Reducing the glycemic impact of carbohydrates on foods and meals: Strategies for the food industry and consumers with special focus on Asia

Deacetylated Konjac Glucomannan with a Slower Hydration Rate Delays Rice Digestion and Weakens Appetite Response

The physical characteristics of chyme during gastrointestinal digestion are considered to significantly affect nutrient digestion and absorption (such as glucose diffusion), which has an impact on postprandial satiety. The present study aims to analyze the hydration rate (HR) and rheological properties of deacetylated konjac glucomannan (DKGM) at different degrees and then explore their effects on rice texture, digestive properties, and the subjects' post-meal appetite. The present results show that, as the deacetylation degree (DD) of KGM increased, the intersection point of the viscoelastic modulus shifted to a high shear rate frequency, and as the swelling time of the DKGM was prolonged, its HR decreased significantly. The results of the in vitro gastrointestinal digestion tests show that the hardness and chewability of the rice in the fast-hydration group (MK1) were remarkably reduced. In contrast, the slow-hydration group (MK5) exhibited an outstanding ability to resist digestion. The kinetics of starch hydrolysis revealed that the HR of the rice in the fast-hydration group was 1.8 times faster than that of the slow-hydration group. Moreover, it was found that the subjects' appetite after the meal was highly related to the HR of the MK. Their hunger (p < 0.001), desire to eat (p < 0.001), and prospective food consumption (p < 0.001) were significantly inhibited in the slow-hydration group (MK5) compared to the control. This study explored the nutritional effects of the hydration properties derived from the DKGM, which may contribute to modifying the high glycemic index food and provide ideas for the fabrication of food with enhanced satiating capacity.

Glycemic load, but not glycemic index, is associated with an increased risk of ovarian cancer: A systematic review and meta-analysis

The association between glycemic index (GI),glycemic load (GL) and ovarian cancer risk remains unclear. Carbohydrate intake promotes insulin secretion, leading to cell proliferation and invasion. We hypothesized that high GI and GL intake may increase ovarian cancer risk. Therefore, we conducted a meta-analysis after systematically searching PubMed, Embase, Web of Science, and Cochrane Library from inception to December 2022. Fixed- or random-effect models calculated the pooled relative risks (RRs) and corresponding 95% confidence intervals (CIs). Subgroup, sensitivity, publication bias analysis, and dose-response analysis were performed. Nine original studies were included, involving 4716 cases and 119,960 controls. No significant association was observed between GI or GL and ovarian cancer risk (GI: RR = 1.02 [95% CI, 0.83-1.26]; GL: RR = 1.11 [95% CI, 0.84-1.47]). Subgroup analysis suggested the results were not significantly modified by any group. Sensitivity analysis identified the sources of heterogeneity. No publication bias was observed. A linear positive dose-response relationship was observed between dietary GL and ovarian cancer risk after removing heterogeneous sources (RR = 1.11 [95% CI, 1.05-1.17], I2 = 32.9%, P = .23 at 50 U/d; RR = 1.04 [95% CI, 1.02-1.07], I2 = 19.1%, P = .29 at 20 U/d). These outcomes suggest that high dietary GL, but not GI, is associated with significantly increased ovarian cancer risk. Thus, sufficient intake of a low dietary GL is important for reducing ovarian cancer risk.

Exploring Rice Consumption Habits and Determinants of Choice, Aiming for the Development and Promotion of Rice Products with a Low Glycaemic Index

Current consumption drivers, particularly those related to health and wellbeing, have been influencing trends for the lower consumption of cereals, particularly rice, due to their typical high glycaemic index (GIs) and consequent impacts on obesity. To satisfy this consumer concern, more food innovations that promote healthy eating habits are required. Such innovations must be consumer-oriented to succeed, understanding the dynamics of consumer habits and responding to consumer expectations. This study explored these habits, from acquisition to consumption practices, and the expectations of the European market from the perspective of the major European consumer, Portugal, to obtain insights that support the development of low glycaemic index (GI) rice products. A mixed-methods approach was applied. For the first quantitative questionnaire, 256 Portuguese rice consumers aged 18-73 years were recruited. Twenty-four individuals were selected according to their gender and rice consumption profiles for in-depth interviews. The results confirmed that rice was the main side dish for the participants and was mainly consumed at home, cooked from raw milled rice. The drivers of consumption differ according to the provisioning process stage. In the acquisition stage, participants reported benefits from the rice's dynamic market by comparing products on price, brand, and rice types. In the preparation stage, participants reported the adequacy of the recipe and occasion, while in the consumption stage, participants enhanced their sensory preferences, depending on the rice dish. Although the GI concept was unknown to half of the participants, it was perceived as interesting and positive for healthy eating. Consumers showed concern about the taste and naturalness of the product, preferring it to be as close to a homemade dish as possible. The negative perceptions we verified were interpreted to be due to a lack of knowledge about the GI concept. Therefore, awareness actions and informative campaigns are recommended to promote low-GI rice products.

Savory Cracker Development for Blood Glucose Control and Management: Glycogen Storage Diseases

The blood glucose response of savory slow energy-release crackers (GLY-HYP) were evaluated in volunteers carrying glycogen storage diseases (GSDs), Types I (Ia) and IV. The crackers have been shown previously to provide a "flat" slow glucose response in healthy volunteers, for up to 4 h. On average for the mixed-sex volunteer group aged 53 to 70 for Type I, the blood glucose concentration increased from baseline to a maximum of 9.5 mmol/L at 60 min and remained above baseline for up to 210 min; overall, above 5 mmol/L for 4 h. In common with healthy individuals, a relatively flat blood glucose response was recorded. For Type IV, mixed-sex patients aged between 55 and 72, the blood glucose concentration reached maximum of 10.2 mmol/L at 45 min and then stayed above baseline for 150 min. Again, overall, above 5 mmol/L for 4 h. Altogether, these data indicate that these crackers would provide a valuable contribution to the nutritional needs of people of different age groups with GSDs (Clinical Registration Number: HRC10032021).

