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16 pages, 475 KiB

Open AccessArticle

Dietary Glycemic Index and Glycemic Load Are Not Associated with the Metabolic Syndrome in Lebanese Healthy Adults: A Cross-Sectional Study

by Cecile Borgi, Mandy Taktouk, Mona Nasrallah, Hussain Isma’eel, Hani Tamim and Lara Nasreddine

Nutrients 2020, 12(5), 1394; https://doi.org/10.3390/nu12051394 - 13 May 2020

Cited by 1 | Viewed by 3966

Abstract

High dietary glycemic index (GI) and glycemic load (GL) were suggested to increase the risk of metabolic syndrome (MetS). This study aims to estimate dietary GI and GL in a sample of healthy Lebanese adults and examine their association with MetS and its [...] Read more.

High dietary glycemic index (GI) and glycemic load (GL) were suggested to increase the risk of metabolic syndrome (MetS). This study aims to estimate dietary GI and GL in a sample of healthy Lebanese adults and examine their association with MetS and its individual abnormalities. The study uses data from a community-based survey of 501 Lebanese urban adults. Dietary intake was assessed using a food frequency questionnaire. Biochemical, anthropometric, and blood pressure measurements were obtained. Subjects with previous diagnosis of chronic disease, metabolic abnormalities, or with incomplete data or implausible energy intakes were excluded, yielding a sample of 283. Participants were grouped into quartiles of GI and GL. Multivariate logistic regression analyses were performed. Average dietary GI and GL were estimated at 59.9 ± 8 and 209.7 ± 100.3. Participants belonging to the highest GI quartile were at increased risk of having MetS (odds ratio (OR) = 2.251, 95% CI:1.120–4.525) but this association lost significance with further adjustments. Those belonging to the second quartile of GI had significantly lower odds of having hyperglycemia (OR: 0.380, 95% CI:0.174–0.833). No associations were detected between GL and MetS. The study contributes to the body of evidence discussing the relationship between GI, GL, and MetS, in a nutrition transition context. Full article

(This article belongs to the Special Issue Dietary Glycemic Index and Glycemic Load: Clinical Significance and Limitations in the Prevention, Pathophysiology, and Treatment of Disease)

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Review

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78 pages, 1215 KiB

Open AccessEditor’s ChoiceReview

Effects of Diet, Lifestyle, Chrononutrition and Alternative Dietary Interventions on Postprandial Glycemia and Insulin Resistance

by Emilia Papakonstantinou, Christina Oikonomou, George Nychas and George D. Dimitriadis

Nutrients 2022, 14(4), 823; https://doi.org/10.3390/nu14040823 - 16 Feb 2022

Cited by 66 | Viewed by 20358

Abstract

As years progress, we are found more often in a postprandial than a postabsorptive state. Chrononutrition is an integral part of metabolism, pancreatic function, and hormone secretion. Eating most calories and carbohydrates at lunch time and early afternoon, avoiding late evening dinner, and [...] Read more.

As years progress, we are found more often in a postprandial than a postabsorptive state. Chrononutrition is an integral part of metabolism, pancreatic function, and hormone secretion. Eating most calories and carbohydrates at lunch time and early afternoon, avoiding late evening dinner, and keeping consistent number of daily meals and relative times of eating occasions seem to play a pivotal role for postprandial glycemia and insulin sensitivity. Sequence of meals and nutrients also play a significant role, as foods of low density such as vegetables, salads, or soups consumed first, followed by protein and then by starchy foods lead to ameliorated glycemic and insulin responses. There are several dietary schemes available, such as intermittent fasting regimes, which may improve glycemic and insulin responses. Weight loss is important for the treatment of insulin resistance, and it can be achieved by many approaches, such as low-fat, low-carbohydrate, Mediterranean-style diets, etc. Lifestyle interventions with small weight loss (7–10%), 150 min of weekly moderate intensity exercise and behavioral therapy approach can be highly effective in preventing and treating type 2 diabetes. Similarly, decreasing carbohydrates in meals also improves significantly glycemic and insulin responses, but the extent of this reduction should be individualized, patient-centered, and monitored. Alternative foods or ingredients, such as vinegar, yogurt, whey protein, peanuts and tree nuts should also be considered in ameliorating postprandial hyperglycemia and insulin resistance. This review aims to describe the available evidence about the effects of diet, chrononutrition, alternative dietary interventions and exercise on postprandial glycemia and insulin resistance. Full article

