Glycaemic index and glycaemic load of three traditional Mexican dishes

The purpose of the present study was to assess the glycaemic index (GI) and glycaemic load (GL) of different mixed meals traditionally consumed in Mexico. GI was measured for three meals (Pozole, Molletes and Mole), using glucose as a reference in 12 college student subjects. Mole (p = 0.002), Molletes (p = 0.043) and Pozole (p = 0.016) showed a lower IAUC than glucose. However, there was not difference between meals. Higher GI and GL levels were observed than the estimated GI using as reference the International Table of Atkinson et al. (2008. Diabetes Care 31(12):2281–2283). Since food ingredients vary among Mexican regions, it is recommended to assess the GI and GL of mixed meals according to the cooking habits of each region.     

Diets with a low glycaemic load have favourable effects on prediabetes progression and regression: a prospective cohort study

Background

To date, no study assessing the associations among glycaemic index (GI ), glycaemic load (GL ) and progression to diabetes has focused specifically on prediabetes. Moreover, the available data on the association between these variables and regression to normal glucose regulation (NGR ) are insufficient. Therefore, the present study aimed to evaluate the longitudinal associations among GI , GL and prediabetes outcomes.

Methods

This prospective study included 640 adults aged 40–79 years with prediabetes at baseline. Dietary data were assessed using a previously validated 3‐day food record. The participants were divided into three groups according to GI and GL tertiles. Outcomes were defined based on annual oral glucose tolerance test results.

Results

During a median of 5 years of follow‐up, 127 incident cases of diabetes and 249 incident cases of NGR were identified. Dietary GL was positively associated with the risk of developing diabetes and negatively associated with the likelihood of reaching NGR at least once. Comparing the highest and lowest tertiles of GL , the multivariable‐adjusted hazard ratios (95% confidence intervals) were 1.85 (1.07–3.21) for progression and 0.65 (0.44‐0.96) for regression. No association was observed between GI and prediabetes outcomes in the fully adjusted models.

Conclusions

Among patients with prediabetes, high dietary GL was positively associated with diabetes risk. Furthermore, a low‐GL diet contributed to an increased incidence of reaching NGR .

     

Abstracts of Articles on Insulinemic and Glycemic Response,Diabetes

Background: Wholegrain intake is inversely related to weight gain over time, but little information is available on the role of pulses in weight control.

Objective: To compare weight loss, metabolic outcomes, and nutrient intakes in obese people assigned to a diet rich in pulses and wholegrains or a control diet.

Methods: Randomized controlled study of 18 months with 113 volunteers (body mass index [BMI] ≥ 28 kg/m²). Diets were based on guidelines published by the National Heart Foundation of New Zealand. The intervention group was advised to consume 2 serves of pulses and 4 serves of wholegrain foods per day as substitutions for more refined carbohydrates.

Results: Fiber intakes were higher, intakes of several vitamins and minerals were better maintained, and dietary glycemic index was lower in the intervention compared with the control group. Mean (standard error [SE]) weight loss at 6 months was 6.0 (0.7) kg and 6.3 (0.6) kg in the control and intervention groups, respectively, and was not different between groups (p > 0.05). Blood pressure, triglycerides, and glycemic load were lowered in both groups compared with baseline. Waist circumference was decreased at 18 months in the intervention compared with the control group (?2.8 cm; 95% confidence interval [CI]: ?0.4, ?5.1).

Conclusions: Incorporation of pulses and wholegrain foods into a weight loss program resulted in a greater reduction in waist circumference compared with the group consuming a control diet, although no difference in weight loss was noted between groups. Retention of several nutrients was better with the pulse and wholegrain diet.     

