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Cocoa Powder Increases Postprandial Insulinemia in Lean Young Adults1



We hypothesized that chocolate products elicit higher insulin responses than matched products with alternate flavoring. To test this, we used a within-subject, repeated-measures comparison of six pairs of foods, one flavored with chocolate (cocoa powder) and the other not. Healthy subjects (n = 10, 4 men, 6 women) tested each pair of foods. Postprandial glucose and insulin levels were determined at intervals over 2 h using standardized glycemic index (GI) methodology. The product categories were chocolate bars, cakes, breakfast cereals, ice creams, flavored milks and puddings. Although the GI did not differ within each pair, the insulin index (II) of the chocolate product was always higher, by a mean of 28%, than the alternate flavored product (P < 0.001). The greatest difference occurred within the flavored milk category in which the chocolate version elicited 45% greater insulinemia than the strawberry flavored milk (P = 0.021). Macronutrient composition (fat, protein, sugar, fiber or energy density) accounted for nearly all of the variation in GI among the foods, but did not explain differences in insulinemia. The presence of cocoa powder in foods leads to greater postprandial insulin secretion than alternate flavorings. Specific insulinogenic amino acids or greater cephalic phase insulin release may explain the findings.
Human Nutrition and Metabolism
Research Communication
Cocoa Powder Increases
Postprandial Insulinemia in
Lean Young Adults
(Manuscript received 13 May 2003. Initial review completed 8 June
2003. Revision accepted 9 August 2003.)
Jennie Brand-Miller,
Susanna H. A. Holt, Vanessa de Jong
and Peter Petocz*
Human Nutrition Unit, The University of Sydney, NSW, 2006, and
*Department of Mathematical Sciences, University of Technology,
Sydney, NSW, 2007, Australia
ABSTRACT We hypothesized that chocolate products
elicit higher insulin responses than matched products with
alternate flavoring. To test this, we used a within-subject,
repeated-measures comparison of six pairs of foods, one
flavored with chocolate (cocoa powder) and the other not.
Healthy subjects (n10, 4 men, 6 women) tested each pair
of foods. Postprandial glucose and insulin levels were de-
termined at intervals over 2 h using standardized glycemic
index (GI) methodology. The product categories were choc-
olate bars, cakes, breakfast cereals, ice creams, flavored
milks and puddings. Although the GI did not differ within
each pair, the insulin index (II) of the chocolate product was
always higher, by a mean of 28%, than the alternate fla-
vored product (P<0.001). The greatest difference occurred
within the flavored milk category in which the chocolate
version elicited 45% greater insulinemia than the straw-
berry flavored milk (P0.021). Macronutrient composition
(fat, protein, sugar, fiber or energy density) accounted for
nearly all of the variation in GI among the foods, but did not
explain differences in insulinemia. The presence of cocoa
powder in foods leads to greater postprandial insulin se-
cretion than alternate flavorings. Specific insulinogenic
amino acids or greater cephalic phase insulin release may
explain the findings. J. Nutr. 133: 3149 –3152, 2003.
KEY WORDS: chocolate glycemic index
postprandial hyperinsulinemia
Studies on the glycemic index (GI)
of foods indicate that
chocolate and chocolate-containing confectionery elicit rela-
tively low levels of postprandial glycemia compared with
equicarbohydrate amounts of starchy staples such as bread, rice
and potatoes (1). Block chocolate, for example, has a GI of 50
compared with many varieties of bread, rice and potato that
have GI values 70. The low glycemic response can be
attributed at least in part to the sugar content of chocolate
confectionery. Sucrose itself has a GI of 60 because it con-
tains only half the glucose-equivalents of an equal amount of
glucose or starch.
Interestingly, however, we have noted that insulin re-
sponses to chocolate confectionery have often been dispropor-
tionately higher than expected for the glycemic response (2).
In some cases (e.g., chocolate-coated peanuts and chocolate-
coated caramel bar), the insulin response was twice that ex-
pected for the level of glycemia. Foods with a similarly high fat
content such as potato chips and croissants do not induce as
much insulin secretion as some chocolate-containing products
(3,4). This raises the hypothesis that specific insulinogenic
compounds in cocoa powder might directly stimulate
insulin secretion and thereby reduce the accompanying glyce-
mia. It is also possible that the high sensory quality of choc-
olate might promote early cephalic phase insulin secretion (5).
To test the hypothesis that cocoa powder has unique insu-
lin-stimulating properties, separate from those induced by the
presence of large amount of fat and sugar, we studied six pairs
of commercially available foods. Within each pair, one was
flavored with cocoa powder and the other with an alternate
flavor, but both were of substantially equivalent macronutrient
composition. Postprandial glucose and insulin levels were as-
sessed at frequent intervals over a 2-h period using standard-
ized glycemic index (GI) methodology (6).
Subjects. Healthy subjects (n11) were recruited from the staff
and student population of the University of Sydney (4 men, 7
women). Exclusion criteria were as follows: 40 y of age, BMI 25
, prescription medication other than oral contraception, food
intolerance and family history of diabetes. The subjects were 24.7
3.3 y old (range, 21–33 y) and their BMI was 21.8 1.6 kg/m
(range, 20–24 kg/m
). The study was approved by the institutional
ethics committee and all subjects gave written informed consent.
