Effect of the glycemic index and content of indigestible carbohydrates of cereal-based breakfast meals on glucose tolerance at lunch in healthy subjects

Liljeberg, Helena; Åkerberg, Anna K. E.; Björck, Inger

doi:10.1093/ajcn/69.4.647

Cited by 193 publications

(151 citation statements)

References 24 publications

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“…There was a significant increase in GLP-1 concentration with a significant fall in gastric emptying rate and a decrease in postprandial glucose. These effects agree with the reports of decrease glucose and insulin and decrease in gastric emptying from the sodium propionate enrichment of bread (Liljeberg et al, 1999b). GLP-1 is known to have effects on gastric empting Figure 1 Circulating plasma glucose, insulin and GLP-1 response to four pasta-based test meals in healthy volunteers (n ¼ 9).…”

Section: Discussionsupporting

confidence: 87%

“…Studies have demonstrated that the addition of viscous, soluble fibers, like psyllium, to food slows carbohydrate absorption and improves glucose regulation (Jenkins & Jenkins 1985a;Wolever et al, 1991). The inclusion of short chain fatty acids, eg lactic, acetic acid and sodium propionate, to carbohydrate-based products reduces glycemia and insulin demand (Liljeberg et al, 1999a). The addition of butter to potatoes decreases postprandial glycemia (Gannon et al, 1993), as does the addition of fat to pasta (Normand et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

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The effects of fiber enrichment of pasta and fat content on gastric emptying, GLP-1, glucose, and insulin responses to a meal

et al. 2003

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Objective: To assess whether the addition of viscous fiber at an amount recommended by the US FDA to allow a 'low saturated fat, cholesterol, soluble fiber and coronary heart disease', health claim label on a food package (1.7 g psyllium) and=or fat (30 g sunflower oil and 3 g sodium propionate) to a pasta meal would affect gastric emptying, postprandial glucose, insulin and GLP-1 concentrations. Design: Ten subjects participated in a two-by-two single blind randomized crossover study. Four meals containing 50 g of available carbohydrate were consumed: pasta with or without psyllium enrichment served with a tomato sauce with (520 kcal per meal) and without (240 kcal per meal) fat. Blood samples were taken for 240 min following the meal and all subjects consumed a buffet meal at the end of the study. Gastric empting was measured using the paracetamol absorption test. Blood was analysed for glucose, insulin, GLP-1. Visual analog scales were used to record feelings of hunger, pleasantness and nausea. Results: The psyllium-enriched pasta had no significant effect on gastric emptying or the incremental area under the curve (IAUC) for GLP-1, insulin or glucose compared with the control pasta. The addition of polyunsaturated fat and sodium propionate significantly increased the IAUC for GLP-1 (P < 0.001), delaying gastric emptying (P < 0.002), and decreasing glucose (P < 0.002). Conclusions: A dose of 1.7 g psyllium did not evoke measurable effects on gastric emptying, postprandial GLP-1, insulin or glucose metabolism. However the addition of 30 g of oil and 3 g of sodium propionate to the pasta did reduce gastric emptying, increase GLP-1 and reduce glucose and insulin concentrations. While this short-term study may have implications in terms of reducing the risk of diabetes and improving coronary risk factor profiles the long term effects of these nutrients need to be studied.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

The effects of fiber enrichment of pasta and fat content on gastric emptying, GLP-1, glucose, and insulin responses to a meal

et al. 2003

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“…However, a supplementation of the bread meal with 400 ml milk further increased the insulin demand. The spaghetti product used in the present study has previously been characterised regarding the postprandial glycaemic and insulinaemic responses, and was found to have a low GI and II (GI ¼ 52, II ¼ 42; Liljeberg et al, 1999). These favourable characteristics could be seen in the present study when comparing the bread þ water and spaghetti þ water meals (Table 2).…”

