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Glycemic index in the diet of European outpatients with type 1 diabetes: relations to glycated hemoglobin and serum lipids.

BACKGROUND: Little is known about the variation of the glycemic index (GI) in the diet of European outpatients with type 1 diabetes and how the GI of a commonly consumed diet is associated with metabolic control. OBJECTIVE: The present study examined the calculated dietary GI of European outpatients with type 1 diabetes for possible relations to glycated hemoglobin (Hb A(1c)) and serum lipid concentrations. DESIGN: The relation of the GI (calculated from a 3-d dietary record) to Hb A(1c), serum cholesterol (total, LDL, and HDL), and fasting triacylglycerol was analyzed in 2810 people with type 1 diabetes from the EURODIAB Complications Study. RESULTS: The GI was independently related to Hb A(1c) (P = 0.0001). Compared with the highest GI quartile (median GI: 89), adjusted Hb A(1c) in the lowest GI quartile (median GI: 75) was 11% lower in patients from southern European centers and 6% lower in patients from northern, western, and eastern European centers. Of the serum lipids, only the HDL cholesterol in patients from these European centers was independently related to the GI (P = 0.002). In southern European centers, the consumption of pasta, temperate-climate fruit, white bread, and potatoes largely determined the patients' dietary GI, whereas in the northern, western, and eastern European centers, consumption of bread, potatoes, and temperate-climate fruit was most relevant. CONCLUSIONS: This study in European patients with type 1 diabetes showed that a lower dietary GI is related to lower Hb A(1c) concentrations, independently of fiber intake. The consumption of bread and pasta had the biggest effect on the overall dietary GI of European outpatients.

Adolescent↗

Interaction between cholesterol and glucose metabolism during dietary carbohydrate modification in subjects with the metabolic syndrome.

BACKGROUND: Carbohydrate modification based on rye bread and pasta enhances early insulin secretion in subjects with the metabolic syndrome. OBJECTIVE: Because the actions of insulin and cholesterol metabolism are interrelated, the question is raised of whether it is possible to alter cholesterol metabolism by means of dietary carbohydrate modification. DESIGN: We investigated the 12-wk effects of dietary carbohydrate modification on cholesterol synthesis and absorption by measuring the ratios of surrogate markers of precursor (cholestenol, desmosterol, and lathosterol) and absorption (cholestanol and plant sterols) sterols to cholesterol and their association to glucose metabolism in 74 subjects with the metabolic syndrome. The subjects were randomly assigned to diets with rye bread and pasta (RPa) or oat, wheat bread, and potato (OWPo) as the main carbohydrate source (34% and 37% of energy intake, respectively). RESULTS: During the study, serum cholesterol concentrations remained unchanged. Cholesterol synthesis was lower (6-10% for cholestenol and lathosterol; P < 0.05) and absorption higher (9%; P < 0.05 for sitosterol) with the OWPo diet than at baseline. With the RPa diet, cholesterol absorption was lower and synthesis higher than with the OWPo diet. The increment in the glucose area under the curve with the RPa diet was positively related to baseline cholesterol synthesis (eg, lathosterol; r = 0.480, P < 0.05) and negatively to absorption (for cholestanol; r = -0.520, P < 0.05). In the combined group, the changes in the cholestanol ratio and the insulinogenic index were interrelated (r = -0.464, P < 0.001). CONCLUSIONS: Carbohydrate modifications had dissimilar effects on cholesterol metabolism. Consumption of RPa, as compared with OWPo, may be clinically more favorable because it seems to inhibit the absorption of cholesterol, a factor crucial in the development of arterial atherosclerosis.

Adult↗

Relative bioavailability of zinc from selected cereals and legumes using rat growth.

