Glucose Tolerance and Blood Lipids in Bran-Fed Patients with Impaired Glucose Tolerance

Bosello, O; Ostuzzi, R; Armellini, F; Micciolo, Rocco; Scuro, L.A.

doi:10.2337/diacare.3.1.46

Cited by 66 publications

(28 citation statements)

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“…The current study indicates that the same is also true for diabetic patients. Nevertheless, inthe long term other aspects of cereal fibre, as for example in wholemeal bread, may be beneficial [30].…”

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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“…This may at least partly explain controversial results of former studies, with some (e.g., 20) but not all (e.g., 21) indicating metabolic improvement after longer-term interventions with insoluble dietary fibers. We have previously shown that the insoluble fiber used in the current study caused slight, but significantly enhanced, colonic fermentation compared with control, as assessed by postabsorptive hydrogen breath concentrations (8).…”

Section: Hydrogen Breath Testmentioning

confidence: 95%

Cereal Fiber Improves Whole-Body Insulin Sensitivity in Overweight and Obese Women

et al. 2006

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OBJECTIVE -Cereal fiber intake is linked to reduced risk of type 2 diabetes in epidemiological observations. The pathogenic background of this phenomenon is unknown. Based on recent findings, we hypothesized that intake of purified insoluble oat fiber may improve wholebody insulin sensitivity. RESEARCH DESIGN AND METHODS-A randomized, controlled, single-blind, cross-over study was performed, and 17 overweight or obese subjects with normal glucose metabolism were analyzed. After consumption of nine macronutrient-matched portions of fiberenriched bread (white bread enriched with 31.2 g insoluble fiber/day) or control (white bread) over a time period of 72 h, whole-body insulin sensitivity was assessed by euglycemichyperinsulinemic clamp. Energy intake was individually adjusted by providing standardized liquid meals. Hydrogen breath tests were performed to control for dietary adherence.RESULTS -When analyzing the entire cohort, whole-body glucose disposal was improved after fiber consumption (M value 6.56 Ϯ 0.32 vs. 6.07 Ϯ 0.27 mg ⅐ min Ϫ1 ⅐ kg Ϫ1 ; P ϭ 0.043). Thirteen subjects had increased hydrogen breath test concentrations after fiber consumption, indicating probable dietary adherence. Restricting analysis to these subjects, improvements in M value (6.85 Ϯ 0.34 vs. 6.06 Ϯ 0.32 mg ⅐ min Ϫ1 ⅐ kg Ϫ1 ; P ϭ 0.003) and insulin sensitivity, expressed as M/I ratio (M value divided by mean serum insulin at steady state: 3.73 Ϯ 0.23 vs. 3.21 Ϯ 0.27; P ϭ 0.02), after fiber consumption were more pronounced. Plasma lipids, serum magnesium, ghrelin, and adiponectin concentrations, as well as substrate utilization and body weight, were not significantly changed by fiber intake (P Ͼ 0.15).CONCLUSIONS -Increased insoluble dietary fiber intake for 3 days significantly improved whole-body insulin sensitivity. These data suggest a potential mechanism linking cereal fiber intake and reduced risk of type 2 diabetes. Diabetes Care 29:775-780, 2006T he epidemic of obesity-associated insulin resistance and type 2 diabetes is a major burden in modern societies. In population studies, cereal fiber intake is linked, by unknown mechanisms, to reduced risk of developing type 2 diabetes and cardiovascular disease (rev. in 1). Insoluble fibers are nonviscous with negligible effects on gastric emptying, macronutrient absorption from the gut, postprandial glucose responses, and blood lipids (1). In contrast, consumption of soluble viscous fibers reduces postprandial glucose responses and positively influences certain serum lipids (2). Surprisingly, epidemiological studies clearly show that principally insoluble cereal fibers appear to offer protection from cardiovascular disease and diabetes (1). Beneficial effects of cereal fibers are frequently discussed in the context of wholegrain consumption. Fruit, vegetables, unrefined whole grains, and bran products are highly complex substances, containing both soluble and insoluble dietary fibers as well as other biologically active substances, e.g., polyphenols, antioxidants, vitamins, trace mineral...

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“…Interpretation of the results after interventions with unrefined whole grains is difficult because of the presence of other active ingredients, such as minerals, phyto-oestrogens and antioxidants [27]. Bran products, which showed improved glycaemic control in some [28,29] but not all [30] longer-term intervention studies, contain starch, protein and lipids in addition to dietary fibres.…”

Section: Introductionmentioning

confidence: 99%

Impact of cereal fibre on glucose-regulating factors

et al. 2005

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Aims/hypothesis: Insoluble dietary fibre intake is associated, by unknown mechanisms, with a reduced risk of type 2 diabetes. We investigated whether a shortterm dietary intervention with purified insoluble fibres influences acute and delayed responses of glucose, insulin, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1. Methods: Fourteen healthy women with NGT were studied for 300 min on six to eight occasions. Subjects consumed three matched portions of control (C) or fibre-enriched bread (10.

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Glucose Tolerance and Blood Lipids in Bran-Fed Patients with Impaired Glucose Tolerance

Cited by 66 publications

References 0 publications

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

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

Cereal Fiber Improves Whole-Body Insulin Sensitivity in Overweight and Obese Women

Impact of cereal fibre on glucose-regulating factors

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