Postprandial glycaemic response of foxtail millet dosa in comparison to a rice dosa in patients with type 2 diabetes

Use of ancient grains for the management of diabetes mellitus: A systematic review and meta-analysis

AIMS

A systematic review and meta-analysis of published randomized controlled trials was conducted to collate evidence from studies implementing ancient grains and investigate the impact of ancient grain consumption on health outcomes of patients with Diabetes Mellitus (DM).

DATA SYNTHESIS

Twenty-nine randomized controlled trials were included, and 13 were meta-analyzed. Interventions ranged from 1 day to 24 weeks; most samples were affected by DM type 2 (n = 28 studies) and the ancient grains used were oats (n = 10 studies), brown rice (n = 6 studies), buckwheat (n = 4 studies), chia (n = 3 studies), Job's Tears (n = 2 studies), and barley, Khorasan and millet (n = 1 study). Thirteen studies that used oats, brown rice, and chia provided data for a quantitative synthesis. Four studies using oats showed a small to moderate beneficial effect on health outcomes including LDL-c (n = 717, MD: 0.30 mmol/l, 95% CI: 0.42 to -0.17, Z = 4.61, p < 0.05, I2 = 0%), and TC (n = 717, MD: 0.44 mmol/l, 95% CI: 0.63 to -0.24, Z = 4.40, p < 0.05, I2 = 0%). Pooled analyses of studies using chia and millet did not show significant effects on selected outcomes.

CONCLUSIONS

For adults affected by DM type 2, the use of oats may improve lipidic profile. Further experimental designs are needed in interventional research to better understand the effects of ancient grains on diabetes health outcomes.

PROSPERO REGISTRATION

CRD42023422386.

Effects of Mulberry Leaf Fu Tea on the Intestines and Intestinal Flora of Goto-Kakizaki Type 2 Diabetic Rats

Type 2 diabetes mellitus is a disease caused by hyperglycemia, an imbalance in the intestinal flora and disruption of the endocrine system. At present, it is primarily controlled through drug treatment and an improved diet. Mulberry leaf and fu brick tea were considered to have excellent hypoglycemic effects. This study used mulberry leaves and fu brick tea as raw materials to develop a dietary regulator that can assist in the prevention and alleviation of diabetes. The experiment used the Goto-Kakizaki (GK) rat model to investigate the hypoglycemic effect of mulberry leaf fu tea (MFT) and its influence on the intestinal flora of diabetic rats through methods including ELISA, tissue section observation and 16S RNA microbial sequencing. The results showed that, compared with the GK group, the intervention of mulberry leaf fu tea significantly reduced the activities of α-glucosidase (p < 0.05) and α-amylase (p < 0.05) in the duodenum of GK diabetic rats. The height of the duodenal villi was significantly reduced (p < 0.001), leading to decreased intestinal sugar absorption. At the same time, MFT alleviates the imbalance of intestinal flora caused by high blood sugar, promotes the growth of beneficial bacteria (Lactobacillus, Bifidobacterium, etc.), and inhibits the reproduction of harmful bacteria (Blautia, Klebsiella, Helicobacter, Alistipes, etc.). MFT helps reduce the secretion of toxic substances (lipopolysaccharide, p < 0.001), decreases oxidative stress and inflammation, mitigates organ damage, and improves symptoms of diabetes. Finally, the random blood glucose value of GK rats dropped from 22.79 mmol/L to 14.06 mmol/L. In summary, mulberry leaf fu tea can lower sugar absorption in diabetic rats, reduce the body's oxidative stress and inflammatory response, regulate intestinal flora, and reduce blood sugar levels in GK rats. It is hinted that mulberry leaf fu tea could be used as a functional drink to help prevent the occurrence of diabetes.

