1.
Impact of postprandial glycaemia on health and prevention of disease.
Blaak, EE, Antoine, JM, Benton, D, Björck, I, Bozzetto, L, Brouns, F, Diamant, M, Dye, L, Hulshof, T, Holst, JJ, et al
Obesity reviews : an official journal of the International Association for the Study of Obesity. 2012;(10):923-84
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Abstract
Postprandial glucose, together with related hyperinsulinemia and lipidaemia, has been implicated in the development of chronic metabolic diseases like obesity, type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). In this review, available evidence is discussed on postprandial glucose in relation to body weight control, the development of oxidative stress, T2DM, and CVD and in maintaining optimal exercise and cognitive performance. There is mechanistic evidence linking postprandial glycaemia or glycaemic variability to the development of these conditions or in the impairment in cognitive and exercise performance. Nevertheless, postprandial glycaemia is interrelated with many other (risk) factors as well as to fasting glucose. In many studies, meal-related glycaemic response is not sufficiently characterized, or the methodology with respect to the description of food or meal composition, or the duration of the measurement of postprandial glycaemia is limited. It is evident that more randomized controlled dietary intervention trials using effective low vs. high glucose response diets are necessary in order to draw more definite conclusions on the role of postprandial glycaemia in relation to health and disease. Also of importance is the evaluation of the potential role of the time course of postprandial glycaemia.
2.
The glycaemic index: importance of dietary fibre and other food properties.
Björck, I, Elmståhl, HL
The Proceedings of the Nutrition Society. 2003;(1):201-6
Abstract
An increasing body of evidence suggests that a low-glycaemic-index (GI) diet has a therapeutic as well as a preventive potential in relation to the insulin resistance syndrome. The implementation of a low-GI diet, however, will require an extended list of low-GI foods to be available on the market. The tailoring of low-GI bread products offers a particular challenge due to their generally high GI and abundance in the diet. Low-GI bread products can be tailored by, for example,enclosure of cereal kernels, sour dough fermentation and/or addition of organic acids, or use of cereal genotypes with elevated contents of amylose or f-glucans. Low-GI cereal foods appear to vary in effect on 'second-meal' glucose tolerance in healthy subjects. In addition to the slow-release properties of such foods, the content of dietary fibre appears to play a role. The low glycaemia to starch in a pasta breakfast (GI 54) promoted a higher glucose tolerance and lowered triacylglycerol levels at a standardized lunch ingested 4 h later, compared with a white-wheat-bread breakfast (GI 100). The metabolic benefits of the low GI properties per se have been demonstrated also in the longer term. Thus, a reduction in dietary GI improved glucose and lipid metabolism and normalized fibrinolytic activity in type 2 diabetics, while maintaining a similar amount and composition of dietary fibre. However, the higher dietary fibre content frequently associated with low-GI foods may add to the metabolic merits of a low-GI diet. Consequently, a low-GI barley meal rich in dietary fibre (GI 53) improved glucose tolerance from evening meal to breakfast, whereas an evening meal with pasta had no effect (GI 54). The exchange of common high-GI bread for low-GI high-fibre bread, as the only dietary modification, improved insulin economy in women at risk of type 2 diabetes. These results are in accordance with epidemiological evidence of a reduced risk of type 2 diabetes with a low-GI diet rich in cereal fibre. It is concluded that low-GI cereal foods developed should preferably be rich in dietary fibre.
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Low glycaemic-index foods.
Björck, I, Liljeberg, H, Ostman, E
The British journal of nutrition. 2000;:S149-55
Abstract
Accumulating data indicate that a diet characterized by low glycaemic-index (GI) foods not only improves certain metabolic ramifications of insulin resistance, but also reduces insulin resistance per se. Epidemiological data also suggest a protective role against development of non-insulin-dependent diabetes mellitus and cardiovascular disease. A major disadvantage in this connection is the shortage of low-GI foods, and many common starchy staple foods, such as bread products, breakfast cereals and potato products, have a high GI. Studies in our laboratory show that it is possible to significantly lower the GI of starchy foods, for example by choice of raw material and/or by optimizing the processing conditions. Such low-GI foods may or may not influence glucose tolerance at a subsequent meal. Consequently, certain low-GI breakfasts capable of maintaining a net increment in blood glucose and insulin at the time of the next meal significantly reduced post-prandial glycaemia and insulinaemia following a standardized lunch meal, whereas others had no 'second-meal' impact. These results imply that certain low-GI foods may be more efficient in modulating metabolism in the long term. Although the literature supports a linear correlation between the GI and insulinaemic index (II) of foods, this is not always the case. Consequently, milk products elicited elevated IIs, indistinguishable from a white bread reference meal, despite GIs in the lower range. This inconsistent behaviour of milk products has not been acknowledged, and potential metabolic consequences remain to be elucidated.