glycemic and insulinemic response of staple indian foods kasturi sen ray, pooja singhania and neha...
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Glycemic and Insulinemic Response of Staple Indian Foods
Kasturi Sen Ray, Pooja Singhania and Neha PahariaUniversity Dept of Food Science and Nutrition
SNDT Women’s UniversityMumbai,
India
Quality Assessment of Selected Carbohydrate Rich Food for Normal and
Diabetic subjects
In diabetic condition, the metabolism of CHO is completely deranged.-
Dietary management focuses on maintaining the postprandial blood sugar levels close to normal.-
Life long dietary management requires careful selection of the quality and quantity of CHO.
There are food restrictions and taboos controlling the food intake in these subjects.
Many of them are misleading
Glycemic Index (GI) was traditionally used to assess Glycemic Quality of the food on Equi-carbohydrate basis. -
Area under 2 hr bl. Gluc. curve of 50 g CHO from test food Area under 2 hr bl. Gluc. Curve of 50 g glucose in water
GI =
X 100
-Amount of food - providing 50g of available CHO would vary tremendously in different food.
Therefore comparison becomes difficult and impractical.
Watermelon: A high GI of 72, a low GL of only 7.21.
Water melon have 92% water, bread has 37%.
Based on GI, watermelon is not a suitable food for people with diabetes. Bread , not even sweet in taste, have much more starch density and therefore higher glycemic impact.
We do not consume CHO in isolation, rather whole food along with co-nutrients - influencing the glycemic and insulinemic responses of food.
GI cannot reliably predict mixed meal responses.
The quantity of food consumed varies from person to person
GI is an absolute value. So people consume low GI food freely.
To overcome the limitations of GI, Glycemic index food (GIfood) has been introduced. GIfood determines the glycemic impact of
foods on Equi-quantity basis (Monro,
J.A, 2003).
AU 2 hr bl. Gluc. curve after 50 g available CHO from test food AU 2 hr bl. Gluc. curve after 50 g glucose in water
GI =
X 100
Area under 2 hr bl. Glu. response curve after 50 g test food
GI Food = X 100Area under 2 hr bl. Glu. response curve after 50 gm Std. food
GI is based on Food Science point of view
Glycemic index food is a functional classification based on Physiological impact of food
To determine the suitability of food for diabetic subject, we have selected few food items, tested for their physiological impact using GI food
method.
• Rice, • Whole wheat Chapatti • Mango
which are usually modified by the doctors and dietitians for subjects with diabetes.
Rice:
Chapatti:
.
Mango :
Classified as high GI product [GI: 60-110] Commonly restricted for a person with diabetes
Unleavened Indian flat bread made from whole wheat flour, low GI Value (GI = 45.1). Commonly advised and favorably consumed by Indians for its higher nutrient density
Strictly restricted for a person with diabetes due to its high free sugar content. Average GI of 51. An excellent source of soluble fibre, antioxidants like vitamin C and A and Beta carotene, a good source of vitamin B6 and other Phytonutirents of immense health benefits.
Materials and Method
Inclusion criterion of the subject:
The maturity onset diabetic subject [n=8,]
Age group of 45- 65yrs,Without any co-morbidity, Blood HbA1c level < 8, Comparatively stable sugar level with
hypoglycemic medicine ,
Age and BMI matched clinically healthy adults as normal group [n = 6]
Study design:
Blood was collected in fasting state and at 30, 60, 90 and 120 min post consumption of foods (Standard and test) with 100ml water, on different occasions.
Blood glucose and insulin was assessed following the double blind system.
Starch and moisture content of the food were analyzed.
The Incremental Area Under the Curve (IAUC) of Glycemic and Insulinemic response for each food sample was calculated.
•Result and discussion
- Proximate Composition of standard and test food
Food Product
Starchwwb g %
Total sol. Sugars
(g%)
Total CHO (g %)
Protein(g %)
Fat(g %)
Moisture(g %)
W. Bread(Britannia)
33.97±0.7
3.94 41.68 8.31 1.71
±0.9
37.26±3
Boiled Rice
(Surti Kolam)
20.47±0.4
- 20.47 7.33±0.6
1.35±0.9
75.15±1
Chapatti (whole wheat)
39.34±3.5
- 39.34 10.35±1.0
2.5 ± 1.0
27.16±5
MangoVariety:
Alphanso
3.45 ±5 .2
20 23.83 1.01 - 74.09
Fas 30m 60m 90m 120m
5.0
6.0
7.0
8.0
9.0
10.0
11.0
12.0
13.0
14.0
Bread Rice Chapati Mean
+ S
E B
lood
Glu
cose
mm
ol/
L
Diabetic
Fas 30m 60m 90m 120m 5.0 6.0 7.0 8.0 9.0
10.0 11.0 12.0 13.0 14.0 15.0
Bread Rice Chapati
Mea
n +
SE
Blo
od
G
luco
se
mm
ol/
L
Average delta glycemic impact of rice and wheat chapatti
(n = 8/group)
Normal
Diabetic : Cmax for rice was achieved by 30m followed by gradual decline to baseline. Equi-quantity Chapatti and bread cmax at 60m and continue to stay elevated even at the end of 120 min.
