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Gholami Z, Clark CCT, Paknahad Z. The effect of psyllium on fasting blood sugar, HbA1c, HOMA IR, and insulin control: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials. BMC Endocr Disord 2024; 24:82. [PMID: 38844885 PMCID: PMC11155034 DOI: 10.1186/s12902-024-01608-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/23/2024] [Indexed: 06/10/2024] Open
Abstract
There is equivocal evidence that psyllium can prevent or attenuate increases in fasting blood sugar. Therefore, this systematic review and meta-analysis sought to investigate the influence of psyllium on hemoglobin A1C (HbA1c), fasting blood sugar (FBS), insulin, and Homeostatic Model Assessment of Insulin Resistance (HOMA IR). We searched PubMed, ISI Web of Science (WOS), and Scopus for eligible publications, up to 15 July 2022, including randomized controlled trials (RCT) assessing the effect of psyllium on HbA1c, FBS, insulin, and HOMA IR levels in adults. Using a random effects model, we report the weighted mean differences (WMD) with 95% confidence intervals (CI). In this article, 19 RCT studies, consisting of 962 participants, were included. Psyllium significantly decreased FBS, HbA1c, and HOMA IR levels, but not insulin levels, as compared to placebo (FBS: WMD): -6.89; 95% CI: -10.62, -3.16; p < .001), HbA1c: (WMD: -0.75; 95% CI: -1.21, -0.29; p < .001), HOMA IR: (WMD: -1.17; 95% CI: -2.11, -0.23; p < .05), and insulin: (WMD: -2.08; 95% CI: -4.21, -0.035; p > .05)). Subgroup analyses illustrated differences in the effects of psyllium on FBS: dosages less than and more than 10 g/d showed significant differences (p value < 0.05). However, it was not significant in intervention durations less than 50 days (p value > 0.05). For HbA1c: psyllium consumption less than 10 g/d (p value > 0.05) was non-significant. For HOMA IR and insulin: no significant changes were noted with psyllium consumption less than vs. more than 10 g/d. In conclusion, we found that psyllium could significantly decrease FBS, HbA1c, and HOMA IR levels, but not insulin levels, as compared to placebo.
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Affiliation(s)
- Zeinab Gholami
- Ph.D Candidate of Nutrition, School of Nutrition and Food Science, Students' Research Committee , Isfahan University of Medical Sciences, Isfahan, Iran
- Department of clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Cain C T Clark
- Research Institute for Health and Wellbeing, Coventry University, CV1 5FB, Coventry, United Kingdom
| | - Zamzam Paknahad
- Professor of Nutrition, Department of Clinical Nutrition, Faculty of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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2
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Lehoux Dubois C, Boudreau V, Potter KJ, Colomba J, Lavoie A, Mailhot M, Desjardins K, Rabasa-Lhoret R. Acute soluble fibre supplementation has no impact on reducing post-prandial glucose excursions in adults with cystic fibrosis and glucose intolerance. ANNALES D'ENDOCRINOLOGIE 2023; 84:767-772. [PMID: 36764386 DOI: 10.1016/j.ando.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/01/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Cystic fibrosis (CF)-related diabetes (CFRD) is a common comorbidity in CF. In CFRD, fasting blood glucose level is often normal, but post-prandial glycaemia (PPG) is problematic. Elevated PPG has been associated to a higher risk of developing CFRD, a worst clinical state and a lower pulmonary function. Interventional studies in type 2 diabetes have demonstrated a beneficial impact of fibre supplement on PPG. METHODS Our objective is to evaluate the efficiency of 2 doses of a soluble fibre supplement to lower PPG in CF patients with glucose intolerance (pre-diabetic or CFRD patients). This is a double-blinded crossover interventional study with three interventions: placebo or psyllium fibre (5.1g or 7.7g) of soluble fibre consumed before breakfast. A second meal (lunch) is also eaten four hours later to evaluate a second meal effect. Blood glucose and insulin were measured during the interventions. RESULTS In 14 adult CF patients with impaired glucose tolerance (IGT; n=10) or CFRD (n=4), we observed no beneficial effect of fibre supplementation on PPG for both meals. However, all blood glucose levels were lower after the lunch compared to breakfast in spite of the higher carbohydrate content. CONCLUSION An acute treatment with fibre supplementation had no effect on blood glucose control in patients with CF-IGT or CFRD.
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Affiliation(s)
- Catherine Lehoux Dubois
- Institut de recherches cliniques de Montréal, Montréal, Québec H2W 1R7, Canada; Department of Nutrition, université de Montréal, Montréal, Québec H3T 1A8, Canada
| | - Valérie Boudreau
- Institut de recherches cliniques de Montréal, Montréal, Québec H2W 1R7, Canada; Department of Nutrition, université de Montréal, Montréal, Québec H3T 1A8, Canada
| | - Kathryn J Potter
- Institut de recherches cliniques de Montréal, Montréal, Québec H2W 1R7, Canada
| | - Johann Colomba
- Institut de recherches cliniques de Montréal, Montréal, Québec H2W 1R7, Canada; Department of Nutrition, université de Montréal, Montréal, Québec H3T 1A8, Canada
| | - Annick Lavoie
- Cystic fibrosis clinic of the centre hospitalier de l'université de Montréal, Montréal, Québec H2W 1T8, Canada
| | - Marjolaine Mailhot
- Cystic fibrosis clinic of the centre hospitalier de l'université de Montréal, Montréal, Québec H2W 1T8, Canada
| | - Katherine Desjardins
- Institut de recherches cliniques de Montréal, Montréal, Québec H2W 1R7, Canada; Department of Nutrition, université de Montréal, Montréal, Québec H3T 1A8, Canada
| | - Rémi Rabasa-Lhoret
- Institut de recherches cliniques de Montréal, Montréal, Québec H2W 1R7, Canada; Department of Nutrition, université de Montréal, Montréal, Québec H3T 1A8, Canada; Department of Medecine, université de Montréal, Montréal, Québec H3T 1J4, Canada; Cystic fibrosis clinic of the centre hospitalier de l'université de Montréal, Montréal, Québec H2W 1T8, Canada.
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Chen HH, Shyu YT, Wu SJ. Physicochemical characteristics and retardation effects on in vitro starch digestibility of non-starch polysaccharides in jelly-fig (Ficus pumila L. var. awkeotsang). Lebensm Wiss Technol 2023. [DOI: 10.1016/j.lwt.2023.114688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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4
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Derosa G, D'Angelo A, Maffioli P. The role of selected nutraceuticals in management of prediabetes and diabetes: An updated review of the literature. Phytother Res 2022; 36:3709-3765. [PMID: 35912631 PMCID: PMC9804244 DOI: 10.1002/ptr.7564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 07/04/2022] [Accepted: 07/04/2022] [Indexed: 01/05/2023]
Abstract
Dysglycemia is a disease state preceding the onset of diabetes and includes impaired fasting glycemia and impaired glucose tolerance. This review aimed to collect and analyze the literature reporting the results of clinical trials evaluating the effects of selected nutraceuticals on glycemia in humans. The results of the analyzed trials, generally, showed the positive effects of the nutraceuticals studied alone or in association with other supplements on fasting plasma glucose and post-prandial plasma glucose as primary outcomes, and their efficacy in improving insulin resistance as a secondary outcome. Some evidences, obtained from clinical trials, suggest a role for some nutraceuticals, and in particular Berberis, Banaba, Curcumin, and Guar gum, in the management of prediabetes and diabetes. However, contradictory results were found on the hypoglycemic effects of Morus, Ilex paraguariensis, Omega-3, Allium cepa, and Trigonella faenum graecum, whereby rigorous long-term clinical trials are needed to confirm these data. More studies are also needed for Eugenia jambolana, as well as for Ascophyllum nodosum and Fucus vesiculosus which glucose-lowering effects were observed when administered in combination, but not alone. Further trials are also needed for quercetin.
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Affiliation(s)
- Giuseppe Derosa
- Department of Internal Medicine and TherapeuticsUniversity of PaviaPaviaItaly,Centre of Diabetes, Metabolic Diseases, and DyslipidemiasUniversity of PaviaPaviaItaly,Regional Centre for Prevention, Surveillance, Diagnosis and Treatment of Dyslipidemias and AtherosclerosisFondazione IRCCS Policlinico San MatteoPaviaItaly,Italian Nutraceutical Society (SINut)BolognaItaly,Laboratory of Molecular MedicineUniversity of PaviaPaviaItaly
| | - Angela D'Angelo
- Department of Internal Medicine and TherapeuticsUniversity of PaviaPaviaItaly,Laboratory of Molecular MedicineUniversity of PaviaPaviaItaly
| | - Pamela Maffioli
- Centre of Diabetes, Metabolic Diseases, and DyslipidemiasUniversity of PaviaPaviaItaly,Regional Centre for Prevention, Surveillance, Diagnosis and Treatment of Dyslipidemias and AtherosclerosisFondazione IRCCS Policlinico San MatteoPaviaItaly,Italian Nutraceutical Society (SINut)BolognaItaly
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5
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Chen C, Shang C, Xin L, Xiang M, Wang Y, Shen Z, Jiao L, Ding F, Cui X. Beneficial Effects of Psyllium on the Prevention and Treatment of Cardiometabolic Diseases. Food Funct 2022; 13:7473-7486. [PMID: 35781477 DOI: 10.1039/d2fo00560c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Cardiometabolic diseases are reaching epidemic proportions worldwide. Nevertheless, current therapeutic strategies are insufficient; thus, studying novel complementary and alternative medicines remains of the upmost importance. Psyllium has been used for...
