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Carbohydrate Intake in Non-communicable Disease Prevention and Treatment

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (31 October 2018) | Viewed by 105979

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Guest Editor
Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand
Interests: clinical trials; carbohydrate; sugar; fructose; fibre; B vitamins
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In 2011, carbohydrates provided 63% of the dietary energy intake to the world’s population. Historically, carbohydrate-rich diets have been associated with good health and longevity but there has been a move away from traditional carbohydrate-rich diets, with refined carbohydrate taking much criticism for contributing to non-communicable disease. The aim of this Special Issue is to discuss the appropriate use of environmentally sustainable carbohydrate-rich foods in the modern diet in developing and developed countries in the context of prevention and treatment of non-communicable disease.

Dr. Bernard Venn
Guest Editor

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Keywords

  • Carbohydrate
  • Non-communicable disease
  • Diet, historical perspective
  • Developing countries
  • Developed countries
  • Refined
  • Wholegrain

Published Papers (10 papers)

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Research

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9 pages, 870 KiB  
Article
The Timing of Activity after Eating Affects the Glycaemic Response of Healthy Adults: A Randomised Controlled Trial
by Andrew N. Reynolds and Bernard J. Venn
Nutrients 2018, 10(11), 1743; https://doi.org/10.3390/nu10111743 - 13 Nov 2018
Cited by 11 | Viewed by 6474
Abstract
There is scant information on how a time lag between the cessation of eating and commencement of physical activity affects postprandial glycaemia. Starting at baseline (t = 0), participants ingested white bread containing 50 g of available carbohydrates within 10 min. Using two [...] Read more.
There is scant information on how a time lag between the cessation of eating and commencement of physical activity affects postprandial glycaemia. Starting at baseline (t = 0), participants ingested white bread containing 50 g of available carbohydrates within 10 min. Using two crossover conditions, we tested the effect over 2 h on postprandial glycaemia of participants undertaking light activity at 15 or 45 min following baseline and compared it with a sedentary control condition. The activity involved cycling on a stationary ergometer for 10 min at 40 revolutions per min with zero resistance. Seventy-eight healthy adults were randomized to the 15 or 45 min activity arm and then randomised to the order in which they undertook the active and sedentary conditions. Cycling 45 min after baseline changed the course of the blood glucose response (likelihood ratio chi square = 31.47, p < 0.01) and reduced mean blood glucose by 0.44 mmol/L (95% confidence interval 0.14 to 0.74) at 60 min when compared with the sedentary control. No differences in postprandial blood glucose response were observed when cycling started 15 min after baseline compared with the sedentary control. Undertaking activity after waiting for 30 min following eating might be optimal in modifying the glycaemic response. Full article
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10 pages, 985 KiB  
Article
Subjective Satiety Following Meals Incorporating Rice, Pasta and Potato
by Zhuoshi Zhang, Bernard J. Venn, John Monro and Suman Mishra
Nutrients 2018, 10(11), 1739; https://doi.org/10.3390/nu10111739 - 12 Nov 2018
Cited by 14 | Viewed by 10200
Abstract
The satiating capacity of carbohydrate staples eaten alone is dependent upon the energy density of the food but relative satiety when starchy staples are incorporated into mixed meals is uncertain. Our aim was to assess the satiating effects of three carbohydrate staples; jasmine [...] Read more.
The satiating capacity of carbohydrate staples eaten alone is dependent upon the energy density of the food but relative satiety when starchy staples are incorporated into mixed meals is uncertain. Our aim was to assess the satiating effects of three carbohydrate staples; jasmine rice, penne pasta, and Agria potato, each consumed within a standard mixed meal. Cooked portions of each staple containing 45 g carbohydrate were combined with 200 g of meat sauce and 200 g of mixed vegetables in three mixed meals. The quantities of staple providing 45 g carbohydrate were: Rice, 142 g; pasta, 138 g and potato 337 g. Participants (n = 14) consumed each of the mixed meals in random order on separate days. Satiety was assessed with using visual analogue scales at baseline and for 3 h post meal. In an area-under-the-curve comparison, participants felt less hungry (mean (SD)) following potato 263 (230) than following rice 374 (237) or pasta 444 (254) mm∙min, and felt fuller, more satisfied, and wanted to eat less following the potato compared with the rice and pasta meals (p for all <0.01). The superior satiating effect of potato compared with rice and pasta in a mixed meal was consistent with its lower energy density. Full article