Insights into Recent Updates on Factors and Technologies That Modulate the Glycemic Index of Rice and Its Products

Rice is a staple food and energy source for half the world's population. Due to its quick digestion and absorption in the gastrointestinal tract, rice is typically regarded as having a high or medium-high glycemic index (GI); however, this can vary depending on the variety, nutrient compositions, processing, and accompanying factors. This report included a table of the glycemic index for rice and rice products in different countries, which could give an overview and fundamental information on the recent GI of different rice varieties. In addition, latest updates about the mechanism effects of rice nutritional profiles and processing techniques on GI were also provided and discussed. The influence of state-of-the-art GI regulation methods was also evaluated. Furthermore, the effectiveness and efficiency of applied technologies were also given. Furthermore, this review offered some aspects about the potential nutraceutical application of rice that food scientists, producers, or consumers might consider. Diverse types of rice are grown under various conditions that could affect the GI of the product. The instinct nutrients in rice could show different effects on the digestion rate of its product. It also revealed that the rice product's digestibility is process-dependent. The postprandial glucose response of the rice products could be changed by modifying processing techniques, which might produce the new less-digestive compound or the inhibition factor in the starch hydrolysis process. Because of the significant importance of rice, this paper also concluded the challenges, as well as some important aspects for future research.

Slow Digestible Starch in Native Pea Starch (Pisum sativum L.) Lowers Glycemic Response with No Adverse Effects on Gastrointestinal Symptoms in Healthy Adults

Diabetes prevalence achieved 470B in 2021. Diabetics are looking for foods that allow them to better manage the postprandial glycemia. Owing to its large amylose fraction, pea starch may contribute to formulate recipes with a lower glycemic index (GI). This study measured the rapidly, slowly digested and resistant fractions in pea starch and in a powder mix recipe. Starch fractions were determined according to the Englyst methodology. A nonblind repeat measure crossover design trial in healthy humans was used to study the GI of pea starch and maltodextrin powder mix recipes against glucose. Gastrointestinal symptoms were measured. Thirteen healthy volunteers aged 18-60 years with body mass index <30 kg/m2 and fasting blood glucose <6.1 mmol/L participated in the study. They consumed 25 g available carbohydrate portions of the test products. Blood glucose was measured at -5 and 0 min before consumption till 180 min after starting to eat. The slow digestible starch (SDS) content of native pea starch was 30% of the total starch content. The pea-based powder mix recipe contained 25% SDS in comparison with 9% for the maltodextrin-based recipe. The glucose response after pea starch was significantly lower compared with maltodextrin. The glucose response after pea starch recipe was significantly lower compared with maltodextrin recipe. There was no significant difference in mean scores for well-being and gastrointestinal symptoms after consumption of pea starch and maltodextrin or between the two recipes. In conclusion, this study has demonstrated the presence of high SDS content in pea starch, which reduced postprandial glycemic response compared with maltodextrin. The pea starch recipe did not induce any negative gastrointestinal symptoms. Pea starch may, therefore, prove to be a beneficial ingredient in developing food products for improving glycemic control without undesirable side effects.

Oligomalt, a New Slowly Digestible Carbohydrate, Is Well Tolerated in Healthy Young Men and Women at Intakes Up to 180 Gram per Day: A Randomized, Double-Blind, Crossover Trial

In this randomized, double-blind triple-crossover study (NCT05142137), the digestive tolerance and safety of a novel, slowly digestible carbohydrate (SDC), oligomalt, an α-1,3/α-1,6-glucan α-glucose-based polymer, was assessed in healthy adults over three separate 7-day periods, comparing a high dose of oligomalt (180 g/day) or a moderate dose of oligomalt (80 g/day in combination with 100 g maltodextrin/day) with maltodextrin (180 g/day), provided as four daily servings in 300 mL of water with a meal. Each period was followed by a one-week washout. A total of 24 subjects (15 females, age 34 years, BMI 22.2 kg/m², fasting blood glucose 4.9 mmol/L) were recruited, of whom 22 completed the course. The effects on the primary endpoint (the Gastrointestinal Symptom Rating Score (GSRS)) showed a statistically significant dose dependency, albeit of limited clinical relevance, between a high dose of oligomalt and maltodextrin (mean (95% CI) 2.29 [2.04, 2.54] vs. 1.59 [1.34, 1.83], respectively; difference: [-1.01, -0.4], p < 0.0001), driven by the GSRS-subdomains "Indigestion" and "Abdominal pain". The GSRS difference ameliorated with product exposure, and the GSRS in those who received high-dose oligomalt as their third intervention period was similar to pre-intervention (mean ± standard deviation: 1.6 ± 0.4 and 1.4 ± 0.3, respectively). Oligomalt did not have a clinically meaningful impact on the Bristol Stool Scale, and it did not cause serious adverse events. These results support the use of oligomalt across various doses as an SDC in healthy, normal weight, young adults.