Dietary Glycaemic Index Labelling: A Global Perspective

The glycaemic index (GI) is a food metric that ranks the acute impact of available (digestible) carbohydrates on blood glucose. At present, few countries regulate the inclusion of GI on food labels even though the information may assist consumers to manage blood glucose levels. Australia and New Zealand regulate GI claims as nutrition content claims and also recognize the GI Foundation’s certified Low GI trademark as an endorsement. The GI Foundation of South Africa endorses foods with low, medium and high GI symbols. In Asia, Singapore’s Healthier Choice Symbol has specific provisions for low GI claims. Low GI claims are also permitted on food labels in India. In China, there are no national regulations specific to GI; however, voluntary claims are permitted. In the USA, GI claims are not specifically regulated but are permitted, as they are deemed to fall under general food-labelling provisions. In Canada and the European Union, GI claims are not legal under current food law. Inconsistences in food regulation around the world undermine consumer and health professional confidence and call for harmonization. Global provisions for GI claims/endorsements in food standard codes would be in the best interests of people with diabetes and those at risk.     

Glycemic Index and Insulin Response to a Liquid Nutritional Formula Compared with a Standard Meal

Objective: To determine the glycemic index and metabolic responses to a nutritional formula, and to compare these responses to those following an oral glucose meal and a standard test meal.

Methods: Six male and six female healthy non-diabetic volunteers aged 18 to 48 years met screening examination and laboratory assessment criteria. Three test meals were administered, each containing 50 g of carbohydrate: nutritional formula (NF), standard test meal (ST) and a glucose test meal (GT). Each subject underwent the three test meals on separate days in randomized sequence. Blood samples were taken at intervals over 5 hours for determination of glucose, insulin and triglycerides.

Results: The glycemic index was similar for the NF (60.8±13.1) and for the ST (57.8±12.9) meals. The incremental area under the curve for glucose was similar for NF and ST, but each was significantly lower than for the GT meal. The total area under the curve for insulin was significantly greater for the NF meal than for the ST meal. The serum triglyceride responses were similar for NF and ST meals.

Conclusion: In healthy non-diabetic subjects, the blood glucose and triglyceride responses are similar for a nutritional formula compared to an isoenergetic standard test meal. However, the insulin response differs. This information is important in managing tube-fed patients.     

Associations of Dietary Glycemic Index,Glycemic Load and Carbohydrate with the Risk of Cervical Intraepithelial Neoplasia and Cervical Cancer: A Case-Control Study

Background: The association of dietary glycemic index (GI) and glycemic load (GL) with the risk of cervical cancer has never been investigated. Thus, we aimed to find evidence of any association of GI and GL with the risk of cervical intraepithelial neoplasia (CIN) and cervical cancer. Methods: In this hospital-based case-control study, we included 1340 women (670 controls and 262, 187 and 221 patients with CIN1, CIN2/3, and cervical cancer, respectively) from the Korean human papillomavirus cohort study. Completed demographic questionnaires and semi-quantitative food-frequency questionnaires were collected. The association of dietary GI and GL with CIN and cervical cancer was estimated using a logistic regression model. Results: The multivariate odds ratios (OR) of the highest compared with the lowest quintile of GL for CIN1 were 2.8 (95% confidence interval (CI) = 1.33–5.88). Dietary GI and GL were not associated with CIN2/3 and cervical cancer. Stratified analyses by body mass index (BMI) indicated a positive association between GI and GL and CIN 1 risk among women with a BMI (in kg/m²) <23 (OR = 2.94; 95% CI = 1.32–6.53; p for trend = 0.031 for GI and OR = 3.15; 95% CI = 1.53–6.52; p for trend = 0.013 for GL), but not among those with a BMI of ≥23. A stratification analysis by menopausal status showed that the highest quintile of GI and GL was significantly associated with the risk of CIN1 (OR = 2.91; 95% CI = 1.43–5.96; p for trend = 0.005) (OR = 2.96; 95% CI = 1.53–5.69; p for trend = 0.023) among premenopausal women. Also, in HPV positive women, dietary GL showed significant CIN1 risk (OR = 2.61; 95% CI = 1.09–6.24; p for trend = 0.087). Conclusion: Our case-control study supports the hypothesized associations of dietary GI and GL with increased risk of CIN1. Thus, the consumption of low GI and GL foods plays a significant role in the prevention of cervical carcinogenesis.     