(This article belongs to the Special Issue Dietary Glycemic Index and Glycemic Load: Clinical Significance and Limitations in the Prevention, Pathophysiology, and Treatment of Disease)

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33 pages, 2067 KiB

Open AccessEditor’s ChoiceReview

Regulation of Postabsorptive and Postprandial Glucose Metabolism by Insulin-Dependent and Insulin-Independent Mechanisms: An Integrative Approach

by George D. Dimitriadis, Eirini Maratou, Aikaterini Kountouri, Mary Board and Vaia Lambadiari

Nutrients 2021, 13(1), 159; https://doi.org/10.3390/nu13010159 - 6 Jan 2021

Cited by 93 | Viewed by 16986

Abstract

Glucose levels in blood must be constantly maintained within a tight physiological range to sustain anabolism. Insulin regulates glucose homeostasis via its effects on glucose production from the liver and kidneys and glucose disposal in peripheral tissues (mainly skeletal muscle). Blood levels of [...] Read more.

Glucose levels in blood must be constantly maintained within a tight physiological range to sustain anabolism. Insulin regulates glucose homeostasis via its effects on glucose production from the liver and kidneys and glucose disposal in peripheral tissues (mainly skeletal muscle). Blood levels of glucose are regulated simultaneously by insulin-mediated rates of glucose production from the liver (and kidneys) and removal from muscle; adipose tissue is a key partner in this scenario, providing nonesterified fatty acids (NEFA) as an alternative fuel for skeletal muscle and liver when blood glucose levels are depleted. During sleep at night, the gradual development of insulin resistance, due to growth hormone and cortisol surges, ensures that blood glucose levels will be maintained within normal levels by: (a) switching from glucose to NEFA oxidation in muscle; (b) modulating glucose production from the liver/kidneys. After meals, several mechanisms (sequence/composition of meals, gastric emptying/intestinal glucose absorption, gastrointestinal hormones, hyperglycemia mass action effects, insulin/glucagon secretion/action, de novo lipogenesis and glucose disposal) operate in concert for optimal regulation of postprandial glucose fluctuations. The contribution of the liver in postprandial glucose homeostasis is critical. The liver is preferentially used to dispose over 50% of the ingested glucose and restrict the acute increases of glucose and insulin in the bloodstream after meals, thus protecting the circulation and tissues from the adverse effects of marked hyperglycemia and hyperinsulinemia. Full article

(This article belongs to the Special Issue Dietary Glycemic Index and Glycemic Load: Clinical Significance and Limitations in the Prevention, Pathophysiology, and Treatment of Disease)

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32 pages, 1178 KiB

Open AccessReview

Mens sana in corpore sano: Does the Glycemic Index Have a Role to Play?

by Lionel Carneiro and Corinne Leloup

Nutrients 2020, 12(10), 2989; https://doi.org/10.3390/nu12102989 - 29 Sep 2020

Cited by 13 | Viewed by 12822

Abstract

Although diet interventions are mostly related to metabolic disorders, nowadays they are used in a wide variety of pathologies. From diabetes and obesity to cardiovascular diseases, to cancer or neurological disorders and stroke, nutritional recommendations are applied to almost all diseases. Among such [...] Read more.

Although diet interventions are mostly related to metabolic disorders, nowadays they are used in a wide variety of pathologies. From diabetes and obesity to cardiovascular diseases, to cancer or neurological disorders and stroke, nutritional recommendations are applied to almost all diseases. Among such disorders, metabolic disturbances and brain function and/or diseases have recently been shown to be linked. Indeed, numerous neurological functions are often associated with perturbations of whole-body energy homeostasis. In this regard, specific diets are used in various neurological conditions, such as epilepsy, stroke, or seizure recovery. In addition, Alzheimer’s disease and Autism Spectrum Disorders are also considered to be putatively improved by diet interventions. Glycemic index diets are a novel developed indicator expected to anticipate the changes in blood glucose induced by specific foods and how they can affect various physiological functions. Several results have provided indications of the efficiency of low-glycemic index diets in weight management and insulin sensitivity, but also cognitive function, epilepsy treatment, stroke, and neurodegenerative diseases. Overall, studies involving the glycemic index can provide new insights into the relationship between energy homeostasis regulation and brain function or related disorders. Therefore, in this review, we will summarize the main evidence on glycemic index involvement in brain mechanisms of energy homeostasis regulation. Full article