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15 pages, 1309 KiB  
Article
Kiwifruit Exchanges for Increased Nutrient Richness with Little Effect on Carbohydrate Intake, Glycaemic Impact, or Insulin Response
by John Monro, Kerry Bentley-Hewitt and Suman Mishra
Nutrients 2018, 10(11), 1710; https://doi.org/10.3390/nu10111710 - 8 Nov 2018
Cited by 3 | Viewed by 3368
Abstract
Background: Kiwifruit are nutrient-rich and have properties which indicate a low glycaemic impact compared with many cooked cereal foods, suggesting that they may be used for dietary enrichment of vitamin C without glycaemic cost. Aim: To develop tables for equi-carbohydrate and equi-glycaemic partial [...] Read more.
Background: Kiwifruit are nutrient-rich and have properties which indicate a low glycaemic impact compared with many cooked cereal foods, suggesting that they may be used for dietary enrichment of vitamin C without glycaemic cost. Aim: To develop tables for equi-carbohydrate and equi-glycaemic partial exchange of kiwifruit for glycaemic carbohydrate foods. Method: The available carbohydrate content of Zespri® Green and Zespri® SunGold kiwifruit was determined as sugars released during in vitro digestive analysis. Glycaemic potency was determined as grams of glucose equivalents (GGEs) in a clinical trial using 200 g (a two-kiwifruit edible portion) of each cultivar, non-diabetic subjects (n = 20), and a glucose reference. GGE values were also estimated for a range of carbohydrate foods in the New Zealand Food Composition Database for which available carbohydrate and glycaemic index values were available. The values allowed exchange tables to be constructed for either equi-carbohydrate or equi-glycaemic partial exchange of kiwifruit for the foods. Results: GGE values of both kiwifruit cultivars were low (“Hayward”, 6.6 glucose equivalents/100 g; “Zesy002”, 6.7 glucose equivalents/100 g). Partial equi-carbohydrate substitution of foods in most carbohydrate food categories substantially increased vitamin C with little change in glycaemic impact, while equi-glycaemic partial substitution by kiwifruit could be achieved with little change in carbohydrate intake. Conclusion: Equi-carbohydrate partial exchange of kiwifruit for starchy staple foods is a means of greatly increasing nutrient richness in a diet without the physiological costs of increased glycaemia and insulin responses or carbohydrate intake. Full article
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10 pages, 626 KiB  
Article
The Comparative Effect on Satiety and Subsequent Energy Intake of Ingesting Sucrose or Isomaltulose Sweetened Trifle: A Randomized Crossover Trial
by Fiona E. Kendall, Olivia Marchand, Jillian J. Haszard and Bernard J. Venn
Nutrients 2018, 10(10), 1504; https://doi.org/10.3390/nu10101504 - 15 Oct 2018
Cited by 5 | Viewed by 3284
Abstract
The effect that blood glucose concentration has on feelings of satiety is unclear. Our aims were to assess satiety and subsequent energy intake following the ingestion of trifle sweetened with sucrose or isomaltulose whilst measuring plasma glucose concentration to confirm glycemic differences between [...] Read more.
The effect that blood glucose concentration has on feelings of satiety is unclear. Our aims were to assess satiety and subsequent energy intake following the ingestion of trifle sweetened with sucrose or isomaltulose whilst measuring plasma glucose concentration to confirm glycemic differences between trifles. Seventy-seven healthy adults participated in a double-blind crossover trial where trifle sweetened with sucrose or isomaltulose was consumed on separate days with a two-week washout. Blood was sampled at the baseline, 1 and 2 h postprandially, and satiety assessed using visual analogue scales (VAS). Weighed diet records were taken on test days. A statistically significant difference in blood glucose concentration between trifles was found at 60 min following consumption, with the isomaltulose trifle having a 0.69 mmol/L (95% confidence interval: −1.07, −0.31) lower concentration when compared with the sucrose trifle. Mean satiety response by area-under-the-curve (AUC) was not significantly different between trifles. Mean (SD) appetite scores for the sucrose and isomaltulose trifles were 4493 (2393) and 4527 (2590) mm·min, respectively, with a between trifle difference of −9 (95% CI: −589, 572) mm·min. Mean (SD) energy intake for the remainder of the day following trifle consumption was 3894 kJ (1950 kJ) and 3530 kJ (1926 kJ) after the sucrose and isomaltulose trifles, respectively, and was not significantly different (p = 0.133). The differing glycemic response to trifle was not related to satiety or to subsequent energy intake. Full article
