Glycemic Index: The Measure and Its Variability—The True State of the Science

Agave Syrup: Chemical Analysis and Nutritional Profile, Applications in the Food Industry and Health Impacts

Agave syrup (AS), a food product made from agave plant sap, is a vegan sweetener that has become popular for replacing conventional sweeteners such as sucrose. As the demand for naturally derived sweeteners has grown in the last decade, this review paper addresses and discusses, in detail, the most relevant aspects of the chemical AS analysis, applications in the food industry, sustainability issues, safety and quality control and, finally, nutritional profile and health impacts. According to our main research outcome, we can assume that the mid-infrared-principal components analysis, high-performance anion exchange chromatography equipped with a pulsed amperometric detector, and thin-layer chromatography can be used to identify and distinguish syrups from natural sources. The main agave–derived products are juice, leaves, bagasse, and fiber. In sustainability terms, it can be stated that certified organic and free trade agave products are the most sustainable options available on the market because they guarantee products being created without pesticides and according to specific labor standards. The Mexican government and AS producers have also established Mexican guidelines which prohibit using any ingredient, sugar or food additive that derives from sources, apart from agave plants, to produce any commercial AS. Due to its nutritional value, AS is a good source of minerals, vitamins and polyphenols compared to other traditional sweeteners. However, further research into the effects of AS on human metabolism is necessary to back its health claims as a natural sugar substitute.

Slowly Digestible Carbohydrate for Balanced Energy: In Vitro and In Vivo Evidence

There is growing interest among consumers in foods for sustained energy management, and an increasing number of ingredients are emerging to address this demand. The SUSTRA™ 2434 slowly digestible carbohydrate is a blend of tapioca flour and corn starch, with the potential to provide balanced energy after a meal. The aim of the study was to characterize this starch’s digestion profile in vitro (modified Englyst assay) and in vivo (intact and cecectomized rooster study), and to determine its effects on available energy, by measuring post-prandial glycemia in healthy adults (n = 14), in a randomized, double-blind, placebo-controlled, cross-over study, with two food forms: cold-pressed bar and pudding. The in vitro starch digestion yielded a high slowly digestible fraction (51%) compared to maltodextrin (9%). In the rooster digestibility model, the starch was highly digestible (94%). Consumption of slowly digestible starch (SDS), in an instant pudding or bar, yielded a significantly lower glycemic index compared to a control. At individual time points, the SDS bar and pudding yielded blood glucose levels with significantly lower values at 30–60 min and significantly higher values at 120–240 min, demonstrating a balanced energy release. This is the first study to comprehensively characterize the physiological responses to slowly digestible starch (tapioca and corn blend) in in vitro and in vivo studies.

Metabolic Effects of High Glycaemic Index Diets: A Systematic Review and Meta-Analysis of Feeding Studies in Mice and Rats

Low glycaemic index (LGI) diets are often reported to benefit metabolic health, but the mechanism(s) responsible are not clear. This review aimed to systematically identify studies investigating metabolic effects of high glycaemic index (HGI) versus LGI diets in mice and rats. A meta-analysis was conducted to calculate an overall effect size, Hedge's standardised mean differences (hereafter d), for each trait, with moderator variables considered in subsequent meta-regressions. Across 30 articles, a HGI diet increased five of the seven traits examined: body weight (d = 0.55; 95% confidence interval: 0.31, 0.79), fat mass (d = 1.08; 0.67, 1.49), fasting circulating insulin levels (d = 0.40; 0.09, 0.71), and glucose (d = 0.80; 0.35, 1.25) and insulin (d = 1.14; 0.50, 1.77) area under the curve during a glucose tolerance test. However, there was substantial heterogeneity among the effects for all traits and the small number of studies enabled only limited investigation of possible confounding factors. HGI diets favour body weight gain, increased adiposity and detrimentally affect parameters of glucose homeostasis in mice and rats, but these effects may not be a direct result of GI per se; rather they may be due to variation in other dietary constituents, such as dietary fibre, a factor which is known to reduce the GI of food and promote health via GI-independent mechanisms.

