Search Results (25)

Background and Objectives: Sarcopenia is highly prevalent among maintenance hemodialysis (HD) patients, particularly in the presence of diabetes mellitus (DM). Dietary glycemic and insulinemic characteristics may contribute to metabolic disturbances associated with muscle deterioration, although evidence in HD populations remains limited. This study aimed to investigate the associations between dietary indices, sarcopenia, nutritional status, and clinical outcomes in diabetic (DM+) and non-diabetic (DM−) HD patients. Materials and Methods: This cross-sectional study included 92 maintenance HD patients (43 DM+ and 49 DM−). Dietary intake was assessed using three-day food records, and dietary insulin index (DII), dietary insulin load (DIL), dietary glycemic index (DGI), and dietary glycemic load (DGL) were calculated. Sarcopenia was evaluated using handgrip strength, bioelectrical impedance analysis, gait speed, and SARC-F. Anthropometric, biochemical, nutritional, and sarcopenia-related parameters were compared across tertiles of dietary indices. Results: Sarcopenia was identified in 32.6% of patients with diabetes and 36.7% of those without diabetes. Diabetic patients exhibited significantly lower handgrip strength, slower walking speed, longer walking time, and higher SARC-F scores (p < 0.01). Across DGL tertiles in DM+ patients, significant progressive increases were observed in body weight (p < 0.05), body mass index (p < 0.05), lean mass (p < 0.05), mid-upper arm circumference (p < 0.01), and triceps skinfold thickness (p < 0.01). Higher DIL and DGL tertiles were also associated with elevated serum phosphorus, LDL cholesterol, triglycerides, and total cholesterol levels (p < 0.05). DIL and DGL showed stronger associations with overall energy and nutrient intake compared with DII and DGI. However, no significant associations were identified between dietary indices and sarcopenia diagnosis or sarcopenia-related risk indicators after adjustment for age and sex. Conclusions: Dietary indices were associated with various anthropometric, biochemical, and nutritional parameters in HD patients, with more pronounced associations observed among patients with DM, suggesting a potential role of dietary quality in the nutritional and metabolic profile of this population. Full article

Background: Sex-related differences in insulin sensitivity during adolescence remain incompletely understood, particularly in the context of obesity. Whether these differences reflect variations in basal insulin resistance or dynamic insulin responses remains unclear. Objective: To investigate sex differences in glucose and insulin responses during the oral glucose tolerance test (OGTT) and to explore mechanisms underlying potential dissociation between glycemic and insulinemic profiles. Methods: A cross-sectional analysis of 753 adolescents with obesity who underwent a standard oral glucose tolerance test (OGTT). Plasma glucose and insulin were measured at fasting and at 30, 60, 90, and 120 min. Mixed-effects models were used to examine glucose and insulin trajectories over time, including sex-by-time interactions, and to adjust for body mass index standard deviation score (BMI_SDS), pubertal stage (Tanner), metabolic syndrome (MetS), and body composition (resistance index). Multiple linear regression models were fitted to assess associations of sex with HOMA-IR, HOMA-β, total area under the curve (AUC), and phase-specific insulin AUCs. Results: Glucose trajectories during OGTT were similar between sexes, with no significant sex or sex-by-time interaction effects after adjustment. In contrast, insulin trajectories differed significantly by sex (sex-by-time interaction β = −0.10, p < 0.001). Boys exhibited higher baseline insulin levels and greater total insulin exposure (β = −11.2, p < 0.001), independent of BMI_SDS, pubertal stage, MetS, and body composition. Sex differences were sustained across all OGTT phases. HOMA-IR did not differ by sex, whereas HOMA-β showed a sex-related difference. BMI was positively associated with both basal and dynamic insulin measures. Conclusions: In adolescents with obesity, sex differences are characterized by altered dynamic insulin responses rather than differences in glycemic control. Boys exhibit greater compensatory insulin exposure during glucose challenge, independent of BMI-based adiposity, BIA-derived body composition and pubertal development. Full article