Test foods. Six pairs of foods were studied. Within each pair, the
appearance and macronutrient content were similar, but one was
flavored with chocolate (cocoa powder) and the other with an alter-
nate flavor. They represented a wide range of food types: 1)breakfast
cereals: chocolate-coated puffed rice (Coco Pops, Kellogg’s, Page-
wood, NSW, Australia) and plain puffed rice (Rice Bubbles,
Kellogg’s, Australia); 2)cakes made from mixes: chocolate cake topped
with ready-made chocolate frosting (Betty Crocker chocolate fudge
super moist cake mix and Betty Crocker creamy deluxe dark Dutch
fudge frosting, General Mills, Minneapolis, MN) and vanilla cake
topped with ready-made vanilla frosting (Betty Crocker French va-
nilla super moist cake mix and Betty Crocker creamy deluxe vanilla
frosting, General Mills); 3)block chocolate: plain chocolate (classic
full cream milk chocolate, Nestle´, Sydney, NSW, Australia) and
“white” chocolate (Milky Bar, Nestle´); 4)flavored reduced-fat milk:
Presented in abstract form at Proceedings of the annual meeting of the
Nutrition Society of Australia, December 2002 [Holt, S.H.A., de Jong, V., Loyer, S.,
Kennedy, J. & Brand Miller, J. C. (2002) The effects of chocolate-containing
foods on postprandial blood glucose and insulin. Asia Pacific J. Clin. Nutr. 11:
To whom correspondence should be addressed.
Abbreviations used: AUC, area under the curve; CPIR, cephalic phase
insulin response; GI, glycemic index; II, insulin index.
0022-3166/03 $3.00 © 2003 American Society for Nutritional Sciences.
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reduced-fat (1.5%) cows milk (Lite White, NSW Dairy Farmers,
Sydney, Australia) avored with chocolate drinking powder (choco-
late Nesquik, Nestle´) or strawberry drinking powder (strawberry Nes-
quik); 5)ice cream: premium vanilla ice cream (French vanilla classic
ice cream, Sara Lee, Gosford, NSW, Australia) and premium choc-
olate ice cream (Ultra chocolate classic ice cream, Sara Lee); and 6)
puddings: chocolate and vanilla avored versions of the same instant
pudding made from a packet mix with full-cream milk (White Wings
Foods, Smitheld, NSW, Australia).
Test foods and the reference food, anhydrous glucose, were fed as
portions containing 50 g of available carbohydrate with 250 mL
water. The macronutrient composition was calculated using the man-
ufacturers data (Table 1).
Study design. Each pair of foods was tested by 10 subjects using
a within-subject, repeated-measures design. The reference food was
consumed twice (at the rst and last session) by each subject, and the
test foods were given in a random, counterbalanced order with at least
1 d between tests. After a 1012 h overnight fast, a baseline capillary
blood sample (1 mL) was collected by ngerprick using an auto-
matic lancet device (Autoclix; Boehringer Mannheim, Frenchs For-
est, NSW, Australia). Subjects consumed the test food and water
within 12 min. Additional nger-prick blood samples were taken at
15, 30, 45, 60, 90 and 120 min after eating commenced.
Plasma glucose concentrations were analyzed in duplicate using a
glucose-hexokinase enzymatic assay (Roche Diagnostics, Frenchs For-
est, NSW, Australia) and a Cobas Fara automatic spectrophotometric
analyser (Roche Diagnostica, Basel, Switzerland). Mean within- and
between-assay CV were 0.7 and 1.1%, respectively. Plasma insulin
concentration was analyzed using a solid-phase, antibody-coated tube
RIA kit (Coat-A-Count insulin, Diagnostic Products Corporation,
Los Angeles, CA) with internal controls. The mean within- and
between-assay CV were 2.5 and 3.3%, respectively.
Subjects rated how much they liked the food on a 15-cm 7-point
category rating scale anchored from the left-hand end with the
category dislike extremely(3) with a midpoint descriptor of
neither like nor dislike(0) and anchored at the right-hand end with
the descriptor like extremely(3).
Data analysis. The incremental area under each 120-min
plasma glucose and insulin response curve (AUC) was calculated
using the trapezoidal rule with fasting values as the baseline (7). Any
negative area (below the fasting baseline level) was ignored. The GI
was calculated for each individual according to the equation:
GI 120-min glucose AUC value for the test food
100/AUC value for the reference food
Insulin index (II) values were calculated similarly using the insu-
lin AUC. GI and II values (means SEM) for each food were
calculated using all 10 subjects.
ANOVA using general linear models with food group and pres-
ence of chocolate as xed factors and subjects as a random factor was
used to investigate the effects of chocolate on GI and II (SPSS for
Windows 10.0, Chicago, IL; StatView software, version 4.02, Abacus
Concepts, Berkley, CA). Interactions between the factors were in-
vestigated, but found not to be signicant. With 10 subjects, the study
had 80% power to detect a difference of 1.5 SD at the 0.05 level of
signicance. Multiple linear regression analysis was used to examine
the extent to which different nutrient variables (protein, fat, sugar,
ber per test portion) accounted for the variability in GI and II values
for the 12 test foods.
The within-pair GI values did not differ for any of the six
product pairs (Fig. 1A,Table 2). For all of the chocolate
products, the mean GI value (47 2) did not differ from that
of all six nonchocolate products (48 2). In contrast, as
hypothesized, the insulin index for the chocolate version of
each product was invariably higher than that of the alternate
avor (Fig. 1B, Table 2). The greatest difference occurred
within the avored milk category in which the chocolate
version elicited 45% greater insulinemia than the strawberry
avored milk (P0.021). The smallest difference was within
the block chocolate category in which the dark chocolate II
was only 13% higher than the white chocolate II (P0.61).
The mean II of the six chocolate products (79 3) was 28%
higher than the mean of the six nonchocolate products (62
3) (P0.001).