Impact of Pasta Intake on Body Weight and Body Composition: A Technical Review

Pasta is a staple carbohydrate across many cultures but has been implicated in overweight and obesity due to its position as a refined carbohydrate. Yet, the unique structure of pasta and its low glycemic response suggest it may contribute to a healthy body weight. The purpose of this review is to summarize the literature on the effects of pasta and dietary patterns high in pasta on body weight and body composition outcomes, and evaluate potential mechanisms by which pasta may influence body weight. A search of PubMed and CENTRAL identified 38 relevant studies examining pasta intake and body weight outcomes or potential mechanisms. Observational studies generally report no association or an inverse association of pasta intake with body weight/body composition outcomes. One clinical trial reported no difference in weight loss between a hypocaloric diet with high intake vs. low intake of pasta. Pasta may influence body weight via its low glycemic response, but evidence of effects on appetite, appetite-related hormones, and gastric emptying is limited and inconclusive. In conclusion, observational and limited clinical data suggest pasta is either inversely or not associated with overweight or obesity in healthy children and adults, and does not contribute to weight gain within the context of a healthy diet.

Association of dietary intake with body mass index and glycemic profile among newly diagnosed patients with type 2 diabetes mellitus

INTRODUCTION

Dietary intake plays an important role in determining body mass index (BMI) and glycemic profile in patients with type 2 diabetes mellitus (T2DM). Our aim was to describe habitual dietary intake and its associations with BMI and glycemic profile in a cohort of patients with newly diagnosed T2DM in Sri Lanka.

METHODS

A cross-sectional study was carried out among 158 patients with newly diagnosed T2DM in Galle, Sri Lanka. Data on demographic, lifestyle, and family history of diabetes mellitus, and clinical measures were collected. The dietary information was collected using a 24-h dietary recall.

RESULTS

Among the total number of study subjects, only 12.0%, 5.7% and 1.3% met the recommended daily consumption value of protein, fat, and fiber, respectively, whereas 99.4% of subjects had taken carbohydrates that exceeded the recommended consumption. There was a positive association between carbohydrate intake and BMI (0.004, [0.002], p = .048) and carbohydrate intake and glycated hemoglobin (HbA1C ) (0.001, [0.000], p = .049). Fat intake showed positive associations with BMI (0.029, [0.011], p = .006) and HbA1C (0.005, [0.002], p = .050). Protein intake showed a positive association with HbA1C (0.006, [0.003], p = .023). The aforementioned associations were observed after adjusting for demographic, lifestyle, and history of diabetes among the first-degree family members. The carbohydrate intake was positively associated with BMI (0.010, [0.003], p = .003) and HbA1C (0.001, [0.000], p = .050) with further adjustment in nutrient intake (except when used as an independent variable). Furthermore, the fat intake was associated with BMI (0.031, [0.011], p = .004) and HbA1C (0.005 [0.002], p = .050) with additional adjustments.

CONCLUSIONS

The diet of the majority of newly diagnosed T2DM patients in this cohort consisted of a higher carbohydrate intake than the recommended level. However, they did not meet the recommended daily intake of protein, fat, and fiber. Both carbohydrate and fat intake were significantly and positively associated with BMI and HbA1C in patients with newly diagnosed T2DM.

Effects of an Extract of the Brown Seaweed Ascophylum nodosum on Postprandial Glycaemic Control in Healthy Subjects: A Randomized Controlled Study

The effects of the consumption of an extract of the brown seaweed Ascophyllum nodosum (BSW) on postprandial glucose and insulin responses to white bread were investigated in an acute, randomized, double-blind, three-arm, crossover, controlled trial in healthy, normoglycemic subjects. Sixteen subjects were administered either control white bread (50 g total digestible carbohydrates) or white bread with 500 mg or 1000 mg of BSW extract. Biochemical parameters were measured in venous blood over 3 h. Significant inter-individual variation in the glycaemic response to white bread was observed. Analysis of the responses of all subjects to either 500 mg or 1000 mg of BSW extract versus control revealed no significant effects of treatments. The variation in response to the control was used to classify individuals into glycaemic responders and non-responders. In the sub-cohort of 10 subjects with peak glucose levels after white bread above 1 mmol/L, we observed a significant decrease in maximum levels of plasma glucose after the intervention meal with 1000 mg of extract compared with the control. No adverse effects were reported. Further work is warranted to define all factors that determine "responders" to the effects of brown seaweed extracts and identify the cohort that would benefit the most from their consumption.

Loss of function of SSIIIa and SSIIIb coordinately confers high RS content in cooked rice

The sedentary lifestyle and refined food consumption significantly lead to obesity, type 2 diabetes, and related complications, which have become one of the major threats to global health. This incidence could be potentially reduced by daily foods rich in resistant starch (RS). However, it remains a challenge to breed high-RS rice varieties. Here, we reported a high-RS mutant rs4 with an RS content of ~10.8% in cooked rice. The genetic study revealed that the loss-of-function SSIIIb and SSIIIa together with a strong Wx allele in the background collaboratively contributed to the high-RS phenotype of the rs4 mutant. The increased RS contents in ssIIIa and ssIIIa ssIIIb mutants were associated with the increased amylose and lipid contents. SSIIIb and SSIIIa proteins were functionally redundant, whereas SSIIIb mainly functioned in leaves and SSIIIa largely in endosperm owing to their divergent tissue-specific expression patterns. Furthermore, we found that SSIII experienced duplication in different cereals, of which one SSIII paralog was mainly expressed in leaves and another in the endosperm. SSII but not SSIV showed a similar evolutionary pattern to SSIII. The copies of endosperm-expressed SSIII and SSII were associated with high total starch contents and low RS levels in the seeds of tested cereals, compared with low starch contents and high RS levels in tested dicots. These results provided critical genetic resources for breeding high-RS rice cultivars, and the evolutionary features of these genes may facilitate to generate high-RS varieties in different cereals.