Exploring the underutilized novel foods and starches for formulation of low glycemic therapeutic foods: a review

Rising incidences of life-style disorders like obesity, diabetes and cardiovascular diseases are a matter of concern coupled with escalated consumption of highly refined and high energy foods with low nutrient density. Food choices of consumers have witnessed significant changes globally with rising preference to highly processed palatable foods. Thus, it calls food scientists, researchers and nutritionists' attention towards developing and promoting pleasant-tasting yet healthy foods with added nutritional benefits. This review highlights selected underutilized and novel ingredients from different food sources and their by-products that are gaining popularity because of their nutrient density, that can be employed to improve the nutritional quality of conventionally available empty-calorie foods. It also emphasizes on the therapeutic benefits of foods developed from these understudied grains, nuts, processing by-products of grains, fruits- and vegetable-byproducts and nutraceutical starches. This review aims to draw attention of food scientists and industrialists towards popularizing the utilization of these unconventional, yet nutrient rich foods sources in improving the nutritional profile of the conventional foods lacking in nutrient density.

Assessment of sensory and nutritional attributes of foxtail millet-based food products

Millets are a rich source of many health-promoting nutrients as well as bioactive compounds such as dietary fibers, antioxidants, macro and micronutrients etc., compared to other staple cereals such as rice, wheat and maize. These nutrients play a central role in the world nutritional security. Despite the inbuilt nutritional benefits, the production of millets has witnessed sharp decline owing to taste preferences, keeping quality and challenges associated with food preparation from millets. To sensitize the consumers about the nutritional benefits of foxtail millet, the present study was planned to formulate and nutritionally evaluate eight diversified foxtail millet-based food products namely rusk, kheer, pinni, sattu, vegetable dalia, cookies, bar and papad by replacing commonly used cereals such as wheat and rice. The products prepared from Foxtail millet were found to have high acceptability with mean score of more than 8.00. These diversified food products showed higher protein content ranging from 10.98 to 16.10 g/100 g, with the highest protein found in Foxtail millet kheer (16.01 g/100 g). The resistant starch content and predicted glycemic index (PGI) of these products ranged between 13.67 to 22.61 g/100 g and 46.12 to 57.55, respectively, with the highest resistant starch (22.61 ± 0.69 g/100 g) and lowest PGI (48.42 ± 0.20) found in millet bar. The high resistant starch and low PGI in foxtail millet products suggest that they could serve as an excellent food source suitable for diabetics. The obtained results suggest that all the Foxtail millet-based value-added products have superior nutrient profile and are highly acceptable than the traditional products. Inclusion of these foods in the diets of the population may help in the prevention of malnutrition and type 2 diabetes.

What is the Modern Human Eating? Dietary Transition of the Age-Old to the Modern Man of India

Objectives: The objective of this review is to examine the changes in food consumption pattern of Indians over the years and to recommend evidence-based policy making regarding all the factors affecting food consumption. Methods: We have reviewed the articles from major databases such as PubMed and Google Scholar. The keywords used for the search included dietary pattern, dietary trend, dietary intake, food system, nutrition system, prehistoric food systems, drought, famine, whole grains, diets, prices, income, environment, urban food consumption, processed foods, food security, food preferences, demographic transition, fat intake, food production, public distribution system, food consumption pattern, Indian agriculture, and India. Results: There is no facilitating environment for the production and cultivation of healthy and sustainable food. Conclusion: Policymakers should make major amendments to food and agricultural policies, and demotivate the consumption of junk food.

Improvement of nutrient bioavailability in millets: Emphasis on the application of enzymes

Millets are a traditional staple food of the dryland regions of the world and are rich in essential nutrients like protein, fatty acids, minerals, vitamins, and dietary fiber. Also, millets commonly synthesize a range of secondary metabolites to protect themselves against adverse conditions. These factors are collectively termed anti-nutritional factors and the existence of these factors in millets might reduce the accessibility of the nutrients in humans. Some of these factors include protease inhibitors, tannins, non-starch polysaccharides-glucans, phytates, and oxalates each of which might directly or indirectly affect the digestibility of nutrients. Methods like soaking, germination, autoclaving, debranning, and the addition of exogenous enzymes have been used to reduce the anti-nutritional factors and elevate the bioavailability of the nutrients. This review summarizes various methods that have been used to improve nutrient bioavailability, specifically emphasizing the use of enzymes to improve nutrient bioavailability from millets. © 2021 Society of Chemical Industry.