Objectives: This study aimed to investigate the possible association among texture, oral processing and starch digestive characteristics of hard-cooked (HP) and soft-cooked (SP) potato samples, as well as their acute postprandial glycemic and insulinemic response, when co-ingested with rice in a meal. Methods: HP and SP replaced one-third of rice carbohydrates. Postprandial glycemic and insulinemic responses were measured after test meal ingestion. In vitro experiments evaluated sample physicochemical properties. Results: HP retained more resistant starch (RS) and total phenolics than SP. When co-ingested with rice (HP + R), HP elicited more total chews, higher oral sensory exposure time, slower chewing frequency and longer eating duration. HP + R significantly reduced postprandial glucose iAUC, peak glucose and glycemic excursion. SP + R increased glycemic variability despite reduced iAUCglucose. HP + R also lowered iAUCinsulin, peak insulin and insulin resistance index. The hypoglycemic effect did not extend to the second meal, though composite iAUCglucose over 540 min was reduced. Conclusions: Partially substituting rice with hard-cooked potatoes may help stabilize postprandial glycemic and insulinemic responses, an effect largely attributable to RS retention. Full article

It is well established that cold storage results in increased resistant starch and a reduced glycemic index in carbohydrate food. However, the effects of cold storage on the glycemic response of the second meal of cereals remain unclear. The aim of this study was to compare the postprandial glycemic responses between the paired glutinous and non-glutinous grains, either fresh-cooked or refrigerated, after both the first and second meals. In this randomized crossover trial, eighteen healthy female participants consumed eight test meals, each containing 50 g of carbohydrate, including fresh-cooked non-glutinous and glutinous rice, non-glutinous and glutinous millet, and their refrigerated counterparts (4 °C for 24 h). Postprandial blood glucose and insulin were measured at 240 min and 120 min after breakfast. After a standard lunch, the participants’ blood glucose concentrations were measured within 180 min. The rapidly digestible starch (RDS), slowly digestible starch (SDS), and resistant starch (RS) contents of the samples were determined by in vitro enzymatic analysis. Cold-stored non-glutinous rice (CR) and cold-stored non-glutinous millet (CM) had a 24.4% and 29.5% lower incremental area under the curve (iAUC_glu) of glucose within 240 min compared to the control (fresh-cooked rice non-glutinous, FR), respectively (p < 0.05). There were no significant differences between either the cold or hot glutinous grains and FR with respect to postprandial glycemic and insulinemic parameters. After a standard lunch, the fresh-cooked non-glutinous millet (FM) achieved a 39.1% lower iAUC_glu0–180 compared to the FR (p < 0.05). FM had the highest percentage of SDS (64.8%, p < 0.05) among all grain samples. Refrigeration treatment reduced the glycemic excursion only in non-glutinous grains at the first meal, but the FM instead of CM demonstrated a significant second meal effect. Full article

Context and Objectives: Cereals and pseudo-cereals show a variety in terms of shape and color but also nutrition composition and starch structure. Altering particle size and grain integrity may influence the availability of nutrients and their metabolic impact. We studied the impact of different grains with bigger particle sizes than flours on starch digestibility and glycemic and insulinemic indexes in humans. Methods: Moist biscuits, containing 40% of intact grains of quinoa, millet, teff, fonio, or buckwheat grits, and a control made with wheat flour, were produced. Starch digestibility of the final products was analysed according to the Englyst method after two preparation methods: mincing, which led to conditions close to mastication or milling, which led to sample pulverization. Glycemic and insulinemic indexes (GI; II) and response parameters following consumption of these products were evaluated in humans. Product portions provided 50 g of available carbohydrates. The study was performed on 19 healthy normal-weight subjects who tested all six moist biscuits according to a cross-over design. Results: Starch digestibility analyses in minced products showed low Slowly Digestible Starch (SDS) content in control, high SDS content in buckwheat biscuits, high SDS and resistant starch (RS) contents in quinoa and fonio, and high RS in teff and millet products. When analysing milled samples, SDS and RS decreased in buckwheat and quinoa biscuits. RS decreased and SDS increased in teff and millet, and the values remained similar to minced samples for fonio biscuits. GI values for the products were 60 ± 7 for quinoa, 55 ± 7 for millet, 52 ± 7 for control and buckwheat, 41 ± 9 for teff, and 39 ± 5 for fonio biscuits. Teff and fonio biscuits led to lower glycemic responses compared to the other products. Insulin responses were related to the glycemic responses. Conclusions: The type of grains and the use of intact grains strongly impact starch digestibility, allowing for the modulation of glycemic and insulinemic responses. Using different types of grains to wheat and different particle sizes would allow for the modulation of glucose metabolism and potentially lead to long-term beneficial health effects. Full article