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Affiliation(s)
- Chen Chen
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
| | - Chang Shang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Laiyun Xin
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
- First Clinical Medical School, Shandong University of Chinese Medicine, Shandong, 250355, China
| | - Mi Xiang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
| | - Yuling Wang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Zihuan Shen
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Linke Jiao
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Fan Ding
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Xiangning Cui
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
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Suresh H, Zhou J, Ho V. The Short-Term Effects and Tolerability of Low-Viscosity Soluble Fibre on Gastroparesis Patients: A Pilot Clinical Intervention Study. Nutrients 2021; 13:4298. [PMID: 34959850 PMCID: PMC8704257 DOI: 10.3390/nu13124298] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 11/22/2021] [Accepted: 11/26/2021] [Indexed: 12/13/2022] Open
Abstract
Gastroparesis is a motility disorder that causes severe gastric symptoms and delayed gastric emptying, where the majority of sufferers are females (80%), with 29% of sufferers also diagnosed with Type-1 or Type-2 diabetes. Current clinical recommendations involve stringent dietary restriction and includes the avoidance and minimization of dietary fibre. Dietary fibre lowers the glycaemic index of food, reduces inflammation and provides laxation. Lack of dietary fibre in the diet can affect long-term gastrointestinal health. Our previously published rheological study demonstrated that "low-viscosity" soluble fibres could be a potentially tolerable source of fibre for the gastroparetic population. A randomised controlled crossover pilot clinical study was designed to compare Partially-hydrolysed guar gum or PHGG (test fibre 1), gum Arabic (test fibre 2), psyllium husk (positive control) and water (negative control) in mild-to-moderate symptomatic gastroparesis patients (requiring no enteral tube feeding). The principal aim of the study was to determine the short-term physiological effects and tolerability of the test fibres. In n = 10 female participants, post-prandial blood glucose, gastroparesis symptoms, and breath test measurements were recorded. Normalized clinical data revealed that test fibres PHGG and gum Arabic were able to regulate blood glucose comparable to psyllium husk, while causing far fewer symptoms, equivalent to negative control. The test fibres did not greatly delay mouth-to-caecum transit, though more data is needed. The study data looks promising, and a longer-term study investigating these test fibres is being planned.
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Affiliation(s)
- Harsha Suresh
- School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia; (H.S.); (V.H.)
- Gastrointestinal Motility Disorders Unit, Western Sydney University, Campbelltown, NSW 2560, Australia
| | - Jerry Zhou
- School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia; (H.S.); (V.H.)
- Gastrointestinal Motility Disorders Unit, Western Sydney University, Campbelltown, NSW 2560, Australia
| | - Vincent Ho
- School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia; (H.S.); (V.H.)
- Gastrointestinal Motility Disorders Unit, Western Sydney University, Campbelltown, NSW 2560, Australia
- University Medical Clinic of Camden & Campbelltown (UMCCC), Campbelltown, NSW 2560, Australia
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Ahmad R, AlLehaibi LH, AlSuwaidan HN, Alghiryafi AF, Almubarak LS, AlKhalifah KN, AlMubarak HJ, Alkhathami MA. Evaluation of clinical trials for natural products used in diabetes: An evidence-based systemic literature review. Medicine (Baltimore) 2021; 100:e25641. [PMID: 33879744 PMCID: PMC8078398 DOI: 10.1097/md.0000000000025641] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 03/22/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND RELEVANCE A plethora of literature is available regarding the clinical trials for natural products however; no information is available for critical assessments of the quality of these clinical trials. AIM OF STUDY This is a first time report to critically evaluate the efficacy, safety and large scale applications of up-to-date clinical trials for diabetes, based on the three scales of Jadad, Delphi, and Cochrane. METHODOLOGY An in-depth and extensive literature review was performed using various databases, journals, and books. The keywords searched included, "clinical trials," "clinical trial in diabetes," "diabetes," "natural products in diabetes," "ethnopharmacological relevance of natural products in diabetes," etc. RESULTS Based on eligibility criteria, 16 plants with 74 clinical trials were found and evaluated. Major drawbacks observed were; "non-randomization and blindness of the studies," "non-blindness of patients/healthcare/outcome assessors," "lack of patient compliance and co-intervention reports," "missing information regarding drop-out/withdrawal procedures," and "inappropriate baseline characteristics." Principal component analysis and Pearson correlation revealed four components with %variability; PC1: 23.12, PC2: 15.83, PC3: 13.11, and PC4: 11.38 (P ≤ .000). According to descriptive statistics, "non-blinding of outcome assessors" was the major drawback (82%) whereas, "not mentioning the timing of outcome assessment" was observed lowest (6.8%). An in-house quality grading (scale 0-24) classified these clinical trials as; poor (67.6%), acceptable (19.9%), and good quality trials (13.5%). CONCLUSION Proper measures in terms of more strict regulations with pharmacovigilance of plants are utmost needed in order to achieve quality compliance of clinical trials.
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Affiliation(s)
- Rizwan Ahmad
- Natural Products and Alternative Medicines, College of Clinical Pharmacy, Imam Abdul Rahman Bin Faisal University, Kingdom of Saudi Arabia
| | | | - Hind Nasser AlSuwaidan
- College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Ali Fuad Alghiryafi
- College of Clinical Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Lyla Shafiq Almubarak
- College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Khawlah Nezar AlKhalifah
- College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Hawra Jassim AlMubarak
- College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Majed Ali Alkhathami
- First Health Cluster in Eastern Province, Dammam Medical Complex, Dammam, Saudi Arabia
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Rivers CR, Kantor MA. Psyllium husk intake and risk of type 2 diabetes: an evidence-based scientific and regulatory review of a qualified health claim conducted by the US Food and Drug Administration. Nutr Rev 2021; 78:787-797. [PMID: 31968119 DOI: 10.1093/nutrit/nuz103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The US Food and Drug Administration (FDA) received a petition from a company requesting that FDA issue an authorized health claim for the relationship between psyllium husk and a reduced risk of type 2 diabetes. After an initial assessment of the available scientific evidence, FDA determined that significant scientific agreement was lacking for this substance-disease relationship, whereupon the company agreed to have its petition reviewed as a qualified health claim. This article describes the process FDA used in conducting an evidence-based review of the science underpinning the proposed claim and addresses certain safety issues associated with psyllium husk that FDA considered in its review of the petition. Of the 6 studies from which scientific conclusions could be drawn, as identified through FDA's review, psyllium husk significantly improved plasma glucose levels and insulin sensitivity in only 1 study. Therefore, FDA's enforcement discretion letter for this qualified health claim stated: "Psyllium husk may reduce the risk of type 2 diabetes, although the FDA has concluded that there is very little scientific evidence for this claim."
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Affiliation(s)
- Crystal R Rivers
- Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, US Food and Drug Administration, College Park, Maryland, USA
| | - Mark A Kantor
- Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, US Food and Drug Administration, College Park, Maryland, USA
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9
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Potato Fibers Have Positive Effects on Subjective Appetite Sensations in Healthy Men, but Not on Fecal Fat Excretion: A Randomized Controlled Single-Blind Crossover Trial. Nutrients 2020; 12:nu12113496. [PMID: 33203008 PMCID: PMC7697495 DOI: 10.3390/nu12113496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/04/2020] [Accepted: 11/11/2020] [Indexed: 12/14/2022] Open
Abstract
Dietary fibers can affect appetite and gut metabolism, but the effect of the novel potato fibers FiberBind and rhamnogalacturonan I (RG-I) is unknown. We, therefore, aimed to investigate the effect of daily intake of FiberBind and RG-I on appetite sensations and fecal fat excretion. In a single-blinded, randomized, three-way crossover trial, wheat buns with FiberBind, RG-I, or low fiber (control) were consumed by 18 healthy men during a 21-day period. Appetite sensation and blood samples during a 3 h meal test, fecal fat content, and ad libitum energy intake were assessed after each period. Compared to RG-I and control, FiberBind caused a higher composite satiety score (6% ± 2% and 5% ± 2%), lower prospective food consumption (5% ± 2% and 6% ± 2%), and lower desire to eat (7% ± 3% and 6% ± 3%) (all p < 0.05). FiberBind also caused higher satiety (6% ± 2%) and fullness (9% ± 3%) compared to RG-I (all p < 0.01). No effects on fecal fat excretion or energy intake were found. The RG-I fiber caused higher postprandial glucose concentration compared to FiberBind (p < 0.05) and higher insulin concentration at 180 min compared to control (p < 0.05). Compared to the control, RG-I and FiberBind lowered peak insulin concentration (both p < 0.05) and delayed time to peak for glucose (both p < 0.05). In conclusion, FiberBind intake could be beneficial for appetite regulation, but neither FiberBind nor RG-I affected fecal fat excretion or energy intake.
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Kaur B, Koh M, Ponnalagu S, Henry CJ. Postprandial blood glucose response: does the glycaemic index (GI) value matter even in the low GI range? Nutr Diabetes 2020; 10:15. [PMID: 32358482 PMCID: PMC7195487 DOI: 10.1038/s41387-020-0118-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/25/2020] [Accepted: 03/30/2020] [Indexed: 11/10/2022] Open
Abstract
A growing body of research over the last decades has shown that diets based on the low glycaemic index (GI) foods reduce the risk of developing diabetes and improve blood glucose control in people with diabetes. The range of inflexion on the glycaemic response of low GI (LGI) foods is an interesting observation that has not been studied by many. LGI 1 (GI 54 ± 3.3) biscuit was formulated using a basic formulation while the LGI 2 (23.8 ± 3.3) biscuits was a modification of LGI 1 recipe, formulated with the inclusion of functional ingredients. Biscuits were formulated to be iso-caloric (kcal/100 g: 521 ± 12). Each participant consumed identical standard meals for lunch and dinner. Biscuits were consumed as breakfast and mid-afternoon snack. Using a randomized, controlled, crossover study, 13 males [(means ± SD) age: 25.3 ± 1.0 years, BMI 21.6 ± 0.5 kg/m2, fasting blood glucose 4.7 ± 0.1 mmol/L] wore continuous glucose monitoring systems (CGMS™) for 3 days for each test session. The postprandial glycaemic response and insulin response were compared within participants. Total iAUC for breakfast and standard dinner were significantly lower for LGI 2 treatment (p < 0.05) than LGI 1 treatment. Second-meal glucose tolerance was observed at the dinner meal. The overall iAUC insulin response over 180 min was significantly lower for LGI 2 biscuits (p = 0.01). The postprandial glycaemic response of two types of biscuits that fall within the low GI classification (GI 24 and 54) differed with LGI 2 biscuits (GI 24) showing a more suppressed postprandial glycaemic response. Our study shows that even within the low GI range, the GI value matters in influencing postprandial glucose.
