Blackcurrants are rich in polyphenolic glycosides called anthocyanins, which may inhibit postprandial glycemia. The aim was to determine the dose-dependent effects of blackcurrant extract on postprandial glycemia. Men and postmenopausal women (14 M, 9 W, mean age 46 years, S.D.=14) were enrolled into a randomized, double-blind, crossover trial. Low sugar fruit drinks containing blackcurrant extract providing 150-mg (L-BE), 300-mg (M-BE) and 600-mg (H-BE) total anthocyanins or no blackcurrant extract (CON) were administered immediately before a high-carbohydrate meal. Plasma glucose, insulin and incretins (GIP and GLP-1) were measured 0–120 min, and plasma 8-isoprostane F2α, together with arterial stiffness by digital volume pulse (DVP) was measured at 0 and 120 min. Early plasma glucose response was significantly reduced following H-BE (n=22), relative to CON, with a mean difference (95% CI) in area over baseline (AOB) 0-30 min of −0.34 mmol/l.h (−0.56, −0.11, P<.005); there were no differences between the intermediate doses and placebo. Plasma insulin concentrations (AOB 0–30 min) were similarly reduced. Plasma GIP concentrations (AOB 0–120 min) were significantly reduced following H-BE, with a mean difference of −46.6 ng/l.h (−66.7, −26.5, P<.0001) compared to CON. Plasma GLP-1 concentrations were reduced following H-BE at 90 min. There were no effects on 8-isoprostane F2α or vascular function. Consumption of blackcurrant extract in amounts roughly equivalent to 100-g blackcurrants reduced postprandial glycemia, insulinemia and incretin secretion, which suggests that inclusion of blackcurrant polyphenols in foods may provide cardio-metabolic health benefits. This trial was registered at clinicaltrials.gov as NCT01706653.

Postprandial glycemic responses to meals are inhibited by polyphenol-rich plant foods. Combinations of polyphenols may be particularly effective through complementary mechanisms. A randomized, controlled, double-blinded cross-over trial was conducted in healthy volunteers to test the hypothesis that apple and blackcurrant polyphenol-rich drinks would reduce postprandial blood glucose concentrations. Secondary outcomes included insulin and glucose-dependent insulinotropic polypeptide (GIP) secretion. Twenty men (mean age 26 y, SD 8) and 5 postmenopausal women (mean age 57 y, SD 3) consumed a placebo drink (CON) and 2 polyphenol-rich drinks containing fruit extracts: either 1200 mg apple polyphenols (AE), or 600 mg apple polyphenols+600 mg blackcurrant anthocyanins (AE+BE), in random order with a starch and sucrose meal. Incremental areas under the curve (iAUC) for plasma glucose concentrations were lower following AE+BE over 0-30 and 0-120 min compared with CON; mean differences (95% CI) -32 mmol/L·min (-41, -22, P<.0005) and -52 mmol/L min (-94, -9, P<.05), respectively. AE significantly reduced iAUC 0-30 min (mean difference -26 mmol/L min, -35, -18, P<.0005) compared with CON, but the difference over 120 min was not significant. Postprandial insulin, C-peptide and GIP concentrations were significantly reduced relative to CON. A dose response inhibition of glucose transport was demonstrated in Caco-2 cells, including total and GLUT-mediated transport, and SGLT1-mediated glucose transport was strongly inhibited at all doses in Xenopus oocytes, following 10 min incubation with 0.125-4 mg apple polyphenols/ml. In conclusion, ingestion of apple and blackcurrant polyphenols decreased postprandial glycemia, which may be partly related to inhibition of intestinal glucose transport.

The prevalence of type 2 diabetes (T2D) is predicted to reach unprecedented levels in the next few decades. In addition to excess body weight, there may be other overlapping dietary drivers of impaired glucose homeostasis that are associated with an obesogenic diet, such as regular exposure to postprandial spikes in blood glucose arising from diets dominated by highly refined starches and added sugars. Strategies to reduce postprandial hyperglycaemia by optimising the functionality of foods would strengthen efforts to reduce the risk of T2D. Berry bioactives, including anthocyanins, are recognised for their inhibitory effects on carbohydrate digestion and glucose absorption. Regular consumption of berries has been associated with a reduction in the risk of T2D. This review aims to examine the evidence fromin vitro, animal and human studies, showing that berries and berry anthocyanins may act in the gut to modulate postprandial glycaemia. Specifically, berry extracts and anthocyanins inhibit the activities of pancreatic α-amylase and α-glucosidase in the gut lumen, and interact with intestinal sugar transporters, sodium-dependent glucose transporter 1 and GLUT2, to reduce the rate of glucose uptake into the circulation. Growing evidence from randomised controlled trials suggests that berry extracts, purées and nectars acutely inhibit postprandial glycaemia and insulinaemia following oral carbohydrate loads. Evidence to date presents a sound basis for exploring the potential for using berries/berry extracts as an additional stratagem to weight loss, adherence to dietary guidelines and increasing physical exercise, for the prevention of T2D.

