The acute effect of commercially available pulse powders on postprandial glycaemic response in healthy young men. Carbohydrate-rich foods: glycaemic indices and the effect of constituent macronutrients Pulse consumption, satiety, and weight management. Effects of different glycaemic index foods and dietary fibre intake on glycaemic control in type 1 diabetic patients on intensive insulin therapy. Lowering dietary glycaemic index through nutrition education among Malaysian women with a history of gestational diabetes mellitus. Whole foods and increased dietary fibre improve blood glucose control in diabetic children. Impact of glycaemic index and dietary fibre on insulin sensitivity during the refeeding phase of a weight cycle in young healthy men. Glycaemic index methodology. Dietary carbohydrate, fibre, glycaemic index, glycaemic load and the risk of postmenopausal breast cancer Carbohydrate quality is not associated with liver enzyme activity and plasma TAG and HDL concentrations over 5 years in an older population. Low glycaemic index diets improve glucose tolerance and body weight in women with previous history of gestational diabetes: a six months randomized trial Effects of long-term intervention with low- and high-glycaemic-index breakfasts on food intake in children aged 8-11 years. No effect of a diet with a reduced glycaemic index on satiety, energy intake and body weight in overweight and obese women A prospective randomised trial to determine the efficacy of a low glycaemic index diet given in addition to healthy eating and weight loss advice in patients with coronary heart disease A high-fibre bean-rich diet versus a low-carbohydrate diet for obesity. Legume consumption is inversely associated with type 2 diabetes incidence in adults: A prospective assessment from the PREDIMED study. Beneficial effects of a 5-week low-glycaemic index regimen on weight control and cardiovascular risk factors in overweight non-diabetic subjects. Association of diet and lifestyle with glycated haemoglobin in type 1 diabetes participants in the EURODIAB prospective complications study A pulse-based diet is effective for reducing total and LDL-cholesterol in older adults. A low-GI diet is associated with a short-term improvement of glycaemic control in Asian patients with type 2 diabetes. High-carbohydrate-low-glycaemic index dietary advice improves glucose disposition index in subjects with impaired glucose tolerance. A study of Hassawi rice (Oryza sativa L.) in terms of its carbohydrate hydrolysis (in vitro) and glycaemic and insulinaemic indices (in vivo) The use of glycaemic index tables to predict glycaemic index of composite breakfast meals.
Whole pulses ( beans , peas , chickpeas and lentils ) elicit low postpr and ial blood glucose ( BG ) responses in adults ; however , their consumption in North America is low . One potential strategy to increase the dietary intake of pulses is the utilisation of commercial pulse powders in food products ; however , it is unclear whether they retain the biological benefits observed with whole pulses . Therefore , the present study examined the effects of commercially prepared pulse powders on BG response before and after a subsequent meal in healthy young men . Overall , three r and omised , within-subject experiments were conducted . In each experiment , participants received whole , puréed and powdered pulses ( navy beans in Expt 1 ; lentils in Expt 2 ; chickpeas in Expt 3 ) and whole-wheat flour as the control . All treatments were controlled for available carbohydrate content . A fixed-energy pizza meal ( 50·2 kJ/kg body weight ) was provided at 120 min . BG concentration was measured before ( 0 - 120 min ) and after ( 140 - 200 min ) the pizza meal . BG concentration peaked at 30 min in all experiments , and pulse forms did not predict their effect on BG response . Compared with the whole-wheat flour control , navy bean treatments lowered peak BG concentrations ( Expt 1 , P < 0.05 ) , but not the mean BG concentration over 120 min . The mean BG concentration was lower for all lentil ( Expt 2 , P= 0.008 ) and chickpea ( Expt 3 , P= 0.002 ) treatments over 120 min . Processing pulses to powdered form does not eliminate the benefits of whole pulses on BG response , lending support to the use of pulse powders as value-added food ingredients to moderate postpr and ial glycaemic response The glycaemic index ( GI ) ranks foods according to their acute glycaemic impact and is used in planning meals for patients invoking glycaemic control through diet .  