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Affiliation(s)
- Bhupinder Kaur
- Clinical Nutrition Research Centre (CNRC), Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Melvin Koh
- Clinical Nutrition Research Centre (CNRC), Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Shalini Ponnalagu
- Clinical Nutrition Research Centre (CNRC), Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Christiani Jeyakumar Henry
- Clinical Nutrition Research Centre (CNRC), Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore. .,Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
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Lee SE, Choi Y, Jun JE, Lee YB, Jin SM, Hur KY, Ko GP, Lee MK. Additional Effect of Dietary Fiber in Patients with Type 2 Diabetes Mellitus Using Metformin and Sulfonylurea: An Open-Label, Pilot Trial. Diabetes Metab J 2019; 43:422-431. [PMID: 31237126 PMCID: PMC6712222 DOI: 10.4093/dmj.2018.0090] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 07/27/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Metformin, sulfonylurea, and dietary fiber are known to affect gut microbiota in patients with type 2 diabetes mellitus (T2DM). This open and single-arm pilot trial investigated the effects of the additional use of fiber on glycemic parameters, insulin, incretins, and microbiota in patients with T2DM who had been treated with metformin and sulfonylurea. METHODS Participants took fiber for 4 weeks and stopped for the next 4 weeks. Glycemic parameters, insulin, incretins during mixed-meal tolerance test (MMTT), lipopolysaccharide (LPS) level, and fecal microbiota were analyzed at weeks 0, 4, and 8. The first tertile of difference in glucose area under the curve during MMTT between weeks 0 and 4 was defined as 'responders' and the third as 'nonresponders,' respectively. RESULTS In all 10 participants, the peak incretin levels during MMTT were higher and LPS were lower at week 4 as compared with at baseline. While the insulin sensitivity of the 'responders' increased at week 4, that of the 'nonresponders' showed opposite results. However, the results were not statistically significant. In all participants, metabolically unfavorable microbiota decreased at week 4 and were restored at week 8. At baseline, metabolically hostile bacteria were more abundant in the 'nonresponders.' In 'responders,' Roseburia intestinalis increased at week 4. CONCLUSION While dietary fiber did not induce additional changes in glycemic parameters, it showed a trend of improvement in insulin sensitivity in 'responders.' Even if patients are already receiving diabetes treatment, the additional administration of fiber can lead to additional benefits in the treatment of diabetes.
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Affiliation(s)
- Seung Eun Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yongbin Choi
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Ji Eun Jun
- Department of Endocrinology and Metabolism, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - You Bin Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Sang Man Jin
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyu Yeon Hur
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gwang Pyo Ko
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Moon Kyu Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Atkinson FS, Villar A, Mulà A, Zangara A, Risco E, Smidt CR, Hontecillas R, Leber A, Bassaganya-Riera J. Abscisic Acid Standardized Fig ( Ficus carica) Extracts Ameliorate Postprandial Glycemic and Insulinemic Responses in Healthy Adults. Nutrients 2019; 11:nu11081757. [PMID: 31370154 PMCID: PMC6722713 DOI: 10.3390/nu11081757] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/26/2019] [Accepted: 07/29/2019] [Indexed: 12/16/2022] Open
Abstract
Abscisic acid (ABA) can improve glucose homeostasis and reduce inflammation in mammals by activating lanthionine synthetase C-like 2 (LANCL2). This study examined the effects of two fig fruit extracts (FFEs), each administered at two different ABA doses, on glycemic index (GI) and insulinemic index (II) to a standard glucose drink. In a randomized, double-blind crossover study, 10 healthy adults consumed 4 test beverages containing FFE with postprandial glucose and insulin assessed at regular intervals over 2 h to determine GI and II responses. Test beverages containing 200 mg FFE-50× and 1200 mg FFE-10× significantly reduced GI values by -25% (P = 0.001) and -24% (P = 0.002), respectively. Two lower doses of FFE also reduced GI values compared with the reference drink (by approximately -14%), but the differences did not reach statistical significance. Addition of FFE to the glucose solution significantly reduced II values at all dosages and displayed a clear dose-response reduction: FFE-50× at 100 mg and 200 mg (-14% (P < 0.05) and -24% (P = 0.01), respectively) and FFE-10× at 600 mg and 1200 mg (-16% (P < 0.05) and -24% (P = 0.01), respectively). FFE supplementation is a promising nutritional intervention for the management of acute postprandial glucose and insulin homeostasis, and it is a possible adjunctive treatment for glycemic management of chronic metabolic disorders such as prediabetes and type 2 diabetes mellitus.
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Affiliation(s)
- Fiona S Atkinson
- School of Life and Environmental Sciences and Charles Perkins Centre, D17, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Agusti Villar
- Euromed S.A., C/ Rec de Dalt, 21-23, Pol. Ind. Can Magarola, 08100 Mollet del Valles, Barcelona, Spain
| | - Anna Mulà
- Euromed S.A., C/ Rec de Dalt, 21-23, Pol. Ind. Can Magarola, 08100 Mollet del Valles, Barcelona, Spain
| | - Andrea Zangara
- Euromed S.A., C/ Rec de Dalt, 21-23, Pol. Ind. Can Magarola, 08100 Mollet del Valles, Barcelona, Spain.
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia.
| | - Ester Risco
- Euromed S.A., C/ Rec de Dalt, 21-23, Pol. Ind. Can Magarola, 08100 Mollet del Valles, Barcelona, Spain
| | | | - Raquel Hontecillas
- BioTherapeutics, Inc, 1800 Kraft Drive, Suite 200, Blacksburg, VA 24060, USA
| | - Andrew Leber
- BioTherapeutics, Inc, 1800 Kraft Drive, Suite 200, Blacksburg, VA 24060, USA
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13
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Noureddin S, Mohsen J, Payman A. Effects of psyllium vs. placebo on constipation, weight, glycemia, and lipids: A randomized trial in patients with type 2 diabetes and chronic constipation. Complement Ther Med 2018; 40:1-7. [PMID: 30219432 DOI: 10.1016/j.ctim.2018.07.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 06/09/2018] [Accepted: 07/03/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To compare the effects of baked psyllium supplementation versus those who received a placebo on constipation symptoms, body weight, glycemic and lipids control in patients with type 2 diabetes (T2D) and chronic constipation. METHODS In a single-blinded, randomized controlled trial, 51 patients with T2D and chronic constipation with body mass index (BMI) 20-47 kg/m2 received either 10 g of psyllium pre-mixed in cookies twice per day or placebo cookies for 12 weeks. Constipation symptoms, body mass index (BMI), fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), and lipid profile were determined at the beginning and end of 4, 8, and 12-week period. Constipation was evaluated with a stool diary (ROME III). RESULTS The psyllium group showed improvement in constipation symptoms, body weight, glucose and lipid values compared with the baseline and the placebo group. Body weight and FPG decreased from baseline in the psyllium group (P < 0.001 and P = 0.056, respectively). The differences (95% CI) of absolute change of body weight (-2.0 (-3.0, -1.0) kg; P < 0.001), FPG (-13.6 (-24.3, -2.9) mg/dl; P = .040), and HbA1c (-1.7 (-2.9, -0.5)); P = 0.002) between the groups were statistically significant. Cholesterol (-21.5 (-25.6, -14.4); P < 0.001), triglycerides (-20.0 (-32.3, -7.7); P = 0.021) and constipation symptoms (1.5 (0.4, 2.3); P < 0.001) decreased in the psyllium group. The compliance was good and no adverse effects were observed. CONCLUSION In patients with T2D and chronic constipation, psyllium supplementation decreased constipation symptoms, body weight, glycemic, cholesterol, and increased HDLC levels.
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Affiliation(s)
- Soltanian Noureddin
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Janghorbani Mohsen
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Adibi Payman
- Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Ota A, Ulrih NP. An Overview of Herbal Products and Secondary Metabolites Used for Management of Type Two Diabetes. Front Pharmacol 2017; 8:436. [PMID: 28729836 PMCID: PMC5499308 DOI: 10.3389/fphar.2017.00436] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 06/16/2017] [Indexed: 12/29/2022] Open
Abstract
Diabetes mellitus is a common effect of uncontrolled high blood sugar and it is associated with long-term damage, dysfunction, and failure of various organs. In the adult population, the global prevalence of diabetes has nearly doubled since 1980. Without effective prevention and management programs, the continuing significant rise in diabetes will have grave consequences on the health and lifespan of the world population, and also on the world economy. Supplements can be used to correct nutritional deficiencies or to maintain an adequate intake of certain nutrients. These are often used as treatments for diabetes, sometimes because they have lower costs, or are more accessible or "natural" compared to prescribed medications. Several vitamins, minerals, botanicals, and secondary metabolites have been reported to elicit beneficial effects in hypoglycemic actions in vivo and in vitro; however, the data remain conflicting. Many pharmaceuticals commonly used today are structurally derived from natural compounds from traditional medicinal plants. Botanicals that are most frequently used to help manage blood glucose include: bitter melon (Momordica charantia), fenugreek (Trigonella foenum graecum), gurmar (Gymnema sylvestre), ivy gourd (Coccinia indica), nopal (Opuntia spp.), ginseng, Russian tarragon (Artemisia dracunculus), cinnamon (Cinnamomum cassia), psyllium (Plantago ovata), and garlic (Allium sativum). In majority of the herbal products and secondary metabolites used in treating diabetes, the mechanisms of action involve regulation of insulin signaling pathways, translocation of GLUT-4 receptor and/or activation the PPARγ. Several flavonoids inhibit glucose absorption by inhibiting intestinal α-amylase and α-glucosidase. In-depth studies to validate the efficacies and safeties of extracts of these traditional medicinal plants are needed, and large, well designed, clinical studies need to be carried out before the use of such preparations can be recommended for treatment and/or prevention of diabetes. The main focus of this review is to describe what we know to date of the active compounds in these, along with their glucose-lowering mechanisms, which are either through insulin-mimicking activity or enhanced glucose uptake.
