Healthy Clinical Trial
Official title:
Effects of Enriched Fruit Juice on Blood Glucose Levels After a Meal in Healthy Subjects
Results from a large number of studies in humans have shown that diets rich in foods that
give lower glucose response bring lower risk of type 2 diabetes. Polyphenols, naturally found
in fruits, vegetables and grains, have shown the potential to attenuate post-prandial blood
glucose spikes following a carbohydrate-rich meal, through partial inhibition of the main
enzymes of carbohydrate digestion and reduction in glucose and fructose transport from the
gut after digestion and by enhancing the insulin action after glucose reaches the
bloodstream.
This study is designed to determine whether polyphenols, as normally and naturally present in
food extracts and beverages, added to a carbohydrate-rich meal, can lower blood glucose
levels after its consumption, and hence lower its glycaemic index, and if this effect is
mediated through effects on insulin and other hormones. The study is designed as an acute,
double-blind, randomised, placebo-controlled crossover trial in 24 healthy subjects with
normal glycaemic response to white bread. Participants will be asked to consume either white
bread with pomegranate juice enriched with extracts from grape seeds and apple peels or white
bread with placebo drink. The effects on plasma glucose levels, levels of hormones and other
biomarkers involved in postprandial response will be determined over 3 hours after the
consumption.
Consumption of carbohydrate-rich foods or sugary drinks affects blood glucose levels. Results
from a large number of studies in humans have shown that diets rich in foods that give lower
glucose response beneficially affect elevated fasting blood glucose and insulin levels,
increase the sensitivity to insulin, contribute to the reduction of body weight and lipids
levels and ultimately bring lower risk of type 2 diabetes.
Blood glucose responses depend on the amount and type of carbohydrate(s) present in the meal.
Difference in post-prandial blood glucose response to different types of carbohydrates is
mainly due to the different rate of their digestion. However, response to the same
carbohydrate-rich food can be different between different individuals. Blood glucose levels
after carbohydrate-rich meal are shown to be significantly higher in subjects on high-fat
diet, in overweight or obese people, or in subjects with different levels of digestive
enzymes.
Results from in vitro studies indicate the potential of polyphenols, naturally found in
fruits, vegetables and grains, to attenuate post-prandial blood glucose spikes following a
carbohydrate-rich meal. It was previously shown that different polyphenols can slow down
carbohydrate digestion through partial inhibition of the main enzymes involved, can decrease
glucose and fructose transport from the gut after digestion and can improve the action of
insulin after glucose reaches the bloodstream.
In the previous study it was shown that pomegranate juice attenuates the increase in blood
glucose levels after a starchy meal. This effect is, at least partly, the result of hindered
starch digestion by polyphenols present in pomegranate juice.
The present study will determine whether polyphenols, as normally and naturally present in
food extracts and beverages, added to a carbohydrate-rich meal, can lower blood glucose
levels after its consumption, and hence lower its glycaemic index, and if this effect is
mediated through effects on insulin and other hormones or determined by the individual levels
of digestive enzymes.
Healthy volunteers will be asked to consume two different meals: (1) white bread with
pomegranate juice enriched with extracts from grape seeds and apple peels or (2) white bread
with placebo drink with the same type and amount of carbohydrates and similar flavor as
enriched pomegranate juice, but without polyphenols.
The levels of glucose, insulin, gastric inhibitory polypeptide (GIP) and glucagon like
peptide-1 (GLP-1) will be measured in plasma isolated from blood samples obtained before and
up to 3 hours after the consumption of each meal. The levels of triglycerides and relevant
organic and fatty acids will also be determined.
Before recruitment volunteers will be screened for eligibility based on glucose levels, BMI
and glycemic response to white bread. Additional measurements taken at the screening will
include blood pressure values and blood lipids levels. All participants will be characterized
for the activity of salivary a-amylase and copies of a-amylase gene (AMY1).
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