Glycaemic index and glycaemic load intake patterns in older Australian women

Aims:  Dietary glycaemic index and glycaemic load have been associated with risk of chronic diseases, yet limited research exists on patterns of consumption in Australia. Our aims were to investigate glycaemic carbohydrate in a population of older women, identify major contributing food sources and determine low, moderate and high ranges.
Methods:  Subjects were 459 Brisbane women aged 42–81 years participating in the Longitudinal Assessment of Ageing in Women. Diet history interviews were used to assess usual diet and results were analysed into energy and macronutrients using the FoodWorks dietary analysis program combined with a customised glycaemic index database.
Results:  Mean ± SD dietary glycaemic index was 55.6 ± 4.4% and mean dietary glycaemic load was 115 ± 25. A low glycaemic index in this population was ≤52.0, corresponding to the lowest quintile of dietary glycaemic index, and a low glycaemic load was ≤95. Glycaemic index showed a quadratic relationship with age ( P = 0.01), with a slight decrease observed in women aged in their 60s relative to younger or older women. Glycaemic load decreased linearly with age ( P < 0.001). Bread was the main contributor to carbohydrate and dietary glycaemic load (17.1% and 20.8%, respectively), followed by fruit (15.5% and 14.2%), and dairy for carbohydrate (9.0%), or breakfast cereals for glycaemic load (8.9%).
Conclusions:  In this population, dietary glycaemic load decreased with increasing age; however, this was likely to be a result of higher energy intakes in younger women. Focus on careful selection of lower-glycaemic-index items within bread and breakfast cereal food groups would be an effective strategy for decreasing dietary glycaemic load in this population of older women.     

The Association Between Dietary Glycemic Index and Glycemic Load and a Body Shape and Fat Distribution Among Apparently Healthy Iranian Adults

Objective: The role of dietary glycemic index (GI) and glycemic load (GL) in the development of obesity has been debated globally. The relationship with body shape and fat distribution was examined in this cross-sectional association study among apparently healthy Iranian adults.

Methods and materials: A study population of 265 (126 males and 139 females) aged 18–55 years participated in this cross-sectional study from the communities of Tehran based on cluster sampling. GI and GL were assessed by the 147-item food frequency questionnaire (FFQ) completed by a trained dietitian. Weight, height, waist circumference (WC), and hip circumference of the participants were measured, and body mass index (BMI), waist-to-hip ratio (WHR), and A Body Shape Index (ABSI) were further calculated. Fat mass and fat-free mass were also measured using a body composition analyzer, and fat mass index (FMI) and fat-free mass index (FFMI) were then calculated. Multivariate regression models were fitted to assess the association between GI/GL and fat distribution measures such as FMI, FFMI, WC, BMI, WHR, and ABSI, considering potential confounding factors such as sex, age, BMI, and physical activity.

Results: There was a statistically significant inverse association between GL and WC, BMI, and ABSI found in the adjusted model. GL was inversely associated with WC for both the adjusted model (p-trend = 0.027) and the crude model. Also, an inverse association was seen between GL and BMI (p-trend = 0.019) in the adjusted model but a marginal association in the crude model. GL was also inversely associated with ABSI (p-trend = 0.089) in the highest tertile.

Conclusion: Dietary GL but not GI is inversely associated with fat distribution measures such as WC, BMI, and ABSI in the study population. This result may suggest a beneficial role of higher-GL diets in the prevention of obesity.     

Glycemic index and glycemic load are not associated with brain lesions in the elderly

Objective  The goal of this study was to determine if brain lesion volume was correlated with dietary glycemic index and glycemic load in elderly individuals. Design and Setting  This cross-sectional study was performed at an academic medical center as part of a clinical study of late-life depression. Participants  Subjects (n=137) were age 60 or over, and were participating as non-depressed comparison subjects. Measurements  Food intake was assessed using the Block 1998 food frequency questionnaire. Glycemic index and glycemic load measures were derived from reported food intake. Brain lesion volumes were calculated from magnetic resonance imaging (MRI). Results  No significant associations were found between glycemic index or glycemic load, and brain lesion volume. Conclusion  Dietary glycemic measures may be unrelated to brain lesions or may be related to brain lesions only in individuals with impaired glycemic control or other vascular risk factors. Further studies are needed to confirm this finding and to determine if glycemic control moderates this association. (work was completed as part of the Master of Science in Clinical Research program)     

The Effect of Added Peanut Butter on the Glycemic Response to a High–Glycemic Index Meal: A Pilot Study

Objective: The purpose of this pilot study was to determine whether supplementation of a high–glycemic index breakfast meal with peanut butter attenuates the glycemic response.

