Multifaceted dietary approaches for lowering postprandial glycemia: Applications to medical foods.

摘要

Strict blood glucose control has been shown to be an effective method for delaying the onset and progression of diabetes related complications. Novel ingredients may be added to carbohydrate containing food products which may attenuate postprandial glycemia. Three studies were conducted, all with nondiabetic adults. The first explored whether a small dose of fructose administered before or simultaneously with a high glycemic index starchy food decreases postprandial glycemic response. The positive incremental area under the glucose curve was reduced 25 and 27% (P 0.01) only when fructose was fed 60 or 30 min before the meal, respectively.; In the second study, the glycemic, insulinemic and breath hydrogen responses to food starch esterified with 1-octenyl succinic anhydride (OSA) were compared to a glucose control solution. With the OSA beverage, peak plasma glucose concentration was reduced 8% (P 0.03) and peak insulin concentration was decreased 28% (P 0.004). Similarly, OSA reduced (P 0.05) the area under the curve for both plasma glucose and insulin. The number of positive breath hydrogen (BH) tests with the OSA-substituted starch suggests that the lowered glycemic response is at least partially due to small intestinal malabsorption of OSA.; In the third study, beverages containing 3 doses of salacinol herbal extract were administered (500 mg, 700 mg, and 1000 mg). Incremental area under the curve (AUC) was reduced for both glycemic (P = 0.03) and insulinemic (P = 0.002) responses postprandially with the beverage containing 1000 mg salacinol. The AUC for BH was greater for all 3 beverages compared to the control (0 mg) (P = 0.0006, P 0.0001 and P 0.0001 respectively). The beverage containing 1000 mg of salacinol produced an increase in reported abdominal distention (P = 0.020) and flatulence ( P = 0.002). BH results and gastrointestinal intolerance suggest that the decreases in glycemia and insulinemia with the 1000 mg dose of salacinol are at least partially due to incomplete carbohydrate digestion.; In summary, fructose, OSA and salacinol all decrease postprandial glycemia by different mechanisms and may have applications in food products.