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Ethnic Variability in Glycemic Response to Sucrose and Isomaltulose.
Tan, WS, Tan, SY, Henry, CJ
Nutrients. 2017;(4)
Abstract
The aim of this study was to compare the glycemic response of Caucasians and Asians to two disaccharides of different glycemic index (GI), and to examine if ethnic groups that showed the largest glycemic response to sucrose would benefit the most when it is replaced with isomaltulose. Forty healthy participants (10 Chinese; 10 Malays; 10 Caucasians; and 10 Indians) consumed beverages containing 50 g of sucrose or isomaltulose on two separate occasions using a randomized crossover design. Capillary blood glucose was measured in a fasted state and at 15, 30, 45, 60, 90, and 120 min after beverage ingestion. Glycemic response to sucrose was significantly higher in Malays compared to Caucasians (p = 0.041), but did not differ between Caucasians vs. Chinese (p = 0.145) or vs. Indians (p = 0.661). When sucrose was replaced with isomaltulose, glycemic responses were significantly reduced in all ethnic groups, with the largest reduction in glycemic response being observed in Malays. Malays, who had the greatest glycemic response to sucrose, also showed the greatest improvement in glycemic response when sucrose was replaced with isomaltulose. This implies that Malays who are more susceptible to type 2 diabetes mellitus may benefit from strategies that replace high GI carbohydrate with lower GI alternatives to assist in glycemic control.
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Consumption of Honey, Sucrose, and High-Fructose Corn Syrup Produces Similar Metabolic Effects in Glucose-Tolerant and -Intolerant Individuals.
Raatz, SK, Johnson, LK, Picklo, MJ
The Journal of nutrition. 2015;(10):2265-72
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Abstract
BACKGROUND Public health recommendations call for a reduction in added sugars; however, controversy exists over whether all nutritive sweeteners produce similar metabolic effects. OBJECTIVE The objective was to compare the effects of the chronic consumption of 3 nutritive sweeteners [honey, sucrose, and high-fructose corn syrup containing 55% fructose (HFCS55)] on circulating glucose, insulin, lipids, and inflammatory markers; body weight; and blood pressure in individuals with normal glucose tolerance (GT) and those with impaired glucose tolerance (IGT). METHODS In a crossover design, participants consumed daily, in random order, 50 g carbohydrate from assigned sweeteners for 2 wk with a 2- to 4-wk washout period between treatments. Participants included 28 GT and 27 IGT volunteers with a mean age of 38.9 ± 3.6 y and 52.1 ± 2.7 y, respectively, and a body mass index (in kg/m(2)) of 26 ± 0.8 and 31.5 ± 1.0, respectively. Body weight, blood pressure (BP), serum inflammatory markers, lipids, fasting glucose and insulin, and oral-glucose-tolerance tests (OGTTs) were completed pre- and post-treatment. The OGTT incremental areas under the curve (iAUCs) for glucose and insulin were determined and homeostasis model assessment of insulin resistance (HOMA-IR) scores were calculated. RESULTS Body weight and serum glucose, insulin, inflammatory markers, and total and LDL-cholesterol concentrations were significantly higher in the IGT group than in the GT group at baseline. Glucose, insulin, HOMA-IR, and the OGTT iAUC for glucose or insulin did not differ by treatment, but all responses were significantly higher in the IGT group compared with the GT group. Body weight was unchanged by treatment. Systolic BP was unchanged, whereas diastolic BP was significantly lower in response to sugar intake across all treatments. An increase in high-sensitivity C-reactive protein (hsCRP) was observed in the IGT group in response to all sugars. No treatment effect was observed for interleukin 6. HDL cholesterol did not differ as a result of status or treatment. Triglyceride (TG) concentrations increased significantly from pre- to post-treatment in response to all sugars tested. CONCLUSIONS Daily intake of 50 g carbohydrate from honey, sucrose, or HFCS55 for 14 d resulted in similar effects on measures of glycemia, lipid metabolism, and inflammation. All 3 increased TG concentrations in both GT and IGT individuals and elevated glycemic and inflammatory responses in the latter. This trial was registered at clinicaltrials.gov as NCT01371266.
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Effect of sugars in solutions on subjective appetite and short-term food intake in 9- to 14-year-old normal weight boys.