Surprisingly, the median GI and II of all 12 products were
not correlated (r0.03, P0.93). The foods with the most
marked difference between the II and the corresponding GI
The macronutrient composition for the 50-g available carbohydrate portions of the reference food and six pairs
of test foods containing chocolate or an alternate flavor
Food Portion weight Energy Protein Fat Total carbohydrate1Sugar Fiber
gkJ g
Reference food Glucose, 50 800 0.0 0.0 50.0 50.0 0.0
Water, 250
Plain rice cereal 58.3 934 3.9 0.2 50.6 5.3 0.6
Chocolate rice cereal 57.1 921 3.1 0.2 50.7 20.9 0.7
Vanilla cake Cake, 68.3 1400 2.8 13.5 50.9 36.2 0.9
Frosting, 28.9
Chocolate cake Cake, 75.4 1519 4.1 16.0 51.8 35.9 1.8
Frosting, 31.8
White chocolate 86.2 1983 6.2 27.8 50.0 50.0 0.0
Milk chocolate 84.0 1865 6.0 24.7 50.0 48.7 0.0
Vanilla ice cream 277.6 3026 14.6 52.6 50.0 32.1 0.0
Chocolate ice cream 264.1 2800 12.2 47.5 50.0 31.9 0.0
Vanilla pudding 310.6 1398 9.0 10.9 50.0 40.4 0.0
Chocolate pudding 314.5 1415 9.4 11.0 50.0 38.7 0.0
Strawberry milk Powder, 26 1362 17.0 6.0 50.0 50.0 0.0
Milk, 412
Chocolate milk Powder, 28 1441 19.0 7.0 50.0 48.0 0.0
Milk, 439
1The total carbohydrate values include ber.
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were chocolate cake (difference 47), chocolate milk (45),
chocolate ice cream (34) and chocolate pudding (33).
The mean insulin AUC/glucose AUC ratio (a measure of
insulinemia relative to glycemia) was 30% greater for the
chocolate avored version of each pair of foods (P0.001).
However, none of the individual food pairs differed signi-
Multiple regression analysis using the median GI for each
food as the dependent variable and protein, fat, sugar and ber
per serving as independent variables showed that sugar was the
strongest determinant of the GI (P0.001), followed by fat
(P0.009), ber (P0.049) and protein (P0.081).
Together, these variables accounted for 93% of the variance in
GI. In contrast, when median II was the dependent variable,
there were no signicant associations with any one nutrient
(sugar, P0.96; fat, P0.56; ber, P0.77 and protein, P
0.65), and this regression model explained only 8% of the
variance in the II.
Within food pairs, the palatability rating for the chocolate
product was always greater than that of the alternate avor,
with the greatest difference within the breakfast cereals (P
0.001) and the puddings (P0.01).
To our knowledge, this is the rst study to demonstrate that
chocolate (cocoa powder), has a specic insulinotropic effect,
irrespective of food source or the overall macronutrient com-
position of the food. We found that the chocolate-avored
product within six product categories produced greater insu-
linemia, whether expressed as the AUC over a 2-h period or as
an insulin index relative to a reference food. In general, the
chocolate product produced 28% greater insulinemia than the
alternate avor, ranging from 45% greater in the chocolate
milk vs. the strawberry milk, to 13% greater in dark vs. white
block chocolate. Within-pair differences in glycemia were
minimal and did not explain the marked difference in insu-
linemia. Macronutrient composition accounted for nearly all
of the variation in GI among the foods, but did not explain
differences in insulinemia.
Our ndings are consistent with those of other studies in
healthy and diabetic individuals (2,4,8,9). Although those
studies were not designed specically to demonstrate an insu-
linogenic effect of chocolate, comparisons with other foods
tested simultaneously allow a similar conclusion. For example,
FIGURE 1 The glycemic index (A) and insulin index (B) of six pairs
of foods, one containing chocolate and the other an alternative avor
determined in lean young adults. Values are means SEM,n10.
Asterisks indicate different from the nonchocolate version, *P0.001,
**P0.05, ***P0.01.
The glucose, insulin and sensory responses of lean adults to the six pairs of foods containing chocolate or an alternate avor1,2
Food Glucose AUC Insulin AUC
Insulin AUC
glucose AUC GI II Palatability
mmol/(L min) pmol/(L min 103) RS units
Plain rice cereal 173 17 10.2 1.1 62 6844646 0.4 0.4
Chocolate rice cereal 177 23 12.2 1.0 76 98711 79 10** 1.9 0.2
Vanilla cake 80 10 7.3 1.4 99 17 41 46712 1.8 0.5
Chocolate cake 76 6 9.2 1.0 127 17 41 48814* 2.1 0.5
White chocolate 84 14 6.6 1.1 92 14 43 66313 2.1 0.4
Milk chocolate 78 13 9.0 2.4 125 25 42 77113 2.6 0.1
Vanilla ice cream 80 10 9.3 1.3 123 16 38 3544 2.7 0.1
Chocolate ice cream 78 11 11.2 1.2 169 23 37 3713* 2.8 0.1
Vanilla pudding 87 11 10.2 1.1 125 17 43 56250.2 0.5
Chocolate pudding 95 11 13.3 1.6 159 27 47 4805*** 1.6 0.3
Strawberry milk 64 4 6.9 1.0 112 17 35 3595 1.1 0.5
Chocolate milk 74 6 9.4 1.2 137 24 41 48611** 2.1 0.3
1Values are the means SEM,n10. Asterisks indicate different from the nonchocolate product: * P0.001, ** P0.05, *** P0.01.
2Abbreviations: AUC, area under the curve; GI, glycemic index; II, insulin index; RS, rating scale.