Introduction: The health benefits of eating fruits have been well established. Fruit juice is the product of the extraction or pressing of the natural liquid contained in fruits. The glycemic index (GI) is a tool developed to systematically classify carbohydrate-containing foods according to the time-integrated effects on postprandial glycemic responses. This study aimed to determine the effects of consuming a mixed commercial fruit juice (containing apples, oranges, grapes, and pomegranates) fortified either with two probiotic strains (Lacticaseibacillus casei Shirota and Lacticaseibacillus rhamnosus GG), or with vitamin D3, or with n-3 polyunsaturated fatty acids (PUFA), or with a combination of all of the aforementioned biofunctional ingredients versus the same control fruit juice without biofunctional ingredients on the postprandial glycemic and insulinemic responses. Methods: Eleven healthy, normal-weight volunteers (25—2 years; five females; BMI = 23 ± 1 kg/m²) participated in this randomized, double-blind, crossover clinical trial and were randomly assigned to receive five types of fruit juices (the fruit juice control, fruit juice with 50 μg vitamin D3, fruit juice with 8.33 g n-3 PUFA, fruit juice with 10⁸ cfu/mL probiotics, and fruit juice with vitamin D3, n-3 PUFA, and probiotics, all tested once) and D-glucose as a reference drink, which was tested two times. They all contained 50 g available carbohydrates, and the fruit juices were administered at different weeks in a random sequence according to the recommended glycemic index methodology. Capillary blood glucose and salivary insulin samples were collected at the baseline and for 180 min post consumption. Results: All the fruit juices provided low GI values (control: 54; vitamin D3: 52; n-3: 51; probiotics: 50; vitamin D3-n-3 PUFA-probiotics combination: 52, on the glucose scale). All the fruit juice types provided lower peak glucose values, smaller mean glycemic and insulinemic responses, and were more pleasurable than glucose was. Discussion: All the fruit juice types, regardless of the added biofunctional ingredients, attenuated the postprandial glycemic responses, which may offer advantages for glycemic control. Full article

High glycemic response (GR) is part of cardiometabolic risk factors. Dietary polyphenols, starch digestibility, and dietary fibers could play a role in modulating GR. We formulated cereal products with high dietary fibers, polyphenols, and slowly digestible starch (SDS) contents to test their impact on the glycemic index (GI) and insulin index (II). Twelve healthy subjects were randomized in a crossover-controlled study to measure the GI and II of four biscuits according to ISO-26642(2010). Two types of biscuits were enriched with dietary fibers and polyphenols and high in SDS, and two similar control biscuits with low levels of these compounds were compared. The subjects consumed 50 g of available carbohydrates from the biscuits or from a glucose solution (reference). Glycemic and insulinemic responses were monitored for 2 h after the start of the consumption. The two enriched biscuits led to low GI and II (GI: 46 ± 5 SEM and 43 ± 4 SEM and II: 54 ± 5 SEM and 45 ± 3 SEM) when controls had moderate GI and II (GI: 57 ± 5 SEM and 58 ± 5 SEM and II: 61 ± 4 SEM and 61 ± 4 SEM). A significant difference of 11 and 15 units between the GI of enriched and control products was obtained. These differences may be explained by the polyphenol contents and high SDS levels in enriched products as well as potentially the dietary fiber content. This study provides new proposals of food formulations to induce beneficial health effects which need to be confirmed in a longer-term study in the context of the SINFONI consortium. Full article