Kurakkan ( Eleusine coracana ) flour roti , rice flour roti , atta flour roti , boiled breadfruit ( Artocarpus altilis/Artocarpus communis ) and boiled legumes ( mungbean , cowpea and chickpea ) were categorized as low-GI foods ( relative to white bread ; Prima Crust Top ™ ) , and the corresponding GI ( ± st and ard error of the mean ) values were 70±8 , 69±7 , 67±9 , 64±7 , 57±6 , 49±8 and 29±5 , respectively . Kurakkan flour pittu and wheat flour roti were classified as medium-GI foods with GI values of 85±6 and 72±6 . Hoppers , rice flour pittu , wheat flour pittu and Olu-milk rice ( seeds of Nymphaea lotus ) were categorized as high-GI foods , and the corresponding GI ( ± st and ard error of the mean ) values were 120±8 , 103±7 , 101±8 and 91±8 , respectively . The GI values significantly ( P<0.01 ) and negatively correlated with the insoluble dietary fibre ( ρ = − 0.780 ) , soluble dietary fibre ( ρ = − 0.712 ) and protein ( ρ = − 0.738 ) contents in grams per 100 g digestible starch containing foods The prevalence of obesity has reached epidemic proportions , making finding effective solutions to reduce obesity a public health priority . One part of the solution could be for individuals to increase consumption of nonoilseed pulses ( dry beans , peas , chickpeas , and lentils ) , because they have nutritional attributes thought to benefit weight control , including slowly digestible carbohydrates , high fiber and protein contents , and moderate energy density . Observational studies consistently show an inverse relationship between pulse consumption and BMI or risk for obesity , but many do not control for potentially confounding dietary and other lifestyle factors . Short-term ( ≤1 d ) experimental studies using meals controlled for energy , but not those controlled for available carbohydrate , show that pulse consumption increases satiety over 2 - 4 h , suggesting that at least part of the effect of pulses on satiety is mediated by available carbohydrate amount or composition . R and omized controlled trials generally support a beneficial effect  of pulses on weight loss when pulse consumption is coupled with energy restriction , but not without energy restriction . However , few r and omized trials have been conducted and most were short term ( 3 - 8 wk for whole pulses and 4 - 12 wk for pulse extracts ) . Overall , there is some indication of a beneficial effect of pulses on short-term satiety and weight loss during intentional energy restriction , but more studies are needed in this area , particularly those that are longer term ( ≥1 y ) , investigate the optimal amount of pulses to consume for weight control , and include behavioral elements to help overcome barriers to pulse consumption To evaluate the influence of a low glycaemic index ( GI ) , high GI and high fibre diet on glycaemic control and insulin requirement in Type 1 diabetic patients on intensive insulin therapy , nine well-controlled , highly-motivated Type 1 diabetic patients were put on a control diet for 12 days and then r and omized in a consecutive manner to 12 days of each diet , in a crossover design . During each experimental diet , the study subjects adjusted their premeal insulin ( soluble ) dose to maintain their 1-h postpr and ial capillary glucose at or below 10 mmol l(-1 ) . At the end of each experimental diet , they were su bmi tted to a st and ardized breakfast of the diet under study , using the same premeal insulin dose as that required for the control diet . The control diet contained 16.0+/-3.0 g of fibre day(-1 ) with a GI of 77.4+/-2.7 