The relative bioavailability of zinc (RBAZ) in corn, rice, wheat and legumes was determined by the ratio of net weight gains a 6 ppm of added zinc, a measure derived from sigmoidal curves for weight gain estimated by a non-linear, least-squares curve fitting computer program. Each food was prepared as for human consumption, incorporated into a semi-purified diet to provide varying levels of zinc and fed to weanling rats. Among cereals, whole corn and brown rice had low RBAZ (0.58 or less), while whole wheat flour and unleavened whole wheat bread had medium values (0.63-0.74). Refined cereal grains, such as white flour, leavened and unleavened white bread and white rice, had high RBAZ (0.89-1.08) as did leavened whole wheat bread (1.04). Of the legumes, lima beans had a high RBAZ (0.84) while white beans had a medium value (0.74). Phytic acid content of the foods, but not neutral-detergent fiber content, appeared to be inversely related to RBAZ, more so among the cereals than with the legumes.

Animals↗

The effect of pectin on the utilization of marginal levels of dietary protein by weanling rats.

The effect of dietary pectin levels on protein utilization was studied in weanling rats. Levels of 0, 4.8, 16.7 and 28.6% pectin were used in diets containing 10% protein from casein, bread or bread supplemented with lysine or lysine and threonine. Food intake, energy digestibility and protein digestibility were lowered by dietary pectin, resulting in very strong decreases in digestible energy and digestible protein intakes, protein being affected relatively more than energy. The weight gain of the experimental animals was also incrementally inhibited, with a net loss of weight occurring at the 28.6% pectin level. At this level of pectin addition, the mortality of the experimental groups averaged 50%, death occurring within the first 2 weeks of feeding the experimental diets. Dietary pectin worsened the animal's feed conversion and affected negatively the efficiency with which dietary protein was utilized for growth as measured by the net protein ratio, this effect being much more severe for the higher quality protein diets. It seems to have brought the animals' net protein utilization (NPUs) toward intermediate values, increasing the NPUs of the groups fed the bread-based diets and diminishing those of the other protein groups. The cause of these effects is not clear, although they may be due in part to a lower ratio of digestible protein to digestible energy with increasing dietary pectin. Other participating mechanisms may be the development of adverse intestinal microflora or binding of some essential amino acids to a greater extent than others.

Animals↗

From Olympia to Atlanta: a cultural-historical perspective on diet and athletic training.

Greek and Roman writers described diet and training of Olympic athletes. Lucian (A.D. 120-ca. 180) described distance and speed work in runners; Galen (A.D. 131-201) recommended ball-related exercises to train vision and the body; Philostratos (A.D. 170-249) suggested cross training by endurance running, weight training, and wrestling with animals. The ancient Greek training system, the tetrad (eta tau epsilon tau rho alpha sigma), was a four-day cycle with each day devoted to a different activity. Diogenes Laertius (died A.D. 222) wrote that Greek athletes trained on dried figs, moist cheese and wheat; then the pattern changed and focused on meat. Epictetus (2nd century A.D.) wrote that Olympic victors avoided desserts and cold water and took wine sparingly. Philostratos deprecated athletic diet in his era, a pattern based on white bread sprinkled with poppy seeds, fish and pork. Americans at the XIth Olympiad in Berlin (1936) consumed beefsteak with average daily intake of 125 grams of butter or cotton oil, three eggs, custard for dessert and 1.5 L of milk. The American pattern at Berlin was characterized by ad libitum intake of white bread, dinner rolls, fresh vegetables and salads. At Atlanta, more than 5 million meals will be served during the Olympic festival. The highly varied menu will include fresh vegetables and dips; fruits, cheeses and breads; salads; pasta, rice and fruit salads; soups; meat and seafood entrees; hot vegetables; desserts; and beverages. American Southern specialties will be served.

Diet↗

Almonds decrease postprandial glycemia, insulinemia, and oxidative damage in healthy individuals.