This study aimed to determine the glycemic index (GI) of a commercial mixed fruit juice (apple, orange, grape, and pomegranate; FJ) fortified with vitamin D3 or n-3 polyunsaturated fatty acids (PUFA) or probiotics, and their combination, and their effects on glycemic responses and salivary insulin concentrations. In a randomized controlled, double-blind, crossover study, 11 healthy participants (25 ± 2 years; five women; body mass index = 23 ± 1 kg/m²) were randomly assigned to receive five types of FJs [vitD (with vitamin D3); n-3 (with n-3 PUFA); probiotics (with Lacticaseibacillus casei Shirota and Lacticaseibacillus rhamnosus GG); vitD-n-3-probiotics FJ (combination of vitD3-n-3-probiotics), control (regular FJ)], all containing 50 g available carbohydrate, and glucose as reference drink. All FJs provided low GI values (control: 54; vitD3: 52; n-3: 51; probiotics: 50; and vitD-n-3-probiotics combination: 52, on glucose scale). Compared to the FJ control, the enriched FJs produced different postprandial glycemic and insulinemic responses and affected satiety scores. All FJ types, regardless of the added biofunctional ingredients, attenuated postprandial glycemic responses, which may offer advantages to glycemic control. Full article

The inflammatory and insulinemic potentials of diets have been associated with colorectal cancer risk. However, it is unknown whether the plasma metabolite profiles related to inflammatory diets, or to insulinemic diets, underlie this association. The aim of this study was to evaluate the association between metabolomic profile scores related to the food-based empirical dietary inflammatory patterns (EDIP), the empirical dietary index for hyperinsulinemia (EDIH), and plasma inflammation (CRP, IL-6, TNFα-R2, adiponectin) and insulin (C-peptide) biomarkers, and colorectal cancer risk. Elastic net regression was used to derive three metabolomic profile scores for each dietary pattern among 6840 participants from the Nurses’ Health Study and Health Professionals Follow-up Study, and associations with CRC risk were examined using multivariable-adjusted logistic regression, in a case-control study of 524 matched pairs nested in both cohorts. Among 186 known metabolites, 27 were significantly associated with both the EDIP and inflammatory biomarkers, and 21 were significantly associated with both the EDIH and C-peptide. In men, odds ratios (ORs) of colorectal cancer, per 1 standard deviation (SD) increment in metabolomic score, were 1.91 (1.31–2.78) for the common EDIP and inflammatory-biomarker metabolome, 1.12 (0.78–1.60) for EDIP-only metabolome, and 1.65 (1.16–2.36) for the inflammatory-biomarkers-only metabolome. However, no association was found for EDIH-only, C-peptide-only, and the common metabolomic signatures in men. Moreover, the metabolomic signatures were not associated with colorectal cancer risk among women. Metabolomic profiles reflecting pro-inflammatory diets and inflammation biomarkers were associated with colorectal cancer risk in men, while no association was found in women. Larger studies are needed to confirm our findings. Full article