compared to 15.3+/-6.3 and 66.2+/-1.2 for the low GI diet , 17.1+/-7.2 and 92.9+/-3.6 for the high GI diet , and 56.1+/-3.6 ( including 15 g of guar ) and 73.5+/-2.1 for the high fibre diet . Prebreakfast capillary blood glucose ( 6.2+/-1.2 mmol l(-1 ) ) on the low GI diet and postbreakfast capillary blood glucose ( 8.7+/-1.8 mmol l(-1 ) ) on the high fibre diet were significantly lower than the values obtained with the control diet ( 8.0+/-1.8 and 10.6+/-2.4 , respectively ; p<0.05 ) . No change in premeal or basal insulin dose was required . During the st and ardized breakfasts , the incremental area under the curve was 1.6+/-1.5 mmol l(-1 ) min(-1 ) for the control diet compared to 1.1+/-1.8 for the low GI diet , 3.2+/-1.4 for the high GI diet ( p<0.05 versus low GI and high fibre ; p=0.08 versus control ) , and 1.0+/-0.9 for the high fibre diet . These observations indicate that in well-controlled Type 1 diabetic subjects on intensive insulin therapy  , major alterations in the GI and fibre content of meals induce small but significant changes in glucose profile . In everyday life , however , these differences are blunted , and plasma glucose remains within the target range for optimal metabolic control INTRODUCTION Gestational diabetes mellitus ( GDM ) increases risks for type 2 diabetes and cardiovascular diseases . Low glycaemic index ( GI ) diets improve cardio-metabolic outcomes in insulin-resistant individuals . We examined the feasibility of lowering GI through GI-based-education among Asian post-GDM women . METHODS A 3-month investigation was carried out on 60 Malaysian women with a mean age of 31.0 + /- 4.5 years and a history of GDM . Subjects were r and omised into two groups : LGIE and CHDR . The CHDR group received conventional healthy dietary recommendations only . The LGIE group received GI based-education in addition to conventional healthy dietary recommendations . At baseline and after 3-months , dietary intake of energy and macronutrient intakes including GI diet and glycaemic load was assessed using 3-day food records .  Diabetes-Diet and GI-concept scores and physical activity levels were assessed using a question naire . Adherence to dietary instructions was measured at the end of 3 months . RESULTS At the end of 3 months , the LGIE group had significant reductions in energy intake ( 241.7 + /- 522.4Kcal , P = 0.037 , ES=0.463 ) , total carbohydrate ( 48.7 + /- 83.5 g , P = 0.010 , ES = 0.583 ) , GI ( 3.9 + /- 7.1 , P = 0.017 , ES = 0.549 ) and GL ( 39.0 + /- 55.3 , P = 0.003 , ES = 0.705 ) and significant increases in protein ( 3.7 + /- 5.4 g , 0.003 , ES = 0.685 ) and diet fibre ( 4.6 + /- 7.3 g , P = 0.06 ) . The CHDR group had a significant reduction in fat only ( 5.7 + /- 9.4 g , P = 0.006 , ES = 0.606 ) . There was a 30 % increase in GI-concept scores in the LGIE group ( p < 0.001 ) . Changes in GI-concept scores correlated significantly to the reduction in dietary GI ( r = -0.642 , P = 0.045 ) . Dietary adherence was comparable in both groups . CONCLUSION GI-education improves GI-concept knowledge and helps lower dietary glycaemic index among women with a history of GDM In prescribing a diabetic diet more attention has traditionally been paid to the amount of dietary carbohydrate than to its type or structure . We have compared the effect on blood glucose of substituting unrefined , whole foods for refined , processed foods in liberal carbohydrate diets ( 50 - 55 % of dietary energy ) eaten by 10 diabetic children in a r and omised crossover study . All measurements were made at home . The unrefined diet used whole foods ( including ) dried beans ) supplying 60 g/day of dietary fibre . The refined diet used processed foods supplying 20 g/day of dietary fibre . Diets were isocaloric for carbohydrate , fat , and protein . Glycaemic control was assessed by daily urine analysis for glucose , home blood glucose measurements , glycosylated haemoglobin , and by a 24-hour profile of blood and urinary glucose carried out at home after 6 weeks on each diet . Glycaemic control was