiber analysis was performed using the
multienzyme method (Nova et al., 2020;
Tuwohingide et al., 2022). A total of 0,5 grams of
sample (cookies) were weighed and then added
50 mL of pH 7 phosphate buffer and 0,1 mL of
alpha-amylase enzyme. The mixture was then
heated in a water bath at 100 °C for 30 min and
stirred occasionally.
The samples were then removed and
cooled. After cooling, 20 mL distilled water and 5
mL 1 N HCl were added. Then, 1 mL of 1%
pepsin enzyme was added and heated in a water
bath for 30 min.
After that, remove the sample and add 5
mL of 1 N NaOH and 0,1 mL of beta-amylase
enzyme. The samples were incubated in a water
bath for 1 h. The sample was then filtered
through a filter paper of known weight.
Next, the sample was washed with 2 × 10
mL of ethanol and 2 × 10 mL of acetone. The
sample was dried overnight in an oven at 105 °C.
The sample was then cooled in a desiccator and
the final weight of the sample was measured.
The final weight of the sample is an illustration
of the level of insoluble dietary fiber.
Meanwhile, 100 ml of the filtered filtrate
was measured and 400 ml of 95% ethanol was
added. The filtrate was allowed to settle for 1 h.
The filtrate was then filtered using ash-free filter
paper and washed with 2 × 10 ml ethanol and 2
× 10 ml acetone. The samples were then dried
overnight in an oven at 105 °C. It was then
placed in a desiccator, and the final sample was
weighed. The final weight of the sample is an
illustration of the water-soluble dietary fiber
content.
The total dietary fiber content was the
sum of the levels of insoluble and soluble dietary
fiber. Dietary fiber testing was performed in
triplicate for two units of each cookie variant.
Resistant Starch and Starch Digestibility
Testing
Resistant starch analysis was performed using
the multienzyme method (Anugrahati &
Widjanarko, 2018). A total of 0,5 grams of
sample (cookies) was weighed and then added
25 mL of 0,1 M phosphate buffer solution (pH 7)
was added and stirred to form a suspension.
Then, add 0,1 mL) was then added. Next, they
were incubated in a water bath at 100 °C for 15
min and stirred occasionally.
The samples were then removed and
cooled. After cooling, 20 mL distilled water, 5
mL 1 M HCl, and 1 mL 1% pepsin enzyme were
added. The cells were then incubated again in
a water bath for 30 min. Next, add 20 mL of
distilled water, 5 mL of 1 N NaOH, and 0,1 mL
of beta-amylase enzyme. The mixture was
again incubated in a shaking water bath for 30
min. Filter paper was used to dissolve the
residue, and the resistant starch content was
analyzed through glucose weight conversion
using the acid hydrolysis method with the
following mathematical calculations (Polnaya
et al., 2018). The G value is the weight of
glucose in grams and the conversion of 0,9
comes from the free D-glucose conversion
factor determined in the form of D-glucose in
starch (162/180).
% Resistant Starch = 1−𝐺𝑥0,9
𝑠𝑎𝑚𝑝𝑙𝑒 𝑤𝑒𝑖𝑔ℎ𝑡 x 100%
186
Optimizing healthy snacks for diabetics …
Puspaningtyas et al.
Starch digestibility was determined by
comparing the starch content of the enzymatic
method with that of the acid hydrolysis method
using the AOAC 2005 method (Anugrahati &
Widjanarko, 2018). Testing for resistant starch
and starch digestibility was performed in
triplicate for two units of cookies for each cookie
variant. The mathematical calculation for
determining the starch digestibility is as follows:
Starch digestibility:
=𝑠𝑡𝑟𝑎𝑐ℎ 𝑐𝑜𝑛𝑡𝑒𝑛𝑡 𝑜𝑓 𝑒𝑛𝑧𝑦𝑚𝑎𝑡𝑖𝑐 𝑚𝑒𝑡ℎ𝑜𝑑
𝑠𝑡𝑟𝑎𝑐ℎ 𝑐𝑜𝑛𝑡𝑒𝑛𝑡 𝑜𝑓 𝑎𝑐𝑖𝑑 ℎ𝑦𝑑𝑟𝑜𝑙𝑦𝑠𝑖𝑠 𝑚𝑒𝑡ℎ𝑜𝑑 x 100%
Statistical analysis
Data on dietary fiber (insoluble dietary fiber,
water-soluble dietary fiber, and total dietary
fiber), resistant starch, and starch digestibility
were first analyzed for distribution using the
Shapiro–Wilk test. The data on resistant starch
and starch digestibility were not normally
distributed (p<0,05). Meanwhile, the dietary
fiber data were normally distributed (p>0,05).
Next, for normally distributed data, a
homogeneity of variance test was performed
using the Levene Test. Only water-soluble
dietary fiber data showed homogeneous
variance (p>0,05).