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Affiliation(s)
| | - Nataša P. Ulrih
- Department of Food Science and Technology, Biotechnical Faculty, University of LjubljanaLjubljana, Slovenia
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15
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Ground flaxseed increased nitric oxide levels in adults with type 2 diabetes: A randomized comparative effectiveness study of supplemental flaxseed and psyllium fiber. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.obmed.2017.01.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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16
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Maki KC, Phillips-Eakley AK, Smith KN. The Effects of Breakfast Consumption and Composition on Metabolic Wellness with a Focus on Carbohydrate Metabolism. Adv Nutr 2016; 7:613S-21S. [PMID: 27184288 PMCID: PMC4863265 DOI: 10.3945/an.115.010314] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Findings from epidemiologic studies indicate that there are associations between breakfast consumption and a lower risk of type 2 diabetes mellitus (T2DM) and metabolic syndrome, prompting interest in the influence of breakfast on carbohydrate metabolism and indicators of T2DM risk. The objective of this review was to summarize the available evidence from randomized controlled trials assessing the impact of breakfast on variables related to carbohydrate metabolism and metabolic wellness. Consuming compared with skipping breakfast appeared to improve glucose and insulin responses throughout the day. Breakfast composition may also be important. Dietary patterns high in rapidly available carbohydrate were associated with elevated T2DM risk. Therefore, partial replacement of rapidly available carbohydrate with other dietary components, such as whole grains and cereal fibers, proteins, and unsaturated fatty acids (UFAs), at breakfast may be a useful strategy for producing favorable metabolic outcomes. Consumption of fermentable and viscous dietary fibers at breakfast lowers glycemia and insulinemia. Fermentable fibers likely act through enhancing insulin sensitivity later in the day, and viscous fibers have an acute effect to slow the rate of carbohydrate absorption. Partially substituting protein for rapidly available carbohydrate enhances satiety and diet-induced thermogenesis, and also favorably affects lipoprotein lipids and blood pressure. Partially substituting UFA for carbohydrate has been associated with improved insulin sensitivity, lipoprotein lipids, and blood pressure. Overall, the available evidence suggests that consuming breakfast foods high in whole grains and cereal fiber, while limiting rapidly available carbohydrate, is a promising strategy for metabolic health promotion.
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Affiliation(s)
- Kevin C Maki
- Midwest Center for Metabolic and Cardiovascular Research, Glen Ellyn, IL
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17
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El Khoury D, Goff HD, Anderson GH. The role of alginates in regulation of food intake and glycemia: a gastroenterological perspective. Crit Rev Food Sci Nutr 2016; 55:1406-24. [PMID: 24915329 DOI: 10.1080/10408398.2012.700654] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Regulation of food intake through modulation of gastrointestinal responses to ingested foods is an ever-growing component of the therapeutic approaches targeting the obesity epidemic. Alginates, viscous and gel-forming soluble fibers isolated from the cell wall of brown seaweeds and some bacteria, are recently receiving considerable attention because of their potential role in satiation, satiety, and food intake regulation in the short term. Enhancement of gastric distension, delay of gastric emptying, and attenuation of postprandial glucose responses may constitute the basis of their physiological benefits. Offering physical, chemical, sensorial, and physiological advantages over other viscous and gel-forming fibers, alginates constitute promising functional food ingredients for the food industry. Therefore, the current review explores the role of alginates in food intake and glycemic regulation, their underlying modes of action and their potential in food applications.
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Affiliation(s)
- D El Khoury
- a Department of Nutritional Sciences, Faculty of Medicine, University of Toronto , Toronto , M5S 3E2 , ON , Canada
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18
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Gibb RD, McRorie JW, Russell DA, Hasselblad V, D'Alessio DA. Psyllium fiber improves glycemic control proportional to loss of glycemic control: a meta-analysis of data in euglycemic subjects, patients at risk of type 2 diabetes mellitus, and patients being treated for type 2 diabetes mellitus. Am J Clin Nutr 2015; 102:1604-14. [PMID: 26561625 DOI: 10.3945/ajcn.115.106989] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 09/22/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND A number of health benefits are associated with intake of soluble, viscous, gel-forming fibers, including reduced serum cholesterol and the attenuation of postprandial glucose excursions. OBJECTIVE We assess the effects of psyllium, which is a soluble, gel-forming, nonfermented fiber supplement, on glycemic control in patients who were being treated for type 2 diabetes mellitus (T2DM) and in patients who were at risk of developing T2DM. DESIGN A comprehensive search was performed of available published literature (Scopus scientific database) and clinical records stored by Procter & Gamble with the use of key search terms to identify clinical studies that assessed the glycemic effects of psyllium in nondiabetic, pre-T2DM, and T2DM patients. RESULTS We identified 35 randomized, controlled, clinical studies that spanned 3 decades and 3 continents. These data were assessed in 8 meta-analyses. In patients with T2DM, multiweek studies (psyllium dosed before meals) showed significant improvement in both the fasting blood glucose (FBG) concentration (-37.0 mg/dL; P < 0.001) and glycated hemoglobin (HbA1c) [-0.97% (-10.6 mmol/mol); P = 0.048]. Glycemic effects were proportional to baseline FBG; no significant glucose lowering was observed in euglycemic subjects, a modest improvement was observed in subjects with pre-T2DM, and the greatest improvement was observed in subjects who were being treated for T2DM. CONCLUSIONS These data indicate that psyllium would be an effective addition to a lifestyle-intervention program. The degree of psyllium's glycemic benefit was commensurate with the loss of glycemic control. Because the greatest effect was seen in patients who were being treated for T2DM, additional studies are needed to determine how best to incorporate psyllium into existing prevention and treatment algorithms with concomitant hypoglycemic medications.
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Affiliation(s)
| | | | | | | | - David A D'Alessio
- Division of Endocrinology, Metabolism and Nutrition, Duke Department of Medicine, Duke University, Durham, NC
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19
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Hussain MA, Muhammad G, Jantan I, Bukhari SNA. Psyllium Arabinoxylan: A Versatile Biomaterial for Potential Medicinal and Pharmaceutical Applications. POLYM REV 2015. [DOI: 10.1080/15583724.2015.1078351] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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20
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Park CJ, Han JS. Hypoglycemic Effect of Jicama (Pachyrhizus erosus) Extract on Streptozotocin-Induced Diabetic Mice. Prev Nutr Food Sci 2015; 20:88-93. [PMID: 26175995 PMCID: PMC4500521 DOI: 10.3746/pnf.2015.20.2.88] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 05/13/2015] [Indexed: 11/25/2022] Open
Abstract
The purpose of this research was to investigate the inhibitory effect of jicama extract on α-glucosidase activity, α-amylase activity, and postprandial hyperglycemia in streptozotocin (STZ)-induced diabetic mice. Jicama extract showed prominent inhibitory effects against α-glucosidase and α-amylase. The IC50 values of jicama extract against α-glucosidase and α-amylase were 0.083±0.004 and 0.091±0.017 mg/mL, respectively. The increase in postprandial blood glucose levels was more significantly suppressed in the jicama extract-administered group than in the control group of both STZ-induced diabetic and normal mice. Blood glucose levels of the control group increased to 383.75±11.54 and 402.50±15.32 mg/dL at 30 and 60 min after a meal and decreased to 349.67±11.62 mg/dL at 120 min. However, postprandial blood glucose levels were significantly decreased, when diabetic mice were fed with jicama extract (342.00±15.73, 367.00±13.00, and 329.67±12.43 mg/dL at 30, 60, and 120 min, respectively). Furthermore, the area under the curve was significantly decreased with jicama extract administration in diabetic mice (P<0.05). Therefore, these results indicate that jicama extract may help decrease postprandial blood glucose level by inhibiting α-glucosidase.
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Affiliation(s)
- Chan Joo Park
- Department of Food Science and Nutrition, Pusan National University, Busan 609-735, Korea
| | - Ji-Sook Han
- Department of Food Science and Nutrition, Pusan National University, Busan 609-735, Korea
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21
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Díez-Láiz R, García-Vieitez JJ, Diez-Liébana MJ, Sierra-Vega M, Sahagún-Prieto AM, Calle-Pardo ÁP, Fernández-Martínez N. Evaluation of the Association Metformin: Plantago ovata Husk in Diabetic Rabbits. J Diabetes Res 2015; 2015:167526. [PMID: 26576433 PMCID: PMC4630395 DOI: 10.1155/2015/167526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 01/15/2015] [Indexed: 12/20/2022] Open
Abstract
In this experimental study we have investigated whether the inclusion of the dietary fiber Plantago ovata husk could be recommended as coadjuvant in treatments with oral hypoglycemic drugs. We evaluated the use of Plantago ovata husk-metformin association in diabetic rabbits by determining its effects on glucose and insulin concentrations. Six groups of 6 rabbits were used. Groups 1 to 3 were fed with standard chow and groups 4 to 6 with chow supplemented with Plantago ovata husk (3.5 mg/kg/day). Two groups (numbers 1 and 4) were used as controls (receiving standard or supplemented chow), two groups (numbers 2 and 5) received metformin orally, and the other two (numbers 3 and 6) were treated orally with metformin and psyllium. Plasma glucose concentrations were lower in groups fed with fiber-supplemented chow whereas insulin levels showed important interindividual variations. Glucose pharmacokinetics parameters showed significant differences in Cmax and t(max) in relation to fiber intake. Insulin pharmacokinetics parameters after treatment with oral metformin showed an important increase in Cmax, AUC, and t(max) in animals fed with fiber. We conclude that Plantago ovata husk intake can contribute to the oral antihyperglycemic treatment of type 2 diabetes.