A Randomized, Placebo-Controlled Crossover Study to Evaluate Postprandial Glucometabolic Effects of Mulberry Leaf Extract, Vitamin D, Chromium, and Fiber in People with Type 2 Diabetes

INTRODUCTION

Reducing postprandial (PP) hyperglycemia and PP glucose excursions is important for overall glycemic management. Although most therapeutic lifestyle interventions that reduce caloric intake would affect this, there is no particular nutritional intervention favored.

METHODS

We evaluated the effects of a novel natural food adjuvant combining mulberry leaf extract (MLE) with other bioactive ingredients, in people with type 2 diabetes (T2D) originating from Asia, on improving PP glucometabolic response in a randomized controlled exploratory crossover, two-center study (USA, Singapore). A 2-g blend of 250 mg MLE [containing 12.5 mg of 1-deoxynojirimycin (DNJ)], fiber (1.75 g), vitamin D₃ (0.75 μg), and chromium (75 μg), compared with a similar blend without the MLE, was sprinkled over a 350-kcal breakfast meal (55.4 g carbs) and PP blood glucose (primary exploratory endpoint), insulin, and incretin hormones (GLP-1, GIP) were evaluated in blood samples over 3 h. Changes in incremental areas under the concentration curve (iAUC) and maximum concentrations (C_max) were compared.

RESULTS

Thirty individuals (12 women, mean age 59 years, HbA1c 7.1%, BMI 26.5 kg/m²) were enrolled and the MLE-based blend relative to the blend without MLE significantly reduced glucose iAUC at 1 h (- 20%, p < 0.0001), 2 h (- 17%, p = 0.0001), and 3 h (- 15%, p = 0.0032) and C_max [mean (95% CI) difference - 0.8 (- 1.2, - 0.3) mmol/L, p = 0.0006]. A statistically significant reduction in 1 h insulin iAUC (- 24%, p = 0.0236) was observed, but this reduction was no longer present at either 2 h or 3 h. No difference in GLP-1 was seen, but GIP response (iAUC and C_max) was less with the MLE-based blend.

CONCLUSIONS

The observation of a significant glucose reduction paralleled with a significant lower insulin response supports a reduced gastrointestinal glucose absorption. These results support the use of a 2-g natural blend of MLE, fiber, vitamin D, and chromium in T2D as a convenient dietary adjuvant to improve PP glucometabolic response.

CLINICALTRIALS

gov identifier NCT04877366.

Apple preload increased postprandial insulin sensitivity of a high glycemic rice meal only at breakfast

PURPOSE

The possible impact of preload food on insulin sensitivity has yet been reported. This study aimed to investigate the glycemic and insulinemic effect of an apple preload before breakfast, lunch and early supper, based on high glycemic index (GI) rice meals.

METHODS

Twenty-three healthy participants in Group 1 and 14 participants in Group 2 were served with the reference meal (white rice containing 50 g of available carbohydrate) or experimental meals (apple preload and rice, each containing 15 and 35 g of available carbohydrate). The meals were either served at 8:00 for breakfast, 12:30 for lunch or 17:00 for early supper to explore the possible effect of time factor. The group 1 assessed the postprandial and subsequent-meal glycemic effect of the test meals by continuous glucose monitoring (CGM), along with subjective appetite; The group 2 further investigated the glycemic and insulin effect by blood collection.

RESULTS

The apple preload lowered the blood glucose peak value by 33.5%, 31.4% and 31.0% in breakfast, lunch and supper, respectively, while increased insulin sensitivity by 40.5% only at breakfast, compared with the rice reference. The early supper resulted significantly milder glycemic response than its breakfast and lunch counterparts did. The result of CGM tests was consistent with that of the fingertip blood tests.

CONCLUSION

Apple preload performed the best at breakfast in terms of enhancing the insulin sensitivity. The preload treatment could effectively attenuate postprandial GR without increasing the area under insulin response curve in any of the three meals.

Consumer Health Behavior and Business Adaptation of Thai Street Food Vendors Under the Covid-19 Pandemic: A Case Study of Street Food Vendors In Lower Northeastern Thailand

Objective: Street food has been a Thai cultural experience valued by locals and visitors alike. The epidemic of covid-19 has affected the hospitality industry worldwide, including tiny and medium-sized enterprises (SME) eateries. Street food vendors unquestionably operate the least successful businesses among these food providers. The purpose of investigating the adaptation of street food vendors is to learn about new ways for small businesses to adjust regarding consumer health behavior (CHB) to survive under a crisis situation and discover new dimensions of business survival. Methods: This study questioned 400 street food vendors in the lower northeastern region of Thailand using a Likert scale questionnaire to collect data. Results: According to the findings of this study, the CHB influences the adoption of new business practices from the standpoint of consumers. Conclusion: This study's model is a substantial contribution to the corpus of knowledge. This study's practical consequences offer a path ahead for adopting a CHB-oriented street food company.

Zingiber officinale, Phyllanthus emblica, Cinnamomum verum, and Curcuma longa to Prevent Type 2 Diabetes: An Integrative Review

Diabetes mellitus has become a global pandemic progressively rising and affecting almost every household in all world regions. Diet is a significant root cause of type II diabetes; thus, the significance of dietary interventions in preventing and managing the disease cannot be neglected. Lowering the glycemic impact of diet is an alternative way of managing type II diabetes while improving insulin sensitivity. Medicinal plants are rich in therapeutic phytochemicals which possess hypoglycemic properties. Therefore, it could be speculated that the glycemic impact of diet can be reduced by adding hypoglycemic plant ingredients without altering the sensory properties of food. The main aim of this review is to discuss dietary interventions to manage diabetes and summarize available information on the hypoglycemic properties of four prime herbs of Asian origin. This article collected, tabulated, and summarized groundbreaking reveals from promising studies. This integrative review provides information on the hypoglycemic properties of ginger, Indian gooseberry, cinnamon, and turmeric and discusses the possibility of those herbs reducing the glycemic impact of a diet once incorporated. Further research should be done regarding the incorporation of these herbs successfully into a regular diet.