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Holt et al. (4) tested postprandial blood glucose and insulin
responses to isoenergetic portions of 40 common foods. Foods
such as potato crisps, cheese and croissants, which are also rich
in fat and energy dense, had insulin scores (insulin AUC
relative to that of a reference food) that were comparable to
their glucose scores. On the other hand, the chocolate con-
fectionery (Mars Bar) had an insulin score that was 50%
higher than its glucose score. In another study (8), a choco-
late-avored breakfast cereal (Coco Pops) had an insulin index
60% higher than its GI.
Cocoa powder is a complex substance containing several
biologically active compounds, including caffeine, theobro-
mine, serotonin, phenylethylamine and cannabinoid-like fatty
acids (10,11). These intrinsic factors might affect glucose
homeostasis not only by directly promoting insulin secretion,
but also by producing insulin resistance. Some amino acids,
particularly arginine, and amino acid mixtures have been
found to be strongly insulinotrophic when consumed simulta-
neously with carbohydrate (12). Van Loon et al. (13) showed
that a mixture of free leucine, phenylalanine and arginine
produced twice the insulin response compared with carbohy-
drate alone. The presence of protein and amino acids in the
cocoa powder but not the alternative avor might therefore
explain our ndings.
Cocoa butter, the fat component of the cocoa bean, is also
one of the richest food sources of triglycerides containing
stearic acid, 18:0. Stearate has been found to be a powerful
stimulant of insulin secretion in perfused rat pancreas com-
pared with four other fatty acids (ocatonoate, linoleate, oleate
and palmitate) (14). However, this in itself does not explain
our ndings because two of the product pairs in the present
study (rice cereal and low fat milk) were devoid of cocoa
butter. Further research is therefore required to identify the
source of the high insulin response to cocoa powder.
Chocolate may not be unique in its insulinogenic capacity.
We and others have noted that dairy products produce hyper-
insulinemia despite a low GI (1517). In the present study, the
milk-based categories (liquid low fat milk, pudding and ice
cream) displayed the highest insulin AUC/glucose AUC ratios
Together with its chemical components, the sensory char-
acteristics of chocolate may also potentiate insulin secretion.
Chocolate is an extremely palatable food, the mere thought of
which can trigger a Pavlovianresponse, and therefore en-
hance cephalic phase insulin release (CPIR), particularly in
people with a high preference for chocolate (5). Because our
subjects rated the chocolate version of each product as more
palatable, it is conceivable that greater CPIR contributed to
our ndings.
The physiologic importance of postprandial hyperinsulin-
emia is unknown, particularly if the corresponding level of
glycemia is low, as in this case. Hyperinsulinemia may be
pathogenic when associated with dyslipidemia, hypertension,
impaired brinolysis and other features of the metabolic syn-
drome (18). However, other components in chocolate may
play a protective role in the disease process (19).
We thank Stephanie Loyer and Julia Kennedy who assisted in
parts of the study.
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... One possible mechanism of action is that chocolate elicits low blood glucose response. Indeed, chocolate is classified as having a low glycemic index (GI) and glycemic load (GL), while the insulin index (II) tends to be relatively high compared to the GI (Shively et al., 1986;Holt et al., 1997;Brand-Miller et al., 2003). Since chocolate appears to have specific characteristics in terms of inducing insulin secretion, it is important to examine both the glycemic and insulin response to chocolate and the incretin response, which influences insulin release. ...
... Current evidence on the influence of chocolate on both the glycemic and incretin responses is limited. In human subjects, chocolate induced slower increases in glucose concentrations than reference food, and cocoa powder induced insulin release (Brand-Miller et al., 2003;Zhang et al., 2018). Furthermore, the gut-derived incretin hormones glucagon-like peptide-1 (GLP-1) stimulated insulin secretion in a glucose-dependent manner in response to food intake, and decreased the rate of gastric emptying (Holst, 2007). ...
... In contrast, the insulin responses to the chocolates were comparable to those to the reference food at all time points, and the IAUC for insulin did not differ significantly for the chocolates and reference food, in contrast to the glucose response. This finding is in line with a report by Brand-Miller et al. (2003) that showed cocoa powder may increase insulin release. Indeed, cocoa powder contains a variety of amino acids and biogenic amines, such as theobromine, arginine, and phenylethylamine, which may influence insulin secretion (Bruinsma and Taren, 1999). ...
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Chocolate may affect the glycemic response, which is related the insulin and incretin response. We evaluated the glucose, insulin, and glucagon-like peptide-1 (GLP-1) responses in male adults after consumption of three commonly consumed chocolates. Furthermore, we assessed the glycemic index (GI), insulin index (II), and glycemic load (GL) of the chocolates. The study protocol was adapted from the International Standard Organization recommendations. Test foods were chocolate A (milky chocolate), chocolate B (creamy chocolate), chocolate C (chocolate ball), and reference food (glucose solution). Glucose, insulin, and GLP-1 concentrations were assessed at 0, 15, 30, 45, 60, 90, and 120 min after consumption of the test foods. The glycemic responses of the three chocolates were lower than those of the reference food at 30 and 45 min (P<0.001). However, the insulin and GLP-1 responses did not differ between the three chocolates and the reference food. The GI value of chocolates A, B, and C were 39.2, 47.8, and 33.7, respectively; all GI values were lower than that of the reference food. The II values of all test foods were similar, aside for chocolate B (97.9). All chocolates were classified as low-GL. This study showed that glycemic responses depends on the amount of carbohydrates and the physical properties. Further research is required to examine incretin responses and to determine if the type of chocolate can influence metabolic response beyond glycemia.