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Affiliation(s)
- Raquel Díez-Láiz
- Pharmacology, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
- *Raquel Díez-Láiz:
| | | | - M. José Diez-Liébana
- Pharmacology, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
| | - Matilde Sierra-Vega
- Pharmacology, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
| | - Ana M. Sahagún-Prieto
- Pharmacology, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
| | - Ángela P. Calle-Pardo
- Pharmacology, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
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22
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In vitro hypoglycemic effects and starch digestibility characteristics of wheat based composite functional flour for diabetics. Journal of Food Science and Technology 2014; 52:4530-6. [PMID: 26139921 DOI: 10.1007/s13197-014-1470-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 05/21/2014] [Accepted: 07/02/2014] [Indexed: 12/11/2022]
Abstract
The associations between chronic feeding of high level of soluble/insoluble fibers and low serum glucose levels have been well documented. In the present study, composite flours were formulated using psyllium, barley and oat at two different levels [WPOB-I = wheat flour (75 %), psyllium (5 %), oat (10 %) and barley (10 %), WPOB-II = wheat flour (60 %), psyllium (10 %), oat (15 %) and barley (15 %)]. Chapaties were prepared from all formulations and various starch fractions were analyzed using controlled enzymatic digestion. The digestibility characteristics were studied using amylolysis kinetics employing porcine pancreatic α-amylase in vitro. Results showed that both the variations (WPOB-I & WPOB-II) had acceptable sensory qualities and had significantly lower (p ≤ 0.05) values for total starch (TS), rapidly digestible starch (RDS), resistant starch (RS), starch digestibility index (SDI) and rapidly available glucose (RAG) compared to control. Between the two variations, WPOB-I showed better starch digestibility characteristics with significantly lower (p ≤ 0.05) starch digestibility index (SDI). In case of amylolysis kinetics, both the variations significantly (p ≤ 0.05) inhibited α-amylase as reflected by lower glucose diffusion and significantly higher (p ≤ 0.05) glucose dialysis retardation index (GDRI) compared to control. It is inferred that, consumption of the composite flours might be helpful in establishing stable blood glucose pattern due to the redistribution of nutritionally important starch fractions and inhibition of carbohydrate digestion in the gastrointestinal tract.
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23
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Wu NJ, Chiou FJ, Weng YM, Yu ZR, Wang BJ. In vitrohypoglycemic effects of hot water extract fromAuricularia polytricha(wood ear mushroom). Int J Food Sci Nutr 2014; 65:502-6. [DOI: 10.3109/09637486.2014.886183] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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24
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Harish M, Ahmed F, Urooj A. In vitro hypoglycemic effects of Butea monosperma Lam. leaves and bark. JOURNAL OF FOOD SCIENCE AND TECHNOLOGY 2014; 51:308-14. [PMID: 24493888 PMCID: PMC3907641 DOI: 10.1007/s13197-011-0496-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 08/03/2011] [Accepted: 08/09/2011] [Indexed: 11/30/2022]
Abstract
The present study evaluated the antidiabetic potential of Butea monosperma Lam. Kuntze (Fabaceae) leaves and the stem bark using various in vitro techniques. The samples were studied for their effects on glucose adsorption, diffusion, amylolysis kinetics, enteric enzymes and glucose transport across yeast cells. Both the samples adsorbed glucose and the adsorption of glucose increased with increase in glucose concentration. The samples also inhibited movement of glucose across the dialysis membrane to varying degree in both glucose diffusion and amylolysis kinetic experiment models. B. monosperma leaves inhibited α-amylase, α-glucosidase and sucrase enzymes in succession to varying degrees, whereas the bark inhibited only α-amylase to a significant extent and slightly activated α-glucosidase and sucrase enzymes. The extracts of both leaves and bark promoted glucose uptake by yeast cells compared to control. Enhancement of glucose uptake was dependent on both the sample and glucose concentration. It was directly proportional to the sample concentration and inversely proportional to the molar concentration of the glucose. From the results of the study, it is inferred that, B. monosperma leaves and bark possesses antidiabetic activity. However, these effects need to be confirmed using in vivo models and clinical trials for its effective utilization as therapeutic agents.
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Affiliation(s)
- M. Harish
- Department of Studies in Food Science and Nutrition, Manasagangotri, University of Mysore, Mysore, 570006 India
| | - Faiyaz Ahmed
- Department of Studies in Food Science and Nutrition, Manasagangotri, University of Mysore, Mysore, 570006 India
| | - Asna Urooj
- Department of Studies in Food Science and Nutrition, Manasagangotri, University of Mysore, Mysore, 570006 India
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25
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Russell WR, Baka A, Björck I, Delzenne N, Gao D, Griffiths HR, Hadjilucas E, Juvonen K, Lahtinen S, Lansink M, Loon LV, Mykkänen H, östman E, Riccardi G, Vinoy S, Weickert MO. Impact of Diet Composition on Blood Glucose Regulation. Crit Rev Food Sci Nutr 2013; 56:541-90. [DOI: 10.1080/10408398.2013.792772] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Wendy R. Russell
- Rowett Institute of Nutrition and Health, University of Aberdeen, Aberdeen, UK
| | | | - Inger Björck
- Centre for Chemistry and Chemical Engineering, University of Lund, Lund, Sweden
| | - Nathalie Delzenne
- Louvain Drug Research Institute, Université Catholique de Louvain, Brussels, Belgium
| | - Dan Gao
- Department of Diabetes and Metabolic Diseases, Beckman Research Institute of City of Hope, Duarte, California, USA
| | | | - Ellie Hadjilucas
- Coca-Cola Europe, Scientific and Regulatory Affairs Department, Brussels, Belgium
| | - Kristiina Juvonen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | | | - Mirian Lansink
- Danone Research, Centre for Specialised Nutrition, Wageningen, The Netherlands
| | - Luc Van Loon
- Department of Movement Sciences, Maastricht University, Maastricht, The Netherlands
| | - Hannu Mykkänen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Elin östman
- Centre for Chemistry and Chemical Engineering, University of Lund, Lund, Sweden
| | - Gabriele Riccardi
- Department of Clinical and Experimental Medicine, University Federico II, Naples, Italy
| | - Sophie Vinoy
- Kraft Foods, R&D Centre, Nutrition Department, Saclay, France
| | - Martin O. Weickert
- University Hospitals Coventry and Warwickshire and Division of Metabolic and Vascular Health, University of Warwick, Coventry, UK
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Abstract
Despite years of advising patients to alter their dietary and supplementary fiber intake, the evidence surrounding the use of fiber for functional bowel disease is limited. This paper outlines the organization of fiber types and highlights the importance of assessing the fermentation characteristics of each fiber type when choosing a suitable strategy for patients. Fiber undergoes partial or total fermentation in the distal small bowel and colon leading to the production of short-chain fatty acids and gas, thereby affecting gastrointestinal function and sensation. When fiber is recommended for functional bowel disease, use of a soluble supplement such as ispaghula/psyllium is best supported by the available evidence. Even when used judiciously, fiber can exacerbate abdominal distension, flatulence, constipation, and diarrhea.
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Affiliation(s)
- Shanti Eswaran
- Division of Gastroenterology, University of Michigan Health System, Ann Arbor, MI 48109-5362, USA
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27
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Feinglos MN, Gibb RD, Ramsey DL, Surwit RS, McRorie JW. Psyllium improves glycemic control in patients with type-2 diabetes mellitus. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.bcdf.2013.02.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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28
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Kaialy W, Emami P, Asare-Addo K, Shojaee S, Nokhodchi A. Psyllium: a promising polymer for sustained release formulations in combination with HPMC polymers. Pharm Dev Technol 2013; 19:269-77. [DOI: 10.3109/10837450.2013.775156] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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29
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Nutritional supplements and their effect on glucose control. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2013; 771:381-95. [PMID: 23393691 DOI: 10.1007/978-1-4614-5441-0_27] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
As diabetes mellitus (DM) continues to be a growing health concern, many people have been turning to natural health products (NHPs) in order to manage this condition, adjunctive to, or even in place of conventional therapies. In order to keep up with this trend, research focussing on the efficacy and mechanisms behind the most common NHPs has been growing amongst the scientific community. The purpose of this chapter is to search and compile scientific literature focussing on the most commonly used NHPs in diabetes treatment, so to educate health professionals on the efficacy, safety and dosage of these products. From our findings, it is apparent that there are promising results from many studies on the potential benefit of NHPs in the treatment of diabetes. Nonetheless, many of the herbs and single nutraceuticals still require further studies in order to confirm safety, dosage and potential interactions with standard conventional therapies. Soluble fibre, alpha lipoic acid, milk thistle, prickly pear cactus and pycnogenol appear to be the most beneficial in the treatment of diabetes.