Methods: Sixteen healthy adults, aged 24.1?±?3.5 years, reported in the morning to a nutrition assessment laboratory for two days of data collection, having fasted 8 to 12?hours. On day 1 (control), fasting blood glucose (BG) was measured using glucometers, then participants consumed two slices of white bread and 250 mL apple juice (60?g carbohydrate) within 15?minutes. BG was measured again at 15, 30, 60, 90, and 120?minutes after the first bite of the meal. On day 2, the protocol was repeated, except 32?g (2 tbsp) of peanut butter was added to the meal (treatment).

Results: The spike in BG was significantly lower on the treatment versus control day (35.8?±?16.4 vs. 51.0?±?20.8?mg/dL, respectively; p?<?0.01), and BG was significantly lower on the treatment day at 15, 30, and 60?minutes post–meal consumption (p?<?0.05).

Conclusions: This study indicates that supplementation with 32 g (2 tbsp) peanut butter attenuates the magnitude of BG spike and overall glycemic response to high–glycemic index meal and may be a practical, beneficial strategy to prevent undesirable elevations in BG.     

The Glycaemic and Insulinaemic Response of Pasta in Chinese and Indians Compared to Asian Carbohydrate Staples: Taking Spaghetti Back to Asia

In this study, we compared the metabolic properties of the Asian staples rice and noodles, which are typically high in glycaemic index (GI), to two types of spaghetti. It is hypothesised that pasta can be a healthy replacement, particularly amongst the Asian population. Thirty Chinese and Indian subjects (17 men, 13 women; BMI: 18.5–25 kg/m²) participated in this randomised crossover trial. On seven occasions, they consumed a glucose reference drink (3 times), white rice, wheat-based mee pok noodles, semolina spaghetti and wholegrain spaghetti. Blood samples were taken to measure glucose and insulin response over a period of 3 h. The current evaluation showed that semolina spaghetti and wholegrain spaghetti can be classified as low GI products, with a GI of 53 and 54, respectively, significantly lower than wheat based mee pok noodles (74) and rice (80) (p < 0.005). In addition, both spaghettis had a lower insulin response compared to rice (p < 0.05). Furthermore, there was no difference in glucose or insulin response between semolina and wholegrain spaghetti. After controlling for gender, ethnicity, fat and fat free mass (kg), the glucose and insulin results did not change. In conclusion, wheat-based pasta can be helpful to modify the carbohydrate-rich Asian diet. Notably, there was no effect of gender, ethnicity and body composition on the glycaemic and insulinaemic response. We speculate that the starch-protein structure as a result of the spaghetti production process is a major driver of its favourable metabolic properties.     

Food intake and dietary glycaemic index in free-living adults with and without type 2 diabetes mellitus

A recent Cochrane review concluded that low glycaemic index (GI) diets are beneficial in glycaemic control for patients with type 2 diabetes mellitus (T2DM). There are limited UK data regarding the dietary GI in free-living adults with and without T2DM. We measured the energy and macronutrient intake and the dietary GI in a group (n = 19) of individuals with diet controlled T2DM and a group (n = 19) without diabetes, matched for age, BMI and gender. Subjects completed a three-day weighed dietary record. Patients with T2DM consumed more daily portions of wholegrains (2.3 vs. 1.1, P = 0.003), more dietary fibre (32.1 vs. 20.9 g, P < 0.001) and had a lower diet GI (53.5 vs. 57.7, P = 0.009) than subjects without T2DM. Both groups had elevated fat and salt intake and low fruit and vegetable intake, relative to current UK recommendations. CONCLUSIONS: Patients with T2DM may already consume a lower GI diet than the general population but further efforts are needed to reduce dietary GI and achieve other nutrient targets.     