Strategies that decrease postprandial glucose excursions, including digestive enzyme inhibition, and low glycemic index diets result in lower diabetes incidence and coronary heart disease (CHD) risk, possibly through lower postprandial oxidative damage to lipids and proteins. We therefore assessed the effect of decreasing postprandial glucose excursions on measures of oxidative damage. Fifteen healthy subjects ate 2 bread control meals and 3 test meals: almonds and bread; parboiled rice; and instant mashed potatoes, balanced in carbohydrate, fat, and protein, using butter and cheese. We obtained blood samples at baseline and for 4 h postprandially. Glycemic indices for the rice (38 +/- 6) and almond meals (55 +/- 7) were less than for the potato meal (94 +/- 11) (P < 0.003), as were the postprandial areas under the insulin concentration time curve (P < 0.001). No postmeal treatment differences were seen in total antioxidant capacity. However, the serum protein thiol concentration increased following the almond meal (15 +/- 14 mmol/L), indicating less oxidative protein damage, and decreased after the control bread, rice, and potato meals (-10 +/- 8 mmol/L), when data from these 3 meals were pooled (P = 0.021). The change in protein thiols was also negatively related to the postprandial incremental peak glucose (r = -0.29, n = 60 observations, P = 0.026) and peak insulin responses (r = -0.26, n = 60 observations, P = 0.046). Therefore, lowering postprandial glucose excursions may decrease the risk of oxidative damage to proteins. Almonds are likely to lower this risk by decreasing the glycemic excursion and by providing antioxidants. These actions may relate to mechanisms by which nuts are associated with a decreased risk of CHD.

Adult↗

Work-related asthma in a population exposed to grain, flour and other ingredient dusts.

The purpose of the study was to determine the prevalence and causation of work-related asthmatic symptoms in a population exposed to grain, flour and other ingredient dusts. Where workers complained of asthmatic symptoms which were the result of dust exposure, follow-up aimed to identify whether the symptoms were the result of sensitisation or of non-specific irritation. A questionnaire was presented to 3,450 workers who had exposure to dust during the course of flour milling (528), bread baking (1,756), cake baking (209) and other activities in food preparation (957). Those with positive responses were followed-up by taking a formal history, examination, skin prick testing and serial peak flow measurement. The overall prevalence of work-related asthmatic symptoms was 4.4% (153 out of 3,450). In the group who were followed-up (128 out of 153), non-specific respiratory irritation was thought to be the cause in 90 (2.6%), whilst sensitisation was responsible for symptoms in 12 (0.3%). Of the 12 cases due to sensitisation, the agents responsible were: fungal amylase (10 cases, all associated with bread baking), flour (one case, associated with flour packing), and grain (one case, associated with flour milling). Non-specific irritation is considerably more common than sensitisation as the cause of work-related asthmatic symptoms in flour milling, baking and other flour-based industries. The prevalence of sensitisation to flour is very low (less than 1 in 1,000) in all these industries. The principal sensitiser encountered in modern plant bakeries appears to be fungal amylase. The most important source of exposure to fungal amylase is probably the debagging, sieving, weighing and mixing of bread improvers.

Adult↗

Health surveillance in milling, baking and other food manufacturing operations--five years' experience.

The objective of this study was to describe the incidence of allergic respiratory disease and its outcome in terms of symptoms and jobs, across different flour-using industries. It uses the findings of a health surveillance programme in a large food organization over a five-year period. The population under surveillance consisted of 3,450 employees with exposure to ingredient dusts, of whom 400 were in flour milling, 1,650 in bread baking, 550 in cake baking and 850 in other flour-using operations. A total of 66 employees with either asthma or rhinitis symptoms attributable to sensitization to allergens in the workplace were identified. The majority of these (48/66) had become symptomatic prior to the commencement of the health surveillance programme in 1993. The incidence rates (per million employees per year) for those who developed symptoms between 1993 and 1997 were 550 for flour milling, 1,940 for bread baking, 0 for cake baking and 235 for other flour-using operations. The agent believed to be responsible for symptoms was most commonly grain dust in flour millers and fungal amylase in bread bakers. Wheat flour appeared to have a weaker sensitizing potential than these other two substances. In terms of outcome, at follow-up 18% of symptomatically sensitized employees had left the company. Two of the ex-employees retired through ill health due to occupational asthma. Of those still in employment, 63% described an improvement in symptoms, 32% were unchanged and 4% were worse than when first diagnosed. Over half the cases still in employment were continuing to work in the same job as at the time of diagnosis.

Amylases↗

Coffee, dietary habits, and serum cholesterol among men and women 35-49 years of age.