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... Глікемічний та інсуліновий індекси (ГІ, ІІ) деяких продуктів харчування [1,4,7,12,18] 1 FOR A MEDICAL PRACTITIONER / ЛІКАРЮ-ПРАКТИКУ ною масою тіла, і можуть бути використані лише умовно до хворих на ЦД2 [4]. Теоретично облік ІІ при формуванні дієти може зменшити вираженість постпрандіальної гіперінсулінемії, сприяти збереженню чутливості тканин до інсуліну і функції бета-клітин; проте довготривалі ефекти потребують подальших досліджень [5]. ...
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... Polyphenols present in cocoa can significantly influence energy metabolism. These compounds affect insulin modulation, increasing glucose uptake in skeletal muscle and favoring muscle glycogen resynthesis [12,13]. In addition, cocoa polyphenols can stimulate the nervous system, but less than caffeine [44]. ...
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Beverage strategies with balanced carbohydrate and protein supply are important for athletes’ recovery. Cow’s milk with added bioactive compounds present in coffee and cocoa facilitates glucose metabolism and may help post-workout glycogen recovery. Home-prepared beverages are cost and nutritionally effective strategies. Thus, the objectives were: (1) To develop home-prepared beverages containing nonfat powdered milk and sugar combined with filtered coffee or cocoa powder in balanced amounts for recovery after endurance exercise; and (2) to perform sensory analysis. Sensory evaluation was conducted by an acceptance test, applying nine-point hedonic scale and descriptive analysis, using the check-all-that-apply method (CATA). McNemar’s test and logistic regression with the proportional odds model were employed. The sample included 44 triathletes and 56 runners, of both sexes, 31–70 years old. Both beverages were well accepted by runners and triathletes, with higher acceptance of the coffee beverage (odds ratio coffee vs cocoa 5.232, p=0.0038). There was no significant difference between acceptance of triathletes and runners for the two beverages. The descriptive sensory analysis (CATA) resulted in slightly different characterizations between the two beverages. Both beverages were well accepted and characterized by the athletes, who can supply different options of post-workout beverages according to individual tastes, composition, and characteristics.
... There is a variety of cocoa powder products in the market. The GI value of cocoa powder is classified as low (42) , and only one Australian cocoa powder product was classified as high GI and reported to increase postprandial insulin concentrations in healthy adults (43) . One study examining the effects of a chocolate drink with aspartame compared to a chocolate drink with sucrose on the glycaemic responses found higher postprandial glucose concentrations after consumption of the beverage containing sucrose compared to sweetener, without differences between the two regarding insulin concentrations (44) . ...
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High sugar intake has been associated with adverse effects on health, with some types of breakfast being highly linked to overweight and obesity. The aim was to compare the effects of four sugar-free breakfast items, apricot jam with white bread (JWB), white bread (WB), cocoa with fat-free milk (CM), and dried cranberry cereal bar (CB), compared to D-glucose on the glycaemic responses. Using a cross-over design, twelve healthy individuals (25 ± 4 years; BMI 22 ± 2 kg/m 2) received isoglucidic test meals (25 g of available carbohydrate) and 25 g glucose reference, in random order. Glycaemic index/load (GI/GL) were calculated, and capillary blood glucose samples were collected at 0-120 min after meal consumption. Subjective appetite was assessed with visual analogue scales. Sugar-free apricot jam and cocoa powder contained traces of available carbohydrates and were consumed along with bread and fat-free milk, respectively. JWB and WB were classified as medium GI, low-to-medium GL; CM as medium GI, low GL; and CB as high GI, low-to-medium GL. Subjective hunger was lower after JWB, fullness was higher after CM and pleasure was higher after CB (P for all < 0⋅05). In conclusion, sugar-free apricot jam with and without WB and cocoa powder with fat-free milk are suitable healthy breakfast options leading to improved glycaemic and subjective appetite responses.
... The reason that sweets are the most common choice of food during stress is related to several factors. One of them is the increased need for carbohydrates [21,23,24]. Stress accelerates the breakdown of serotonin, so it is more common to feel the urge to introduce sugars into the body to make up for serotonin deficiencies. ...
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Background: Emotional eating (EE) is not a separate eating disorder, but rather a type of behavior within a group of various eating behaviors that are influenced by habits, stress, emotions, and individual attitudes toward eating. The relationship between eating and emotions can be considered on two parallel levels: psychological and physiological. In the case of the psychological response, stress generates a variety of bodily responses relating to coping with stress. Objective: Therefore, the main objective of this study was to evaluate and compare the prevalence of emotional eating in groups of students in health-related and non-health-related fields in terms of their differential health behaviors-diet and physical activity levels. Material and methods: The cross-sectional survey study included 300 individuals representing two groups of students distinguished by their fields of study-one group was in health-related fields (HRF) and the other was in non-health-related fields (NRF). The study used standardized questionnaires: the PSS-10 and TFEQ-13. Results: The gender of the subjects was as follows: women, 60.0% (174 subjects) (HRF: 47.1%, n= 82; NRF: 52.9%, n = 92); men, 40.0% (116 subjects) (HRF: 53.4%, n = 62; NRF: 46.6%, n = 54). The age of the subjects was 26 years (±2 years). Based on the results of the TFEQ-13, among 120 subjects (41.4%) there were behaviors consistent with limiting food intake (HRF: 72.4%; NRF: 11.0%), while 64 subjects (20.7%) were characterized by a lack of control over food intake (HRF: 13.8%, 20 subjects; NRF: 27.4%, 20 subjects). Emotional eating was characteristic of 106 students (37.9%), with the NRF group dominating (61.6%, n = 90). It was observed that a high PSS-10 score is mainly characteristic of individuals who exhibit EE. Conclusions: The results obtained in the study indicate that lifestyle can have a real impact on the development of emotional eating problems. Individuals who are characterized by elevated BMI values, unhealthy diets, low rates of physical activity, who underestimate meal size in terms of weight and calories, and have high-stress feelings are more likely to develop emotional eating. These results also indicate that further research in this area should be undertaken to indicate whether the relationships shown can be generalized.
