Does food insulin index in the context of mixed meals affect postprandial metabolic responses and appetite in obese adolescents with insulin resistance? A randomised cross-over trial

Abstract

The food insulin index (II) is a novel classification to rank foods based on their physiological insulin demand relative to an isoenergetic reference food and may be a valid predictor of postprandial insulin responses and appetite. The present study aimed to compare the postprandial metabolic responses and appetite sensations to two macronutrient- and glycaemic index-matched meals with either high or low II in obese adolescents with insulin resistance (IR). A randomised, single-blind and cross-over trial included fifteen obese adolescents aged 12–18 years with IR. All participants were provided with two different breakfasts: low glycaemic index, low insulin index (LGI-LII) and low glycaemic index, high insulin index (LGI-HII), with a 1-week washout period between meals. At time 0 (just before breakfast), 15, 30, 45, 60, 90, 120, 180 and 240 min after the meal, serum glucose, insulin and C-peptide levels and appetite scores were measured. At the end of 4 h, participants were served ad libitum lunch. Early (0–30 min), late (45–240 min) and total (0–240 min) postprandial insulin responses were lowered by 56·1, 34·6 and 35·6 % after the LGI-LII meal v. LGI-HII meal (P < 0·05). The feeling of hunger was also decreased by 25·8 and 27·5 % after the LGI-LII meal v. LGI-HII meal during the late and total responses (P < 0·05). The calculation II of meals or diets may be a useful dietary approach to reduce postprandial hyperinsulinaemia and the perceived hunger in obese adolescents with IR.

Effects of a novel combination of orlistat and acarbose on tolerability, appetite, and glucose metabolism in persons with obesity

“…Acarbose inhibits amylase, consequently reducing the intestinal absorption rate of glucose. Both lower blood glucose concentrations as well as lower insulin concentrations have been associated with lower ratings of appetite . Moreover, the 1 mmol difference in C max has been shown to be equivalent of a clinically relevant change in HbA1c .…”

The Application of the Food Insulin Index in the Prevention and Management of Insulin Resistance and Diabetes: A Scoping Review

“…Full-text screening was performed on 72 articles of which 47 were excluded. Data extraction was performed on the remaining 25 articles [ 27 , 29 , 30 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 ].…”

The Effect of Healthy Lifestyle Strategies on the Management of Insulin Resistance in Children and Adolescents with Obesity: A Narrative Review

“…Although carbohydrates are the major stimulus for insulin secretion, recent studies have pointed out that they are not the only one [ 145 , 150 ]. In fact, dietary proteins and fats also elicit a significant insulin response [ 145 ].…”

“…II directly quantifies the postprandial insulin response to any food, not just carbohydrates, with respect to a food reference (glucose). This index has been suggested to be more suitable in evaluating conditions related to insulin exposure, such as obesity [ 150 , 151 ]. Caferoglu et al were the first to evaluate the postprandial metabolic response and appetite control following the consumption of a meal with the same GI but different II in a group of adolescents with obesity and IR.…”

“…Even if meals were matched for GI and macronutrient distribution, they resulted in a less favorable postprandial response when presenting food with a high insulin index. The authors speculate that a low-II diet may reduce nutrient-induced hyperinsulinemia and lead to a greater improvement in IR and insulin sensitivity in adolescents with obesity [ 150 ]. These potential implications are of great interest for future research.…”