Retrospective Evaluation of Metformin and/or Metformin Plus a New Polysaccharide Complex in Treating Severe Hyperinsulinism and Insulin Resistance in Obese Children and Adolescents with Metabolic Syndrome

Background: Pharmacological treatment of obesity and glucose-insulin metabolism disorders in children may be more difficult than in adults. Thus, we evaluate the effects of metformin in comparison with metformin plus a polysaccharide complex (Policaptil Gel Retard^®, PGR) on body weight and metabolic parameters in obese children and adolescents with metabolic syndrome (MetS). Patients and methods: We retrospectively collected 129 children and adolescents (67 girls, 62 boys; median age 12.6 years) treated for a minimum of two years with metformin and low glycemic index (LGI) diet. Of these, 71 patients were treated with metformin plus PGR after at least 12 months of metformin alone. To minimize the confounding effect of the LGI on auxological and metabolic parameters, the patients were compared with age-, sex-, and BMI-matched control group with obesity and MetS (51 subjects; 24 males, 27 females) treated only with a LGI diet. Assessments included lipids, glucose and insulin (fasting and after oral glucose tolerance test) concentrations. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), Matsuda, insulinogenic and disposition indices were calculated. Results: Metformin treatment led to a significant reduction in BMI SDS (p < 0.0001), with a significant difference in ΔBMI SDS between patients and controls (p < 0.0001). Moreover, metformin treated patients showed a reduction in HOMA-IR (p < 0.0001), HbA1c levels (p < 0.0001) and a significant increase in Matsuda index (p < 0.0001) in respect to the reduction discovered in controls (p < 0.05). Moreover, in contrast to the group treated with metformin alone and controls, patients treated with metformin plus PGR showed a further reduction in BMI SDS (p < 0.0001), HOMA-IR (p < 0.0001), HbA1c (p < 0.0001), total, HDL and LDL cholesterol (p < 0.0001), as well as an increase in Matsuda (p < 0.0001), disposition (p < 0.005) and insulinogenic (respectively, p < 0.05 and p < 0.0001) indices. Conclusions: Metformin appears to show short-term efficacy in reducing BMI, adiposity and glucose and insulin parameters in obese children and adolescents with MetS. However, PGR added to metformin may be useful to potentiate weight loss and to improve glucose-insulin metabolism and adiposity parameters in these patients.

Xylobiose, an Alternative Sweetener, Ameliorates Diabetes-Related Metabolic Changes by Regulating Hepatic Lipogenesis and miR-122a/33a in db/db Mice

Type 2 diabetes is a major public health concern worldwide. Xylobiose (XB) consists of two molecules of d-xylose and is a major disaccharide in xylooligosaccharides that are used as prebiotics. We hypothesized that XB could regulate diabetes-related metabolic and genetic changes via microRNA expression in db/db mice. For six weeks, C57BL/KsJ-db/db mice received 5% XB as part of the total sucrose content of their diet. XB supplementation improved glucose tolerance with reduced levels of OGTT AUC, fasting blood glucose, HbA1c, insulin, and HOMA-IR. Furthermore, XB supplementation decreased the levels of total triglycerides, total cholesterol, and LDL-C. The expression levels of miR-122a and miR-33a were higher and lower in the XB group, respectively. In the liver, expressions of the lipogenic genes, including, fatty acid synthase (FAS), peroxisome proliferator activated receptor γ (PPARγ), sterol regulatory element-binding protein-1C (SREBP-1C), sterol regulatory element-binding protein-2 (SREBP-2), acetyl-CoA carboxylase (ACC), HMG-CoA reductase (HMGCR), ATP-binding cassette transporter G5/G8 (ABCG5/8), cholesterol 7 alpha-hydroxylase (CYP7A1), and sterol 12-alpha-hydroxylase (CYP8B1), as well as oxidative stress markers, including superoxide dismutase 1 (SOD1), superoxide dismutase 2 (SOD2), glutathione peroxidase (GPX), and catalase, were also regulated by XB supplementation. XB supplementation inhibited the mRNA expressions levels of the pro-inflammatory cytokines, tumor necrosis factor (TNF)-α, interleukin (IL)-1β, interleukin (IL)-6, and monocyte chemoattractant protein (MCP)-1, as well as phosphorylation of c-Jun N-terminal kinase/stress activated protein kinase (JNK/SAPK), p38 mitogen-activated protein kinases (MAPK), and extracellular signal-regulated kinases 1/2 (ERK1/2). These data demonstrate that XB exhibits anti-diabetic, hypolipogenic, and anti-inflammatory effects via regulation of the miR-122a/33a axis in db/db mice.