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10 pages, 670 KiB  
Article
The Effect of White Rice and White Bread as Staple Foods on Gut Microbiota and Host Metabolism
by Fumika Mano, Kaori Ikeda, Erina Joo, Yoshihito Fujita, Shunsuke Yamane, Norio Harada and Nobuya Inagaki
Nutrients 2018, 10(9), 1323; https://doi.org/10.3390/nu10091323 - 18 Sep 2018
Cited by 17 | Viewed by 9192
Abstract
The purpose of this study was to examine the influence of two kinds of major Japanese staple foods, white rice and white bread, on gut microbiota against the background in which participants eat common side dishes. Seven healthy subjects completed the dietary intervention [...] Read more.
The purpose of this study was to examine the influence of two kinds of major Japanese staple foods, white rice and white bread, on gut microbiota against the background in which participants eat common side dishes. Seven healthy subjects completed the dietary intervention with two 1-week test periods with a 1-week wash-out period in cross-over design (UMIN registration UMIN000023142). White bread or white rice and 21 frozen prepared side dishes were consumed during the test periods. At baseline and at the end of each period, fasting blood samples, breath samples, and fecal samples were collected. For fecal samples, 16S rRNA gene sequencing was used to analyze the gut microbiota. After the bread period, the abundance of fecal Bifidobacterium genus (19.2 ± 14.5 vs. 6.2 ± 6.6 (%), p = 0.03), fasting glucagon-like peptide 1 (GLP-1) (13.6 ± 2.0 vs. 10.5 ± 2.9 (pg/mL), p = 0.03), and breath hydrogen (23.4 ± 9.9 vs. 8.2 ± 5.5 (ppm), p = 0.02) were significantly higher than those of after the rice period. Plasma SCFAs also tended to be higher after the bread period. White bread contains more dietary fiber than refined short grain rice. These findings suggest that indigestible carbohydrate intake from short grain rice as a staple food may be smaller than that of white bread. Full article
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13 pages, 249 KiB  
Article
Carbohydrate Knowledge and Expectations of Nutritional Support among Five Ethnic Groups Living in New Zealand with Pre- and Type 2 Diabetes: A Qualitative Study
by Zhuoshi Zhang, John Monro and Bernard J. Venn
Nutrients 2018, 10(9), 1225; https://doi.org/10.3390/nu10091225 - 4 Sep 2018
Cited by 7 | Viewed by 4587
Abstract
Despite availability of diabetes and nutrition information for people with pre- and type 2 diabetes, the uptake and understanding of these resources may differ among ethnic groups. Our objective was to explore dietary knowledge and diabetes experiences amongst Māori, European, Pacific Island, Indian [...] Read more.
Despite availability of diabetes and nutrition information for people with pre- and type 2 diabetes, the uptake and understanding of these resources may differ among ethnic groups. Our objective was to explore dietary knowledge and diabetes experiences amongst Māori, European, Pacific Island, Indian and East Asian people living in New Zealand with a focus on carbohydrate-containing foods. A registered diabetes dietitian led ethnic-specific discussions in groups involving 29 people with pre- or type 2 diabetes. Discussions were audio-recorded, fully transcribed and coded independently by two investigators. Themes were developed using deductive and inductive techniques. Five themes emerged: knowledge, concerns, achievements, simplicity and self-determination. Nutritional knowledge was lacking and a greater awareness of trustworthy dietary resources was needed. There were concerns about diabetes complications and appropriate carbohydrate-containing foods and portions. Contrary to this, people felt proud when achieving dietary goals and grateful for support from health care providers and family. Participants were willing to engage in self-care if advice from health professionals was given in plain language, and in a culturally appropriate manner. Given the desire to take an active role in diabetes self-management and willingness to use electronic devices, an ethnic-specific nutrition education resource could be a valuable tool. Full article
