The intestinal microbiome is a co-determinant of the postprandial plasma glucose response

Abstract

Elevated postprandial plasma glucose is a risk factor for development of type 2 diabetes and cardiovascular disease. We hypothesized that the inter-individual postprandial plasma glucose response varies partly depending on the intestinal microbiome composition and function. We analyzed data from Danish adults (n = 106), who were self-reported healthy and attended the baseline visit of two previously reported randomized controlled cross-over trials within the Gut, Grain and Greens project. Plasma glucose concentrations at five time points were measured before and during three hours after a standardized breakfast. Based on these data, we devised machine learning algorithms integrating bio-clinical, as well as shotgun-sequencing-derived taxa and functional potentials of the intestinal microbiome to predict individual postprandial glucose excursions. In this post hoc study, we found microbial and clinical features, which predicted up to 48% of the inter-individual variance of postprandial plasma glucose responses (Pearson correlation coefficient of measured vs. predicted values, R = 0.69, 95% CI: 0.45 to 0.84, p<0.001). The features were age, fasting serum triglycerides, systolic blood pressure, BMI, fasting total serum cholesterol, abundance of Bifidobacterium genus, richness of metagenomics species and abundance of a metagenomic species annotated to Clostridiales at order level. A model based only on microbial features predicted up to 14% of the variance in postprandial plasma glucose excursions (R = 0.37, 95% CI: 0.02 to 0.64, p = 0.04). Adding fasting glycaemic measures to the model including microbial and bio-clinical features increased the predictive power to R = 0.78 (95% CI: 0.59 to 0.89, p<0.001), explaining more than 60% of the inter-individual variance of postprandial plasma glucose concentrations. The outcome of the study points to a potential role of the taxa and functional potentials of the intestinal microbiome. If validated in larger studies our findings may be included in future algorithms attempting to develop personalized nutrition, especially for prediction of individual blood glucose excursions in dys-glycaemic individuals.

The Impact of Microbial Composition on Postprandial Glycaemia and Lipidaemia: A Systematic Review of Current Evidence

“…The gut microbiota has been shown to play a critical role in human health, particularly the development of metabolic diseases [51], and is considered a co-determinant of postprandial plasma glucose response [52]. Given that humans spend a significant proportion of time in a postprandial state, it is of the upmost importance that underlying mechanisms influencing metabolic responses post-consumption are studied in greater detail [53].…”

Effect of Total Starch and Resistant Starch in Commercial Extruded Dog Foods on Gastric Emptying in Non-Racing Sled Dogs

“…Fiber naturally present in food can delay the GER of a solid meal [34]. Typically, soluble fiber has a much higher water holding capacity than insoluble dietary fiber, causing solublefiber rich foods to increase viscosity in the stomach, delaying emptying into the small intestine [35]. When comparing all treatments, the 25 g AvCHO portion of the grain-free diet, which induced the highest GER, contained the highest amount of TDF compared to the vegan and traditional diet portions, which had the lowest amount of TDF.…”

“…While the data presented herein helps to improve our understanding of the effects of different diets on GER in dogs, future research investigating the effect of macronutrients on GE using a dog model is warranted. Due to the effect of starch structure on gut microbiome composition and the potential link between the microbiome and PPG [35,39], it may be beneficial to explore this relationship further in dogs.…”

The Present and Future of Personalized Nutrition

“…An excessive frequency of elevated postprandial blood glucose peaks has been shown to be the main determinant for the development of type 2 diabetes and cardiovascular disease 16 . Analyses of the studies conducted so far indicate that the factors affecting postprandial blood glucose peaks are the composition of the food consumed, especially if it is abundant in carbohydrates; to a lesser degree, the person's genetics; although, very importantly by the person's gut microbiota 17 . At present, postprandial glucose peaks have been considered to depend almost exclusively on the carbohydrate load of the foods consumed or their glycemic index; however, the influence of these factors is not absolute, as these studies suggest that the type of gut microbiota is a very important factor determining the variance of the postprandial peak glucose response.…”