... It is notable that chocolate, often chosen during stress, is high in sugar, which, when combined with effects of cocoa, strongly stimulates insulin release (Brand Miller, Holt, de Jong, & Petocz, 2003), but has only 3% to 6% of its energy in the form of protein. Thus, if eaten in sufficient amounts on an empty stomach, chocolate might increase TRP availability to the brain, and so allow improved mood via enhanced serotonin release. ...
... GLP-1 is a well-known incretin hormone released by L cells in the distal small intestine and colon and accentuates glucosedependent insulin release [10]. In another study, the use of cocoa powder has been reported to lead to greater postprandial insulin secretion in healthy participants [11]. ...
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Objective: There is substantial interest in using dark chocolate for preventing postprandial hyperglycemia. We investigated the effects of cacao polyphenol-rich chocolate on postprandial glycemic and insulinemic responses and whether cacao polyphenol-rich chocolate increases glucagon-like peptide 1 (GLP-1) secretion. Methods: In a stratified, randomized, crossover study, 48 healthy participants ingested either water (W) or cacao polyphenol-rich chocolate plus water (C) 15 min before a 50-g oral glucose tolerance test (OGTT). Preprandial and postprandial concentrations of blood glucose, insulin, free fatty acid, glucagon and GLP-1 were evaluated. Results: The peak plasma glucose concentrations did not differ significantly between groups W and C; however, plasma glucose concentrations at 120 min in group C were significantly lower than those of group W (P < 0.01). Postprandial serum insulin and plasma GLP-1 concentrations and incremental serum insulin and plasma GLP-1 area under the curve (AUC)−15–180 min for group C were significantly higher than those for group W (P < 0.05). When comparing the changes after the OGTT, the incremental plasma glucose AUC0–180 min for group C was significantly lower than that for group W (P < 0.05), whereas the incremental serum insulin and plasma GLP-1 AUC0–180 min did not differ significantly between groups W and C. Conclusions: This study indicated that the intake of cacao polyphenol-rich chocolate before a 50-g OGTT could enhance early insulin and GLP-1 secretion in healthy participants and illustrates the potential of cacao polyphenol-rich chocolate in managing postprandial glucose excursions.
... The presence of cocoa powder in foods leads to greater postprandial insulin secretion than alternate flavourings. Specific insulinogenic amino acids or greater cephalic phase insulin release may explain the findings [30]. Cocoa powder is a complex substance containing several biologically active compounds, including caffeine, theobromine, serotonin, phenylethylamine and cannabinoid-like fatty acids [31] and [32]. ...
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One of the soybean products that people like was tempeh. Tempeh could not be stored for a long time and smells unpleasant, so it was less preferred by children, so tempeh milk powder was made with the aim to determine the effect of varieties and flavour on the quality of tempeh milk powder. The research method used was a completely randomized design factorial pattern with 3 replications. The first factors were the six soybean varieties (Anjasmoro, Grobogan, Agromulyo, Burangrang, Kepak Hijau and import variety), the second factor was various flavourings, 4 levels (cocoa paste, strawberry paste, cocoa powder and vanilla paste). This activity is held from January until December 2015. Soybeans were harvested in Soppeng and Jeneponto Districts, South Sulawesi and then taken to the Post-Harvest Laboratory Assessment Institutes for Agricultural Technology (AIAT) of South Sulawesi for processing soybean to became of tempeh milk powder. The results showed that there was significant interaction between soybean varieties and flavour added of the yield, moisture, ash, protein, carbohydrate and organoleptic test (colour, aroma, texture and taste of tempeh milk powder. The best milk powder of tempeh was treatment interaction of Grobogan variety and strawberry flavouring with a yield of 86.31%, moisture 10.10%, ash 0.58%, protein 3.01%, fat 0.0% and carbohydrates 86.31 %.
... The basis for this phenomenon is not clear; yet, various compounds of cocoa could contribute to its calciuric properties. It is likely to be related to an insulinotropic effect of cocoa; as it was reported, plasma insulin itself can cause calciuria (Brand-Miller, Holt, de Jong, & Petocz, 2003). Furthermore, cocoa contains oxalate, methylxanthines, theobromine, and caffeine. ...
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The present study evaluated the impact of cocoa on skeleton of ovariectomized rats. Animals were randomized into four groups: sham (basal diet: AIN-93M Ca and P-deficient), and three ovariectomized groups: OVX (basal diet), C6 and C12 (6% and 12% cocoa powder, respectively). Urinary calcium loss was decreased in C6 but not C12, while serum insulin-like growth factor (IGF)-I increased in both cocoa groups. Improvement in bone quality and strength was observed in femur mid-shaft in C6 but not C12. Bone density, quality and strength of lumbar vertebrae were improved in both cocoa groups. Cocoa improved systemic oxidative stress and inflammatory biomarkers. In bone tissue of C12, higher levels of H2O2 and lower levels of glutathione peroxidase (GPx) were observed. Cocoa down-regulated osteoblast- and osteoclast-related genes while up-regulated GPx and superoxide dismutase (SOD). Cocoa decreased bone turnover in ovariectomized rats. Its effects depended on the dose applied and the bone site.