Section: Milk As a Supplement May Elevate Postprandial Insulinaemia Hsupporting

confidence: 61%

Milk as a supplement to mixed meals may elevate postprandial insulinaemia

Elmståhl

Björck

2001

Eur J Clin Nutr

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Objective: The objective was to evaluate the impact of milk added to a high-glycaemic index (GI) white bread meal vs a low-GI spaghetti meal, respectively, on postprandial glucose and insulin responses in healthy subjects. Design: The volunteers were served the bread or spaghetti meals with either milk (200 or 400 ml, respectively) or water (400 ml) following an overnight fast. Capillary blood samples were collected before and during 3 h after the meals. Setting: The study was performed at the Department of Applied Nutrition and Food Chemistry, Lund University, Sweden. Subjects: Ten healthy volunteers, seven men and three women, aged 22 -30 y, with normal body mass indices, were recruited. Results: There was no difference in postprandial glucose area under curve (AUC) with and without added milk in the case of the high-GI bread meals. As could be expected, glucose AUC after the bread meal þ water was higher than after the spaghetti meal þ water. Milk added at 200 or 400 ml to the spaghetti meal did not affect glucose AUC. However, a significantly higher insulin AUC was seen with the bread meal with 400 ml milk ( þ 65%) and the spaghetti meal with 200 ml or 400 ml milk ( þ 300%), respectively, compared with corresponding test meal with water Conclusions: The addition of milk to a low-GI spaghetti meal may significantly increase the postprandial insulinaemia. Even an ordinary amount of milk (200 ml) increased the insulin AUC to a low-GI spaghetti meal to the same level as seen with white bread. The mechanism for the insulinotrophic effect of milk is not known, and the potential long-term metabolic consequences need to be elucidated.

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“…To what extent the second meal effect might be influenced by the rate of carbohydrate digestion or by fermentable carbohydrate is uncertain. To address this question, Liljeberg et al (1999) conducted a series of experiments in which comparisons were made between high fibre/low fibre breads, spaghetti and bread (similar fibre contents), and bread with and without a spread of raw potato starch. The results showed that the content of fermentable carbohydrates did not influence glycaemia after the second meal.…”

Section: Second Meal Effectmentioning

confidence: 99%

Cereal grains, legumes and diabetes

2004

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This review examines the evidence for the role of whole grain foods and legumes in the aetiology and management of diabetes. MedLine and SilverPlatter ('Nutrition' and 'Food Science FSTA') databases were searched to identify epidemiological and experimental studies relating to the effects of whole grain foods and legumes on indicators of carbohydrate metabolism. Epidemiological studies strongly support the suggestion that high intakes of whole grain foods protect against the development of type II diabetes mellitus (T2DM). People who consume B3 servings per day of whole grain foods are less likely to develop T2DM than low consumers (o3 servings per week) with a risk reduction in the order of 20-30%. The role of legumes in the prevention of diabetes is less clear, possibly because of the relatively low intake of leguminous foods in the populations studied. However, legumes share several qualities with whole grains of potential benefit to glycaemic control including slow release carbohydrate and a high fibre content. A substantial increase in dietary intake of legumes as replacement food for more rapidly digested carbohydrate might therefore be expected to improve glycaemic control and thus reduce incident diabetes. This is consistent with the results of dietary intervention studies that have found improvements in glycaemic control after increasing the dietary intake of whole grain foods, legumes, vegetables and fruit. The benefit has been attributed to an increase in soluble fibre intake. However, prospective studies have found that soluble fibre intake is not associated with a lower incidence of T2DM. On the contrary, it is cereal fibre that is largely insoluble that is associated with a reduced risk of developing T2DM. Despite this, the addition of wheat bran to the diets of diabetic people has not improved indicators of glycaemic control. These apparently contradictory findings might be explained by metabolic studies that have indicated improvement in glucose handling is associated with the intact structure of food. For both grains and legumes, fine grinding disrupts cell structures and renders starch more readily accessible for digestion. The extent to which the intact structure of grains and legumes or the composition of foods in terms of dietary fibre and other constituents contribute to the beneficial effect remains to be quantified. Other mechanisms to help explain improvements in glycaemic control when consuming whole grains and legumes relate to cooking, type of starch, satiety and nutrient retention. Thus, there is strong evidence to suggest that eating a variety of whole grain foods and legumes is beneficial in the prevention and management of diabetes. This is compatible with advice from around the world that recommends consumption of a wide range of carbohydrate foods from cereals, vegetables, legumes and fruits both for the general population and for people with diabetes.

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Effect of the glycemic index and content of indigestible carbohydrates of cereal-based breakfast meals on glucose tolerance at lunch in healthy subjects

Abstract: Glucose tolerance can improve in a single day. Slow absorption and digestion of starch from the breakfast meal, but not the content of indigestible carbohydrates in the breakfast meal, improved glucose tolerance at the second meal (lunch).

Cited by 193 publications

References 24 publications

The effects of fiber enrichment of pasta and fat content on gastric emptying, GLP-1, glucose, and insulin responses to a meal

The effects of fiber enrichment of pasta and fat content on gastric emptying, GLP-1, glucose, and insulin responses to a meal

Milk as a supplement to mixed meals may elevate postprandial insulinaemia

Cereal grains, legumes and diabetes

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