The relations between coffee and dietary habits and between coffee, dietary habits, and serum cholesterol were examined in 11,912 men and 12.328 women aged 35-49 years in the Cardiovascular Disease Risk Factor Study in Oppland, southern Norway, 1976-1978. Dietary data are based on results from a self-administered questionnaire. In both sexes, the dietary pattern of persons with a high coffee consumption differed from that of persons with a low coffee consumption: Heavy coffee drinkers had a higher consumption of bread, potatoes, and butter or margarine per slice of bread and more frequent use of hard margarine; men had a higher consumption of eggs and a lower consumption of skim milk. These results suggest a higher total food and fat consumption and a lower ratio of polyunsaturated to saturated fatty acids among heavy coffee drinkers. However, only 20% of the variation in coffee consumption was explained by dietary and lifestyle variables. The study confirmed a positive relation between serum cholesterol and use of butter or hard margarine (p less than 0.001) and between serum cholesterol and coffee consumption (p less than 0.001). Bread consumption and milk consumption were negatively correlated to serum cholesterol. The negative association with skim milk was significant only in women (p less than 0.01).

Adult↗

Rapid generation of new powdery mildew resistance genes after wheat domestication.

Plant defence against pathogens is controlled by disease resistance (R) gene products that directly or indirectly detect specific pathogen effectors. Plant-pathogen interactions have been proposed to follow a co-evolutionary arms-race model where R genes are recent and evolve rapidly in response to structural changes in matching pathogen effectors. However, the longevity and extensive polymorphism of R genes studied were more consistent with balancing selection maintaining ancient and diverse R genes or alleles. In bread wheat (Triticum aestivum), the Pm3 locus confers race-specific resistance to wheat powdery mildew (Blumeria graminis f.sp. triticii). Here we describe recently generated Pm3 resistance alleles that all derive from one susceptible allele, Pm3CS, which is widespread among hexaploid bread-wheat lines. One group of four Pm3 resistance alleles shows few, clearly delimited, polymorphic sequence blocks of ancient origin, embedded in sequences identical to Pm3CS and possibly derived from gene conversion. A second group of three alleles differs from Pm3CS by only two to five mutations, all non-synonymous, and all in the leucine-rich repeat-encoding region. Transient transformation experiments confirmed that Pm3 resistance specificities are based on one or few amino acid changes. The Pm3CS allele was found in wild tetraploid wheat, the ancestor of hexaploid bread wheat, specifically from southern Turkey, a region proposed to be the site of wheat domestication. Based on these data, we propose that the Pm3 resistance alleles were generated in agricultural ecosystems after domestication of wheat 10,000 years ago. The evolution of Pm3 alleles in wheat is best described by the model of evolved recycling, where novel genetic variation is integrated in plant populations together with recycling of old variation.

Alleles↗

Influence of ripeness of banana on the blood glucose and insulin response in type 2 diabetic subjects.

Banana is a popular and tasty fruit which often is restricted in the diet prescribed for diabetic patients owing to the high content of free sugars. However, in under-ripe bananas starch constitutes 80-90% of the carbohydrate content, which as the banana ripens changes into free sugars. To study the effect of ripening on the postprandial blood glucose and insulin responses to banana, 10 type 2 (non-insulin-dependent) diabetic subjects consumed three meals, consisting of 120 g under-ripe banana, 120 g over-ripe banana or 40 g white bread on separate days. The mean postprandial blood glucose response area to white bread (181 +/- 45 mmol l-1 x 240 min) was significantly higher compared with under-ripe banana (62 +/- 17 mmol l-1 x 240 min: p < 0.01) and over-ripe banana (106 +/- 17 mmol l-1 x 240 min: p < 0.01). Glycaemic indices of the under-ripe and over-ripe bananas differed (43 +/- 10 and 74 +/- 9: p < 0.01). The mean insulin response areas to the three meals were similar: 6618 +/- 1398 pmol l-1 x 240 min (white bread), 7464 +/- 1800 pmol l-1 x 240 min (under-ripe banana) and 8292 +/- 2406 pmol l-1 x 240 min (over-ripe banana). The low glycaemic response of under-ripe compared with over-ripe bananas may be ascribed to the high starch content, which has previously been found to be only hydrolysed slowly by alfa-amylase in humans.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Glucose↗

Investigation of Ancient Egyptian Baking and Brewing Methods by Correlative Microscopy

Ancient Egyptian methods of baking and brewing are investigated by optical and scanning electron microscopy of desiccated bread loaves and beer remains. The results suggest that current conceptions about ancient Egyptian bread and beer making should be modified. Bread was made not only with flour from raw grain, but sometimes also with malt and with yeast. Brewing blended cooked and uncooked malt with water; the mixture was strained free of husk before inoculation with yeast.

