South Indian Cuisine with Low Glycemic Index Ingredients Reduces Cardiovascular Risk Factors in Subjects with Type 2 Diabetes

Abstract

Background: Inflammation is considered as a predictor of cardiovascular diseases in type 2 diabetes mellitus. No previous studies have investigated the effect of low glycemic index (LGI) recipes of South Indian cuisine on the risk factors of cardiovascular disease in patients with diabetes. Aim: The aim of this randomized controlled trial was to evaluate the improvement in cardiovascular risk factors and blood glucose control, in patients with type 2 diabetes, after intervention with recipes of Kerala cuisine, from locally available whole grain cereals, low in glycemic index. Method: This was a prospective and randomized controlled study that was conducted over a period of 24 weeks. A total of 80 participants were recruited from the Department of Endocrinology and Diabetes Outpatient in Kerala, South India. All 80 patients had type 2 diabetes, and were aged between 35 and 65 years. Participants were randomly assigned and advised to follow either a LGI diet plan (n = 40) or their usual diet, which served as a control group (n = 40). The advice was reinforced throughout the study period. Anthropometric, biochemical parameters which included glycemic and cardio-metabolic parameters were measured according to standard procedures. T-tests were conducted to compare the differences between intervention and control groups, and the Pearson correlation coefficient was used to evaluate associations between the variables. Results: There were significant differences (p < 0.05) between the intervention and control groups with respect to weight, HbA1c, insulin, triglycerides, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), high sensitivity C-reactive protein (hs-CRP) and apolipoprotein B (ApoB). There was also a positive correlation between weight and blood glucose variables. ApoB was positively correlated with lipid profile and insulin levels. Conclusions: The long-term implementation of LGI diet of Kerala cuisine has been found to promote weight loss, enhance insulin sensitivity and reduce the cardiovascular risk.

Effect of low glycaemic index or load dietary patterns on glycaemic control and cardiometabolic risk factors in diabetes: systematic review and meta-analysis of randomised controlled trials

“…Of 188 reports reviewed in full, 161 were excluded based on eligibility criteria. A total of 27 reports containing data for 29 trial comparisons involving 1617 participants with diabetes were included in the final analyses 212223242627283031545556575859606162636465666768697071…”

“…Supplemental figures S17-S30 show influence analyses, in which systematic removal of individual trials altered the results. Removal of single trial comparisons resulted in changes in a gain of significance in the pooled effect estimate for the decrease in waist circumference26; loss of significance for the decrease in triglycerides22232627565771 and apoB,6268 although the direction of the pooled effect estimate still favoured low GI/GL diets; and partial explanation of the evidence of substantial heterogeneity for HbA 1c ,21 fasting glucose,212768 non-HDL-C,65 HDL-C,222763 apoB,71 waist circumference,26 and SBP and DBP 27…”

Whole Grain Consumption and Inflammatory Markers: A Systematic Literature Review of Randomized Control Trials

“…Consumption of whole grains in preference to refined grains is known to have improved health benefits, with the broad range of benefits often attributed solely to the presence of dietary fiber [10,53]; however, other components, phytochemicals, fatty acids, amino acids, vitamins, and minerals are all likely to play a role. This review of 31 RCTs found that consumption of whole grain foods had a moderate effect on reducing inflammatory markers, with five of the possible 15 crossover studies [33,38,40,42,50], and seven of 16 parallel studies demonstrating statistically significant changes [23,[29][30][31][32]43,49]. Within the population groups studied, the reduction in markers was most often observed in obese and overweight populations, and among those with pre-existing conditions, compared with studies of healthy populations, although there were only two studies in this category.…”

“…The included studies were assessed against the predetermined criteria of the Cochrane RoB2 tool for randomized control and crossover trials [21]. Within Domain 1: Randomization Process, there were five studies with some concerns of bias [24,28,30,31,43], with the remaining studies (n = 26) with a low risk of bias. In Domain 2: Deviations from intended intervention, there was one study with a high risk of bias [22], one with some concern [31], and the remainder with a low risk of bias (n = 29).…”

“…In the 12 studies that reviewed individuals with pre-existing conditions, which included type 2 diabetes [23,35,43,45,50], metabolic syndrome [27,28,31,48], type 2 diabetes and metabolic syndrome [23], acute coronary syndrome [50], and hypercholesterolaemia [42], one study had two intervention arms included in this SLR [23] (Table 4). Of the 11 studies measuring CRP, four observed a statistically significant change [23,31,42,43]. Seven studies measured IL-6 levels, with only one showing a significant change [42].…”