Prediction of glycemic response to mixed meals in noninsulin-dependent diabetic subjects

Abstract

Recent studies suggest the glycemic response of different mixed meals cannot be predicted from the glycemic index (GI) of individual carbohydrate foods. Postprandial glucose levels following five different mixed meals in six noninsulin-dependent diabetic volunteers were therefore assessed. Each meal comprised 50% carbohydrate, 30% fat, and 20% protein, varying only in type of carbohydrate. The carbohydrate exchanged in each meal (potato, white bread, rice, spaghetti, or lentils and barley) contributed 37% of total meal calories. The correlation between predicted glucose response and postprandial glucose area was highly significant; estimated meal GI was virtually proportional to the actual mean glycemic response. These results demonstrate that the relative glycemic effects of mixed meals can be predicted from the GI of their carbohydrate components, again stressing the importance of type of carbohydrate in regulating postprandial blood-glucose levels.

A systematic review on the relations between pasta consumption and cardio-metabolic risk factors

“…Among studies that evaluated postprandial glucose response in terms of iAUC and/or GI in the context of mixed meals in diabetic patients (Table 1), most found significantly lower glucose response to pasta meals compared to bread meals [29,31,[33][34][35][36]60] and/or potato meals. [30,[32][33][34][35] The glucose response differences expressed in percentages ranged from 35% to over 50%.…”

Glycemic index in chronic disease: a review

“…Factors affecting the rate of glucose absorption from starchy food and therefore the GI value include (1) the nature of the food and (2) the type and extent of food processing (Table 5). The former includes the ratio of amylose to amylopectin present in the raw food (Behall et al, 1988) and the type of monosaccharide components, the amount and type of dietary fiber (Jenkins et al, 1978), the presence of large amounts of fat or protein (Nuttall et al, 1984;Wolever et al, 1985;Collier et al, 1986;Bornet et al, 1987), antinutrients such as phytic acid, lectins and tannins (Yoon et al, 1983;Thompson et al, 1984;Rea et al, 1985) and nutrient -starch interactions in carbohydrate-containing foods, such as in wheat products (Jenkins et al, 1987a). Extrusion, flaking, grinding, canning, storing and cooking of the carbohydrate-containing foods can affect the particle size and the integrity of the starch granules (Jenkins et al, 1988a) and plant cell walls (Ellis et al, 1991), making the carbohydrate portion more accessible to digestive enzymes (Wolever, 1990;Collins et al, 1981).…”

“…Low GI foods include vegetables, fruit, legumes and wholegrain breads such as pumpernickel, while high-GI foods include most refined grain products such as white bread, potatoes and rice (Table 2). The GI tables may have various applications, for instance in designing diets aimed at long-term blood glucose control, as some researchers have found that the GI may be applied not only to single foods but also to mixed meals (Wolever et al, 1985;Chew et al, 1985;Collier et al, 1986;Bornet et al, 1987;Le Floch et al, 1991). The GI of mixed meals has also been shown to correlate positively with the insulinemic index (a measure of postprandial insulin rise; Bornet et al, 1987).…”

Postprandial lipid, glucose, insulin, and cholecystokinin responses in men fed barley pasta enriched with β-glucan

“…Dietary fiber alters postprandial glycemia and insulinemia in both healthy (9,16) and diabetic subjects (9,17,18). Many of the studies reporting such effects of fiber have tested isolated fiber sources independent of consumption of a complete mixed meal.…”