A Systematic Review and Meta-Analysis of the Potential of Millets for Managing and Reducing the Risk of Developing Diabetes Mellitus

Millets (including sorghum) are known to be highly nutritious besides having a low carbon footprint and the ability to survive in high temperatures with minimal water. Millets are widely recognised as having a low Glycaemic Index (GI) helping to manage diabetes. This systematic review and meta-analyzes across the different types of millets and different forms of processing/cooking collated all evidences. Of the 65 studies that were collected globally, 39 studies with 111 observations were used to analyze GI outcomes and 56 studies were used to analyze fasting, post-prandial glucose level, insulin index and HbA1c outcomes in a meta-analysis. It is evident from the descriptive statistics that the mean GI of millets is 52.7 ± 10.3, which is about 36% lower than in typical staples of milled rice (71.7 ± 14.4) and refined wheat (74.2 ± 14.9). The descriptive, meta and regression analyses revealed that Job's tears, fonio, foxtail, barnyard, and teff were the millets with low mean GI (<55) that are more effective (35–79%) in reducing dietary GI than the control samples. Millets with intermediate GI (55–69) are pearl millet, finger millet, kodo millet, little millet, and sorghum which have a 13–35% lower GI than the control with high GI (>69). A meta-analysis also showed that all millets had significantly (p < 0.01) lower GI than white rice, refined wheat, standard glucose or white wheat bread except little millet which had inconsistent data. Long term millet consumption lowered fasting and post-prandial blood glucose levels significantly (p < 0.01) by 12 and 15%, respectively, in diabetic subjects. There was a significant reduction in HbA1c level (from 6.65 ± 0.4 to 5.67 ± 0.4%) among pre-diabetic individuals (p < 0.01) who consumed millets for a long period. Minimally processed millets were 30% more effective in lowering GI of a meal compared to milled rice and refined wheat. In conclusion, millets can be beneficial in managing and reducing the risk of developing diabetes and could therefore be used to design appropriate meals for diabetic and pre-diabetic subjects as well as for non-diabetic people for a preventive approach.

Lessons From the Aftermaths of Green Revolution on Food System and Health

Food production has seen various advancements globally in developing countries, such as India. One such advancement was the green revolution. Notably, the World Bank applauds the introduction of the green revolution as it reduced the rural poverty in India for a certain time. Despite the success of the green revolution, the World Bank reported that health outcomes have not been improved. During the post-green revolution period, several notable negative impacts arose. Exclusive studies were not conducted on the benefits and harms before the introduction of the green revolution. Some of such interventions deviate from the natural laws of balance and functioning and are unsustainable practices. To avoid the adverse effects of some of these developments, a review of these interventions is necessary.

A glycaemic index compendium of non-western foods

Current international tables published on the glycaemic index (GI) of foods represent valuable resources for researchers and clinicians. However, the vast majority of published GI values are of Western origin, notably European, Australian and North American. Since these tables focus on Western foods with minimal inclusion of other foods from non-Western countries, their application is of limited global use. The objective of this review is to provide the GI values for a variety of foods that are consumed in non-Western countries. Our review extends and expands on the current GI tables in an attempt to widen its application in many other regions of the world.

Glycemic index of millet based food mix and its effect on pre diabetic subjects

Diet plays an important role in management of diabetes and foods having low glycemic index are gaining more importance as they delay the release of glucose in the blood. It is essential to develop low glycemic food mix from regionally available ingredients for use in daily dietaries. Hence, the present study was undertaken to assess the glycemic index of the traditional recipes prepared from developed millet based food mix and their effect on pre diabetic subjects. The developed millet based food mix had appreciable amount of protein (19.41 g/100 g) and dietary fibre (21.11 g/100 g). The traditional recipes viz., roti, dosa and dumpling (mudde) prepared from developed mix exhibited higher acceptance with good sensory parameters and are comparable to regional preparations. The glycemic index was found to be 37, 48 and 53 for dosa, mudde and roti respectively with a glycemic load of 11.05, 18.43 and 18.09. However, all the three developed products showed the relatively lower glycemic index (< 55) and moderate glycemic load of < 20. Further, dietary intervention on pre diabetic subjects revealed that there was a significant reduction in FBS (120.50 ± 18.73 to 97.81 ± 20.00) and HbA1c (6.14 ± 0.30 to 5.67 ± 0.40) indicating their preferable option in the management of diabetes mellitus.