Formulation optimization of functional wheat bread with low glycemic index from technological and nutritional perspective

Inclusion of prebiotic compounds as indigestible dietary fiber in wheat bread has grown rapidly considering the increased public awareness about their impact on health. However, through their incorporation, the technological characteristics may adversely be influenced by gluten dilution impacts. This study was done to evaluate the impacts of long chain, native and short chain inulin (L-, N-, and S-type inulin, respectively) at 8%, 10%, 12%, 14%, and 16% w/w as Inulin Reconstituted Wheat Flour (IRWF) with similar gluten: carbohydrate ratio of wheat flour (at 10%, 12.5%, 15%, 17.5%, 20% w/w) on technological and nutritional value of wheat bread. Results indicated that despite no gluten dilution induced by IRWF supplementation, technological characteristics were adversely influenced especially at higher substitution level of L-type-containing formulations which is attributed to their higher water absorption index (WAI). Reversely, the nutritional value was positively influenced in which the lowest hydrolysis index (26.64%); predicted Glycemic Index (51.93%) and fructan loss content (25.42%) were found at L-type inulin-containing IRWF at the highest substitution level (20% w/w). As the nutritional value of wheat bread as staple foodstuff is important, optimizing the bread-making process to decrease all reverse impacts induced by L-inulin-type inclusion seems to be required.

Extended Inter-Meal Interval Negatively Impacted the Glycemic and Insulinemic Responses after Both Lunch and Dinner in Healthy Subjects

This study aimed to investigate the glycemic and insulinemic effects of lunch timing based on a fixed feeding window, and the effects of apple preload on postprandial glucose and insulin responses after nutrient-balanced lunch and the subsequent high-fat dinner in healthy participants. Twenty-six participants completed four randomized, crossover experimental trials: (1) early standardized lunch at 12:00 (12S); (2) apple preload to 12S (12A+S); (3) late standardized lunch at 14:00 (14S); and (4) apple preload to 14S (14A+S); wherein twenty participants’ blood samples were collected for insulin analysis following the lunch trails. In each experimental trial, each participant equipped with a continuous glucose monitor (CGM) was provided with a standardized breakfast and a high-fat dinner to be consumed at 8:00 and 18:00, respectively. The late lunch (14S) resulted in significantly elevated glucose peak, delayed insulin peak time, decreased insulin sensitivity, and increased insulin resistance following the lunch; also decreased glycemic response following the subsequent dinner and larger blood glucose fluctuation over the 24-h period compared with the 12S. The 14A+S significantly reduced the glucose peak, the insulin peak time and the glycemic variability following the lunch, also the 24-h glycemic variability compared with the 14S. The insulin sensitivity was significantly improved in the 12A+S, compared with that of the 12S. In conclusion, the present study found that an extra 2-h inter-meal fasting before and after lunch resulted in elevated glycemic response in both macronutrient-balanced meal and high-fat meal in healthy subjects. The negative impact of a late lunch could be partly reversed by the apple preload, without a trade-off of insulin secretion.

Conceptualization of Rice with Low Glycaemic Index: Perspectives from the Major European Consumers

Rice and cereal consumption has become a concern for consumers due to usually high glycaemic indexes (GI), which is a critical issue for a balanced and healthy diet. Therefore, the development of new products with low GI is an important target of the industry, particularly in countries with high consumption. This study assesses consumers’ perceptions about “rice” and “rice with low GI” and evaluates the effect of consumers’ rice consumption profiles through the application of a free word association technique in a structured self-administered electronic questionnaire with 256 Portuguese consumers (the European market with the highest per capita consumption of rice by far). The frequency of rice consumption was evaluated, and the consumption profile was determined through a hierarchical cluster analysis, with 9% identified as daily consumers. The response words were categorized by the triangulation technique, and the association between the word categories and dimensions, sociodemographic characteristics, and consumption profile were determined. Respondents most frequently associated “rice” with rice dishes, its sensory attributes, and nutrition, highlighting the satisfaction of nutritional and hedonic needs. Consumers revealed positive expectations in relation to the functionality of “rice with low GI”. The consumers’ rice consumption profiles, sex, age, and educational levels influenced their perception towards “rice“ and “rice with low GI”. This study provides important insights for the industry to develop a consumer-oriented, low GI rice product.

Investigating the Impact of Dragon Fruit Peel Waste on Starch Digestibility, Pasting, and Thermal Properties of Flours Used in Asia

As a by-product of dragon fruit consumption, dragon fruit peel (DFP) was developed into powder as a natural ingredient. Nevertheless, the effect of DFP on the physicochemical properties of flours used in Asian food processing and cooking remains unknown. In this study, starch digestibility, thermal, pasting, and physicochemical properties of DFP and flours (potato, rice, glutinous rice, and wheat) were characterized. It was found that DFP contained 65.2% dietary fiber together with phenolic compounds, betacyanins, and antioxidant activity. The results demonstrated that DFP (from 125 to 500 mg) reduced starch digestibility of flours, rapidly digestible starch, and slowly digestible starch, along with an increased proportion of undigested starch. A marked increase in phenolic compounds, betacyanins, and antioxidant activity occurred when DFP and flour were incubated for 180 min under simulated gastrointestinal digestion. The results indicate that bioactive compounds in DFP were highly bioaccessible and remained intact after digestion. Moreover, DFP exerted a significantly lower gelatinization enthalpy of flours with increasing peak viscosity and setback with decreasing pasting temperature. FTIR confirmed the decreased ratio at 1047/1022 cm−1, indicating the disruption of short-range orders of starch and DFP. These findings would expand the scope of DFP food applications and provide a knowledge basis for developing DFP flour-based products.