Journal Article↗

Rate of digestion of foods and postprandial glycaemia in normal and diabetic subjects.

Carbohydrate portions (2 g) of lentils, soya beans, and wholemeal bread were incubated for three hours with human digestive juices and the effect of digestibility on blood glucose examined. Lentils and soya beans released only 39% and 8% respectively of the sugars and oligosaccharides liberated from bread. In healthy volunteers 50 g carbohydrate portions of cooked lentils and soya beans raised blood glucose concentrations by only 42% (p < 0.001) and 14% (p < 0.001) of the bread value. There was a similar response in diabetics. These results suggest that rate of digestion might be a important factor determining the rise in blood glucose concentration after a meal and that supplementing chemical analysis with in-vitro and in-vivo food testing might permit identification of especially useful foods for diabetics.

Adult↗

Effect of guar crispbread with cereal products and leguminous seeds on blood glucose concentrations of diabetics.

To compare the effect on blood glucose concentrations of guar incorporated into crispbreads with that of unprocessed high-fibre foods groups of four to six diabetics took a total of seven test breakfasts on separate days. By comparison with a breakfast of wholemeal bread and cheese, guar crispbread combined with bread reduced the area under the glucose response curve to 51% (p < 0.05); bread and soya beans reduced the area to 65% (p < 0.05); guar crispbread with soya beans to 25% (p < 0.002); and soya beans with lentils to 29% (p < 0.002). Porridge and cornflake breakfasts showed no difference. The favourable results with leguminous seeds may not make such meals more acceptable than meals of guar products, but a combination of leguminous seeds and guar may allow smaller and more acceptable amounts of both to be used.

Adult↗

Calculated iodine intake before and after simulated iodization (Dutch Nutrition Surveillance System).

To estimate the effect of possible goitre prophylactic measures on the intake of iodine among population groups, simulation studies, based on the first Dutch National Food Consumption Survey, were carried out. Iodine intake figures and prevalence of low intakes were calculated after fictively iodizing either bread, a combination of industrial products, milk and dairy products (without cheese) or margarine and shortenings. In addition, the effect of iodizing both bread and cheese or bread + biscuits + rusks was calculated. The simulated iodization of different products increased mean calculated iodine intakes by up to 45% and gave a reduction of 60-90% in the prevalence of iodine intakes below 100 micrograms/day. The maximum acceptable intake of 1 mg iodine per day was never reached by any subject (average of 2 days). It is concluded that it is possible to increase substantially the mean iodine intake of the Dutch population and to decrease the prevalence of low iodine intakes without a clear risk of exceeding the maximum acceptable daily oral iodine intake.

Administration, Oral↗

Effects of dietary fat on postprandial substrate oxidation and on carbohydrate and fat balances.