Van Engelen, M, Khodabandeh, S, Akhavan, T, Agarwal, J, Gladanac, B, Bellissimo, N
European journal of clinical nutrition. 2014;(7):773-7
Abstract
BACKGROUND AND OBJECTIVE The role of sugars in solutions on subjective appetite and food intake (FI) has received little investigation in children. Therefore, we examined the effect of isocaloric solutions (200 kcal/250 ml) of sugars including sucrose, high-fructose corn syrup-55 (HFCS) or glucose, compared with a non-caloric sucralose control, on subjective appetite and FI in 9- to 14-year-old normal weight (NW) boys. PARTICIPANTS AND METHODS NW boys (n=15) received each of the test solutions, in random order, 60 min before an ad libitum pizza meal. Subjective appetite was measured at baseline (0 min), and 15, 30, 45 and 60 min. RESULTS Only glucose (P=0.003), but neither sucrose nor HFCS, reduced FI compared with the sucralose control. This led to a higher cumulative energy intake, compared with sucralose, after sucrose (P=0.009) and HFCS (P=0.01), but not after glucose. In all treatment sessions, subjective average appetite increased from baseline to 60 min, but change from baseline average appetite was the highest after sucrose (P<0.005). Furthermore, sucrose (r=-0.59, P=0.02) and HFCS (r=-0.56, P=0.03), but not glucose, were inversely associated with test meal FI when the treatment dose (200 kcal) was expressed on a body weight (kg) basis. CONCLUSIONS Change from baseline subjective average appetite was the highest after sucrose, but only the glucose solution suppressed FI at the test meal 60 min later in NW boys.
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Consumption of fructose-sweetened beverages for 10 weeks reduces net fat oxidation and energy expenditure in overweight/obese men and women.
Cox, CL, Stanhope, KL, Schwarz, JM, Graham, JL, Hatcher, B, Griffen, SC, Bremer, AA, Berglund, L, McGahan, JP, Havel, PJ, et al
European journal of clinical nutrition. 2012;(2):201-8
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BACKGROUND/OBJECTIVES The results of short-term studies in humans suggest that, compared with glucose, acute consumption of fructose leads to increased postprandial energy expenditure and carbohydrate oxidation and decreased postprandial fat oxidation. The objective of this study was to determine the potential effects of increased fructose consumption compared with isocaloric glucose consumption on substrate utilization and energy expenditure following sustained consumption and under energy-balanced conditions. SUBJECTS/METHODS As part of a parallel arm study, overweight/obese male and female subjects, 40-72 years, consumed glucose- or fructose-sweetened beverages providing 25% of energy requirements for 10 weeks. Energy expenditure and substrate utilization were assessed using indirect calorimetry at baseline and during the 10th week of intervention. RESULTS Consumption of fructose, but not glucose, led to significant decreases of net postprandial fat oxidation and significant increases of net postprandial carbohydrate oxidation (P<0.0001 for both). Resting energy expenditure (REE) decreased significantly from baseline values in subjects consuming fructose (P=0.031) but not in those consuming glucose. CONCLUSIONS Increased consumption of fructose for 10 weeks leads to marked changes of postprandial substrate utilization including a significant reduction of net fat oxidation. In addition, we report that REE is reduced compared with baseline values in subjects consuming fructose-sweetened beverages for 10 weeks.
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Postprandial glucose, insulin, and free fatty acid responses to sucrose consumed with blackcurrants and lingonberries in healthy women.
Törrönen, R, Kolehmainen, M, Sarkkinen, E, Mykkänen, H, Niskanen, L
The American journal of clinical nutrition. 2012;(3):527-33
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BACKGROUND Sucrose induces high postprandial glucose and insulin responses. In vitro studies suggest that berries may reduce the digestion and absorption of sucrose and thereby suppress postprandial glycemia, but the evidence in humans is limited. OBJECTIVE We investigated the effects of sucrose ingested with blackcurrants (Ribes nigrum) and lingonberries (Vaccinium vitis-idaea) on postprandial glucose, insulin, and free fatty acid responses. DESIGN Twenty healthy women participated in a randomized, controlled, crossover meal study. They consumed whole blackcurrants or lingonberries (150 g served as purées) or blackcurrant or lingonberry nectars (300 mL), each with 35 g added sucrose. Sucrose alone (35 g in 300 mL water) was used as a reference. Blood samples were collected at 0, 15, 30, 45, 60, 90, and 120 min. RESULTS In comparison with sucrose alone, ingestion of sucrose with whole berries resulted in reduced glucose and insulin concentrations during the first 30 min and a slower decline during the second hour and a significantly improved glycemic profile. Berries prevented the sucrose-induced late postprandial hypoglycemic response and the compensatory free fatty acid rebound. Nearly similar effects were observed when sucrose was consumed with berry nectars. The improved responses were evident despite the higher content of available carbohydrate in the berry and nectar meals, because of the natural sugars present in berries. CONCLUSIONS Blackcurrants and lingonberries, as either whole berries or nectars, optimize the postprandial metabolic responses to sucrose. The responses are consistent with delayed digestion of sucrose and consequent slower absorption of glucose.