significantly better on the unrefined diet . On profile days mean blood glucose levels on the unrefined and refined diets respectively were : prepr and ial : 5.5 and 8.4 mmol/l ; postpr and ial 8.5 and 12.2 mmol/l . The mean 24-hour urinary glucose excretion on the unrefined diet was 9.3 g and on the refined diet was 38.0 g. Six months after the study the children were eating appreciably more  dietary fibre  than before ( mean increase 13.6 g/day ) . Attention to food type and structure can improve blood glucose control in diabetic children and should provide an acceptable and more rational basis for dietary prescription than one based on carbohydrate quantity alone Previous studies suggest that a low-glycaemic index ( LGI ) diet may improve insulin sensitivity ( IS ) . As IS has been shown to decrease during refeeding , we hypothesised that an LGI- v. high-GI ( HGI ) diet might have favourable effects during this phase . In a controlled nutritional intervention study , sixteen healthy men ( aged 26·8 ( SD 4·1 ) years , BMI 23·0 ( SD 1·7 ) kg/m2 ) followed 1 week of overfeeding , 3 weeks of energy restriction and of 2 weeks refeeding at ^50 % energy requirement ( 50 % carbohydrates , 35 % fat and 15 % protein ) . During refeeding , subjects were divided into two matched groups receiving either high-fibre LGI or lower-fibre HGI foods ( GI 40 v. 74 , fibre intake 65 ( SD 6 ) v. 27 ( SD 4 ) g/d ) . Body weight was equally regained in both groups with refeeding ( mean regain 70·5 ( SD 28·0)% of loss ) . IS was improved by energy restriction and decreased with refeeding . The decreases in IS were greater in the HGI than in the LGIgroup ( group £ time interactions for insulin , homeostasis model assessment of insulin resistance ( HOMAIR ) , Matsuda IS index (MatsudaISI);all P,0·05 ) . Mean interstitial glucose profiles during the day were also higher in the HGI group ( DAUCHGI-LGI of continuous interstitial glucose monitoring : 6·6 mmol/l per 14 h , P¼0·04 ) . At the end of refeeding , parameters of IS did not differ from baseline values in either diet group ( adiponectin , insulin , HOMAIR , Matsuda ISI , M-value ; all P.0·05 ) . In conclusion , nutritional stress imposed by dietary restriction and refeeding reveals a GI/fibre effect in healthy non-obese subjects . LGI foods rich in fibre may improve glucose metabolism during the vulnerable refeeding phase of a weight cycle The glycaemic index ( GI ) concept was originally introduced to classify different sources of carbohydrate (CHO)-rich foods , usually having an energy content of > 80 % from CHO , to their effect on post-meal glycaemia . It was assumed to apply to foods that primarily deliver available CHO , causing hyperglycaemia . Low-GI foods were classified as being digested and absorbed slowly and high-GI foods as being rapidly digested and absorbed , result ing in different glycaemic responses . Low-GI foods were found to induce benefits on certain risk factors for CVD and diabetes . Accordingly it has been proposed that GI classification of foods and drinks could be useful to help consumers make ' healthy food choices ' within specific food groups . Classification of foods according to their impact on blood glucose responses requires a st and ardised way of measuring such responses . The present review discusses the most relevant method ological considerations and highlights specific recommendations regarding number of subjects , sex , subject status , inclusion and exclusion criteria , pre-test conditions , CHO test dose , blood sampling procedures , sampling times , test r and omisation and calculation of glycaemic response area under the curve . All together , these technical recommendations will help to implement or reinforce measurement of GI in laboratories and help to ensure quality of results . Since there is current international interest in alternative ways of expressing glycaemic responses to foods , some of these methods are discussed Evidence that the insulin pathway may be involved in breast carcinogenesis has increased the interest in