Effects of Diet, Lifestyle, Chrononutrition and Alternative Dietary Interventions on Postprandial Glycemia and Insulin Resistance

Abstract

As years progress, we are found more often in a postprandial than a postabsorptive state. Chrononutrition is an integral part of metabolism, pancreatic function, and hormone secretion. Eating most calories and carbohydrates at lunch time and early afternoon, avoiding late evening dinner, and keeping consistent number of daily meals and relative times of eating occasions seem to play a pivotal role for postprandial glycemia and insulin sensitivity. Sequence of meals and nutrients also play a significant role, as foods of low density such as vegetables, salads, or soups consumed first, followed by protein and then by starchy foods lead to ameliorated glycemic and insulin responses. There are several dietary schemes available, such as intermittent fasting regimes, which may improve glycemic and insulin responses. Weight loss is important for the treatment of insulin resistance, and it can be achieved by many approaches, such as low-fat, low-carbohydrate, Mediterranean-style diets, etc. Lifestyle interventions with small weight loss (7–10%), 150 min of weekly moderate intensity exercise and behavioral therapy approach can be highly effective in preventing and treating type 2 diabetes. Similarly, decreasing carbohydrates in meals also improves significantly glycemic and insulin responses, but the extent of this reduction should be individualized, patient-centered, and monitored. Alternative foods or ingredients, such as vinegar, yogurt, whey protein, peanuts and tree nuts should also be considered in ameliorating postprandial hyperglycemia and insulin resistance. This review aims to describe the available evidence about the effects of diet, chrononutrition, alternative dietary interventions and exercise on postprandial glycemia and insulin resistance.

Effects of Spaghetti Differing in Soluble Fiber and Protein Content on Glycemic Responses in Humans: A Randomized Clinical Trial in Healthy Subjects

“…The use of GI for the classification of carbohydrate-rich foods has been endorsed by the FAO/WHO, who recommended that the GI of foods should be considered together with information about food composition to guide food choices [ 2 ]. Consumption of foods and meals that induce a lower glycemic response and delay gastric emptying, thus leading to decreased insulin requirements and postprandial glucose excursions, has been proposed as an important strategy to ameliorate postprandial hyperglycemia and insulin resistance [ 36 ]. Such foods typically contain high fiber, particularly soluble fiber, low amounts of easily absorbable carbohydrates, and are high in proteins [ 36 , 37 , 38 ].…”

“…Consumption of foods and meals that induce a lower glycemic response and delay gastric emptying, thus leading to decreased insulin requirements and postprandial glucose excursions, has been proposed as an important strategy to ameliorate postprandial hyperglycemia and insulin resistance [ 36 ]. Such foods typically contain high fiber, particularly soluble fiber, low amounts of easily absorbable carbohydrates, and are high in proteins [ 36 , 37 , 38 ]. It has been shown that consumption of fibers (i.e., beta-glucans, whole-grain cereals) may slow the rates of gastric emptying and intestinal glucose absorption, thus reducing postprandial glucose responses in a dose-dependent manner [ 39 ].…”

Changing Meal Sequence Affects Glucose Excursions in Gestational Diabetes Mellitus

“…Peak glucose after breakfast and lunch in group B was higher than in the other two groups, but peak glucose levels after dinner and time to peak after meals did not differ among the three test days. Many factors can influence postprandial glucose, including the circadian clock, meal timing, and activity [ 36 – 38 ]. The peak postprandial glucose after dinner in group B was higher than in groups A and C after dinner; however, the difference did not reach statistical significance, and we believe this finding may be related to the following factors.…”

Short-term effects of sugar-free apricot jam, cocoa powder and dried cranberry cereal bar on glycaemic responses in healthy adults: a randomised clinical trial

“…The use of GI for the classification of carbohydrate-rich foods has been endorsed by the FAO/WHO, who recommended that the GI of foods should be considered together with information about food composition to guide food choices (11) . Consumption of foods and meals that induce a lower glycaemic response and delay gastric emptying, thus leading to decreased insulin requirements and postprandial glucose excursions, has been proposed as an important strategy to ameliorate postprandial hyperglycaemia and insulin resistance (22) . Such foods typically contain low amounts of easily absorbable carbohydrates (22)(23)(24) .…”

“…Consumption of foods and meals that induce a lower glycaemic response and delay gastric emptying, thus leading to decreased insulin requirements and postprandial glucose excursions, has been proposed as an important strategy to ameliorate postprandial hyperglycaemia and insulin resistance (22) . Such foods typically contain low amounts of easily absorbable carbohydrates (22)(23)(24) . Lowering the GI of a food may be significant as it has been shown that consumption of low GI foods may be sufficient to achieve a lower glycaemic response from one meal to the next (25)(26)(27)(28) .…”