To study the effect of dietary fat on postprandial substrate utilization and nutrient balance, respiratory exchange was determined in seven young men for 1 h before and 9 h after the ingestion of one of three different breakfasts: i.e., bread, jam, and dried meat (482 kcal: 27% protein, 62% carbohydrate, and 11% fat); bread, jam, and dried meat plus 50 g of margarine containing long-chain triglycerides (LCT); or bread, jam, and dried meat plus 40 g medium-chain triglycerides (MCT) and 10 g LCT margarine (858 kcal: 15% protein, 35% carbohydrate, and 50% fat). Plasma glucose concentrations peaked 45 min after the start of the meals. When compared with the low fat meal, the LCT margarine supplement had no effect at any time on circulating glucose and insulin concentrations, nor on the respiratory quotient. When MCTs were consumed, plasma glucose and insulin concentrations remained lower and plasma FFA concentrations higher during the first 2 h. 9 h after the breakfasts, the amounts of substrates oxidized were similar in each case, i.e., approximately 320, 355, and 125 kcal for carbohydrate, fat, and protein, respectively. This resulted in comparable carbohydrate (mean +/- SD = -22 +/- 32, -22 +/- 37, and -24 +/- 22 kcal) and protein balances (-7 +/- 9, +7 +/- 7, and -8 +/- 11 kcal) after the low fat, LCT- and MCT-supplemented test meals, respectively. However, after the low fat meal, the lipid balance was negative (-287 +/- 60 kcal), which differed significantly (P less than 0.001) from the fat balances after the LCT- and MCT-supplemented meals, i.e., +60 +/- 33 and +57 +/- 25 kcal, respectively. The results demonstrate that the rates of fat and of carbohydrate oxidation are not influenced by the fat content of a meal.

Blood Glucose↗

Food selection associated with sense of coherence in adults.

BACKGROUND: Favorable dietary habits promote health, whereas unfavorable habits link to various chronic diseases. An individual's "sense of coherence" (SOC) is reported to correlate with prevalence of some diseases to which dietary habits are linked. However, understanding what determines an individual's dietary preferences and how to change his/her behavior remains limited. The aim of the present study was to evaluate associations between dietary intake and SOC in adults. METHODS: Diet intake was recorded by an 84-item semi-quantitative food frequency questionnaire and SOC was measured by the 13-item Antonovsky questionnaire in 2,446 men and 2,545 women (25-74 years old) from the population based northern Sweden MONICA screening in 1999. RESULTS: Intakes of energy, total and saturated fat, ascorbic acid, sucrose, and servings of fruits, vegetables, cereals, and sweets correlated with SOC among women, whereas intakes of total and saturated fat, ascorbic acid, fiber, and alcohol, and servings of fruits, vegetables, bread, bread and cereals, fish, and potatoes correlated with SOC among men. With a few exceptions, intakes of these nutrients/foods were significantly explained by SOC quartile scores in linear GLM models. Both women and men classified into the highest SOC quartile had significantly higher age-BMI-education standardized mean intakes of vegetables than those in the lowest quartiles. Women in the highest SOC quartile also had higher intake of fruits but lower intakes of energy, total and saturated fat, sucrose, and sweets. Projection to latent structures (PLS) multivariate modeling of intakes of the 84 food items and food aggregates simultaneously on SOC scores supported low SOC to coincide with a presumably less health promoting dietary preference, e.g. intake of pizza, soft drinks, candies, sausages for main course, hamburgers, mashed potato, chips and other snacks, potato salad, French fries, whereas men and women with high SOC scores were characterized by e.g. high intake of rye crisp whole meal bread, boiled potato, vegetables, berries, and fruits. CONCLUSION: Both men and women in the highest, as compared with the lowest, SOC score quartile reported more "healthy" food choices. Dietary habits for individuals in the lowest SOC quartile therefore may render a higher risk for various endemic diseases.

Adult↗

In vitro activation of adenylate cyclase of atrophic celiac intestinal mucosa by wheat gliadin-derived peptides.

In order to demonstrate that gliadin peptides may interact with cell membranes of celiac small intestinal mucosa, the capacity of these peptides to activate the cell membrane enzyme adenylate cyclase was tested. The addition of peptides from bread wheat purified A-gliadin and whole gliadin (proteins that are toxic for celiac patients) enhanced the adenylate cyclase activity of crude cell membrane preparations obtained from atrophic small intestinal mucosa of celiac patients. No activation of adenylate cyclase of this tissue was observed with peptides from proteins nontoxic for celiac patients (bread wheat albumin and maize prolamin). Gliadin peptides did not activate adenylate cyclase of morphologically normal small intestinal mucosa from normal subjects or from celiac patients in remission. These results, therefore, suggest that peptides from bread wheat gliadin may interact with cell membrane of atrophic small intestinal mucosa of celiac patients.

Adenylyl Cyclases↗