dietary factors that influence insulin secretion and resistance . We investigated dietary carbohydrate , fibre , glycaemic index ( GI ) and glycaemic load ( GL ) in a prospect i ve study of 324 breast cancers diagnosed in 12,273 post‐menopausal women . Although an increase of 1 st and ard deviation in carbohydrate was marginally associated with risk of breast cancer , relative risk ( RR ) 1.31 ( 95 % CI , 0.98 , 1.75 ) , there were no significant associations with fibre , 1.08 ( 0.92 , 1.26 ) , GI , 0.98 ( 0.88 , 1.10 ) or GL , 1.19 ( 0.93 , 1.52 ) or with carbohydrate foods ( bread , rice , pasta ) . The RR for carbohydrate and localized disease was elevated , 1.40 ( 1.02 , 1.92 ) , but like those for fibre , GI and GL did not differ significantly between localized and non‐localized disease . RRs for grade I , but not grade II or III , tumours were elevated for fibre , 1.38 ( 1.08 , 1.75 ) , carbohydrate , 1.56 ( 1.08 , 2.25 ) and GL , 1.41 ( 1.01 , 1.98 ) but not for GI , 0.84 ( 0.65 , 1.09 ) . The RRs for fibre and oestrogen receptor ( ER ) positive ( + ) and progesterone receptor ( PR ) positive ( + ) tumours , 1.36 ( 1.10 , 1.67 ) , differed significantly from those for ER positive ( + ) and PR negative ( − ) tumours , 1.01 ( 0.61 , 1.69 ) and ER−/PR− tumours , 0.65 ( 0.43 , 0.99 ) , p = 0.005 . Our data do not support a strong role for GI and GL in breast carcinogenesis but suggest that increased intake of fibre and carbohydrate may be associated with the diagnosis of cancers of more favourable prognosis . © 2005 Wiley‐Liss , Non-alcoholic fatty liver disease ( NAFLD ) is closely associated with insulin resistance and obesity . Hence , carbohydrate quality could be of relevance to the risk of NAFLD , but prospect i ve data are lacking . The aim of the present study was to investigate longitudinal associations between carbohydrate quality ( including dietary glycaemic index  ( GI ) and intakes of sugar , starch and fibre ) and markers of liver function in an older Australian population . The analysis was based on 866 participants ( ≥ 49 years ) of the Blue Mountains Eye Study with fasting blood specimens and dietary intake data at baseline and 5-year follow-up . Multi-level mixed regression analysis was used to relate dietary GI and  sugar , starch and fibre  intake to the liver enzymes alanine aminotransferase ( ALT ) and γ-glutamyltransferase ( GGT ) , as well as fasting TAG and HDL-cholesterol ( HDL-C ) . After adjustment for potential confounding factors , a lower fibre intake was cross-sectionally related to higher GGT ( P= 0.02 ) and fasting TAG ( P= 0.002 ) levels , with fruit fibre being the most relevant fibre source ( P= 0.095 for GGT ; P= 0.003 for TAG ) . A higher dietary GI was associated with lower HDL-C ( P= 0.046 ) . Changes in carbohydrate quality during 5 years were not related to changes in ALT , GGT , TAG or HDL-C ( P≥ 0.08 ) . In conclusion , the absence of longitudinal associations between carbohydrate quality and liver enzymes and serum lipids in this older population does not support a major role of carbohydrate nutrition in liver function among the elderly Background Gestational Diabetes Mellitus ( GDM ) increases risks for type 2 diabetes and weight management is recommended to reduce the risk . Conventional dietary recommendations ( energy-restricted , low fat ) have limited success in women with previous GDM . The effect of lowering Glycaemic Index ( GI ) in managing glycaemic variables and body weight in women post-GDM is unknown . Objective To evaluate the effects of conventional dietary recommendations administered with and without additional low-GI education , in the management of glucose tolerance and body weight in Asian women with previous GDM . MethodS eventy seven Asian , non-diabetic women with previous GDM , between 20- 40y were r and omised into Conventional healthy dietary recommendation ( CHDR )  and  low GI  ( LGI ) groups . CHDR received conventional dietary recommendations only ( energy restricted , low in fat and refined sugars , high-fibre ) . LGI group received