Can certain foods counter the response of high glycemic index meals?
The increasing prevalence of type 2 diabetes (T2D) is a major health concern. According to the International Diabetes Federation Eighth edition 2017, 425 million adults (20-79 years of age) worldwide are affected by diabetes, out of which 159 million adults are from Western Pacific region2.
Various studies have found a significant incident risk relation between T2D with dietary GI and GL, but the results were inconsistent. In view of this, Livesey et al.3conducted a systematic review and meta-analyses of observational studies. They searched MEDLINE, EMBASE, PROSPERO and Cochrane Library for relevant peer reviewed prospective cohort studies published before 6th December 2018. The researchers evaluated 24 studies for T2D-GI risk relation and T2D-GL risk relation.
Livesey and colleagues concluded that in adults initially with good health, high GI or GL diet is strongly associated with incident T2D. The reference range of GI ranged from low (<55), moderate (56-69) and high (≥70). According to global observations, a diet with a GI of 76.1 units has an 87% increased risk of diabetes development than a diet of 47.6 units GI. Likewise, a diet with GL of 257 g/day out of 2,000 kcal has an 89% increased risk of diabetes development than a diet with GL of 73 g/day out of 2,000 kcal3.
Since white rice is a staple of Asian diet, which is rich in carbohydrate along with high GI4, research is focused on dietary intervention to modify Asian diet to reduce the risk of diabetes. The GI of foods can be lowered by various plant derived ingredients such as beta-glucan, alginates, pectins, isomaltulose and high viscosity hydroxylpropylmethylcellulose (HV-HPMC). For example, beta-glucan has been used to lower the GI of chapattis (unleavened Indian flatbread)5 and HV-HPMC has been used for reducing glycemic response of mashed potato6.
Essence of chicken (EOC), a popular health beverage rich in amino acids has been used in Southeast Asia for various health benefits including as a nutritional supplement in adults, a health supplement to improve breast milk quantity and quality in lactating mothers and to relief stress in general population. Sun and colleagues studied the health benefit of EOC on 10 healthy individuals. They demonstrated that GI of white bread is reduced from 83 to 57 after co-consumption of EOC with white bread6. Another study conducted on 16 healthy Chinese males showed a significant effect in reducing the peak postprandial blood glucose level after co-ingestion of white rice with EOC (68 ml or 136 ml)8.
Similarly, amino acids (threonine, lysine, isoleucine, leucine, valine) consumption from whey and soy protein drinks before meal has been shown to improve insulin secretion and reduce glycemic response9. Furthermore, co-ingestion of sugar-free soymilk and rice bran-fortified soymilk with a carbohydrate (white bread) is associated with reduced glycemic response and increased early-phase insulin secretion10.
Since people in Southeast Asia enjoy high GI foods such as white bread and rice, which have been linked to higher diabetes prevalence; additional dietary intervention with EOC, soymilk, fibers and other plant derived ingredients can be consumed with carbohydrate rich diet to reduce GI and glycemic response of these foods as part of a healthy lifestyle.
- Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes: energy, carbohydrates, fiber, fat, fatty acids, cholesterol, protein, and amino acids. Washington: National Academies Press; 2002. Available from: https://www.nal.usda.gov/sites/default/files/fnic_uploads/energy_full_report.pdf
- International Diabetes Federation – Facts & figures [Internet]. Idf.org. 2019 [cited 7 August 2019]. Available from: https://www.idf.org/aboutdiabetes/what-is-diabetes/facts-figures.html
- Livesey G, Taylor R, Livesey HF, Buyken AE, Jenkins DJA, Augustin LSA, Sievenpiper JL, Barclay AW, Liu S, Wolever TMS, Willett WC, Brighenti F, Salas-Salvadó J, Björck I, Rizkalla SW, Riccardi G, La Vecchia C, Ceriello A, Trichopoulou A, Poli A, Astrup A, Kendall CWC, Ha MA, Baer-Sinnott S, Brand-Miller JC. Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes: A Systematic Review and Updated Meta-Analyses of Prospective Cohort Studies. Nutrients. 2019;11(6):1280.
- Hu EA, Pan A, Malik V, Sun Q. White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review. BMJ. 2012;344:e1454.
- Thondre PS, Henry CJK. High-molecular-weight barley beta-glucan in chapatis (unleavened Indian flatbread) lowers glycemic index. Nutrition Research. 2009;29(7):480–486.
- Lightowler HJ, Henry CJ. Glycemic response of mashed potato containing high-viscocityhydroxypropylmethylcellulose. Nutrition Research. 2009;29(8): 551–557.
- Sun L, Tan KW, Henry CJ. Co-ingestion of essence of chicken to moderate glycaemic response of bread. International Journal of Food Sciences and Nutrition. 2015;66(8):931-5.
- Soong YY, Lim J, Sun L, Henry CJ. Effect of co-ingestion of amino acids with rice on glycaemic and insulinaemic response. The British Journal of Nutrition. 2015;114(11):1845-51.
- Gunnerud UJ, Heinzle C, Holst JJ, Östman EM, Björck IM. Effects of pre-meal drinks with protein and amino acids on glycemic and metabolic responses at a subsequent composite meal. PLoS One. 2012;7(9):e44731.
- Camps SG, Lim J, Ishikado A, Inaba Y, Suwa M, Matsumoto M, Henry CJ. Co-Ingestion of Rice Bran Soymilk or Plain Soymilk with White Bread: Effects on the Glycemic and Insulinemic Response. Nutrients. 2018;10(4):449.