Differences in water-soluble dietary fiber
levels between the groups were tested using
ANOVA. If the test results were significant, the
Tukey’s HSD test was continued. Differences in
the levels of insoluble dietary fiber, total
dietary fiber, resistant starch, and starch
digestibility between the groups were tested
using the Kruskal-Wallis test. If the test results
were significant, the Mann-Whitney test was
used.
Result and Discussion
Dietary Fiber Content
There were differences in the levels of insoluble
dietary fiber, water-soluble dietary fiber, and
total dietary fiber between cookies A, B, C, D, and
E. Growol cookies with the addition of 7%
glucomannan (cookies E) had the highest levels
of insoluble dietary fiber, water-soluble dietary
fiber, and total dietary fiber compared to other
cookies (Table 1).
Table 1. Dietary fiber content of Growol cookies
Growol
Cookies
% Insoluble Dietary Fiber
% Water-Soluble
Dietary Fiber
% Total Dietary Fiber
Mean±SD
Mean
Rank
p-value*
Mean±SD
p-value#
Mean±SD
Mean
Rank
p-value*
Cookies A
3,16±0,07
3,50a
<0,001
0,36±0,03a
<0,001
3,52±0,10
3,50a
<0,001
Cookies B
3,79±0,07
9,50b
0,47±0,02b
4,26±0,07
9,50b
Cookies C
5,26±0,38
15,50c
0,57±0,02c
5,83±0,38
15,50c
Cookies D
7,43±0,15
21,50d
0,65±0,02d
8,08±0,14
21,50d
Cookies E
8,55±0,20
27,50e
0,74±0,01e
9,29±0,20
27,50e
*Kruskal-Wallis; #ANOVA
abcdeDifferent letter notations indicate differences between groups
Resistant Starch Content and Starch
Digestibility
The greater the addition of glucomannan to the
Growol cookies, the higher the level of resistant
starch in the cookies. There were significant
differences in resistant starch levels between all
variant cookies, with the highest resistant starch
found in cookies E (Table 2). The greater the
addition of glucomannan to cookies, the lower
the starch digestibility. The lowest starch
digestibility is found in cookies E followed by
cookies D, cookies A, cookies C, and the highest
starch digestibility at cookies B. There was no
significant difference in starch digestibility
among the cookies (Table 2).
Based on the results of statistical analysis,
glucomannan-modified Growol cookies have
higher levels of dietary fiber (both insoluble
dietary fiber, water-soluble dietary fiber, and
total dietary fiber) and resistant starch than
control Growol cookies and inulin-modified
Growol cookies. The starch digestibility of
glucomannan-modified Growol cookies was
lower than that of the control and inulin-
modified Growol cookies. The addition of
glucomannan to Growol cookies has been
Aceh. Nut r i. J. Vol: 9, No: 1, 2024
187
proven to increase the levels of dietary fiber and
resistant starch. This is the basic reason for the
development of modified glucomannan growth
cookies as healthy snacks for diabetics.
Table 2. Resistant starch content and starch digestibility of Growol cookies
Growol
Cookies
% Resistant Starch
% Starch Digestibility
Mean±SD
Mean
Rank
p-value*
Mean±SD
Mean
Rank
p-value*
Cookies A
2,78±0,04
3,50a
<0,001
51,36±6,53
17,50
0,104
Cookies B
4,10±0,08
9,50b
56,66±13,13
20,00
Cookies C
6,29 (5,89-6,70)#
15,50c
52,66±6,53
19,33
Cookies D
8,68 (8,59-8,75)#
21,50d
44,98 (44,62-56,51)#
12,17
Cookies E
9,36±0,07
27,50e
42,88 (41,33-55,17)#
8,50
*Kruskal-Wallis
#Median (Minimum-Maximum)
abcdeDifferent letter notations indicate differences between groups
Dietary fiber is a carbohydrate that is
difficult to process or break down by digestive
enzymes. This property allows dietary fiber to
provide good glycemic control. Dietary fiber,
especially soluble dietary fiber, can increase the
sensation of fullness owing to increased
viscosity in the stomach. This increase in
viscosity causes changes in the hormonal and
enzymatic responses in the digestive tract. This
affects the slow rate of glucose absorption
(Giuntini et al., 2022; Noviasari et al., 2015).
Based on the results of the dietary fiber
content tests, control Growol cookies and
Growol cookies with the addition of inulin can
be classified as a food source of fiber,
considering that the total dietary fiber
content in the cookies has reached the
minimum standard, namely 3 g in 100 g of
food (3%). Consuming 100 g of cookies can
meet 10% of daily fiber needs. Furthermore,
glucomannan-modified Growol cookies can be
classified as a high-fiber food, considering
that the amount of total dietary fiber in the
cookies achieves the minimum standard for
high-fiber foods, namely 6 g in 100 g (6%),
which can meet 20% of the daily fiber needs
(Codex Alimentarius Commission, 2009;
Noviasari et al., 2015). The addition of
glucomannan to Growol cookies can increase
the levels of dietary fiber by two to three
times compared with control cookies.