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Intestinal permeability, vitamin A absorption and serum alpha-tocopherol in gastrointestinal stromal tumor patients treated with imatinib.
Melichar, B, Kašparová, M, Kalábová, H, Dvorák, J, Hyšpler, R, Tichá, A, Krcmová, L, Plíšek, J, Holecková, P, Solichová, D
Journal of nutritional science and vitaminology. 2010;(6):347-52
Abstract
Administration of imatinib is the therapy of choice in patients with advanced (inoperable) or metastatic gastrointestinal stromal tumors (GIST). Gastrointestinal toxicity is one of the most common side effects of anticancer therapy, including imatinib. Measurement of intestinal permeability represents a method of noninvasive laboratory assessment of gastrointestinal toxicity. We have measured intestinal permeability (by determining absorption of lactulose, mannitol and xylose), vitamin A absorption and serum alpha-tocopherol in 16 patients with advanced/metastatic GIST treated with imatinib. Lactulose/mannitol and lactulose/xylose ratios as well as parameters of vitamin A absorption did not change significantly during the treatment, but a significant decrease of alpha-tocopherol was observed. We conclude that, in contrast to most other anticancer agents studied so far, imatinib does not have an effect on intestinal permeability. No effect on vitamin A absorption was observed, but serum alpha-tocopherol decreased significantly during the treatment.
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The metabolic fate of doubly labelled lactose-[13C, 15N]ureide after pre-dosing with different ureides.
Wutzke, KD, Mix, J
European journal of clinical nutrition. 2010;(7):733-8
Abstract
BACKGROUND To date, the measurement of the orocaecal transit time (OCTT) with lactose-[(13)C]ureide usually requires a pre-dosing with the analogous substrate in its unlabelled form. OBJECTIVE In this study, the enzyme induction provoked by different unlabelled sugar ureides in OCTT measurements when using doubly labelled lactose-[(13)C, (15)N]ureide (DLLU) was evaluated. METHODS Thirteen healthy adults (age: 22-58 years) received 500 mg DLLU together with a standardized breakfast. Expired air, urine and faeces were collected over a period of 14, 48 and 72 h, respectively. After 1 and 2 weeks, the test was repeated after pre-dosing of 3 x 120 mg glucose ureide (GU) and 3 x 200 mg cellobiose ureide (CU), respectively, on the day before study begin. The (13)C- and (15)N-enrichments were measured by isotope ratio mass spectrometry. The OCTT was calculated by the detection of a significant (13)CO(2) increase. RESULTS In comparison with the period without pre-dosing (7.8+/-2.2 h), the measured OCTT was significantly lowered either after GU pre-dosing (5.8+/-1.9 h, P=0.033) or CU pre-dosing (6.0+/-2.2 h, P=0.039). The respective renal (13)C- and (15)N-excretions amounted to 24.5 and 45.6, 24.7 and 54.0, and 22.5 and 50.1%, respectively, whereas the faecal (13)C- and (15)N-excretions amounted to 12.1 and 45.8, 4.8 and 21.5, and 9.6 and 39.8%, respectively. CONCLUSIONS Pre-dosing with unlabelled GU and CU before the administration of DLLU led to an unequivocal induction of the enzyme activity and resulted in a definitive estimation of the OCTT, clearly demonstrating that glucose-[(13)C]ureide is the matrix of the bacterial degradation in the caecum.
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Relative glycaemic impact of customarily consumed portions of eighty-three foods measured by digesting in vitro and adjusting for food mass and apparent glucose disposal.
Monro, JA, Wallace, A, Mishra, S, Eady, S, Willis, JA, Scott, RS, Hedderley, D
The British journal of nutrition. 2010;(3):407-17
Abstract
Practical values to guide food choices for control of postprandial glycaemia need to refer to entire foods in amounts customarily consumed. We tested an in vitro method for determining the relative glycaemic impact (RGI) of customarily consumed portions of foods. Sugars released during in vitro pancreatic digestion of eighty-three foods were measured as glucose equivalents (GE) per gram of food, adjusted by the glycaemic indexes of the sugars to obtain glycaemic GE (GGE) per gram and multiplied by food portion weight to obtain the GGE contribution of the food portion, its RGI. The results were compared with clinical GGE values from subjects who consumed the same food amounts. In vitro and in vivo GGE values were significantly correlated, but the slope of the regression equation was significantly less than one, meaning in vitro GGE values overestimated in vivo GGE values. Bland-Altman method comparison showed the in vitro-in vivo disparity to increase as mean GGE increased, suggesting the need to allow for different rates of homeostatic blood glucose disposal (GD) due to different GGE doses in the customarily consumed food portions. After GD correction, Bland-Altman method comparison showed that the bias in predicting in vivo GGE values from in vitro GGE values was almost completely removed (y = 0.071x - 0.89; R2 0.01). We conclude that in vitro food values for use in managing the glycaemic impact of customarily consumed food quantities require correction for blood GD that is dependent on the GGE content of the food portions involved.