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Chutkan R, Fahey G, Wright WL, McRorie J. Viscous versus nonviscous soluble fiber supplements: mechanisms and evidence for fiber-specific health benefits. ACTA ACUST UNITED AC 2012; 24:476-87. [PMID: 22845031 DOI: 10.1111/j.1745-7599.2012.00758.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE This review focuses on the health benefits of viscous versus nonviscous soluble fibers, why symptoms can occur with increased fiber consumption, and how to avoid symptoms to improve adherence with a high-fiber diet. DATA SOURCES Review of scientific literature as well as evidence-based guidelines and resources. CONCLUSIONS While it is generally known that "fiber is good for you," it is less well known that specific health benefits are associated with specific fiber characteristics. Many of the health benefits of fiber can be directly correlated with the viscosity of soluble fibers when hydrated (i.e., gel-forming). A reduction in viscosity of a given fiber will attenuate these health benefits, and a nonviscous fiber does not exhibit these health benefits. IMPLICATIONS FOR PRACTICE Increasing the viscosity of chyme with a viscous soluble fiber has been shown clinically to lower cholesterol for cardiovascular health, improve glycemic control in type 2 diabetes, normalize stool form in both constipation (softens hard stool) and diarrhea (firms loose/liquid stool), and improve the objective clinical measures of metabolic syndrome (glycemic control, lipoprotein profile, body mass index/weight loss, and blood pressure).
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Brockman DA, Chen X, Gallaher DD. Hydroxypropyl methylcellulose, a viscous soluble fiber, reduces insulin resistance and decreases fatty liver in Zucker Diabetic Fatty rats. Nutr Metab (Lond) 2012; 9:100. [PMID: 23146593 PMCID: PMC3565887 DOI: 10.1186/1743-7075-9-100] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 11/05/2012] [Indexed: 12/13/2022] Open
Abstract
Background Diets producing a high glycemic response result in exaggerated insulin secretion which induces hepatic lipogenesis, contributing to development of insulin resistance and fatty liver. Viscous dietary fibers blunt the postprandial rise in blood glucose, however their effect on type 2 diabetes and obesity are not entirely known. This study examined the effect of chronic consumption of the viscous, non-fermentable dietary fiber, hydroxypropyl methylcellulose (HPMC), on glucose control, insulin resistance and liver lipids in an obese diabetic rat model. Methods Three groups of Zucker Diabetic Fatty (ZDF) rats were fed diets containing either 5% non-viscous cellulose (control), low viscosity HPMC (LV-HPMC) or high viscosity HPMC (HV- HPMC) for six weeks. Zucker lean littermates consuming cellulose served as a negative control. Markers of glucose control, including oral glucose tolerance test, glycated hemoglobin and urinary glucose, were measured as well as adiposity and the accumulation of liver lipids. Results The HPMC diets increased the viscosity of the small intestinal contents and reduced the postprandial rise in blood glucose. The food efficiency ratio was greater with HPMC feeding compared to the obese control and urinary excretion of glucose and ketone bodies was reduced. The two HPMC groups had lower glycated hemoglobin and kidney weights and a reduced area under the curve during a glucose tolerance test, indicating improved glucose control. Epididymal fat pad weight as percent of body weight was reduced in the HV-HPMC group compared to the obese control group. The HV-HPMC group also had lower concentrations of liver lipid and cholesterol and reduced liver weight. However, HV-HPMC feeding did not affect hepatic gene expression of SREBP-1c or FAS. Muscle concentration of acylcarnitines, a lipid intermediate in fatty acid β-oxidation, was not different between the HPMC groups and obese control, suggesting no change in muscle fatty acid oxidation by HPMC. Conclusions Consumption of the viscous non-fermentable fiber HPMC decreased diabetic wasting, improved glucose control and reduced insulin resistance and fatty liver in a model of obesity with diabetes.
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Affiliation(s)
- David A Brockman
- Department of Food Science and Nutrition, University of Minnesota-Twin Cities, 1334 Eckles Avenue, St, Paul, MN 55108-1038, USA.
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Fernandez N, Lopez C, Díez R, Garcia JJ, Diez MJ, Sahagun A, Sierra M. Drug interactions with the dietary fiberPlantago ovatahusk. Expert Opin Drug Metab Toxicol 2012; 8:1377-86. [DOI: 10.1517/17425255.2012.716038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Hall M, Flinkman T. Do Fiber and Psyllium Fiber Improve Diabetic Metabolism? ACTA ACUST UNITED AC 2012; 27:513-6. [DOI: 10.4140/tcp.n.2012.513] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Nsor-Atindana J, Zhong F, Mothibe KJ. In vitro hypoglycemic and cholesterol lowering effects of dietary fiber prepared from cocoa (Theobroma cacao L.) shells. Food Funct 2012; 3:1044-50. [PMID: 22735710 DOI: 10.1039/c2fo30091e] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Three dietary fiber (DF) powders; soluble dietary fiber (SDF), insoluble dietary fiber (IDF) and total dietary fiber (TDF) were prepared from cocoa bean shells (CBS) by enzymatic treatment. These DFs were evaluated for their effects on glucose adsorption, glucose diffusion, starch hydrolysis, cholesterol binding, sodium cholate binding and oil binding capacities using in vitro model systems by simulating gastric intestinal conditions. The results showed that SDF generally exhibited significantly (p < 0.05) higher glucose adsorption capacity (GAC), α-amylase inhibition activity, cholesterol and sodium cholate binding capacity, but less significant (>0.05) glucose dialysis retardation index (GDRI) and oil binding capacity, when compared with IDF and TDF which both showed similar effects. Moreover, it was discovered that the three CBS dietary fiber powders contained intrinsic antioxidants (phenolic compounds). The study suggested that CBS could be an alternative cheap source of DF with additional benefits. Thus, CBS fibers could be incorporated as low calorie bulk ingredients in high-fiber diet to reduce calorie and cholesterol levels and control blood glucose level.
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Affiliation(s)
- John Nsor-Atindana
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, China
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Dow S, Pritchett KL, Hawk S, Herrington SJ, Gee DL. Ultrahigh-Viscosity Hydroxypropylmethylcellulose Blunts Postprandial Glucose after a Breakfast Meal in Women. J Am Coll Nutr 2012; 31:94-9. [DOI: 10.1080/07315724.2012.10720014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
The development of lower-glycaemic index (GI) foods requires simple, palatable and healthy strategies. The objective of the present study was to determine the most effective dose of a novel viscous fibre supplement (PGX®) to be added to starchy foods to reduce their GI. Healthy subjects (n 10) consumed glucose sugar (50 g in water × 3) and six starchy foods with a range of GI values (52–72) along with 0 (inert fibre), 2·5 or 5 g granular PGX® dissolved in 250 ml water. GI testing according to ISO Standard 26 642-2010 was used to determine the reduction in GI. PGX® significantly reduced the GI of all six foods (P < 0·001), with an average reduction of 19 % for the 2·5 g dose and 30 % for the 5 g dose, equivalent to a reducing the GI by 7 and 15 units, respectively. Consuming small quantities of the novel functional fibre PGX®, mixed with water at the start of a meal, is an effective strategy to reduce the GI of common foods.
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Ahmed F, Sairam S, Urooj A. In vitro hypoglycemic effects of selected dietary fiber sources. JOURNAL OF FOOD SCIENCE AND TECHNOLOGY 2011; 48:285-9. [PMID: 23572748 PMCID: PMC3551159 DOI: 10.1007/s13197-010-0153-7] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 03/04/2010] [Accepted: 10/15/2010] [Indexed: 10/18/2022]
Abstract
The physiological functions of dietary fiber and its role in health promotion and risk reduction of some chronic diseases has been well documented. In the present investigation, the effect of three dietary fiber sources, oats (OA), barley (BA) and psyllium husk (PH) on glucose adsorption, diffusion and starch hydrolysis were studied using in vitro techniques by simulating gastrointestinal conditions and compared with the commercial dietary fiber sources wheat bran (WB), acarbose (ACB) and guar gum (GG). The glucose binding capacity of all the samples was higher than WB and ACB at 5 mM concentration. In all the samples, the diffusion of glucose was directly proportional to the time and diffusion rate was significantly lower (p ≤ 0.01) in the system containing various samples compared to control. Glucose dialysis retardation index (GDRI) was 100 for OA, BA and PH at 60 min, at 120 min the maximal GDRI was in PH. Whereas; WB and ACB exhibited maximal GDRI at 180 and 240 min. All of these mechanisms might create a concerted function in lowering the rate of glucose absorption and as a result, decrease the postprandial hyperglycemia.
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Affiliation(s)
- Faiyaz Ahmed
- Department of Studies in Food Science and Nutrition, Manasagangotri, University of Mysore, Mysore, 570006 India
| | - Sudha Sairam
- Department of Studies in Food Science and Nutrition, Manasagangotri, University of Mysore, Mysore, 570006 India
| | - Asna Urooj
- Department of Studies in Food Science and Nutrition, Manasagangotri, University of Mysore, Mysore, 570006 India
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Mello VDD, Laaksonen DE. [Dietary fibers: current trends and health benefits in the metabolic syndrome and type 2 diabetes]. ACTA ACUST UNITED AC 2011; 53:509-18. [PMID: 19768242 DOI: 10.1590/s0004-27302009000500004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2009] [Accepted: 06/05/2009] [Indexed: 11/22/2022]
Abstract
Dietary fiber may contribute to both the prevention and treatment of type 2 diabetes mellitus (T2DM). In epidemiological studies the intake of insoluble fiber, but not the intake of soluble fiber, has been inversely associated with the incidence of T2DM. In contrast, in postprandial studies, meals containing sufficiently quantities of beta-glucan, psyllium, or guar gum have decreased insulin and glucose responses in both healthy individuals and patients with T2DM. Diets enriched sufficiently in soluble fiber may also improve overall glycemic control in T2DM. Insoluble fiber has little effect on postprandial insulin and glucose responses. Fiber increases satiety. In some studies, insoluble fiber has been associated with less weight gain over time. Limited cross-sectional evidence suggests an inverse relationship between intake of cereal fiber and whole-grains and the prevalence of the metabolic syndrome. Although long-term data from trials focusing on specifically dietary fiber are lacking, meeting current recommendations for a minimum fiber intake of 25 g/d based on a diet rich in whole grains, fruits and legumes will probably decrease the risk of obesity, the metabolic syndrome and T2DM.