The prevalence of food allergy (FA) has not been estimated at a population level in Central American countries and, consequently, the magnitude and relevance of the problem in the Central American region remains unknown. Thus, our aim was to evaluate the parent-reported prevalence of FA in a population of schoolchildren from the Central American country El Salvador. A Spanish version of a structured questionnaire was utilized. Five hundred and eight (508) parents returned the questionnaire with valid responses (response rate, 32%). The estimated prevalence rates (95% CI) were: adverse food reactions 15.9 (13.0–19.3), “perceived FA, ever” 11.6 (9.1–14.6), “physician-diagnosed FA, ever” 5.7% (4.0–8.0), “immediate-type FA, ever” 8.8% (6.6–11.6), “immediate-type FA, current” 5.3% (3.6–7.6), and anaphylaxis 2.5% (1.5–4.3). The most common food allergens were milk (1.7%), shrimp (1.3), chili (0.7%), chocolate (0.7%), and nuts (0.3%). Most of the “food-dependent anaphylaxis” cases (60.5%) sought medical attention, but only one case reported the prescription of an epinephrine autoinjector. Mild and severe FA cases are not uncommon among Salvadoran schoolchildren and both the prescription of epinephrine autoinjectors by healthcare personnel and the use of the autoinjectors by anaphylactic individuals should be encouraged.

Adherence to dietary guidelines (DG) may result in higher intake of polyphenols via increased consumption of fruits, vegetables and whole grains. We compared polyphenol dietary intake and urinary excretion between two intervention groups in the Cardiovascular risk REduction Study: Supported by an Integrated Dietary Approach study: a 12-week parallel-arm, randomised controlled trial (n161; sixty-four males, ninety-seven females; aged 40–70 years). One group adhered to UK DG, whereas the other group consumed a representative UK diet (control). We estimated polyphenol dietary intake, using a 4-d food diary (4-DFD) and FFQ, and analysed 24-h polyphenol urinary excretion by liquid chromatography-tandem MS on a subset of participants (n46 control;n45 DG). A polyphenol food composition database for 4-DFD analysis was generated using Phenol-Explorer and USDA databases. Total polyphenol intake by 4-DFD at endpoint (geometric means with 95 % CI, adjusted for baseline and sex) was significantly higher in the DG group (1279 mg/d per 10 MJ; 1158, 1412) compared with the control group (1084 mg/d per 10 MJ; 980, 1197). The greater total polyphenol intake in the DG group was attributed to higher intake of anthocyanins, proanthocyanidins and hydroxycinnamic acids, with the primary food sources being fruits, cereal products, nuts and seeds. FFQ estimates of flavonoid intake also detected greater intake in DG compared with the control group. 24-h urinary excretion showed consistency with 4-DFD in their ability to discriminate between dietary intervention groups for six out of ten selected, individual polyphenols. In conclusion, following UK DG increased total polyphenol intake by approximately 20 %, but not all polyphenol subclasses corresponded with this finding.

Consumption of foods with high content of polyphenols has been associated with reduced risk for type 2 diabetes, and randomised controlled trials have shown inhibition of postprandial glycaemia. Mechanisms proposed include blocking of intestinal glucose transporters (e.g. SGLT1, GLUT2) 1-3 . In previous clinical trials, our group has shown an anthocyanin-rich blackcurrant extract (BE) and a proanthocyanidin-and chlorogenic acid-rich apple extract (AE) inhibit postprandial glycaemia (unpublished data). The aim of the present project is to identify the mechanisms of postprandial glycaemia inhibition by BE, AE and BE individual compounds on intestinal sugar transport using Caco-2/TC-7 cells and Xenopus oocytes injected to express SGLT1. For intestinal cell experiments, Caco-2 cells were cultured in 24-well plates and grown for 2-3 weeks. For Xenopus oocytes experiments, oocytes were injected with cRNA encoding SGLT1 and used 3-4 days post injection. Carrier mediated sugar transport and the effects of BE, AE and BE individual compounds (delphinidin-3-rutinoside, delphinidin-3-glucoside, delphinidin, cyanidin-3-rutinoside, cyanindin-3-glucoside and cyanidin) were studied by dose response assays. D-glucose (10 mM) was used alongside radioactive sugar Glucose, D-[14C (U)] as tracer. The range of concentrations applied to cells in uptake media (10 min uptake) was kept at physiological levels; BE 0·075-2·4 mM total anthocyanins, AE 0·05-1·5 mg polyphenols/ml and BE individual anthocyanins 0·1-0·6 mM. Nonlinear regression analysis was used to estimate IC 50 s (GraphPad Prism) and one-way ANOVA for comparisons between treatments (SPSS v.21). The presence of different concentrations of BE and AE in the uptake media significantly reduced total (Na + -containing buffer, SGLT1-and GLUTs-mediated), facilitated (Na + -free buffer, GLUTs-mediated) and SGLT1-mediated (oocytes expressing SGLT1 only) glucose transport into cells in a dose-response manner (P < 0·05). Values for IC 50 s of BE and AE are shown in the table; results suggest a greater inhibition of total compared with only facilitated glucose uptake. At a dose equivalent to 1 portion of blackcurrants (80 g, 0·48 mM anthocyanins) and apple (80 g, 0·1 mg/ml), inhibition of facilitated (GLUTs-mediated) uptake accounted for ∼40 and ∼20 % of total inhibition of glucose uptake respectively. BE individual compounds did not inhibit glucose uptake.In conclusion, these in vitro experiments suggest that the acute inhibitory effect of BE and AE on postprandial glycaemia observed in our clinical studies is likely to be at least partly due to inhibition of SGLT1 and GLUTs, but further investigation is required as to whether individual anthocyanins act predominantly via other routes such as inhibition of digestive enzymes.