Unraveling the impact of viscosity and starch type on the in vitro starch digestibility of different gels

Starch is one of the most important carbohydrates that is present in many foods. Gelatinization is an important property of starch, associated with physical changes that promote an increase in viscosity. The objective of this research was to understand how the viscosity of starch gels affects their hydrolysis and whether that effect was dependent on the type of starch. Different gels (corn, wheat, and rice) with variable or constant viscosity were analyzed using diverse methodologies to determine the changes in the pasting behavior. A rapid force analyzer, a vibration viscometer and a rheometer were used to differentiate the gels based on the starch source and concentration. At a fixed starch concentration, corn gel displayed the highest viscosity, slowing the enzymatic starch hydrolysis. The higher viscosity of those gels prepared with a fixed starch concentration significantly enhanced the slowly digestible starch (SDS) and reduced the kinetic constant (k). Nevertheless, gels with constant viscosity (550 mPa s) showed comparable hydrolysis kinetics, obtaining similar SDS, total hydrolyzed starch and k. The correlation matrix confirmed the relationship between k and gel viscosity (r = -0.82), gelatinization rate (α-slope) (r = -0.87), breakdown (r = -0.84) and elastic modulus (G' 37 °C) (r = -0.73). Therefore, these parameters could be used as predictors of the hydrolysis performance of starch gels as well as in reverse engineering for the design of healthy foods.

Effect of protein enrichment on quality characteristics and glycemic index of gluten free sweet potato (Ipomoea batatas L.) spaghetti

The aim of present investigation was justifying the suitability of sweet potato flour for development of gluten free spaghetti with reduced starch digestibility and to enhance protein content by fortification of whey protein concentrate (WPC) and chickpea flour (CPF) at the rate of 5%, 10%, and 15% respectively along with control. The effect of fortification in spaghetti was assessed for its glycemic index, physical, nutritional, and sensory properties. The data revealed that increase in the level of fortification of WPC and CPF resulted with increase in optimum cooking time, weight and volume without affecting cooking loss as compared to control sample. The percent increase in protein content of spaghetti fortified with WPC and CPF found as 192.20% and 150.08% respectively in comparison with control. However, spaghetti fortified with 15% CPF and 15% WPC showed lowest starch digestibility with reduced glycemic index to 59.43 and 58.73 respectively. The spaghetti fortified with 10% WPC and 10% CPF was found overall acceptable by panelists. Moreover, the fortification of spaghetti with WPC and CPF could significantly increase the protein content along with overall acceptability and functional characteristics.

Quality of life and factors associated with a good quality of life among diabetes mellitus patients in northern Thailand

Background

Quality of life (QOL) is a good indicator of lifespan, especially for individuals who are suffering from a particular illness. QOL among patients with diabetes mellitus (DM) could be used for further implementations in addition to improving patient care and disease management, especially during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to assess QOL and identify factors associated with a good QOL among DM patients in northern Thailand.

Methods

A cross-sectional study was conducted to gather information from DM patients attending six randomly selected hospitals in the Chiang Rai province, northern Thailand. A validated questionnaire and the 26-item quality of life brief version (WHOQOL-BREF) were used to collect socioeconomic factors and assess QOL, respectively. Chi-square tests and logistic regression were used to detect the associations between variables at a significance level of α = 0.05.

Results

A total of 967 participants were enrolled in the study: 58.8% were female, 52.3% were aged ≥ 60 years, 79.7% graduated primary school and had no additional education, 68.7% had an annual income ≤ 50,000 baht, and 29.3% were unemployed. The majority of patients had a poor-to-moderate overall QOL (49.4%); 90.1% reported a moderate QOL in the physical domain, 54.7% reported a moderate QOL in the mental domain, 63.4% reported a good QOL in the social relationship domain, and 50.6% reported a good QOL in the environmental domain. In multivariate analysis, seven variables were found to be associated with good QOL among the participants. Those aged ≤ 59 years had 1.90 times (95% CI 1.32–2.73) greater odds of having good QOL than those aged ≥ 60. Those who had annual income ≥ 100,001 baht had 2.16 times (95% CI 1.17–3.96) greater odds of having good QOL than those who had annual income ≤ 50,000 baht. Those who lived alone and with spouses had 3.38 times (95% CI 1.42–8.02) and 2.20 times (95% CI 1.20–4.02) greater odds of having good QOL, respectively, than those who lived with relatives. Those who exercised regularly had 4.72 times (95% CI 2.71–8.19) greater odds of having good QOL than those who never exercised. Those who had a high level of knowledge regarding prevention and care had 3.26 times (95% CI 1.22–5.55) greater odds of having good QOL than those who had low knowledge. Those who did not have diabetic nephropathy had 7.41 times (95% CI 4.99–11.01) greater odds of having good QOL than those who were diagnosed with diabetic nephropathy, and those whose medical fees were supported by the government under the universal scheme had 4.31 times (95% CI 1.15–16.7) greater odds of having good QOL than those who had to support themselves.

Conclusions

Almost a half of DM patients in northern Thailand reported having a low-to-moderate QOL, which can be improved by focusing on socioeconomic factors, family support as well as improving knowledge regarding DM prevention and care, including the support of medical fees.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12955-022-01986-y.