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Affiliation(s)
- Vanessa D de Mello
- School of Public Health and Clinical Nutrition, Department of Clinical Nutrition, University of Kuopio -- P.O. Box 1627, FIN-70211 -- Kuopio, Finland.
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Bajorek SA, Morello CM. Effects of Dietary Fiber and Low Glycemic Index Diet on Glucose Control in Subjects with Type 2 Diabetes Mellitus. Ann Pharmacother 2010; 44:1786-92. [DOI: 10.1345/aph.1p347] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Objective: To review the effects of dietary fiber and a low glycemic index diet on glycemic risk factors in people with type 2 diabetes mellitus (T2DM) or T2DM and dyslipidemia. Data Sources: Literature search was conducted using PubMed, Cochrane Library, The Natural Standard, and The Natural Medicines through July 2010 using the terms type 2 diabetes mellitus, dietary fiber, psyllium, and glycemic index. Study Selection and Data Extraction: Articles included were randomized controlled studies or meta-analyses examining the effects of dietary interventions (dietary fiber, low glycemic index diet, or psyllium) on glycemic risk factors (glycosylated hemoglobin A1c [A1C] or postprandial plasma glucose [PPG] concentrations) in subjects with T2DM or T2DM and dyslipidemia Data Synthesis: Both psyllium supplementation and low glycemic index diets have been studied as monotherapy in the treatment of T2DM. Seven studies were reviewed (3 randomized crossover studies, 1 randomized parallel study, 3 randomized blinded parallel studies). Individually, psyllium supplementation and a low glycemic index diet improved glycemic risk factors. PPG and A1C decreased with psyllium 10.2 g per day, while A1C decreased with a low glycemic index diet (average glycemic index 59). However, the results for the low glycemic index diet are controversial. One study was underpowered to detect changes in A1C, while another study had psyllium fiber as a confounding variable. Conclusions: Psyllium supplementation might be an additional therapeutic option for people with T2DM who are already receiving diabetes medication and who still experience elevated PPG concentrations. Further well-designed clinical trials and adjustment for confounding variables are needed to determine the role of a low glycemic index diet in the treatment of T2DM.
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Affiliation(s)
- Sarah A Bajorek
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA
| | - Candis M Morello
- Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego; Ambulatory Care Pharmacist Specialist, Veterans Affairs of San Diego Healthcare System, San Diego, CA
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Brand-Miller JC, Atkinson FS, Gahler RJ, Kacinik V, Lyon MR, Wood S. Effects of PGX, a novel functional fibre, on acute and delayed postprandial glycaemia. Eur J Clin Nutr 2010; 64:1488-93. [PMID: 20924393 PMCID: PMC2996513 DOI: 10.1038/ejcn.2010.199] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background: Viscous fibre in food has established health benefits, but few functional fibre preparations are both effective and palatable. Our objective was to determine the most effective dose, formulation and timing of consumption of a novel fibre supplement (PolyGlycopleX (PGX)) in reducing postprandial glycaemia. Subjects/methods: Three trials were undertaken, each with 10 subjects (8M and 8F; age 24.4±2.6 years). Granular supplement was tested at four doses (0, 2.5, 5.0 and 7.5 g) with breakfast (study 1). Granular and capsule forms of the supplement were given in a single dose (5 g for granules and 4.5 g in capsules) at −60, −45, −30, −15 and 0 before, and +15 min after a bread meal (study 2). Capsules at increasing doses (1.5, 3, 4.5 and 6 g) were consumed with the evening meal to determine effects on glucose tolerance at breakfast (study 3). Incremental area under the blood glucose curve was determined. Results: Granular PGX at breakfast time at doses of 2.5, 5 and 7.5 g reduced the incremental area under the curve by up to 50% in a linear dose–response fashion (P<0.001). The granular form of PGX (5 g), but not the capsules, reduced glycaemia by up to 28% when consumed from −45 to +15 min (P<0.001). Capsules containing 3, 4.5 and 6 g PGX consumed with the evening meal reduced glycaemia at breakfast by up to 28% (P<0.001). Conclusions: PGX has biologically important, dose-related effects on acute and delayed (second meal) postprandial glycaemia.
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Affiliation(s)
- J C Brand-Miller
- Boden Institute of Obesity, Nutrition and Exercise and the School of Molecular Bioscience, University of Sydney, Sydney, NSW 2006, Australia.
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Singh B, Chauhan N. Dietary fiber psyllium based hydrogels for use in insulin delivery. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/j.ijdm.2009.12.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lightowler HJ, Henry CJK. Glycemic response of mashed potato containing high-viscocity hydroxypropylmethylcellulose. Nutr Res 2009; 29:551-7. [PMID: 19761889 DOI: 10.1016/j.nutres.2009.06.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2009] [Revised: 06/22/2009] [Accepted: 06/22/2009] [Indexed: 11/26/2022]
Abstract
Potatoes generally have one of the highest glycemic index values of any food. Relatively small differences in the glycemic response (GR) of regularly consumed starch foods have shown beneficial effects on health. Lowering the GR of a potato-based meal has potentially wide-reaching health benefits. High-viscosity hydroxypropylmethylcellulose (HV-HPMC) is a modified cellulose dietary fiber extensively used in the food industry. We hypothesized that the GR of a high-glycemic index product such as mashed potato would be lower with the addition of HV-HPMC. In a nonblind, randomized, repeat-measure, crossover controlled trial, 15 healthy adults consumed portions of mashed potato with different doses (0%, 1%, 2%, and 4%) of a specially selected and optimized HV-HPMC and a reference food (glucose) on separate occasions. Five subjects were excluded from the final analysis due to noncompliance with study procedures. Capillary blood glucose was measured in fasted subjects and at 15, 30, 45, 60, 90, and 120 minutes after starting to eat. For each sample, the incremental area under the blood glucose response curve was calculated and the GR determined. There was a significant lowering effect of HV-HPMC on GR (P < .001) of mashed potato. Glycemic responses for all mashed potato samples with the HV-HPMC were significantly lower than the standard mashed potato: 1% level (P < .05), 2% level (P < .05), and 4% level (P < .05). However, there was no significant effect of the HV-HPMC dose on GR. We conclude that addition of select HV-HPMC to mashed potato blunts GR.
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Affiliation(s)
- Helen J Lightowler
- Functional Food Centre, Oxford Brookes University, Gipsy Lane Oxford OX3 0BP, UK
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López JC, Villanueva R, Martínez-Hernández D, Albaladejo R, Regidor E, Calle ME. Plantago ovata consumption and colorectal mortality in Spain, 1995-2000. J Epidemiol 2009; 19:206-11. [PMID: 19561384 PMCID: PMC3924111 DOI: 10.2188/jea.je20080059] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2008] [Accepted: 04/03/2009] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Consumption of Plantago ovata may protect against colorectal cancer. To test this hypothesis, an ecological study was performed to determine mortality rates and distribution of colorectal cancer, and the consumption and distribution of P ovata, in different provinces in Spain. The putative association between P ovata consumption and mortality from colorectal cancer was then evaluated. METHODS We conducted a comparative ecological study of Spanish provinces, with colorectal cancer mortality as the dependent variable and per capita consumption of P ovata by province and year as the independent variable. Associations were analyzed by calculating Spearman's correlation coefficients and a Poisson multiple regression model. RESULTS Consumption of P ovata tended to be inversely correlated with mortality from colorectal cancer. In the Poisson regression analysis this tendency remained and reached statistical significance for the top quintile of P ovata consumption in the adjusted analysis (P = 0.042). CONCLUSIONS Our results show an inverse trend between the consumption of P ovata and colorectal cancer mortality. We recommend additional observational studies of individuals, in order to better control confounding factors.
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Affiliation(s)
- José Carlos López
- Department of Preventive Medicine and Public Health and History of Science, Faculty of Medicine, Complutense University, Madrid, Spain
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Singh B, Chauhan N. Modification of psyllium polysaccharides for use in oral insulin delivery. Food Hydrocoll 2009. [DOI: 10.1016/j.foodhyd.2008.06.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Maki KC, Reeves MS, Carson ML, Miller MP, Turowski M, Rains TM, Anderson K, Papanikolaou Y, Wilder DM. Dose-response characteristics of high-viscosity hydroxypropylmethylcellulose in subjects at risk for the development of type 2 diabetes mellitus. Diabetes Technol Ther 2009; 11:119-25. [PMID: 19848579 DOI: 10.1089/dia.2008.0036] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hydroxypropylmethylcellulose (HPMC) is a modified cellulose fiber that creates a viscous solution in the gastrointestinal tract. The present study examined the dose-response characteristics of high-viscosity (HV)-HPMC consumption on postprandial glucose and insulin levels in men and women at increased risk for type 2 diabetes mellitus. METHODS Subjects were a subset of participants in two trials with elevated peak postprandial glucose [>or=7.8 mmol/L (>or=140 mg/dL)] and body mass index (BMI) >or=27 kg/m(2). Subjects (n = 39) consumed breakfast meals containing 75 g of carbohydrate, each of which contained 1, 2, 4, or 8 g of HV-HPMC or a cellulose control in a randomized, double-blind manner. Each subject completed tests with control and two HV-HPMC doses. RESULTS Peak glucose concentration was lower than control (all P < 0.01) following 2 g (10%), 4 g (18%), and 8 g (20%) of HV-HPMC. Peak insulin was also reduced (P < 0.01) following 2 g (32%), 4 g (35%), and 8 g (46%) of HV-HPMC doses versus control. Incremental areas for glucose from 0 to 120 min were reduced by 8-40% versus control but only reached significance for the 4-g and 8-g conditions, whereas incremental areas under the insulin curves were reduced by 14-53% (P < 0.01 for 2, 4, and 8 g of HV-HPMC). CONCLUSIONS Among subjects at risk for type 2 diabetes mellitus, 1.0-8.0 g of HV-HPMC blunted postprandial glucose and insulin responses in a dose-dependent manner. Additional research is warranted to assess whether chronic consumption might retard the development or progression of glucose intolerance.