14 pages, 2229 KiB  
Article
Postprandial Glycaemic, Hormonal and Satiety Responses to Rice and Kiwifruit Preloads in Chinese Adults: A Randomised Controlled Crossover Trial
by Alex Lubransky, John Monro, Suman Mishra, Hui Yu, Jillian J. Haszard and Bernard J. Venn
Nutrients 2018, 10(8), 1110; https://doi.org/10.3390/nu10081110 - 17 Aug 2018
Cited by 18 | Viewed by 5290
Abstract
Controlling postprandial glycaemia helps to prevent and manage non-communicable diseases. One strategy in controlling glycaemia may be to consume meals in two parts; a preload, followed by the remainder of the meal. Our aim was to test preloading a rice meal given for [...] Read more.
Controlling postprandial glycaemia helps to prevent and manage non-communicable diseases. One strategy in controlling glycaemia may be to consume meals in two parts; a preload, followed by the remainder of the meal. Our aim was to test preloading a rice meal given for breakfast and lunch on different days, either by splitting the meal (rice preload followed by rice meal) or by using kiwifruit as a preload compared with consuming the rice meal in one sitting. Primary outcomes were glycaemic and insulinaemic responses with secondary outcomes of other hormonal responses, subjective satiety, and subsequent energy intake. Following breakfast, postprandial glycaemic peak concentration was 0.9 (95% CI: 0.2, 1.6) mmol/L lower for the kiwifruit preload compared with the rice meal eaten in one sitting. Following lunch, glycaemic peak concentrations were 1.0 (0.7, 1.4) and 1.1 (0.5, 1.7) mmol/L lower for the rice-split and kiwifruit preload compared with the rice meal alone, respectively. Postprandial insulinaemia area-under-the-curve was 1385 (87, 2684) mU/L·min less for the kiwifruit preload compared with the rice-split. There were no differences among treatments for subsequent energy intake. Meal splitting is useful for lowering postprandial glycaemia, and replacing part of a meal with kiwifruit may help with insulin efficiency without detriment to subsequent energy intake. Full article
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8 pages, 958 KiB  
Article
Efficacy of a Moderately Low Carbohydrate Diet in a 36-Month Observational Study of Japanese Patients with Type 2 Diabetes
by Mariko Sanada, Chinatsu Kabe, Hisa Hata, Junichi Uchida, Gaku Inoue, Yoko Tsukamoto, Yoshifumi Yamada, Junichiro Irie, Shogo Tabata, Mitsuhisa Tabata and Satoru Yamada
Nutrients 2018, 10(5), 528; https://doi.org/10.3390/nu10050528 - 24 Apr 2018
Cited by 12 | Viewed by 11847
Abstract
We previously showed that a non-calorie-restricted, moderately low-carbohydrate diet (mLCD) is more effective than caloric restriction for glycemic and lipid profile control in patients with type 2 diabetes. To determine whether mLCD intervention is sustainable, effective, and safe over a long period, we [...] Read more.
We previously showed that a non-calorie-restricted, moderately low-carbohydrate diet (mLCD) is more effective than caloric restriction for glycemic and lipid profile control in patients with type 2 diabetes. To determine whether mLCD intervention is sustainable, effective, and safe over a long period, we performed a 36-month observational study. We sequentially enrolled 200 patients with type 2 diabetes and taught them how to follow the mLCD. We compared the following parameters pre- and post-dietary intervention in an outpatient setting: glycated hemoglobin (HbA1c), body weight, lipid profile (total cholesterol, low and high-density lipoprotein cholesterol, triglycerides), systolic and diastolic blood pressure, liver enzymes (aspartate aminotransferase, alanine aminotransferase), and renal function (urea nitrogen, creatinine, estimated glomerular filtration rate). Data from 157 participants were analyzed (43 were lost to follow-up). The following parameters decreased over the period of study: HbA1c (from 8.0 ± 1.5% to 7.5 ± 1.3%, p < 0.0001) and alanine aminotransferase (from 29.9 ± 23.6 to 26.2 ± 18.4 IL/L, p = 0.009). Parameters that increased were high-density lipoprotein cholesterol (from 58.9 ± 15.9 to 61.2 ± 17.4 mg/dL, p = 0.001) and urea nitrogen (from 15.9 ± 5.2 to 17.0 ± 5.4 mg/dL, p = 0.003). Over 36 months, the mLCD intervention showed sustained effectiveness (without safety concerns) in improving HbA1c, lipid profile, and liver enzymes in Japanese patients with type 2 diabetes. Full article
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Review

