To test whether impaired carbohydrate tolerance in cirrhosis could be modified by dietary means ten cirrhotic patients, five of them taking insulin, took as breakfast either lentils or wholemeal bread and cottage cheese containing the same amount of carbohydrate and protein. Lentils resulted in significantly diminished blood glucose, insulin (in those not on insulin) and gastric inhibitory peptide responses. Enteroglucagon and neutrotensin levels were high with lentils, suggesting that absorption of lentil carbohydrate continued into the ileum with perhaps some malabsorption, so confirming the results of earlier studies in vitro. However, breath hydrogen studies on a separate group of eight healthy volunteers indicated that the difference in carbohydrate malabsorption between lentil, and wholemeal bread was insignificant. It is suggested that slowly digested carbohydrate foods, such as leguminous seeds, may minimize carbohydrate intolerance in patients with cirrhosis.

Blood Glucose↗

PubMed1984

Human intestinal parasitism in three areas of Indonesia: a survey.

Stools from 1387 people were examined quantitatively for eggs of nematode parasites. The people were residents of Padangganting, near Sawahlunto, Sumatra (227 people), Sukamaju and Cibungur rubber plantations near Sukabumi, Java (831 people) and the villages of Mahima and Rabo near Reo, Manggarai, Flores (329 people). Ascaris lumbricoides, Trichuris trichiura and Necator americanus were common; Ancylostoma was not observed. Prevalence of parasitism was highest in Java and lowest in Flores. Egg counts were low, suggesting low worm burdens; intensity of infection with Ascaris and Trichuris was highest in Java, while hookworm was highest in Sumatra. Ascaris infections decreased and hookworm infections increased in prevalence and intensity with age; Trichuris was unaffected. A sex-related difference was observed only in Sumatra, where more females than males were infected with Ascaris. Village-to-village variation in prevalence of nematode infestation was observed in Flores and on the Sukamaju plantation; the topography of other areas did not allow for village comparisons. Ad hoc anthelmintic treatment of the residents of Cibungur plantation was reflected in reduced parasitism by Ascaris and Trichuris, but not hookworm, compared with neighbouring Sukamaju. Comparison of the patterns of disease in the three areas, in terms of the occurrence of single, double or triple infections, revealed marked differences. In Java most people with parasitism had triple infections. In Sumatra the most common expression of parasitism was single infection with hookworm. In Flores single infection with Ascaris prevailed. It is suggested that the clinical effects of intestinal parasitism might depend on the pattern of infection. Samples collected in Flores were also examined for protozoa which were found in about half the population; Entamoeba coli and E. histolytica were most common.

Adolescent↗

PubMed1984

Relationship between polyphenol intake and blood glucose response of normal and diabetic individuals.

Five leguminous and eight nonleguminous foods were analyzed for polyphenol concentration by the Prussian Blue and the Folin Denis methods and correlated with blood glucose response (glycemic index) in normal or diabetic volunteers. Polyphenol concentrations and intakes per 50 g available carbohydrate portions were higher in the leguminous foods than those in the nonleguminous foods. In both normal and diabetic individuals, a negative correlation was observed between glycemic index and the concentration or total intake of polyphenols. Polyphenols, especially the large polymeric type or condensed tannins, appear to be responsible in part for the reduced glycemic response to carbohydrate foods and in part to lower blood glucose response to legumes compared with cereal products.

Blood Glucose↗

PubMed1984

Glycemic responses to foods: possible differences between insulin-dependent and noninsulin-dependent diabetics.

The effect on the blood glucose response of varying the amount (25 or 50 g) and type (bread or beans) of carbohydrate (CH2O) in test meals and of adding fat and protein was examined in a group of insulin dependent and noninsulin dependent diabetic volunteers. With noninsulin-dependent diabetics, the blood glucose area after a half bread portion was 48% that of the full bread meal (p less than 0.001). White pea beans (50 g CH2O) gave a blood glucose response of 41 +/- 5% (p less than 0.001) that of bread (50 g CH2O). A combined meal of bread (25 g CH2O) and beans (25 g CH2O) gave a blood glucose response of 60 +/- 8% of the full bread meal (p less than 0.005) and similar to that expected. Addition to bread of butter and skim milk cheese either singly or in combination had little effect on the glycemic response although a reduced rise was seen after addition of fat and protein as peanut butter. Insulin-dependent diabetics tended to respond similarly to noninsulin-dependent diabetics but their greater variability indicates that other factors in addition to the nature of the food may also be major determinants of their glycemic responses to foods.

Adult↗

PubMed1984

The relationship between glycemic response, digestibility, and factors influencing the dietary habits of diabetics.

A significant relationship was found between the rate of release of the sugars; glucose, maltose, and maltotriose from amylitic digestion of 10 foods tested in vitro (expressed as the digestibility index) and the blood glucose response to 50-g carbohydrate portions of the same foods eaten by diabetics (expressed as the glycemic index), (r = 0.815, n = 10, p greater than 0.01). The glycemic index related to both the palatability of the foods (r = 0.731, p less than 0.05) and their frequency of use (r = 0.698, p less than 0.05). However, in this group of motivated diabetics food use was not related directly to palatability, but rather to health belief (r = 0.689, p less than 0.05). The results suggest that carbohydrate foods of potential use to the diabetic may be identified by their in vitro digestion characteristics but to a large extent their acceptance will depend on health belief and possibly ease of preparation.