Nutrition policy: developing scientific recommendations for food-based dietary guidelines for older adults living independently in Ireland

Older adults (≥65 years) are the fastest growing population group. Thus, ensuring nutritional well-being of the ‘over-65s’ to optimise health is critically important. Older adults represent a diverse population – some are fit and healthy, others are frail and many live with chronic conditions. Up to 78% of older Irish adults living independently are overweight or obese. The present paper describes how these issues were accommodated into the development of food-based dietary guidelines for older adults living independently in Ireland. Food-based dietary guidelines previously established for the general adult population served as the basis for developing more specific recommendations appropriate for older adults. Published international reports were used to update nutrient intake goals for older adults, and available Irish data on dietary intakes and nutritional status biomarkers were explored from a population-based study (the National Adult Nutrition Survey; NANS) and two longitudinal cohorts: the Trinity-Ulster and Department of Agriculture (TUDA) and the Irish Longitudinal Study on Ageing (TILDA) studies. Nutrients of public health concern were identified for further examination. While most nutrient intake goals were similar to those for the general adult population, other aspects were identified where nutritional concerns of ageing require more specific food-based dietary guidelines. These include, a more protein-dense diet using high-quality protein foods to preserve muscle mass; weight maintenance in overweight or obese older adults with no health issues and, where weight-loss is required, that lean tissue is preserved; the promotion of fortified foods, particularly as a bioavailable source of B vitamins and the need for vitamin D supplementation.

Development and validation of rapid and cost-effective protocol for estimation of amylose and amylopectin in maize kernels

Maize possesses wide variation in amylose and amylopectin which assumes significance as a part of both food-chain and different industrial applications. Estimation of amylose and amylopectin in maize kernels is important for developing suitable hybrids. The existing protocols for estimation of amylose and amylopectin in maize are elaborate and lengthy, and involve high cost. Here, we developed a rapid and cost-effective method for estimation of amylose and amylopectin in maize kernels. 10% toluene and 80% ethanol were used for removal of proteins (~ 10%) and lipids (~ 4%) from maize flour. The over-estimation of amylose was minimized using NaOH with KI to stop free KI to bind with amylopectin. Standards were improved by mixing amylose and amylopectin in different concentrations (0-100%), rather than using amylose or amylopectin alone. Standard curve generated regression equation of y = 90.436x + 0.8535 with R ² = 0.9989. Two types of samples viz., (1) protein, amylose and amylopectin (2) amylose and amylopectin, showed that starch fractions were highly comparable to expected values with correlation coefficient (r) of 0.9998 and mean standard deviation of 0.54. The protocol successfully estimated wide range of amylose (2.79-50.04%) and amylopectin (59.96-97.21%) among diverse maize inbreds including amylose extender1 (ae1) and waxy1 (wx1) mutants. Present protocol required 75% less time and 92.5% less cost compared to existing protocols. The newly developed method would be highly useful in developing maize hybrids high in amylose or amylopectin. This is the first report of rapid and cost-effective protocol for estimation of starch fractions in maize kernels.

Seaweeds as Ingredients to Lower Glycemic Potency of Cereal Foods Synergistically-A Perspective

Seaweeds are traditional food ingredients mainly in seaside regions. Modern food science and nutrition researchers have identified seaweed as a source of functional nutrients, such as dietary soluble and insoluble fibers, proteins, omega-3 fatty acids, prebiotic polysaccharides, polyphenols, and carotenoids. Owing to the rich nutrients, seaweeds and seaweed extract can be used as functional ingredients by modifying the nutrients composition to reduce the proportion of available carbohydrates, delaying the gastric emptying time and the absorption rate of glucose by increasing the digesta viscosity, and attenuating the digesting rate by blocking the activity of digestive enzymes. This review presents the concept of using seaweed as unconventional ingredients that can function synergistically to reduce the glycemic potency of cereal products.

'Old Is Gold': How Traditional Indian Dietary Practices Can Support Pediatric Diabetes Management

Nutrition is crucial for maintaining normal growth, development, and glycemic control in young people with diabetes (PwD). Undue restrictions cause nutrient deficiencies as well as poor adherence to meal plans. Widespread availability of low-cost, ultra-processed, and hyperpalatable food is further damaging. Most families struggle to find ways to provide nutritious, yet attractive, food with a low glycemic index (GI). India is one of the oldest continuous civilizations with a rich and diverse cultural and culinary heritage. Traditional dietary practices, including the centuries-old 'Thali' (meaning plate) concept, emphasize combinations (grains, lentils, vegetables, dairy, spices, prebiotics and probiotics, and fats) of local, seasonal, and predominantly plant-based ingredients. These practices ensure that all of the necessary food groups are provided and fit well with current evidence-based recommendations, including the International Society for Pediatric and Adolescent Diabetes (ISPAD) 2018 Guidelines. Techniques for the preparation, cooking, and preservation of food further impact the GI and nutrient availability. These practices benefit nutrient density, diet diversity, and palatability and thus improve adherence to meal plans and glycemic control. This narrative review describes the ancient wisdom, food composition, and culinary practices from across India which are still valuable today. These may be of benefit worldwide to improve glycemic control as well as quality of life, especially in PwD.