advice on lowering GI in addition . Fasting and 2-h post-load blood glucose after 75 g oral glucose tolerance test ( 2HPP ) were measured at baseline and 6 months after intervention . Anthropometry and dietary intake were assessed at baseline , three and six months after intervention . The study is registered at the Malaysian National Medical Research Register ( NMRR ) with Research ID : 5183 . Results After 6 months , significant reductions in body weight , BMI and waist-to-hip ratio were observed only in LGI group ( P<0.05 ) . Mean BMI changes were significantly different between groups ( LGI vs. CHDR : -0.6 vs. 0 kg/m2 , P= 0.03 ) . More subjects achieved weight loss ≥5 % in LGI compared to CHDR group ( 33 % vs. 8 % , P=0.01 ) . Changes in 2HPP were significantly different between groups ( LGI vs. CHDR : median ( IQR ) : -0.2(2.8 ) vs. + 0.8 ( 2.0 ) mmol/L , P=0.025 ) . Subjects with baseline fasting insulin≥2 μIU/ml had greater 2HPP reductions in LGI group compared to those in the CHDR group ( −1.9±0.42 vs. + 1.31±1.4 mmol/L , P<0.001 ) . After 6 months , LGI group diets showed significantly lower GI ( 57±5 vs. 64±6 , P<0.001 ) , GL ( 122±33 vs. 142±35 , P=0.04 ) and higher fibre content ( 17±4 vs.13±4 g , P<0.001 ) . Caloric intakes were comparable between groups . Conclusion In women post-GDM , lowering GI of healthy diets result ed in significant improvements in glucose tolerance and body weight reduction as compared to conventional low-fat diets with similar energy prescription The aim of the present study was to investigate the effects of long-term intervention of low-glycaemic-index ( GI ) v. high-GI breakfasts on energy and macronutrient intakes in children aged 8 - 11 years . Preadolescent children were assigned to one of two groups in a r and om cross-over design . Each group was given low-GI and high-GI breakfasts on two non-consecutive days per week for 10 weeks per breakfast type . Each breakfast provided approximately 1273 kJ ( 300 kcal ) and was closely matched for macronutrient and dietary fibre content . Subsequent food intake at an ad libitum buffet lunch was recorded and daily energy and macronutrient intakes were measured by 24 h recall and 3 d food diaries . There was a tendency towards a reduced energy intake at lunch following the low-GI breakfast compared with the high-GI breakfast , although the mean difference of 75 kJ ( 18 kcal ) was not significant ( P = 0.406 ) . In particular , there was a trend towards a reduced energy intake in the low-GI arm compared with the high-GI arm among boys . In addition , data from the 3 d food diaries showed that there was a tendency towards a reduced energy intake during the low-GI compared with the high-GI study period . In conclusion , although the difference in energy intake following the low-GI and high-GI breakfasts was not statistically significant , the reduced energy intake following the low-GI breakfast is encouraging . Both dietary fibre and carbohydrate type may affect GI , thus their potential and relative modulating effect on appetite requires further investigation Objective : To investigate whether a diet with a reduced glycaemic index ( GI ) has effects on appetite , energy intake , body weight and composition in overweight and obese female subjects . Design : R and omized crossover intervention study including two consecutive 12-week periods . Lower or higher GI versions of key carbohydrate-rich foods ( breads , breakfast cereals , rice and pasta/potatoes ) were provided to subjects to be incorporated into habitual diets in ad libitum quantities . Foods intended as equivalents to each other were balanced in macronutrient composition , fibre content and energy density . Subjects : Nineteen overweight and obese women , weight-stable , with moderate hyperinsulinaemia ( age : 34–65 years , body mass index : 25–47 kg m−2 , fasting insulin : 49–156 pmol l−1 ) .  