Normal: Bl. Glucose for all the product came down below baseline within 120m.
Fas 30m 60m 90m 120m -
2
4
6
8
10
12
14
16
18
20
Bread Rice Chapati
Mean
+ S
E S
eru
m
Insu
lin
mU
/L
Diabetic
Fas 30m 60m 90m 120m -
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
Bread Rice Chapati
Mean
+ S
E S
eru
m I
nsu
lin
m
U/L
Normal
Relative Insulinemic Impact of rice and Wheat chapatti
• Foods which trigger lower insulin secretion will be beneficial in diabetic condition . The insulin response to rice is lowest
followed by chapatti and bread.
Dose Response
The quantity of food consumed per meal varies from person to person ,affecting the blood glucose and insulin levels.
When the quantity changes, the GI Value does not change although it may result hyperglycemic effect.
GIfood Value is dose sensitive as well.
Average IAUC of Rice and Chapatti individuals
Rice 50g Rice 100g Chapatti 50g Chapatti 100g
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
3743
6838
5330
8916
7301244 1273 1692
Glycemic IAUC Insulin IAUC
Rice 50g Rice 100g Chapatti 50g
Chapatti 100g
0
1000
2000
3000
4000
5000
6000
7000
8000
1965
3990
2690
4230
2200
5647
2772
7563
Glycemic IAUCInsulin IAUC
NormalDiabetic
o Diabetic: When dose is increased, insulin is not increasing proportionately and therefore blood glucose is increasing more.
o Normal: The glycemic response to wheat chapatti is only 6% higher than rice, however, the insulin response for the same is 34% higher than rice.
o It indicate the higher insulinemic impact of wheat starch in comparison with rice starch.
GIfood is expressed in terms of Glycemic Bread Equivalent
[GBE]
GBE is “weight of bread that would induce the same glycemic response as a given amount of test food”.
Glycemic Bread Equivalent works like currency
Common serving sizes Food 50g/HH
measure
50g/GBE HH measure /
Serving
Amount (g)
/ Serving
GBE
/serving
Bread 3 ¼ slices 50 2 slices 31 31
Wheat
Chapatti
1½ medium 44 2 medium 60 73
Rice 1/4 cup 11 1 cup 130 26
(Sen Ray & Singhania (2015)
High moisture containing foods e.g. boiled rice (1 cup) can be safely consumed in their regular serving size without posing risk of postprandial hyperglycemia.
whereas, the normal serving size of Chapatti (2 medium) may produce prolonged hyperglycemia even greater than that induced by same amounts of bread
GBE of rice is 20means that 100g rice produces same glycemic responses as 20g bread
Even within a particular food group (cereals) Glycemic and insulin response varies a lot in both diabetic and normal individuals.
Fas 30m 60m 90m 120m
5.0
6.0
7.0
8.0
9.0
10.0
11.0
12.0
13.0
14.0
Bread Mango
Me
an
+ S
E B
loo
d G
luco
se
m
mo
l/L
Dia-betic
Fas 30m 60m 90m 120m 5.0
6.0
7.0
8.0
9.0
10.0
11.0
12.0
13.0
14.0
15.0
Bread Mango
Me
an
+ S
E B
loo
d
Glu
co
se
mm
ol/
L
Normal
Mango exerts a lower glycemic response than white bread in terms of both Cmax as well as AUC in diabetic and normal individuals .
The IAUC of mango was seen to be 3 times lower than standard food bread, in both the groups and this difference is significant.
Glycemic Impact of Mango
Mango FruitsSugars naturally present in food have a lower
glycemic impact than refined starchy carbohydrate foods, e.g. Bread [Wolever and Brand Miller, 1995].
Fruits mainly contain simple sugars such as sucrose, glucose and fructose
In fruits, the starch present in form of resistant starch RS1 or RS2 as intact encapsulated and not available to the digestive enzymes.
RS3 is found in only cooked food items and absent in fresh fruits.
Conclusion Wheat products – Wheat Chapatti and
bread, not sweet in taste, having higher glycemic impact and high demand for insulin, may not be a preferred choice for Diabetic person.
Rice , commonly restricted in diabetic individuals due to its high glycemic index- is a better option as a carbohydrate source for diabetic person.
The lower insulinemic impact of rice may help in reducing the stress on the pancreas, particularly beneficial in management of diabetes and people with insulin resistance.
GBE can be used to predict response to common serving / any measures consumed.
Having same unit in gm, can be included in the Food Exchange table
Thank you