Unabsorbable Carbohydrates and Diabetes: Decreased Post-Prandial Hyperglycæmia

Jenkins, DavidJ.A.; Leeds, A. R.; Wolever, ThomasM.S; Goff, D V; George, K.; Alberti, M.M.; Gassull, M.A.; Derek, T.; Hockaday, R.

doi:10.1016/s0140-6736(76)92346-1

Cited by 412 publications

(126 citation statements)

References 8 publications

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“…Certain leguminous seed fibres, eg. guar, have been shown to reduce the glycaemic response in both normal [27] and diabetic [28] volunteers. In addition, longer term studies of diabetics showed that their urinary glucose losses were reduced with guar supplementation [12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

The glycaemic index of foods tested in diabetic patients: A new basis for carbohydrate exchange favouring the use of legumes

et al. 1983

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Summary. Recently diabetic patients have been encouraged to increase their carbohydrate intake, but exact details of which foods to use are lacking. To determine whether sufficiently large differences existed to justify more specific dietary advice, we compared the glycaemic responses to 50 g carbohydrate portions of different foods, taken as breakfast test meals by groups of five to seven diabetic patients. Two-to threefold differences were seen amongst the 15 foods tested. The glycaemic responses for spaghetti, 'All-bran', rice and beans were significantly below those for bread, while 'Cornflakes' were above. Factors predicted to influence this were without effect, including: substituting wholemeal for white bread, increasing substantially the simple sugars (using 'All-bran' or bananas instead of wholemeal bread) and doubling meal protein by adding cottage cheese to bread. Paired comparisons of the glycaemic response to the five legumes with those of the seven other starchy foods (breads, spaghetti, rice, Cornflakes, oatmeal porridge and potatoes) showed that the mean peak rise in blood glucose concentration and mean area under the glucose curve after beans were 23 and 28% lower, respectively, than the mean for the other foods (p < 0.001). Such results suggest a potentially valuable role for dried leguminous seeds in carbohydrate exchanges for individuals with impaired carbohydrate tolerance. These large differences in the blood glucose response to different food cannot at present be predicted directly from tables of chemical composition. Nevertheless, physiological testing may both aid in understanding the factors responsible and help selection of the appropriate carbohydrate foods for the diabetic diet.Key words: Glycaemic index, leguminous seeds, low blood glucose rise, diabetes, diabetic diet, fat, sugars, protein.To lessen the risk to the diabetic of carciovascular disease, current dietary guidelines of the American [1] and Canadian [2] Diabetes Associations and the British Diabetic Association [3] have recommended increasing complex carbohydrate and fibre intakes, while reducing fat consumption. Exactly how this should be achieved is not known and there are fears that increased intake of specific foods, or carbohydrates in general, may worsen diabetic control [4]. However, in the context of high fibre diets this does not appear to be the case [5]. Indeed studies using purified fibre and high-fibre, high-carbohydrate diets have been associated with improved diabetic control [9][10][11][12][13][14][15]. Nevertheless, the carbohydrate foods of greatest potential use to the diabetic have not as yet been defined and it has now been acknowledged that information on the glycaemic effect of individual foods and meals is urgently needed [3].We have therefore compared the effect of taking 50 g carbohydrate portions of 15 different foods on the blood glucose responses of diabetic patients. We wished to determine whether large differences existed which favoured the use of particular foods. It was also important to s...

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Section: Discussionmentioning

confidence: 99%

The glycaemic index of foods tested in diabetic patients: A new basis for carbohydrate exchange favouring the use of legumes

et al. 1983

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“…When considered as those constituents of plant foods that escape digestion in (Jenkins et al, 1976;Doi et al, 1979;Wolever et al, 1991;Tappy et al, 1996;Lu et al, 2000). The term soluble fibre includes a variety of compounds, some of which have gel-forming properties and others of which do not.…”

Section: Fibrementioning

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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“…Seeds of this plant are the source of galactomanan gum (guar) that is used as bulking agent for food and cosmetics (19). The viscosity effect of guar is exploited as a dietary adjunct to delay the rate of glucose absorption and thereby reduce postprandial hyperglycemia (20).…”

Section: Eugenia Jambo/ana or Syzygium Jambo/ana (Engmentioning

confidence: 99%