Measurements : Dietary intake , body weight and composition after each 12-week intervention . Subjectively rated appetite and short-term ad libitum energy intake at a snack and lunch meal following fixed lower and higher GI test breakfasts ( GI 52 vs 64 ) in a laboratory setting . Results : Free-living diets differed in GI by 8.4 units ( 55.5 vs 63.9 ) , with key foods providing 48 % of carbohydrate intake during both periods . There were no differences in energy intake , body weight or body composition between treatments . On laboratory investigation days , there were no differences in subjective ratings of hunger or fullness , or in energy intake at the snack or lunch meal . Conclusion : This study provides no evidence to support an effect of a reduced GI diet on satiety , energy intake or body weight in overweight/obese women . Cl aims that the GI of the diet per se may have specific effects on body weight may therefore be misleading Objective : Recent epidemiological and prospect i ve trial evidence suggests that consumption of a low glycaemic index ( LGI ) diet will reduce coronary risk . We hypothesise that introduction of an LGI diet will improve the metabolic profile of patients who have undergone coronary artery bypass grafting . Design : We conducted a r and omised parallel group trial comparing a  control group ( n=29 , age 61.8±9 y ) ,  who received currently advocated healthy eating dietary advice only , to an intervention group , who received healthy eating advice emphasising LGI carbohydrates ( n=26 , age 63.6±9.4 y ) over a 12-week period in free-living patients with coronary heart disease . Outcome measures included fasting glucose , insulin , total cholesterol , high-density lipoprotein cholesterol , very low-density lipoprotein cholesterol , low density lipoprotein cholesterol and triglycerides . Results : A significant lower dietary glycaemic index was achieved in the group assigned to an LGI diet compared to the healthy eating control group ( 71±1 vs 81±1 ) ; fibre intake was also higher in the LGI group ( 20±1 vs 15±1 g ) . All biochemical markers of glucose and lipid metabolism measured were similar after 12 weeks of the LGI diet or control diet . Discussion : The LGI group achieved a significant LGI and a higher dietary fibre intake . However , there was no measurable significant effect of either the LGI diet or the health eating diet on lipid levels ; this may have been hidden by concurrent drug therapy BACKGROUND High-fibre and low-carbohydrate diets may enhance satiety and promote weight loss . We compared a diet rich in beans aim ing to increase dietary fibre and promote weight loss with a low-carbohydrate diet in a r and omised controlled trial to assess effect and tolerability of the high-fibre bean-rich diet . METHODS AND RESULTS One hundred and seventy-three women and men , with a mean body mass index of approximately 36 kg m(-2 ) ( one-fifth with diabetes type 2 ) were r and omised to a high-fibre bean-rich diet that achieved mean ( SD ) fibre intakes of 35.5 ( 18.6 ) g day(-1 ) for women and 42.5 ( 30.3 ) g day(-1 ) for men , or a low-carbohydrate diet . Both diets were induced gradually over 4 weeks and included a 3-day feeding phase . Among 123 ( 71.1 % ) completers at 16 weeks , mean ( SD ) weight loss was 4.1 ( 4.0 ) kg in the high-fibre versus 5.2 ( 4.5 ) kg in the low-carbohydrate group [ difference , 1.1 kg , 95 % confidence interval ( CI ) = -2.6 to -0.5 ; P = 0.2 ] , with results similar to the intent-to-treat population . Low-density lipoprotein (LDL)-cholesterol levels decreased with the high-fibre diet ( difference in LDL-cholesterol versus low-carbohydrate diet , 0.2 mmol L(-1 ) , 95 % CI = 0.01 - 0.44 mmol L(-1 ) ; P = 0.045 ) , as did total cholesterol ( P = 0.038 ) , whereas changes in other lipids and glucose did not differ . After 52 weeks , the low-carbohydrate ( n = 24 ) group tended to retain weight loss better than the high-fibre group ( P = 0.06 ) , although total cholesterol remained lower with the bean-rich diet ( P = 0.049 ) . CONCLUSIONS A high-fibre bean-rich diet was as effective as a low-carbohydrate diet for weight loss , although only the bean-rich diet lowered atherogenic lipids BACKGROUND & AIMS Legumes , a