The Role of Incorporating Acacia Gum in Foods on Glucose Homeostasis in Healthy Humans: a Pilot Study
Phase: NA
Conditions: Health Adult Subjects
Sponsor: King Abdulaziz University

Incorporating acacia gum into a commonly consumed food improves 
postprandial glucose regulation in healthy adults 
1/11/2021 
 
1 
 
 
 
Study Protocol  
of 
 
 
Incorporating acacia gum into a commonly 
consumed food improves postprandial glucose 
regulation in healthy adults 
 

Incorporating acacia gum into a commonly consumed food improves 
postprandial glucose regulation in healthy adults 
1/11/2021 
 
2 
 
1. INTRODUCTION 
 
Abnormal postprandial blood glucose (PPG) is considered as a strong predictor in developing 
certain metabolic diseases as type 2 diabetes (T2D) (O’Keefe & Bell, 2007). Prolonged high 
blood glucose is a well-known aetiology of T2D and it is diagnostically defined by abnormal 
glucose homeostasis (WHO, 2006). PPG response is determined by carbohydrate-rich foods 
consumption (Wolever & Bolognesi, 1996). These foods are ranked according to their effect on 
PPG by the glycaemic index (Jenkins et al., 1981). Low-glycaemic-index diet was evidenced to be 
beneficial on controlling glycaemia in T2D on the long run (Greenwood et al., 2013; Jenkins et 
al., 2002, 2008). Many factors cause a carbohydrate-based food to affect PPG, including the 
physical structure of that food, the type of carbohydrate it is made up from, and the hormonal 
and neural responses its consumption induces. different PPG and insulin responses can result 
from consuming the same food due to the effect of processing, as evidenced in the cases of 
retrograded and native starch (Wang & Copeland, 2013).  
 
There is systematic evidence that dietary soluble fiber, of which guar gum belongs to, have a 
long-term remarkable effect on controlling glycaemia. One of the proposed mechanisms of 
action of dietary fibre is that it expands in the presence of water upon ingestion to work as a 
bulk laxative to normalizes bowel movement. Like other fibers, it decreases blood glucose by 
absorbing lipids and glucose in the gastrointestinal (GI) tract, and thus reducing carbohydrate 
delivery from the upper GI to the portal vein, and hence the liver. Indeed, daily consumption of 
15g of guar gum for 48 weeks was evidenced to enhance PPG tolerance and glycemic control in 
humans (Chuang et al., 1992; Groop et al., 1993). Moreover, consuming 5g of guar gum four 
times daily for 6 weeks prior to meals was reported to decrease PPG and fasting blood glucose, 
insulin requirements, and hemoglobin A1c (HbA1c) in patients with insulin-dependent diabetes 
(Ebeling et al., 1988; Vuorinen-Markkola et al., 1992). These promising results are encouraging 
approach to be used for long-term prevention of hyperglycemia, at a population level through 
lifestyle interventions. 
 
Limited studies in the literature have shown similar beneficial metabolic results with Acacia gum 
(Arabic gum) consumption. Acacia gum is readily available in our area of the world, and is 
comparatively cheap. A recent study has shown a positive effects of acute 40 g acacia gum 
consumption on satiety and appetite, however, no significant difference was shown on glycemic 
response (Larson et al., 2021). This might be due to the confounding effect of other meal 
composition. Another study indicated significant decrease in both lipid profile and fasting blood 
glucose in patients with T2D (Babiker et al., 2017). However, additional studies are required to 
explore the effect of Acacia gum ingestion on PPG in healthy humans.  
 
The intention of the present protocol is to study the impact of consuming acacia gum 
incorporated food product on PPG. As the physical state of food can be a significant 
determinant of postprandial glycaemic response, using Acacia gum enriched flour allows the 
study of this phenomenon in some depth. 
 

Incorporating acacia gum into a commonly consumed food improves 
postprandial glucose regulation in healthy adults 
1/11/2021 
 
3 
 
2. Study: The role of incorporating Acacia gum in foods on glucose homeostasis in healthy 
humans: a pilot study 
 
Study methodology: A randomised, control, paralleled study. 
 
Participants: 12 normal and overweight healthy male and female volunteers aged between 18 and 
40 years with body mass index (BMI) of 18.5-30 kg/m2. 
 