In this study, cardiorespiratory fitness (CRF) and strength level were assessed in women with and without polycystic ovary syndrome (PCOS), matched for age, body composition, androgenic pattern and insulinemic pattern. Patients with and without PCOS were evaluated at the Endocrinology Unit and Sport Medicine Division to assess endocrinological (insulinemic, androgenic pattern and growth hormone), anthropometric (with DEXA) and functional parameters (with cardiopulmonary exercise test and handgrip test), as well as physical activity level (with the Global Physical Activity Questionnaire). A total of 31 patients with PCOS and 13 controls were included. No statistically significant differences were found between groups in terms of age, body mass index, body composition, androgenic pattern, insulin state, growth hormone and physical activity level. The PCOS group demonstrated significantly better cardiorespiratory fitness (VO₂max per kg (30.9 ± 7.6 vs. 24.8 ± 4.1 mL/kg/min; p = 0.010), VO₂max per kg of fat-free mass (52.4 ± 8.9 vs. 45.3 ± 6.2 mL/kg/min; p = 0.018)), strength levels (handgrip per kg (0.36 ± 0.09 vs. 0.30 ± 0.08; p = 0.009), handgrip per kg of fat-free mass (13.03 ± 2.32 vs. 11.50 ± 1.91; p = 0.001)) and exercise capacity (METs at test (14.4 ± 2.72 vs. 12.5 ± 1.72 METs; p = 0.019)). In this study, women with PCOS showed a better cardiorespiratory fitness and strength than the control group. The only determinant that could explain the differences observed seems to be the presence of the syndrome itself. These results suggest that PCOS per se does not limit exercise capacity and does not exclude good functional capacity. Full article

Background and objectives: Chinese type 2 diabetes mellitus (T2DM) patients are characterized by a low body mass index (BMI), and significant insulin resistance (IR). The triglyceride glucose (TyG) index has not been studied as a means of assessing IR in Chinese T2DM patients with a BMI < 35 kg/m². Materials and Methods: An open-label cross-sectional study recruited 102 Chinese T2DM patients with a BMI < 35 kg/m². The hyper-insulinemic euglycemic clamp, homeostatic model assessment of IR (HOMA-IR), and TyG index were used to determine the level of IR. Based on Pearson’s correlations, glucose disposal rate (GDR), TyG index, and HOMA-IR were analyzed. HOMA-IR and TyG index for IR were evaluated using multiple linear regression and multivariate logistic regression analyses. On the basis of the receiver operating characteristic (ROC) curve, the sensitivity, specificity, and optimal cut-off value of HOMA-IR and the TyG index were determined. Results: The mean values of GDR, HOMA-IR, and TyG index were 4.25 ± 1.81, 8.05 ± 7.98, and 8.12 ± 0.86 mg/kg/min, respectively. Pearson’s correlation coefficient was −0.418 between GDR and TyG index and −0.324 between GDR and HOMA-IR. ROC curve analysis showed that, among both sexes, the TyG index was a better discriminator of IR than HOMA-IR. The area under the ROC curve (AUC) of the TyG index (0.785, 0.691–0.879) was higher than that of HOMA-IR (0.73, 0.588–0.873) in all genders. The optimal cut-off values of the TyG index and HOMA-IR were 7.99 and 3.39, respectively. Conclusions: The TyG index showed more effectiveness in identifying IR in Chinese T2DM patients with a BMI < 35 kg/m² compared to HOMA-IR. Full article

Background: Commercial infant formulas attempt to imitate human milk’s unique composition. However, lactose-free and milk protein-free formulas are often chosen due to medical reasons or personal preferences. The aim of this study was to determine the glycemic and insulinemic indices of a variety of infant formulas. Methods: We conducted a three-arm, randomized, double-blind, crossover study. Participants were 25–40-year-old healthy adults. Three commercial infant formulas (cow’s milk protein-based [“standard”], soy protein-based, and lactose-free) were randomly given to each participant. Glycemic and insulinemic responses were determined and compared between the three formulas. Results: Twenty subjects were enrolled (11 females/9 males, mean age 32.8 ± 2.9 years). No significant difference was found in the glycemic index between the three formulas (21.5, 29.1, and 21.5 for the standard, soy protein-based, and lactose-free formulas, respectively, p = 0.21). However, maximal glucose levels were significantly higher for the soy protein-based formula compared to both the standard and lactose-free formulas (111.5 compared to 101.8 and 105.8 mg/dL, respectively, p = 0.001). Conclusion: Cow’s milk protein-based, soy protein-based, and lactose-free formulas have a similar glycemic index. However, soy protein-based formula produced a significantly higher increase in postprandial glucose levels. The implication and biological significance of these results have yet to be determined. Full article