Effect of Intake of Food Hydrocolloids of Bacterial Origin on the Glycemic Response in Humans: Systematic Review and Narrative Synthesis

Diabetes mellitus is a chronic condition characterized by increased blood glucose levels from dysfunctional carbohydrate metabolism. Dietary intervention can help to prevent and manage the disease. Food hydrocolloids have been shown to have favorable properties in relation to glycaemic regulation. However, the use of food hydrocolloids of bacterial origin to modulate glucose responses is much less explored than other types of hydrocolloids. We, therefore, carried out the first review examining the impact of intake of food hydrocolloids of bacterial origin (as a direct supplement or incorporated into foods) on glycemic response in humans. Fourteen studies met the inclusion criteria. They used either xanthan gum, pullulan, or dextran as interventions. There was a wide variation in the amount of hydrocolloid supplementation provided and methods of preparation. Postprandial blood glucose responses were reduced in half of the studies, particularly at higher intake levels and longer chain hydrocolloids. When xanthan gum was added to the cooking process of muffins and rice, a significant reduction in postprandial blood glucose was observed. The use of these hydrocolloids is potentially effective though more research is needed in this area.

Oat-Based Foods: Chemical Constituents, Glycemic Index, and the Effect of Processing

The desire for foods with lower glycemic indices has led to the exploration of functional ingredients and novel food processing techniques. The glycemic index (GI) is a well-recognized tool to assess the capacity of foods to raise blood glucose levels. Among cereal crops, oats have shown the greatest promise for mitigating glycemic response. This review evaluated decades of research on the effects of oat components on the GI level of oat-based foods with specific emphasis on oat starch, β-glucans, proteins, and phenolics. The effects of commonly used processing techniques in oats on GI level, including heating, cooling, and germination were also discussed. In addition, the GI of oat-based foods in various physical formats such as whole grain, flakes, and flour was systematically summarized. The aim of this review was to synthesize knowledge of the field and to provide a deeper understanding of how the chemical composition and processing of oats affect GI, thereby further benefiting the development of low-GI oat foods.

Gelatinisation and milling whole-wheat increases postprandial blood glucose: randomised crossover study of adults with type 2 diabetes

AIMS/HYPOTHESES

We examined the effects of milling and cooking whole grains in water to achieve starch gelatinisation on postprandial blood glucose using a randomised crossover open-label design. Participants were adults with type 2 diabetes whose body weight or medications had not changed in at least 3 months.

METHODS

Postprandial blood glucose (measured as incremental AUC [iAUC]) was measured following consumption of four nutrient-matched whole-wheat porridge test-meals. Test-meals included gelatinised or native starch and were made with either finely milled or intact whole-wheat.

RESULTS

Eighteen adults (63.1 ± 9.8 years, HbA_1c 57.0 ± 11.5 mmol/mol [7.4 ± 3.2%]) completed the study. iAUC was higher following cooked meals (gelatinised starch) than following uncooked meals (native starch) (mean difference [MD] 268, 95% CI 188, 348 mmol/l × min). Consuming finely milled whole-wheat produced a higher iAUC compared with intact whole-wheat (MD 173, 95% CI 80, 266 mmol/l × min). There was no evidence of an interaction effect (p = 0.841).

CONCLUSIONS

Both the nature of starch and the grain structure of whole-wheat influence the glycaemic response of adults with type 2 diabetes mellitus.

FUNDING

Baking Industry Research Trust of New Zealand and the Riddet Centre of Research Excellence.

TRIAL REGISTRATION

www.anzctr.org.au ACTRN12617000328370.

Comparison of the Effects of a Bean-Based and a White Rice-Based Breakfast Diet on Postprandial Glucose and Insulin Levels in Chinese Patients with Type 2 Diabetes

BACKGROUND This study compared the effects of a bean-based and a white rice-based breakfast diet on postprandial glucose and insulin levels in Chinese patients with type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS We recruited 63 patients with T2DM. The patients participated in the randomized 2×2 crossover trial. The bean-based diet group and white rice control group were matched for 50 g of available carbohydrate at breakfast. The patients followed the diets for 3 days. Vein blood samples were collected at 0, 30, 60, 120, and 180 min after eating. Data were analyzed using a repeated-measures analysis of variance. The results are expressed as the mean±standard error of mean (SEM) or as the median with interquartile range values. RESULTS Compared with the white rice control, postprandial glucose was significantly lower with the bean-based diet treatments at 60 min (P=0.004), 120 min (P=0.000), and 180 min (P=0.000). The insulin levels of the bean-based diet group were significantly higher at 60 min (P=0.013). The C-peptide levels of the bean-based diet group were significantly higher at 30 min (P=0.042) and 60 min (P=0.005) postprandial. The glucose area under the curve (AUC) showed a similar trend (P=0.000). There were no statistically significant differences in the AUC of insulin and C-peptide, except C-peptide AUC at 0 to 60 min (P=0.027). CONCLUSIONS Compared with a white rice-based breakfast, a bean-based diet significantly reduced postprandial glucose levels and promoted insulin secretion. These results support a dietary approach to reduce postprandial hyperglycemia.

Impact of processing techniques on the glycemic index of rice

Rice is an important starchy staple food and generally, rice varieties are known to have a higher glycemic index (GI). Over the years, the significance of GI on human health is being better understood and is known to be associated with several lifestyle disorders. Apart from the intrinsic characteristics of rice, different food processing techniques are known to have implications on the GI of rice. This work details the effect of domestic and industrial-level processing techniques on the GI of rice by providing an understanding of the resulting physicochemical changes. An attempt has been made to relate the process-dependent digestion behavior, which in turn reflects on the GI. The role of food constituents is elaborated and the various in vitro and in vivo approaches that have been used to determine the GI of foods are summarized. Considering the broader perspective, the effect of cooking methods and additives is explained. Given the significance of the cereal grain, this work concludes with the challenges and key thrust areas for future research.