Support of number of volunteers: As this was a pilot study, a formal sample size calculation was not 
appropriate. A sample size of 12 participants was justified a priori based on the study objectives. This 
sample size was based on published recommendations of a minimum sample size of 12 participants 
for pilot studies (Moore et al., 2011) 
Health Screening  
 
Participants will attend the ‘Food, Nutrition and Lifestyle Research Unit’- King Fahad Medical 
Research at King Abdulaziz University where their eligibility will be assessed. They will have a blood 
test (fasting blood glucose) and height and weight measurements will also be taken. All women of 
child bearing age should confirm a self-reported non-pregnancy status. 
Participants will be told not to start any other new diets or intensive exercise regimes during the 
study period as this may give us conflicting results.  
 
Study Days visits 1 and 2: 
The day prior to the study visit, participants will be requested to refrain from strenuous exercise and 
caffeine intake. Participants will then be requested to fast overnight (they are allowed to drink 
water) and will come to the ‘Food, Nutrition and Lifestyle Research Unit’- King Fahad Medical 
Research at King Abdulaziz University the following morning.  
Participants will then receive a small meal (0 min) with the assigned food product (control or test 
food) that will contain either biscuit made of white flour (control) or 20% of Acacia gum 
incorporated to white flour (test food) on each study visit. Two ml of postprandial blood samples will 
be taken at 15, 30, 45, 60, 90, 120, and 180 min to measure glucose and insulin. 
 
Appetite and satiety will be assessed by visual analogue scale every 60 min.  
 
 
PARTICIPANT ENTRY 
 
INCLUSION CRITERIA 
 
Male and female self-reported healthy volunteers (aged 18 to 40 years) 
 
Normal to overweight individuals (body mass index (BMI) 18.5-30 kg/m2) 
 
EXCLUSION CRITERIA  
 
Substance abuse 
 
Excess alcohol intake 

Incorporating acacia gum into a commonly consumed food improves 
postprandial glucose regulation in healthy adults 
1/11/2021 
 
4 
 
 
Pregnancy 
 
Diabetes 
 
Cardiovascular disease 
 
Cancer  
 
Gastrointestinal disease e.g. inflammatory bowel disease or irritable bowel syndrome 
 
Kidney disease 
 
Liver disease 
 
Pancreatitis 
 
Use of medications likely to interfere with energy metabolism, appetite regulation and 
hormonal balance, including: anti-inflammatory drugs or steroids, antibiotics, androgens, 
phenytoin, erythromycin or thyroid hormones. 
 
Any participants with the above conditions would already have an altered pattern of hormones and 
inflammatory molecules because of their disease process and would therefore give us confounding 
or misleading results.  
 
WITHDRAWAL CRITERIA 
The safety of the study participants takes priority. Any significant adverse event (as assessed by the 
researchers) will halt the study and the ethics committee and sponsor will be informed as per 
standard protocol. All adverse events will be recorded and investigators will review each adverse 
event as it arises. In addition, participants will be free to withdraw at any time and are not required 
to give a reason. 
 
 

Incorporating acacia gum into a commonly consumed food improves 
postprandial glucose regulation in healthy adults 
1/11/2021 
 
5 
 
References: 
 