Genetic Variation of Physicochemical Properties and Digestibility of Foxtail Millet (Setaria italica) Landraces of Taiwan

Foxtail millet is considered a 'smart food' because of nutrient richness and resilience to environments. A diversity panel of 92 foxtail millet landraces preserved by Taiwan indigenous peoples containing amylose content (AC) in the range of 0.7% to 16.9% exhibited diverse physiochemical properties revealed by a rapid viscosity analyzer (RVA). AC was significantly correlated with 5 RVA parameters, and some RVA parameters were also highly correlated with one another. In comparison to rice, foxtail millet contained less starch (65.9-73.1%) and no significant difference in totals of resistant starch (RS), slowly digestible starch (SDS), hydrolysis index (HI), and expected glycemic index (eGI) according to in vitro digestibility assays of raw flour with similar AC. RS was significantly positively correlated with AC and four RVA parameters, cold paste viscosity (CPV), setback viscosity (SBV), peak time (PeT), and pasting temperature (PaT), implying that suitable food processing to alter physicochemical properties of foxtail millet might mitigate hyperglycemia. This investigation of pasting properties and digestibility of diverse foxtail millet germplasm revealed much variation and showed potential for multi-dimensional utilizations in daily staple food and food industries.

Nutrition therapy within and beyond gestational diabetes

With the global rising prevalence of gestational diabetes (GDM), an adaptable, economical approach to nutrition therapy that effectively controls maternal glycemia while promoting normal fetal growth will have far-reaching implications. The conventional focus has been to rigidly limit all types of carbohydrate. While controlling glucose, this approach fosters maternal anxiety and is a primary barrier to adherence. Many mothers substitute fat for carbohydrate, which may unintentionally enhance lipolysis, promote elevated free fatty acids (FFA), and worsen maternal insulin resistance (IR). Nutrition that worsens IR may facilitate nutrient shunting across the placenta, promoting excess fetal fat accretion. Evidence suggests that liberalizing higher quality, nutrient-dense carbohydrates results in controlled fasting/postprandial glucose, lower FFA, improved insulin action, vascular benefits, and may reduce excess infant adiposity. Thus, a less carbohydrate-restricted approach may improve maternal adherence when combined with higher quality carbohydrates, lower fat, appropriate caloric intake, and ethnically acceptable foods. Such a diet can be culturally sensitive, socioeconomically attentive, minimize further weight gain in GDM, with potential relevance for pregnancies complicated by overweight/obesity. Future research is needed to better understand the effect of macronutrient composition on the placenta and gut microbiome, the benefits/risks of nonnutritive sweeteners, and whether precision-nutrition is beneficial in pregnancy.

The Glucose-Lowering Effect of Foxtail Millet in Subjects with Impaired Glucose Tolerance: A Self-Controlled Clinical Trial

Foxtail millet has relatively low starch digestibility and moderate glycemic index compared to other grains. Since there are still no clinical researches regarding its long-term effect on blood glucose, this self-controlled study was conducted to investigate the glucose-lowering effect of foxtail millet in free-living subjects with impaired glucose tolerance (IGT). Fifty g/day of foxtail millet was provided to enrolled subjects throughout 12 weeks and the related clinical parameters were investigated at week 0, 6 and 12, respectively. After 12 weeks of foxtail millet intervention, the mean fasting blood glucose of the subjects decreased from 5.7 ± 0.9 mmol/L to 5.3 ± 0.7 mmol/L (p < 0.001) and the mean 2 h-glucose decreased from 10.2 ± 2.6 mmol/L to 9.4 ± 2.3 mmol/L (p = 0.003). The intake of foxtail millet caused a significant increase of serum leptin (p = 0.012), decrease of insulin resistance (p = 0.007), and marginal reduction of inflammation. Furthermore, a sex-dependent difference in glucose-lowering effect of foxtail millet was observed in this study. Foxtail millet could improve the glycemic control in free-living subjects with IGT, suggesting that increasing the consumption of foxtail millet might be beneficial to individuals suffering from type 2 diabetes mellitus.