Aged↗

PubMed1984

Haematological and serological data from dogs raised worm-free and monospecifically infected with helminths.

Pups free from helminth infection were obtained by treating the bitch prior to parturition, and the bitch and her pups after whelping, with oxfendazole and praziquantel. They were then housed in an area free from contamination with helminth eggs. Freedom from infection was confirmed by necropsy examinations and by serological tests using the Enzyme Linked Immunosorbent Assay (ELISA). Groups of pups were infected with Toxocara canis, Echinococcus granulosus, Taenia ovis, T. pisiformis and T. hydatigena and bled at 5-day intervals. Haematological examinations and measurement of serum proteins were performed on blood samples obtained throughout 30 days of infection. Levels of serum proteins were not significantly altered in any infection. Pups infected with T. canis showed a marked increase in numbers of circulating eosinophils during the phase of larval migration through the liver and lungs; they also showed marked antibody responses to T. canis larval ES antigen. Haematological values were not significantly altered in any other pups.

Animals↗

PubMed1983

The glycaemic index of foods tested in diabetic patients: a new basis for carbohydrate exchange favouring the use of legumes.

Recently diabetic patients have been encouraged to increase their carbohydrate intake, but exact details of which foods to use are lacking. To determine whether sufficiently large differences existed to justify more specific dietary advice, we compared the glycaemic responses to 50 g carbohydrate portions of different foods, taken as breakfast test meals by groups of five to seven diabetic patients. Two- to threefold differences were seen amongst the 15 foods tested. The glycaemic responses for spaghetti, 'All-bran', rice and beans were significantly below those for bread, while 'Cornflakes' were above. Factors predicted to influence this were without effect, including: substituting wholemeal for white bread, increasing substantially the simple sugars (using 'All-bran' or bananas instead of wholemeal bread) and doubling meal protein by adding cottage cheese to bread. Paired comparisons of the glycaemic response to the five legumes with those of the seven other starchy foods (breads, spaghetti, rice, Cornflakes, oatmeal porridge and potatoes) showed that the mean peak rise in blood glucose concentration and mean area under the glucose curve after beans were 23 and 28% lower, respectively, than the mean for the other foods (p less than 0.001). Such results suggest a potentially valuable role for dried leguminous seeds in carbohydrate exchanges for individuals with impaired carbohydrate tolerance. These large differences in blood glucose response to different food cannot at present be predicted directly from tables of chemical composition. Nevertheless, physiological testing may both aid in understanding the factors responsible and help selection of the appropriate carbohydrate foods for the diabetic diet.

Aged↗

PubMed1983

Factors affecting starch digestibility and the glycemic response with special reference to legumes.

Large differences exist in the degree to which different starch containing foods affect the blood glucose levels of both normal volunteers and diabetics. These differences appear to relate to the digestibility of the starch and the factors determining this, including: the interaction of starch with fiber, antinutrients (eg, phytate) and protein in the food, together with the nature of the starch itself and its physical form (eg, raw or cooked, ground or whole). In this respect legumes exemplify a class of foods, high in fiber, protein and antinutrients, with a starch which is digested slowly in vitro. They also produce relatively small blood glucose rises after consumption by both normals and diabetics and in the longterm result in improved diabetic control. Identification of more such foods and further understanding of factors determining starch digestibility will allow greater therapeutic use of diet in the management of diabetics and disorders of carbohydrate metabolism.

Animals↗

PubMed1983

Leguminous seeds in the dietary management of hyperlipidemia.

Seven male hyperlipidemic patients substituted approximately 140g dried beans daily for other sources of starch in their diet over a 4-month period. After this, mean fasting serum triglyceride levels were reduced by 25 +/- 5% (p less than 0.01) while total serum cholesterol levels were 7 +/- 2% (p less than 0.5) lower than the values measured during the previous five clinic attendances (12 +/- 2.5 months). However, low- and high-density lipoprotein cholesterol levels remained unaltered. While taking beans a nonsignificant fall (0.7 kg) was seen in body weight. Nevertheless no change was seen in macronutrient intake determined by 1-wk diet histories recorded both before and four times during the study, although cholesterol intake decreased by 80 mg (p less than 0.02). Reintroduction of dried leguminous seeds into a Western diet may be a useful adjunct to the management of hyperlipidemia.

Adult↗

PubMed1983

The effect of phytic acid on in vitro rate of starch digestibility and blood glucose response.

The effect of phytic acid on starch digestibility was studied in vitro and related to the blood glucose response (glycemic index) in healthy volunteers. The glycemic index was found to correlate negatively with the phytic acid content of the food tested. In vitro digestion studies involving human saliva at physiological pH and temperature showed that in the presence of sodium phytate (equivalent to 2% phytic acid based on the starch portion), the rate of digestion of raw wheat starch was reduced significantly by 50%. This was reversed by the addition of calcium which is known to complex phytic acid. Similarly, when sodium phytate was added to unleavened bread, its digestibility was also decreased and in feeding trials high phytate bread produced a flattened blood glucose response.

Blood Glucose↗

PubMed1983