Babiker, R., Elmusharaf, K., Keogh, M. B., Banaga, A. S. I., & Saeed, A. M. (2017). Metabolic effects of 
Gum Arabic (Acacia Senegal) in patients with Type 2 Diabetes Mellitus (T2DM): Randomized, 
placebo controlled double blind trial. Functional Foods in Health and Disease, 7(3), 219–231. 
https://doi.org/10.31989/ffhd.v7i3.325 
Chuang, L. M., Jou, T. S., Yang, W. S., Wu, H. P., Huang, S. H., Tai, T. Y., & Lin, B. J. (1992). Therapeutic 
effect of guar gum in patients with non-insulin-dependent diabetes mellitus. Journal of the 
Formosan Medical Association = Taiwan Yi Zhi, 91(1), 15–19. 
http://www.ncbi.nlm.nih.gov/pubmed/1352328 
Ebeling, P., Yki-Järvinen, H., Aro, A., Helve, E., Sinisalo, M., & Koivisto, V. A. (1988). Glucose and lipid 
metabolism and insulin sensitivity in type 1 diabetes: the effect of guar gum. The American 
Journal of Clinical Nutrition, 48(1), 98–103. https://doi.org/10.1093/ajcn/48.1.98 
Greenwood, D. C., Threapleton, D. E., Evans, C. E. L., Cleghorn, C. L., Nykjaer, C., Woodhead, C., & 
Burley, V. J. (2013). Glycemic index, glycemic load, carbohydrates, and type 2 diabetes: 
Systematic review and dose-response meta-analysis of prospective studies. Diabetes Care, 
36(12), 4166–4171. https://doi.org/10.2337/dc13-0325 
Groop, P. H., Aro, A., Stenman, S., & Groop, L. (1993). Long-term effects of guar gum in subjects with 
non-insulin-dependent diabetes mellitus. The American Journal of Clinical Nutrition, 58(4), 513–
518. https://doi.org/10.1093/ajcn/58.4.513 
Jenkins, Kendall, C. W. C., Augustin, L. S. A., Franceschi, S., Hamidi, M., Marchie, A., Jenkins, A. L., & 
Axelsen, M. (2002). Glycemic index: Overview of implications in health and disease. American 
Journal of Clinical Nutrition, 76(1), 266S-73S. https://doi.org/10.1093/ajcn/76.1.266s 
Jenkins, Kendall, C. W. C., McKeown-Eyssen, G., Josse, R. G., Silverberg, J., Booth, G. L., Vidgen, E., 
Josse, A. R., Nguyen, T. H., Corrigan, S., Banach, M. S., Ares, S., Mitchell, S., Emam, A., Augustin, 
L. S. A., Parker, T. L., & Leiter, L. A. (2008). Effect of a low-glycemic index or a high-cereal fiber 
diet on type 2 diabetes: A randomized trial. JAMA - Journal of the American Medical 
Association, 300(23), 2742–2753. https://doi.org/10.1001/jama.2008.808 
Jenkins, Wolever, T. M., Taylor, R. H., Barker, H., Fielden, H., Baldwin, J. M., Bowling, A. C., Newman, 
H. C., Jenkins, A. L., & Goff, D. v. (1981). Glycemic index of foods: a physiological basis for 
carbohydrate exchange. The American Journal of Clinical Nutrition, 34(3), 362–366. 
https://doi.org/10.1093/ajcn/34.3.362 
Larson, R., Nelson, C., Korczak, R., Willis, H., Erickson, J., Wang, Q., & Slavin, J. (2021). Acacia gum is 
well tolerated while increasing satiety and lowering peak blood glucose response in healthy 
human subjects. Nutrients, 13(2), 1–14. https://doi.org/10.3390/nu13020618 

Incorporating acacia gum into a commonly consumed food improves 
postprandial glucose regulation in healthy adults 
1/11/2021 
 
6 
 
Moore, C. G., Carter, R. E., Nietert, P. J., & Stewart, P. W. (2011). Recommendations for planning 
pilot studies in clinical and translational research. Clinical and Translational Science, 4(5), 332–
337. https://doi.org/10.1111/j.1752-8062.2011.00347.x 
O’Keefe, J. H., & Bell, D. S. H. (2007). Postprandial Hyperglycemia/Hyperlipidemia (Postprandial 
Dysmetabolism) Is a Cardiovascular Risk Factor. American Journal of Cardiology, 100(5), 899–
904. https://doi.org/10.1016/j.amjcard.2007.03.107 
Vuorinen-Markkola, H., Sinisalo, M., & Koivisto, V. A. (1992). Guar gum in insulin-dependent 
diabetes: effects on glycemic control and serum lipoproteins. The American Journal of Clinical 
Nutrition, 56(6), 1056–1060. https://doi.org/10.1093/ajcn/56.6.1056 
Wang, S., & Copeland, L. (2013). Molecular disassembly of starch granules during gelatinization and 
its effect on starch digestibility: a review. Food & Function, 4(11), 1564. 
https://doi.org/10.1039/c3fo60258c 
WHO. (2006). Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia: report 
of a WHO/IDF consultation. World Health Organization. 
https://www.who.int/diabetes/publications/Definition and diagnosis of diabetes_new.pdf 
Wolever, T. M. S., & Bolognesi, C. (1996). Source and amount of carbohydrate affect postprandial 
glucose and insulin in normal subjects. Journal of Nutrition, 126(11), 2798–2806. 
https://doi.org/10.1093/jn/126.11.2798