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28 pages, 954 KiB  
Review
Starchy Carbohydrates in a Healthy Diet: The Role of the Humble Potato
by Tracey M. Robertson, Abdulrahman Z. Alzaabi, M. Denise Robertson and Barbara A. Fielding
Nutrients 2018, 10(11), 1764; https://doi.org/10.3390/nu10111764 - 14 Nov 2018
Cited by 63 | Viewed by 18273
Abstract
Potatoes have been an affordable, staple part of the diet for many hundreds of years. Recently however, there has been a decline in consumption, perhaps influenced by erroneous reports of being an unhealthy food. This review provides an overview of the nutritional value [...] Read more.
Potatoes have been an affordable, staple part of the diet for many hundreds of years. Recently however, there has been a decline in consumption, perhaps influenced by erroneous reports of being an unhealthy food. This review provides an overview of the nutritional value of potatoes and examines the evidence for associations between potato consumption and non-communicable diseases. Potatoes are an important source of micronutrients, such as vitamin C, vitamin B6, potassium, folate, and iron and contribute a significant amount of fibre to the diet. However, nutrient content is affected by cooking method; boiling causes leaching of water-soluble nutrients, whereas frying can increase the resistant starch content of the cooked potato. Epidemiological studies have reported associations between potato intake and obesity, type 2 diabetes and cardiovascular disease. However, results are contradictory and confounded by lack of detail on cooking methods. Indeed, potatoes have been reported to be more satiating than other starchy carbohydrates, such as pasta and rice, which may aid weight maintenance. Future research should consider cooking methods in the study design in order to reduce confounding factors and further explore the health impact of this food. Full article
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27 pages, 679 KiB  
Review
Relevance of the Glycemic Index and Glycemic Load for Body Weight, Diabetes, and Cardiovascular Disease
by Sonia Vega-López, Bernard J. Venn and Joanne L. Slavin
Nutrients 2018, 10(10), 1361; https://doi.org/10.3390/nu10101361 - 22 Sep 2018
Cited by 124 | Viewed by 32040
Abstract
Despite initial enthusiasm, the relationship between glycemic index (GI) and glycemic response (GR) and disease prevention remains unclear. This review examines evidence from randomized, controlled trials and observational studies in humans for short-term (e.g., satiety) and long-term (e.g., weight, cardiovascular disease, and type [...] Read more.
Despite initial enthusiasm, the relationship between glycemic index (GI) and glycemic response (GR) and disease prevention remains unclear. This review examines evidence from randomized, controlled trials and observational studies in humans for short-term (e.g., satiety) and long-term (e.g., weight, cardiovascular disease, and type 2 diabetes) health effects associated with different types of GI diets. A systematic PubMed search was conducted of studies published between 2006 and 2018 with key words glycemic index, glycemic load, diabetes, cardiovascular disease, body weight, satiety, and obesity. Criteria for inclusion for observational studies and randomized intervention studies were set. The search yielded 445 articles, of which 73 met inclusion criteria. Results suggest an equivocal relationship between GI/GR and disease outcome. The strongest intervention studies typically find little relationship among GI/GR and physiological measures of disease risk. Even for observational studies, the relationship between GI/GR and disease outcomes is limited. Thus, it is unlikely that the GI of a food or diet is linked to disease risk or health outcomes. Other measures of dietary quality, such as fiber or whole grains may be more likely to predict health outcomes. Interest in food patterns as predictors of health benefits may be more fruitful for research to inform dietary guidance. Full article
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