Insoluble dietary fiber plays a role in
increasing fecal volume and making it easier to
expel feces from the digestive tract. Soluble
dietary fiber plays a role in controlling blood
glucose and blood cholesterol levels. These two
mechanisms help improve insulin sensitivity
(Egayanti et al., 2019).
Consuming foods high in dietary fiber can
reduce blood glucose levels by 9,97 to 15,3
mg/dL and also reduce HbA1c levels ranging
from 0,26% to 0,55% (Asif, 2014; Post et al.,
2012; Silva et al., 2013). Increasing fiber intake
to 35 grams a day can reduce glycated
hemoglobin (HbA1c) levels by up to 2,00
mmol/mol (2,3%), fasting plasma glucose by
0,56 mmol/L (10,09 mg/dL), and HOMA-IR by
1,24 mg/dL (Reynolds et al., 2020).
One type of soluble dietary fiber is
glucomannan. Previous studies have applied
glucomannan to instant noodle products. Daily
consumption of 4 g of glucomannan in 400 g of
instant noodles for 28 days can reduce HbA1c by
0,63%. This effect is caused by glucomannan,
which plays a role in increasing the viscosity of
the gastrointestinal tract, causing changes in
hormonal responses and digestive tract
enzymes, and reducing the rate of glucose
absorption (Cheang et al., 2017; Giuntini et al.,
2022).
In line with the results of dietary fiber, the
addition of glucomannan to Growol cookies
increased the levels of resistant starch by two to
three times compared to control cookies. Similar
to dietary fiber, resistant starch has slow
digestibility, which can slow the increase in
glucose levels in the body. In addition, resistant
starch can also increase and maintain feelings of
fullness. This is because the metabolism of
resistant starch occurs from five to seven hours
after food consumption (Egayanti et al., 2019;
Noviasari et al., 2015).
Resistant starch is a food compound that
escapes enzymatic digestion in the small
intestine, is directly processed in the large
intestine, and is fermented by gastrointestinal
188
Optimizing healthy snacks for diabetics …
Puspaningtyas et al.
bacteria to produce short-chain fatty acids such
as acetate, propionate, and butyrate. This plays a
role in maintaining the balance of the
gastrointestinal microbiota (Masrukan, 2020;
Suloi, 2019; Tuaño et al., 2021; Walsh et al.,
2022).
Several studies have shown other benefits
of resistant starch in improving insulin
sensitivity, reducing blood glucose levels to
normal, reducing the sensation of hunger in line
with weight loss therapy, treating obesity, and
controlling the body's lipid profile (Masrukan,
2020; Suloi, 2019; Tuaño et al., 2021; Walsh et
al., 2022)(Labatjo et al., 2023).
A negative correlation was observed
between starch digestibility results. The addition
of glucomannan to Growol cookies can reduce
starch digestibility, although the difference in
starch digestibility between the groups was not
significant. Studies on modified cassava flour
(mocaf) have shown that reducing the levels of
resistant starch can increase starch digestibility.
Conversely, the higher the level of resistant
starch, the lower the digestibility of starch
(Setiarto et al., 2018). In this study, cookies E
(Growol cookies with the addition of 7%
glucomannan) had the highest levels of dietary
fiber and resistant starch with the lowest starch
digestibility.
Other studies have also shown that starch
digestibility is negatively correlated with the
levels of compounds that are not digested by the
small intestine, namely, levels of dietary fiber
and resistant starch (Faridah et al., 2013).
The development of corn noodle products
from corn flour shows that the control of corn
noodles has a resistant starch content of 3,5%,
dietary fiber of 6,87% and starch digestibility of
25,75%. Meanwhile, corn noodles processed
with heat moisture treatment had higher levels
of resistant starch and dietary fiber, namely
4,17% and 7,76% with a lower starch
digestibility of 22,57% (Palupi et al., 2015).
The lower the digestibility of food starch,
the less glucose is produced, which causes a
slight increase in the blood glucose levels. Foods
with low starch digestibility are beneficial for
people with diabetes. The starch digestibility of
food can be assessed using the food glycemic
index approach (Noviasari et al., 2015).
A study on the development of analog rice
using white corn flour as a base ingredient with
the addition of soybean flour showed that analog
rice has high levels of resistant starch and
dietary fiber (3,28% and 5,84%). This analog
rice also has a lower glycemic index (50)
compared to the glycemic index of sosoh rice
(69) (Noviasari et al., 2015). In other words, an
increase in the levels of resistant starch and
dietary fiber can reduce the glycemic index of
analog rice in the food category with a low
glycemic index (≤55) (Vega-López et al., 2018).