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Background: Flavonoids are polyphenolic compounds of plant origin with antioxidant effects. Flavonoids inhibit LDL oxidation and reduce thrombotic tendency in vitro. Little is known about how cocoa powder and dark chocolate, rich sources of polyphenols, affect these cardiovascular disease risk factors. Objective: We evaluated the effects of a diet high in cocoa powder and dark chocolate (CP-DC diet) on LDL oxidative susceptibility, serum total antioxidant capacity, and urinary prostaglandin concentrations. Design: We conducted a randomized, 2-period, crossover study in 23 healthy subjects fed 2 diets: an average American diet (AAD) controlled for fiber, caffeine, and theobromine and an AAD supplemented with 22 g cocoa powder and 16 g dark chocolate (CP-DC diet), providing ≈466 mg procyanidins/d. Results: LDL oxidation lag time was ≈8% greater (P = 0.01) after the CP-DC diet than after the AAD. Serum total antioxidant capacity measured by oxygen radical absorbance capacity was ≈4% greater (P = 0.04) after the CP-DC diet than after the AAD and was positively correlated with LDL oxidation lag time (r = 0.32, P = 0.03). HDL cholesterol was 4% greater after the CP-DC diet (P = 0.02) than after the AAD; however, LDL-HDL ratios were not significantly different. Twenty-four–hour urinary excretion of thromboxane B2 and 6-keto-prostaglandin F1α and the ratio of the 2 compounds were not significantly different between the 2 diets. Conclusion: Cocoa powder and dark chocolate may favorably affect cardiovascular disease risk status by modestly reducing LDL oxidation susceptibility, increasing serum total antioxidant capacity and HDL-cholesterol concentrations, and not adversely affecting prostaglandins.
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To evaluate glucose and insulin responses after ingestion of snacks, we gave healthy, nondiabetic male subjects carbohydrate equivalent (25 g) snacks or isocaloric (265 kcal) snack meals in a random crossover design. Individual snacks composed of either a milk chocolate bar, granola bar, chocolate milk, peanut butter cups, yogurt, or potato chips produced similar glucose response curves. Plasma glucose concentrations were lower (p less than or equal to 0.05) at 30 and 60 min postprandially than after a corresponding oral glucose challenge. In contrast, insulin responses to the snacks exhibited a two-fold variation in peak values. Isocaloric snack meals of cereal-milk, cheese sandwich-milk, and peanut butter sandwich-chocolate milk produced glucose and insulin responses similar to individual snacks. Although glucose concentrations at 60 min fell somewhat below baseline values after each snack, clinical hypoglycemia was not evident. These data clearly indicate a similarity in glycemic response among normal individuals consuming a variety of common snacks.
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The plasma glucose and serum insulin responses were determined in untreated Type 2 (non-insulin-dependent) diabetic patients following the ingestion of foods containing sucrose, glucose, fructose or lactose in portions that contained 50 g of carbohydrate. The results were compared to those obtained following the ingestion of pure fructose, sucrose, glucose + fructose and lactose. The objectives were to determine 1) if the glucose response to naturally occurring foods could be explained by the known carbohydrate content, and 2) whether the insulin response could be explained by the glucose response. The glucose response was essentially the same whether the carbohydrate was given as a pure substance, or in the form of a naturally occurring food. The glucose response to each type of carbohydrate was that expected from the known metabolism of the constituent monosaccharides. The glucose areas following the ingestion of the foods were: Study 1: glucose 11.7, orange juice 7.3, sucrose 5.2, glucose + fructose 6.3, and fructose 0.7 mmol X h/l; Study 2: glucose 14.6, orange juice 7.3, apples 5.5, and apple juice 4.7 mmol X h/l; Study 3: glucose 12.6, ice cream 8.1, milk 3.7, and lactose 4.1 mmol X h/l. The insulin response was greater than could be explained by the glucose response for all meals except apples. Milk was a particularly potent insulin secretagogue; the observed insulin response was approximately 5-fold greater than would be anticipated from the glucose response. In summary, the plasma glucose response to ingestion of fruits and milk products can be predicted from the constituent carbohydrate present. The serum insulin response cannot.
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The primary aim of the present study was to expand the glycaemic index (GI) database by determining the GI and insulin index values of thirty-nine foods containing sugars in healthy adults. The second aim was to examine the hypothesis that glycaemic and insulin responses to foods which contain added sugar(s) are higher than responses to foods containing naturally-occurring sugars. Eight healthy subjects drawn from a pool of eighteen consumed 50 g carbohydrate portions (except 25 g carbohydrate portions for fruits) of the test foods. The GI and insulin index were determined according to standardized methodology and expressed on a scale on which glucose = 100. The median GI and insulin index values of all foods tested were 56 (range 14 to 80) and 56 (range 24 to 124) respectively. The median GI of the foods containing added sugars was similar to that of foods containing naturally-occurring sugars (58 v. 53 respectively, P = 0.08). Likewise, the median insulin index of the foods containing added sugars was not significantly different from that of foods containing naturally-occurring sugars (61 v. 56 respectively, P = 0.16). There was no evidence of 'rebound hypoglycaemia' or excessive insulin secretion relative to the glucose response. We conclude that most foods containing sugars do not have a high GI. In addition, there is often no difference in responses between foods containing added sugars and those containing naturally-occurring sugars.