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Affiliation(s)
- Kevin C Maki
- Provident Clinical Research & Consulting, Inc., Bloomington, Indiana, USA.
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The acute effects of psyllium on postprandial lipaemia and thermogenesis in overweight and obese men. Br J Nutr 2008; 99:1068-75. [DOI: 10.1017/s0007114507864804] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Overweight and obesity is one of the risk factors for developing CVD. At present, very little is known about the acute effects of dietary fibre on lipids, glucose and insulin, resting energy expenditure and diet-induced thermogenesis in overweight and obese individuals. This study examined the postprandial metabolic effects of dietary fibre in overweight and obese men. Ten overweight and obese men consumed a mixed meal accompanied by either a high-fibre or low-fibre supplement on two separate visits, in a random order, 1 week apart. Two isoenergetic breakfast meals with similar composition were consumed by ten overweight/obese men. The meals contained either a low (3 g) or high (15 g) amount of fibre, low-fibre meal (LFM) and high-fibre meal (HFM) respectively. Analysis was carried out using paired t test and ANOVA. Serum TAG incremental area under the curve during 6 h of the postprandial period was significantly lower after the consumption of HFM compared with LFM. At the first hour of the postprandial period, plasma apo B48 concentration after consumption of HFM was significantly lower compared with LFM. The resting energy expenditure and diet-induced thermogenesis after both meals was similar during 6 h of the postprandial period. Collectively, these findings suggest that a single acute dose of dietary fibre in the form of psyllium supplement can decrease arterial exposure to TAG and modify chylomicron responses in the postprandial period.
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Maki KC, Carson ML, Miller MP, Turowski M, Bell M, Wilder DM, Rains TM, Reeves MS. Hydroxypropylmethylcellulose and methylcellulose consumption reduce postprandial insulinemia in overweight and obese men and women. J Nutr 2008; 138:292-6. [PMID: 18203894 DOI: 10.1093/jn/138.2.292] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Hydroxypropylmethylcellulose (HPMC) and methylcellulose (MC) are modified cellulose dietary fibers that generate viscous solutions in the gastrointestinal (GI) tract. This study assessed the effects of high viscosity (HV) HPMC, ultra-HV (UHV) HPMC, and medium viscosity MC on postprandial glucose and insulin responses in overweight and obese men and women (n = 50). After overnight fasts, subjects consumed 5 breakfast meals containing 75 g carbohydrate, each of which contained 1 of the following: 1 g HV-HPMC, 2 g HV-HPMC, 2 g UHV-HPMC, 4 g medium-viscosity MC or control (2 g cellulose). Test sequence was randomized and double-blind, except the MC test, which was last and single-blind (46 subjects completed all 5 tests). Glucose and insulin responses were determined pre-meal and for 120 min postprandially. Median (interquartile limits) peak glucose concentration was lower (P = 0.001) after the meal containing 2.0 g UHV-HPMC (7.1, 6.3-8.2 mmol/L) compared with the control meal (7.7, 6.6-8.7 mmol/L). The control did not differ from the other conditions for peak glucose or for any of the HPMC/MC conditions for glucose incremental areas under the curves (IAUC). Peak insulin was reduced (P < 0.05) for all HPMC/MC conditions compared with control. Insulin IAUC was lower than control (P < 0.001) after meals containing 2 g HV-HPMC, 2 g UHV-HPMC, and 4 g MC. GI symptoms did not differ among treatments. These findings indicate that HV-HPMC (1 and 2 g), UHV-HPMC (2 g), and MC (4 g) consumption reduced postprandial insulin excursions consistent with delayed glucose absorption.
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Affiliation(s)
- Kevin C Maki
- Provident Clinical Research, Bloomington, IN, USA.
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Yu LL, Lutterodt H, Cheng Z. Beneficial health properties of psyllium and approaches to improve its functionalities. ADVANCES IN FOOD AND NUTRITION RESEARCH 2008; 55:193-220. [PMID: 18772105 DOI: 10.1016/s1043-4526(08)00404-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Psyllium is an excellent dietary source for both soluble and insoluble fibers and has been used in supplemental and food products for its beneficial health effects. The strong water-absorbing and gelling capacities have made it a great challenge to incorporate psyllium in foods at the level needed to claim health benefits on the label. This review is focused on the approaches to improve the functionality, sensory property, and bioactivity of psyllium. Also included is a brief summary of the health beneficial effects of psyllium, along with its possible adverse effects. The information may be useful for those in psyllium research and functional food development.
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Affiliation(s)
- Liangli Lucy Yu
- Department of Nutrition and Food Science, University of Maryland, College Park, Maryland 20742, USA
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Maki KC, Carson ML, Miller MP, Turowski M, Bell M, Wilder DM, Reeves MS. High-viscosity hydroxypropylmethylcellulose blunts postprandial glucose and insulin responses. Diabetes Care 2007; 30:1039-43. [PMID: 17259476 DOI: 10.2337/dc06-2344] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE High-viscosity hydroxypropylmethylcellulose (HV-HPMC) is a modified cellulose fiber that produces a viscous gel in the gastrointestinal tract. Clinical trials demonstrate that consumption of HV-HPMC significantly lowers cholesterol, but limited information has been available on the influence of HV-HPMC on postprandial insulin and glucose responses. The objective of this investigation was to assess the influence of HV-HPMC on postprandial glucose and insulin responses in overweight and obese men and women. RESEARCH DESIGN AND METHODS Participants were 31 overweight or obese men and women without diabetes who underwent three breakfast meal tests in random order, separated by > or = 72 h. Test meals containing 75 g carbohydrate plus 4 or 8 g HV-HPMC or control meals containing 8 g cellulose were delivered in a double-blind fashion. RESULTS Peak glucose was significantly lower (P < 0.001) after both HV-HPMC-containing meals (7.4 mmol/l [4 g] and 7.4 mmol/l [8 g]) compared with the control meal (8.6 mmol/l). Peak insulin concentrations and the incremental areas for glucose and insulin from 0 to 120 min were also significantly reduced after both HV-HPMC doses versus control (all P < 0.01). CONCLUSIONS These findings indicate that HV-HPMC consumption reduces postprandial glucose and insulin excursions, which may favorably alter risks for diabetes and cardiovascular disease.
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Affiliation(s)
- Kevin C Maki
- Provident Clinical Research, 1000 W. 1st St., Bloomington, IN 47403, USA.
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Clark CA, Gardiner J, McBurney MI, Anderson S, Weatherspoon LJ, Henry DN, Hord NG. Effects of breakfast meal composition on second meal metabolic responses in adults with Type 2 diabetes mellitus. Eur J Clin Nutr 2006; 60:1122-9. [PMID: 16670695 DOI: 10.1038/sj.ejcn.1602427] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE We tested the relative importance of a low-glycemic response versus a high glycemic response breakfast meal on postprandial serum glucose, insulin and free fatty acid (FFA) responses after consumption of a standardized mid-day meal in adult individuals with Type 2 diabetes mellitus (DM). DESIGN Following an overnight fast of 8-10 h, a randomized crossover intervention using control and test meals was conducted over a 3-week-period. A fasting baseline measurement and postprandial measurements at various time intervals after the breakfast and mid-day meal were taken. SUBJECTS Forty-five Type 2 DM subjects completed the requirements and were included in the study results. INTERVENTIONS Two different breakfast meals were administered during the intervention: (A) a high glycemic load breakfast meal consisting of farina (kJ 1833; carbohydrate (CHO) 78 g and psylium soluble fiber 0 g), (B) a low-glycemic load breakfast meal consisting of a fiber-loop cereal (kJ 1515; CHO 62 g and psyllium soluble fiber 6.6 g). A standardized lunch was provided approximately 4 h after breakfast. Blood plasma concentrations and area under the curve (AUC) values for glucose, insulin and FFA were measured in response to the breakfast and mid-day lunch. Statistical analyses were performed using SAS software (8.02). Comparisons between diets were based on adjusted Bonferroni t-tests. RESULTS In post-breakfast analyses, Breakfast B had significantly lower area under the curve (AUC) values for plasma glucose and insulin compared to Breakfast A (P<0.05) (95% confidence level). The AUC values for FFA were higher for Breakfast B than for Breakfast A (P<0.05) (95% confidence level). Post-lunch analyses indicated similar glucose responses for the two breakfast types. Insulin AUC values for Breakfasts B were significantly lower than Breakfast A (P<0.05) (95% confidence level). The AUC values for FFA were unaffected by breakfast type. CONCLUSIONS These data indicate that ingesting a low-glycemic load meal containing psyllium soluble fiber at breakfast significantly improves the breakfast postprandial glycemic, insulinemic and FFA responses in adults with Type 2 DM. These data revealed no residual postprandial effect of the psyllium soluble fiber breakfast meal beyond the second meal consumed. Thus, there was no evidence of an improvement postprandially in the glycemic, insulinemic and FFA responses after the consumption of the lunch meal.
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Affiliation(s)
- C A Clark
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA
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