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Fructose overconsumption causes dyslipidemia and ectopic lipid deposition in healthy subjects with and without a family history of type 2 diabetes.
Lê, KA, Ith, M, Kreis, R, Faeh, D, Bortolotti, M, Tran, C, Boesch, C, Tappy, L
The American journal of clinical nutrition. 2009;(6):1760-5
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BACKGROUND Both nutritional and genetic factors are involved in the pathogenesis of nonalcoholic fatty liver disease and insulin resistance. OBJECTIVE The aim was to assess the effects of fructose, a potent stimulator of hepatic de novo lipogenesis, on intrahepatocellular lipids (IHCLs) and insulin sensitivity in healthy offspring of patients with type 2 diabetes (OffT2D)--a subgroup of individuals prone to metabolic disorders. DESIGN Sixteen male OffT2D and 8 control subjects were studied in a crossover design after either a 7-d isocaloric diet or a hypercaloric high-fructose diet (3.5 g x kg FFM(-1) x d(-1), +35% energy intake). Hepatic and whole-body insulin sensitivity were assessed with a 2-step hyperinsulinemic euglycemic clamp (0.3 and 1.0 mU x kg(-1) x min(-1)), together with 6,6-[2H2]glucose. IHCLs and intramyocellular lipids (IMCLs) were measured by 1H-magnetic resonance spectroscopy. RESULTS The OffT2D group had significantly (P < 0.05) higher IHCLs (+94%), total triacylglycerols (+35%), and lower whole-body insulin sensitivity (-27%) than did the control group. The high-fructose diet significantly increased IHCLs (control: +76%; OffT2D: +79%), IMCLs (control: +47%; OffT2D: +24%), VLDL-triacylglycerols (control: +51%; OffT2D: +110%), and fasting hepatic glucose output (control: +4%; OffT2D: +5%). Furthermore, the effects of fructose on VLDL-triacylglycerols were higher in the OffT2D group (group x diet interaction: P < 0.05). CONCLUSIONS A 7-d high-fructose diet increased ectopic lipid deposition in liver and muscle and fasting VLDL-triacylglycerols and decreased hepatic insulin sensitivity. Fructose-induced alterations in VLDL-triacylglycerols appeared to be of greater magnitude in the OffT2D group, which suggests that these individuals may be more prone to developing dyslipidemia when challenged by high fructose intakes. This trial was registered at clinicaltrials.gov as NCT00523562.
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Increased sucrose intake is not associated with a change in glucose or insulin sensitivity in people with type 2 diabetes.
Brynes, AE, Frost, GS
International journal of food sciences and nutrition. 2007;(8):644-51
Abstract
BACKGROUND Debate continues over the role of sucrose and sucrose-containing food in the diet for people with type 2 diabetes. Traditionally, dietary recommendations have suggested sucrose be reduced to a minimum level to improve glycaemic control. More recently the American Diabetes Association evidence-based guidelines have suggested a more liberal approach. OBJECTIVE To investigate whether a 50 g increase in sucrose given as three slices of cake a day over a period of 24 days (88 +/- 7.5 g total sucrose/day) in combination with an increased monounsaturated fat intake (20% E) in line with current American Diabetes Association recommendations has an effect on glycaemic control or insulin sensitivity in people with type 2 diabetes. DESIGN We re-examined results from a larger study that investigated the type of fat in the diet of people with type 2 diabetes. Nine overweight people with type 2 diabetes received a high-sucrose, high-monounsaturated-fat isocaloric diet for 24 days. Results Weight and glycaemic control remained stable throughout the study. There was no significant change in HbAlc over the study period. There was no change in insulin sensitivity, measured by the short insulin tolerance test. There was no change in fasting or postprandial incremental area under the curve in response to an identical standard test meal for glucose or insulin. CONCLUSIONS Over the 3-week intervention period, an isocaloric increase in the dietary intakes of sucrose to 13% of total energy per day in people with type 2 diabetes was not associated with a decline in glycaemic control or insulin sensitivity.