The aim of this study was to systematically compare postprandial insulin responses to isoenergetic 1000-kJ (240-kcal) portions of several common foods. Correlations with nutrient content were determined. Thirty-eight foods separated into six food categories (fruit, bakery products, snacks, carbohydrate-rich foods, protein-rich foods, and breakfast cereals) were fed to groups of 11-13 healthy subjects. Finger-prick blood samples were obtained every 15 min over 120 min. An insulin score was calculated from the area under the insulin response curve for each food with use of white bread as the reference food (score = 100%). Significant differences in insulin score were found both within and among the food categories and also among foods containing a similar amount of carbohydrate. Overall, glucose and insulin scores were highly correlated (r = 0.70, P < 0.001, n = 38). However, protein-rich foods and bakery products (rich in fat and refined carbohydrate) elicited insulin responses that were disproportionately higher than their glycemic responses. Total carbohydrate (r = 0.39, P < 0.05, n = 36) and sugar (r = 0.36, P < 0.05, n = 36) contents were positively related to the mean insulin scores, whereas fat (r = -0.27, NS, n = 36) and protein (r = -0.24, NS, n = 38) contents were negatively related. Consideration of insulin scores may be relevant to the dietary management and pathogenesis of non-insulin-dependent diabetes mellitus and hyperlipidemia and may help increase the accuracy of estimating preprandial insulin requirements.
Background: Protein induces an increase in insulin concentrations when ingested in combination with carbohydrate. Increases in plasma insulin concentrations have been observed after the infusion of free amino acids. However, the insulinotropic properties of different amino acids or protein (hydrolysates) when co-ingested with carbohydrate have not been investigated. Objective: The aim of this study was to define an amino acid and protein (hydrolysate) mixture with a maximal insulinotropic effect when co-ingested with carbohydrate. Design: Eight healthy, nonobese male subjects visited our laboratory, after an overnight fast, on 10 occasions on which different beverage compositions were tested for 2 h. During those trials the subjects ingested 0.8 g*kg(-)(1)*h(-)(1) carbohydrate and 0.4 g*kg(-)(1)*h(-)(1) of an amino acid and protein (hydrolysate) mixture. Results: A strong initial increase in plasma glucose and insulin concentrations was observed in all trials, after which large differences in insulin response between drinks became apparent. After we expressed the insulin response as area under the curve during the second hour, ingestion of the drinks containing free leucine, phenylalanine, and arginine and the drinks with free leucine, phenylalanine, and wheat protein hydrolysate were followed by the largest insulin response (101% and 103% greater, respectively, than with the carbohydrate-only drink; P < 0.05). Conclusions: Insulin responses are positively correlated with plasma leucine, phenylalanine, and tyrosine concentrations. A mixture of wheat protein hydrolysate, free leucine, phenylalanine, and carbohydrate can be applied as a nutritional supplement to strongly elevate insulin concentrations.
Tetrahydro-beta -carbolines (TH beta Cs), potential neuroactive alkaloids, were found in chocolate and. cocoa. 6-Hydroxy-1-methyl-1,2,3,4-tetrahydro-beta -carboline (60HMTH betaC), 1,2,3,4-tetrahydro-beta -carboline-3-carboxylic acid (THCA), 1-methyl-1,2,3,4-tetrahydro-beta -carboline-3-carboxylic acid (MTCA) in both diastereoisomers (1S,3S and 1R,3S), and 1-methyl-1,2,3,4-tetrahydro-beta -carboline (MTH betaC), besides serotonin and tryptamine biogenic amines, were identified and quantified in dark chocolate, milk chocolate, cocoa, and chocolate-containing cereals by RP-HPLC-fluorescence and HPLC-MS. For each TH betaC, the concentration ranges were determined: 60HMTH betaC (0.16-3.92 mug/g), THCA (0.01-0.85 mug/g), 1S,3S-MTCA (0.35-2 mug/g), 1R,3S-MTCA (0.14-0.88 mug/g), and MTH betaC (nd-0.21 mug/g). The highest content was generally found in chocolates and cocoas, but cereals containing chocolate also showed an appreciable amount of TH beta Cs. The possible biological implications of this novel group of alkaloids in chocolate are discussed.
To test the hypothesis that glucose only affects the responsiveness (maximum velocity) of the beta-cell to arginine without changing the sensitivity (ED50) of the beta-cell to arginine, we investigated the influence of hyperglycemia on the responsiveness and sensitivity of arginine-induced insulin secretion in eight healthy male volunteers. Plasma C-peptide and insulin levels achieved during infusions of five doses of arginine (30 min) with and without a 60-min hyperglycemic clamp (17 mmol/L) were analyzed using a modified Michaelis-Menten equation. At euglycemia, the ED50 (half-maximally stimulating serum arginine concentration) was significantly less for first phase than for second phase plasma C-peptide secretion (0.7 +/- 0.1 vs. 2.7 +/- 0.4 mmol/L; P less than 0.002). Hyperglycemia significantly increased arginine-induced insulin secretion at all arginine infusion rates (P less than 0.01) without significantly altering the ED50 for either phase. We conclude 1) that the regulation of arginine-induced insulin secretion differs between both phases of insulin secretion, and 2) that a 1-h infusion with glucose significantly potentiates arginine-induced insulin secretion without influencing the difference in regulation of both phases of arginine-induced insulin secretion, supporting the validity of the use of arginine as a secretagogue in studies involving hyperglycemia.
There has been much interest in the use of the glycemic index (GI). A recent study reporting plasma glucose responses to mixed meals containing fat and protein concluded that the results were totally disparate from what would have been expected from published GI values of the foods fed. However, this conclusion was based upon an inappropriate assessment of the data using absolute rather than incremental blood glucose response areas. The present report demonstrates how data may be analyzed to make use of the GI values of individual foods to predict the GI of mixed meals (r = 0.987; p less than 0.02). It is concluded that the GI concept applies well to mixed meals containing fat and protein.
Glycaemic and insulinaemic index of maltitol and maltitol-containing chocolate have been determined in healthy subjects with reference to glucose and compared with those of sucrose solution and sucrose containing chocolate. All maltitol containing products (solutions and chocolate) show a reduced glycaemic index. Insulinaemic index of maltitol solutions is also low, while that of maltitol chocolate remains high.