Sorghum is used to provide good quality gluten-free products due to phytochemicals and low glycemic index (GI). This study aimed to determine the chemical composition, the antioxidant activity and capacity, and the glycemic and insulinemic responses of gluten-free (GF) sorghum bread. GF bread samples were produced with three different sorghum genotypes. The samples were analyzed for chemical composition, resistant starch and dietary fiber content; antioxidant activity by ORAC; antioxidant capacity by FRAP; GI; and insulinemic responses. This double-blind, crossover, randomized clinical trial was conducted with 10 healthy men aged 28.0 ± 4.9 years (77.6 ± 11.7 kg and 24.2 ± 2.3 kg/m²⁾. All sorghum bread showed significantly more fiber than rice bread (control). Brown sorghum bread was classified as low GI, bronze and white as medium GI, and control as high GI. Brown sorghum bread presented a low carbohydrate content, a significant amount of fiber, and a significantly lower 3 h AUC glucose response than those of the control, aside from the highest antioxidant activity value (p ≤ 0.001). Therefore, brown sorghum was superior to other genotypes analyzed in this study, and its production should be encouraged to provide gluten-free products with a better nutritional profile. More research is required to explore the effects of different sorghum genotypes in food products on human health. Full article

During processing of cereal-based food products, starch undergoes dramatic changes. The objective of this work was to evaluate the impact of food processing on the starch digestibility profile of cereal-based foods using advanced imaging techniques, and to determine the effect of preserving starch in its native, slowly digestible form on its in vivo metabolic fate. Four different food products using different processing technologies were evaluated: extruded products, rusks, soft-baked cakes, and rotary-molded biscuits. Imaging techniques (X-ray diffraction, micro-X-ray microtomography, and electronic microscopy) were used to investigate changes in slowly digestible starch (SDS) structure that occurred during these different food processing technologies. For in vivo evaluation, International Standards for glycemic index (GI) methodology were applied on 12 healthy subjects. Rotary molding preserved starch in its intact form and resulted in the highest SDS content (28 g/100 g) and a significantly lower glycemic and insulinemic response, while the three other technologies resulted in SDS contents below 3 g/100 g. These low SDS values were due to greater disruption of the starch structure, which translated to a shift from a crystalline structure to an amorphous one. Modulation of postprandial glycemia, through starch digestibility modulation, is a meaningful target for the prevention of metabolic diseases. Full article

Diabetes mellitus is a chronic disease whose prevalence is growing worldwide. Consumption of desserts with low glycemic index (GI) and low glycemic load (GL) in a balanced hypocaloric diet has a positive impact on anthropometric and metabolic parameters in patients with type 2 diabetes mellitus (T2DM). The aim of the present study was to evaluate the glycemic and insulinemic response after consumption of desserts with low GI/GL in patients with T2DM. Fifty-one patients consumed either 83 g of the conventional dessert or 150 g of the low GI/GL dessert in random order after an overnight fast. Serum glucose, triglycerides, and insulin were measured at baseline (immediately before ingestion) and at 30, 60, 90, and 120 min postprandially. Subjective appetite measurements were performed using visual analog scales (VASs). There were significant differences at 30 (p = 0.014), 60 (p < 0.001), and 90 min (p < 0.001) postprandially between the two desserts for glucose and at 30 (p = 0.014) and 60 min (p = 0.033) postprandially for insulin. Glucose iAUC was significantly lower in low-GI/GL dessert compared to control (p < 0.001). Serum triglycerides and insulin iAUC did not differ between the two trials. Fullness VAS ratings were significantly higher after consumption of the low-GI/GL dessert compared to conventional dessert. Likewise, hunger, additional food, and additional food quantity VAS ratings were significantly lower after the consumption of the low-GI/GL dessert compared to control. Consumption of low-GI/GL dessert indicates a positive impact on metabolic parameters in T2DM patients. Full article