(This article belongs to the Special Issue Dietary Glycemic Index and Glycemic Load: Clinical Significance and Limitations in the Prevention, Pathophysiology, and Treatment of Disease)

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22 pages, 513 KiB

Open AccessReview

Effects of Dietary and Lifestyle Interventions on Liver, Clinical and Metabolic Parameters in Children and Adolescents with Non-Alcoholic Fatty Liver Disease: A Systematic Review

by Christina N. Katsagoni, Eleftheria Papachristou, Amalia Sidossis and Labros Sidossis

Nutrients 2020, 12(9), 2864; https://doi.org/10.3390/nu12092864 - 19 Sep 2020

Cited by 22 | Viewed by 5664

Abstract

Non-alcoholic fatty liver disease (NAFLD) affects 5.5–10.3% of children worldwide, while in obese individuals, it increases to almost 34%. Pediatric NAFLD is consistently associated with metabolic syndrome and insulin resistance. As no pharmacological agents exist for the treatment of NAFLD, lifestyle modifications remain [...] Read more.

Non-alcoholic fatty liver disease (NAFLD) affects 5.5–10.3% of children worldwide, while in obese individuals, it increases to almost 34%. Pediatric NAFLD is consistently associated with metabolic syndrome and insulin resistance. As no pharmacological agents exist for the treatment of NAFLD, lifestyle modifications remain the only therapy. However, as not all overweight/obese children have NAFLD, high-quality data, focused exclusively on NAFLD population are needed. Therefore, the present systematic review assessed the efficacy of lifestyle (diet or exercise) based on randomized controlled clinical trials (RCTs) on liver, anthropometric, glucose, and lipid parameters in children, with imaging or biopsy-proven NAFLD. In general, the results were inconclusive and therefore no specific recommendations could be drawn. In most studies, differences were derived from within group comparisons, which are known to be highly misleading. However, both low-carbohydrate and low-fat diets could benefit liver outcomes, as long as weight loss is achieved, but not necessary glucose and lipid parameters. No RCTs were found on exercise alone, as compared to no intervention on pediatric NAFLD. Concerning diet plus exercise interventions, all studies led to improvements in liver outcomes accompanied with weight loss. Resolution of NAFLD was found in considerably high percentages, while improvements were also seen in glucose but were modest in lipid parameters. Full article

(This article belongs to the Special Issue Dietary Glycemic Index and Glycemic Load: Clinical Significance and Limitations in the Prevention, Pathophysiology, and Treatment of Disease)

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21 pages, 566 KiB

Open AccessReview

The Impact of Dietary Glycemic Index and Glycemic Load on Postprandial Lipid Kinetics, Dyslipidemia and Cardiovascular Risk

by Vaia Lambadiari, Emmanouil Korakas and Vasilios Tsimihodimos

Nutrients 2020, 12(8), 2204; https://doi.org/10.3390/nu12082204 - 24 Jul 2020

Cited by 15 | Viewed by 4853

Abstract

Many recent studies have acknowledged postprandial hypetriglyceridemia as a distinct risk factor for cardiovascular disease. This dysmetabolic state is the result of the hepatic overproduction of very low-density lipoproteins (VLDLs) and intestinal secretion of chylomicrons (CMs), which leads to highly atherogenic particles and [...] Read more.

Many recent studies have acknowledged postprandial hypetriglyceridemia as a distinct risk factor for cardiovascular disease. This dysmetabolic state is the result of the hepatic overproduction of very low-density lipoproteins (VLDLs) and intestinal secretion of chylomicrons (CMs), which leads to highly atherogenic particles and endothelial inflammation. Postprandial lipid metabolism does not only depend on consumed fat but also on the other classes of nutrients that a meal contains. Various mechanisms through which carbohydrates exacerbate lipidemia have been identified, especially for fructose, which stimulates de novo lipogenesis. Glycemic index and glycemic load, despite their intrinsic limitations, have been used as markers of the postprandial glucose and insulin response, and their association with metabolic health and cardiovascular events has been extensively studied with contradictory results. This review aims to discuss the importance and pathogenesis of postprandial hypertriglyceridemia and its association with cardiovascular disease. Then, we describe the mechanisms through which carbohydrates influence lipidemia and, through a brief presentation of the available clinical studies on glycemic index/glycemic load, we discuss the association of these indices with atherogenic dyslipidemia and address possible concerns and implications for everyday practice. Full article