A similar study on various rice variants in
the Philippines also showed that the higher the
resistant starch content, the lower the estimated
value of the glycemic index of rice. This is also
related to the in vitro starch hydrolysis index.
The lower the starch hydrolysis value, the lower
is the estimated value of the rice glycemic index
(Tuaño et al., 2021).
Another study related to the increase in
resistant starch with a decrease in glycemic
index was observed in the development of wheat
substitute biscuits. The higher the wheat
substitution, the higher the resistant starch
content, which is indicated by an increase in
resistant starch from 17,8% to 30,19% with
50% wheat substitution (Haryani et al., 2014).
The higher the wheat substitution, the lower the
glycemic index of the biscuit. Biscuits without
wheat substitution had a resistant starch
content of 17,8% with a glycemic index of 52,11.
Biscuits with 20% wheat substitution have a
resistant starch content of 21,23% with a
glycemic index of 49,94 (Haryani et al., 2017).
It is known that the higher the level of
resistant starch in a product, the lower the
starch digestibility of the product, which can
optimize the role of food as an alternative food
for people with diabetes. A study conducted on
56 women with type 2 diabetes mellitus showed
that the group that received a resistant starch
intake of 10 g/day for eight weeks showed
improvements in glycemic control. This is
characterized by a decrease in glycosylated
hemoglobin by 9,40%, insulin by 29,36%, and
HOMA-IR by 32,85% (Karimi et al., 2016; Volpe,
2016). Another study also proved that
administering 10 g of resistant starch a day can
reduce fasting plasma glucose by 18,6 mg/dl and
HbA1c by 0,2% (Gargari et al., 2015; Volpe,
2016).
The addition of glucomannan to growth
cookies has been shown to increase the levels of
resistant starch. These results show that
glucomannan-modified Growol cookies have the
Aceh. Nut r i. J. Vol: 9, No: 1, 2024
189
potential to be developed as snacks for people
with DM. However, this study has a weakness in
that it did not study the types of resistant starch
contained in Growol cookies, considering that
there are five types of resistant starch: type 1,
type 2, type 3, type 4, and type 5 resistant starch.
Type 1 and type 2 resistant starches can influence
glucose homeostasis through their mechanisms,
and it is thought that there are differences in the
mechanisms between resistant starch types 1 and
2. Type 1 and type 2 resistant starches can reduce
postprandial blood glucose levels. Meanwhile,
type 2 resistant starch can increase postprandial
insulin response and improve fasting blood
glucose levels. However, the role of type 3, type 4,
and type 5 resistant starch has not been studied
extensively (Pugh et al., 2023).
Furthermore, there are potential
glucomannan-modified Growol cookies that
need to be studied more deeply, especially
regarding the effects of cookie consumption on
changes in the metabolic profile in diabetes,
such as changes in fasting blood glucose levels,
postprandial blood glucose, HbA1c, insulin, and
HOMA-IR.
Conclusion
The addition of glucomannan to Growol cookies
can increase the levels of insoluble dietary fiber,
water-soluble dietary fiber, total dietary fiber,
and resistant starch compared to control cookies
and Growol cookies with the addition of inulin.
In addition, the addition of glucomannan can
reduce the digestibility of starch in Growol
cookies compared to that in control Growol
cookies and Growol cookies with the addition of
inulin. Growol cookies modified with
glucomannan 7% (cookies E) are the best for
diabetes sufferers in terms of levels of soluble
dietary fiber, insoluble dietary fiber, total
dietary fiber, resistant starch, and starch
digestibility.
Glucomannan-modified Growol cookies
have the potential to be used as a healthy snack
for people with diabetes in terms of increasing
levels of dietary fiber and resistant starch as
well as decreasing starch digestibility in cookies.
Further studies regarding the effectiveness of
glucomannan-modified Growol cookies on
changes in the metabolic profile of diabetes
mellitus indicators, such as changes in blood
glucose levels (temporary, fasting, and 2 h
postprandial), changes in lipid profiles
(triglycerides, HDL cholesterol, LDL cholesterol,
and total cholesterol), and changes in HbA1c
levels and insulin are needed. In addition,
collaboration with the business industry is
needed to commercialize and introduce cookies
to the general public.
Acknowledgments
We thank the Ministry of Education, Culture,
Research and Technology, Directorate General of
Higher Education (Kemendikbudristek DIKTI)
for funding this research through the Basic-
Fundamental Research scheme with contract
number 181/E5/PG.02.00.PL/2023.
The author would also like to express his
thanks to the Unit of Research and Community
Service at Universitas Respati Yogyakarta, which
guided this research. Thank you also to Anita
Nidyarini as research assistant and Renata Deby
Sintia and Dhea Putri Ananda as field assistants
in this research activity.
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