Milk as a supplement to mixed meals may elevate postprandial insulinaemia

Abstract

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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“…However, when taking into account the GI of various dairy products, a more likely cause for the association of dairy with AV is the insulin index, defined as the elevation of insulin levels in the blood during the 2‐h period after food is ingested 45 . Milk has a very high insulin index, irrespective of fat content 45,46 . By comparison, cheese has a low insulin index, whereas ice cream has a high insulin index due to added sugar; therefore, this theory, based on hyperinsulinaemia, would account for the association between ice cream and AV and the lack of association between cheese and AV.…”