(This article belongs to the Special Issue Dietary Glycemic Index and Glycemic Load: Clinical Significance and Limitations in the Prevention, Pathophysiology, and Treatment of Disease)

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26 pages, 1065 KiB

Open AccessReview

How Important Is Eating Rate in the Physiological Response to Food Intake, Control of Body Weight, and Glycemia?

by Georgia Argyrakopoulou, Stamatia Simati, George Dimitriadis and Alexander Kokkinos

Nutrients 2020, 12(6), 1734; https://doi.org/10.3390/nu12061734 - 10 Jun 2020

Cited by 31 | Viewed by 7508

Abstract

The link between eating rate and energy intake has long been a matter of extensive research. A better understanding of the effect of food intake speed on body weight and glycemia in the long term could serve as a means to prevent weight [...] Read more.

The link between eating rate and energy intake has long been a matter of extensive research. A better understanding of the effect of food intake speed on body weight and glycemia in the long term could serve as a means to prevent weight gain and/or dysglycemia. Whether a fast eating rate plays an important role in increased energy intake and body weight depends on various factors related to the studied food such as texture, viscosity and taste, but seems to be also influenced by the habitual characteristics of the studied subjects as well. Hunger and satiety quantified via test meals in acute experiments with subsequent energy intake measurements and their association with anorexigenic and orexigenic regulating peptides provide further insight to the complicated pathogenesis of obesity. The present review examines data from the abundant literature on the subject of eating rate, and highlights the main findings in people with normal weight, obesity, and type 2 diabetes, with the aim of clarifying the association between rate of food intake and hunger, satiety, glycemia, and energy intake in the short and long term. Full article

(This article belongs to the Special Issue Dietary Glycemic Index and Glycemic Load: Clinical Significance and Limitations in the Prevention, Pathophysiology, and Treatment of Disease)

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13 pages, 252 KiB

Open AccessReview

Glycemic Index (GI) or Glycemic Load (GL) and Dietary Interventions for Optimizing Postprandial Hyperglycemia in Patients with T2 Diabetes: A Review

by Dionysios Vlachos, Sofia Malisova, Fedon A. Lindberg and Georgia Karaniki

Nutrients 2020, 12(6), 1561; https://doi.org/10.3390/nu12061561 - 27 May 2020

Cited by 75 | Viewed by 17831

Abstract

The increasing prevalence of type 2 diabetes (T2D) worldwide calls for effective approaches to its management. Strategies for diabetes have generally focused on optimizing overall glycemic control as assessed by glycated hemoglobin (HbA1c) and fasting plasma glucose (FPG) values. However, since 2001, the [...] Read more.

The increasing prevalence of type 2 diabetes (T2D) worldwide calls for effective approaches to its management. Strategies for diabetes have generally focused on optimizing overall glycemic control as assessed by glycated hemoglobin (HbA1c) and fasting plasma glucose (FPG) values. However, since 2001, the American Diabetes Association has established postprandial glucose (PPG) as an independent contributor to both HbA1c and diabetes complications, and increasing evidence suggests that all three glycemic parameters of HbA1c, FPG, and postprandial glucose (PPG) are independently important. Objectives: The objective of this review was to comprehensively summarize the literature on the effects of nutritional strategies incorporating glycemic index (GI)/glycemic load (GL) on the postprandial hyperglycemia in people with T2D, as well as to provide recommendations for effective dietary strategies addressing both the dietary glycemic index and load in clinical practice. Design: An advanced Pubmed search was conducted. A total of 10 randomized controlled studies met the inclusion criteria. Six studies compared low-GI with higher GI meals, three included studies that compared reduced carbohydrate content with higher carbohydrate content, and one study compared meals of low-GI (with high or low fiber) with meals of higher GI (with high or low fiber). Results: Most of the clinical trials resulted in significant improvement (p < 0.05) of postprandial hyperglycemia. Conclusions: Either reducing the amount of carbohydrate in a meal or increasing consumption of soluble fiber has a favorable effect on postprandial glucose excursions. Full article

(This article belongs to the Special Issue Dietary Glycemic Index and Glycemic Load: Clinical Significance and Limitations in the Prevention, Pathophysiology, and Treatment of Disease)

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