Agave as a model CAM crop system for a warming and drying world

As climate change leads to drier and warmer conditions in semi-arid regions, growing resource-intensive C3 and C4 crops will become more challenging. Such crops will be subjected to increased frequency and intensity of drought and heat stress. However, agaves, even more than pineapple (Ananas comosus) and prickly pear (Opuntia ficus-indica and related species), typify highly productive plants that will respond favorably to global warming, both in natural and cultivated settings. With nearly 200 species spread throughout the U.S., Mexico, and Central America, agaves have evolved traits, including crassulacean acid metabolism (CAM), that allow them to survive extreme heat and drought. Agaves have been used as sources of food, beverage, and fiber by societies for hundreds of years. The varied uses of Agave, combined with its unique adaptations to environmental stress, warrant its consideration as a model CAM crop. Besides the damaging cycles of surplus and shortage that have long beset the tequila industry, the relatively long maturation cycle of Agave, its monocarpic flowering habit, and unique morphology comprise the biggest barriers to its widespread use as a crop suitable for mechanized production. Despite these challenges, agaves exhibit potential as crops since they can be grown on marginal lands, but with more resource input than is widely assumed. If these constraints can be reconciled, Agave shows considerable promise as an alternative source for food, alternative sweeteners, and even bioenergy. And despite the many unknowns regarding agaves, they provide a means to resolve disparities in resource availability and needs between natural and human systems in semi-arid regions.

High Amylose White Rice Reduces Post-Prandial Glycemic Response but Not Appetite in Humans

The present study compared the effects of three rice cultivars on postprandial glycemic control and appetite. A single-blind, randomized, crossover clinical trial was performed with 18 healthy subjects, nine males and nine females. Three treatments were administered at three separate study visits: commercially available conventional white rice (short grain), specialty high amylose white rice 1 (Dixiebelle), and specialty high amylose white rice 2 (Rondo). Postprandial capillary blood glucose, venous blood glucose and insulin measurements, and appetite visual analog scale (VAS) surveys were done over the course of two hours. The capillary blood glucose concentrations were significantly lower for Rondo compared to short grain rice at 30 min, and for Dixiebelle and Rondo compared to short grain rice at 45, 60, and 120 min. Capillary blood glucose area under the curve (AUC) was significantly lower for Dixiebelle and Rondo compared to short grain rice. Subjects were significantly more hungry at 30 min after Dixiebelle intake than Rondo intake, but there were no other significant effects in appetite ratings. The present study determined that intake of high amylose rice with resistant starch (RS) can attenuate postprandial blood glucose and insulin response in comparison to short grain rice.

Is glycaemic index (GI) a valid measure of carbohydrate quality?

Recent criticisms of the glycaemic index (GI) focus on its validity with assertions that GI methodology is not valid, GI values are inaccurate and imprecise, GI does not predict what foods are healthy and that whole grain and fibre are better markers of carbohydrate quality than GI. None of the critics provide sound reasons for rejecting GI because some of their arguments are based on flagrant errors in understanding and interpretation while others are not supported by current data or are inconsistent with other nutritional recommendations. This paper addresses current criticisms of GI and outlines reasons why GI is valid: (1) GI methodology is accurate and precise enough for practical use; (2) GI is a property of foods; and (3) GI is biologically meaningful and relevant to virtually everyone. Current dietary guidelines recommend increased consumption of whole grains and dietary fibre but do not mention GI. However, this is illogical because the evidence that GI affects health outcomes is at least as good or better than that for whole grains and fibre. GI is a novel concept from a regulatory point of view and a number of problems need to be addressed to successfully translate GI knowledge into practice. The problems are not insurmountable but no progress can be made until bias and misunderstanding about GI can be overcome and there is better agreement about what is the actual state of knowledge on GI so that the real issues can be identified and addressed.