Effects of Hydrolyzed Whey versus Other Whey Protein Supplements on the Physiological Response to 8 Weeks of Resistance Exercise in College-Aged Males

Objective: The objective of this study was to compare the chronic effects of different whey protein forms on body composition and performance when supplemented with resistance training.

Methods: Resistance-trained men (N = 56, 21.4 ± 0.4 years, 79.5 ± 1.0 kg) participated in an 8-week resistance training regimen (2 upper-body sessions and 2 lower-body sessions per week) and received one of 4 double-blinded treatments: 30 g/serving carbohydrate placebo (PLA) or 30 g/serving protein from either (a) 80% whey protein concentrate (WPC), (b) high-lactoferrin-containing WPC (WPC-L), or (c) extensively hydrolyzed WPC (WPH). All subjects consumed 2 servings of treatment per day; specifically, once immediately before and after training and between meals on nontraining days. Blood collection, one repetition maximum (1RM) testing for bench press and hack squat, and body composition assessment using dual-energy x-ray absorptiometry (DXA) occurred prior to training and 48 hours following the last training session.

Results: Total body skeletal muscle mass increased in all groups (p < 0.0125). There were similar between-group increases in upper-body (4%–7%, analysis of covariance [ANCOVA] interaction p = 0.73) and lower-body (24%–35%, ANCOVA interaction p = 0.85) 1RM strength following the intervention. Remarkably, WPH reduced fat mass (?6%), which was significantly different from PLA (+4.4%, p < 0.0125). No time or between-group differences were present for serum markers of health, metabolism, or muscle damage, with the exception of blood urea nitrogen being significantly lower for WPH than WPC (p < 0.05) following the intervention.

Conclusions: WPH may augment fat loss but did not provide any other advantages when used in combination with resistance training. More mechanistic research is needed to examine how WPH affects adipose tissue physiology.     

Does a Low Glycaemic Index (GI) Diet Cost More during Pregnancy?

The aim of this study was to examine the monetary cost of dietary change among pregnant women before and after receiving low glycaemic index (GI) dietary advice. The pregnant women in this study were a subgroup of participants in the Pregnancy and Glycaemic Index Outcomes (PREGGIO) study. Twenty women from the low GI dietary advice group, who had completed their pregnancies, were randomly chosen. All these women had completed three day food records at 12–16 weeks and again around 36 weeks of gestation. Consumer food prices were applied to recorded dietary intake data. The mean ± SD GI of the diet reduced from 55.1 ± 4.3 to 51.6 ± 3.9 (p = 0.003). The daily cost of the diet (AUD) was 9.1 ± 2.7 at enrolment and 9.5 ± 2.1 prior to delivery was not significantly different (p = 0.52). There were also no significant differences in the daily energy intake (p = 0.2) or the daily cost per MJ (p = 0.16). Women were able to follow low GI dietary advice during pregnancy with no significant increase in the daily costs.     

Moringa oleifera Leaf Supplementation as a Glycemic Control Strategy in Subjects with Prediabetes

Moringa oleifera (MO) is a multipurpose plant with a high polyphenol content, which is being increasingly consumed to lessen the risk of chronic metabolic diseases such as Type 2 diabetes; however, scientific evidence from clinical trials is scarce. A double-blind, randomized, placebo-controlled, parallel group intervention study with MO leaves as a food supplement was conducted in subjects with prediabetes. They consumed six daily capsules of MO dry leaf powder (2400 mg/day) (MO, n = 31) or placebo (PLC, n = 34) over 12 weeks. Glycemia, appetite-controlling hormones and gut microbiota composition were studied. ANCOVA with the fixed factor “treatment” and the basal value as covariate was used to compare the change score between the groups. The results showed significant differences between groups in the rate of change of fasting blood glucose (FBG) and glycated hemoglobin (HbA1c), which showed opposite directions during the intervention, decreasing in MO and increasing in PLC. No different change scores were found between the groups in microbiota, hepatic and renal function markers or the appetite-controlling hormones measured. In conclusion, MO supplementation resulted in favorable changes in glycaemia markers compared to placebo in the subjects with prediabetes studied, suggesting that MO might act as a natural antihyperglycemic agent.