Elevated postprandial glucose concentrations lead to endothelial dysfunction. Certain fruit polyphenols (e.g. phloridzin, anthocyanins) inhibit intestinal glucose transport (1) . Others (e.g. anthocyanins, proanthocyanidins, ellagitannins) reduce starch-and sucrosedigesting enzyme activity (2) . The effects of consumption of apple polyphenols on postprandial glucose concentrations following starch/sucrose-containing meals have not been fully characterised. The aim of this study was to determine whether postprandial glycaemia and vascular function following high-carbohydrate meals were influenced by a polyphenol-rich apple extract, with and without an anthocyanin-rich blackcurrant extract.Twenty-five healthy subjects (20 M, 5 postmenopausal W, mean age 32 y, SD 14) completed a randomised, double-blind, crossover study. Three matched fruit cordial drinks contained either 1) 1·2 g apple polyphenols (A); 2) 0·6 g apple polyphenols + 0·6 g blackcurrant anthocyanins (1·4 g blackcurrant polyphenols) (AB); or, 3) no added polyphenols (CON; control). The drink (12·2 g carbohydrate, 195 kJ) was administered immediately before a high-carbohydrate meal (41 g starch, 22 g sucrose, 1·3 MJ). Venous plasma glucose was measured at baseline and frequent time-points up to 2 h, and digital volume pulse stiffness index (DVP-SI) and reflection index (DVP-RI) were assessed at baseline and 1, 1½ and 2 h.Plasma glucose total iAUC 0-120 min (P < 0·05) and early iAUC 0-30 min, Cmax and Tmax were reduced by treatments A and AB compared with CON (all P < 0·0001). Mean differences in iAUC 0-30 min were: A -CON, −25·3 mmol/L·min (95 % CI −33·6, −16·9); AB -CON, −33·1 mmol/L·min (95 % CI −42·4, −23·8); AB -A, −7·8 mmol/L·min (95 % CI −12·5, −3·2). The overall treatment effect was significant for changes in DVP-RI (P = 0·015), a parameter of vascular function which is indicative of small-to medium-sized arterial stiffness and influenced by peripheral arterial vasodilation. DVP-RI significantly decreased following A compared to CON but the decrease following AB was not statistically significantly different from CON (mean differences in ΔDVP-RI (% units)): A-CON, −6 % (95 % CI −11, −2); AB-CON, −3 % (95 % CI −8, 1); AB-A, 3 % (95 % CI −4, 10). There were no significant effects of treatment on DVP-SI, an indicator of stiffness of large elastic arteries.In conclusion, consumption of 1·2 g apple polyphenols reduced plasma glucose concentrations following a starch and sucrosecontaining meal and prevented the postprandial increase in pulse wave reflection associated with postprandial glycaemia. Although the lower dose of apple polyphenols (plus blackcurrant polyphenols) had a slightly larger inhibitory effect on glycaemic response, there was no significant amelioration of postprandial vascular dysfunction. These findings suggest that apple polyphenol metabolites absorbed within 2 h of ingestion may have been primarily responsible for the observed improvements in postprandial vascular function within this timeframe.

Obesity (O) is a multifactorial disorder and is associates with the development of several chronic diseases. The metabolic syndrome (MS) is diagnosed when three or more than any factors like dislipidemia, hyperglicemia, hypertension or central obesity are presented. Some studies associated the carbohydrate intake with the development of obesity and the MS has been reported. The objective of this study was to evaluate the effect of a low calorie‐ moderate carbohydrate diet (40% energy) on obesity and the MS in people from Mexico for 8 weeks. 156 subjects participated in the study, however only 29 finished it. Every week, the participants came for the recommended diet used within the intervention and the anthropometric and clinical parameters were measured. Blood sample were drowning at points 0, 4 and 8 weeks of the study which were used to analyze the biochemical parameters. Anthropometric, clinical and biochemical parameters were measured by using standardized methods. Participants lost 14.4 pounds average during the whole intervention, 8.4 cm of waist circumference and 2.5 of BMI. 21.4 and 17.8% reduced hypertension and glucose respectively. 32.1% reduced total cholesterol, 32.1% reduced LDL‐C concentrations and triacylglycerides and 28.6% increased their HDL‐C. Low calorie‐moderate carbohydrate diet (40% energy) is very useful in the control of obesity and the factors related to the MS, and also it resulted very convenient for Mexican since, carbohydrates are an important part of their cultural dietary habits.FOUNDED BY PROFAPI‐UAS 2006