low-energy , nutrient-dense and low glycemic index food , have shown beneficial effects on glycemic control and adiposity . As such , legumes are widely recommended in diabetic diets , even though there is little evidence that their consumption protects against type 2 diabetes . Therefore the aim of the present study was to examine the associations between consumption of total legumes and specific subtypes , and type 2 diabetes risk . We also investigated the effect of theoretically substituting legumes for other protein- or carbohydrate-rich foods . METHODS Prospect i ve assessment of 3349 participants in the PREvención con DIeta MEDiterránea ( PREDIMED ) study without type 2 diabetes at baseline .  Dietary information was assessed at baseline and yearly during follow-up . We used Cox regression models to estimate hazard ratios ( HRs ) and 95 % confidence intervals ( 95 % CIs ) for type-2 diabetes incidence according to quartiles of cumulative average consumption of total legumes , lentils , chickpeas , dry beans and fresh peas . RESULTS During a median follow-up of 4.3 years , 266 new cases of type 2 diabetes occurred . Individuals in the highest quartile of total legume and lentil consumption had a lower risk of diabetes than those in the lowest quartile ( HR : 0.65 ; 95 % CI : 0.43 , 0.96 ; P-trend = 0.04 ; and HR : 0.67 ; 95 % CI : 0.46 - 0.98 ; P-trend = 0.05 , respectively ) . A borderline significant association was also observed for chickpeas consumption ( HR 0.68 ; 95 % CI : 0.46 , 1.00 ; P-trend = 0.06 ) . Substitutions of half a serving/day of legumes for similar servings of eggs , bread , rice or baked potato was associated with lower risk of diabetes incidence . CONCLUSIONS A frequent consumption of legumes , particularly lentils , in the context of a Mediterranean diet , may provide benefits on type 2 diabetes prevention in older adults at high cardiovascular risk . TRIAL REGISTRATION The trial is registered at http://www.controlled-trials.com ( IS RCT N35739639 ) . Registration date : 5th October 2005 The glycaemic index ( GI ) has been developed in order to classify food according to the postpr and ial glycaemic response . This parameter is of interest , especially for people prone to glucose intolerance ; however , the effects of a low-GI ( LGI ) diet on body weight , carbohydrate and lipid metabolism remain controversial . We studied the effects of either a LGI or high-GI ( HGI ) diet on weight control and cardiovascular risk factors in overweight , non-diabetic subjects . The study was a r and omized 5-week intervention trial . The thirty-eight subjects ( BMI 27.3 ( sem 0.2 ) kg/m2 ) followed an intervention diet in which usual starch was replaced ad libitum with either LGI or HGI starch .  Mean body weight decrease was significant in the LGI group ( - 1.1 ( sEM 0.3 ) kg , P = 0.004 ) and was significantly greater than in the HGI group ( - 0.3 ( sEM 0.2 ) kg , P = 0.04 between groups ) . Hunger sensation scales showed a trend towards a decrease in hunger sensation before lunch and dinner in the LGI group when compared with the HGI group ( P = 0.09 ) . No significant increase in insulin sensitivity was noticed . The LGI diet also decreased total cholesterol by 9.6 % ( P < 0.001 ) , LDL-cholesterol by 8.6 % ( P = 0.01 ) and both LDL-:HDL-cholesterol ratio ( 10.1 % , P = 0.003 ) and total : HDL-cholesterol ratio ( 8.5 % , P = 0.001 ) while no significant changes were observed in the HGI group . Lowering the GI of daily meals with simple dietary recommendations results in increased weight loss and improved lipid profile and is relatively easy to implement with few constraints . These potential benefits of consuming a LGI diet can be useful to develop practical dietetic advice Background / Objectives : Diet and lifestyle advice for type 1 diabetes ( T1DM ) patients is based on little evidence and putative effects on glycaemic control . Therefore , we investigated the longitudinal relation between dietary and lifestyle variables and HbA1c levels in patients with type 1 diabetes . Subjects/ Methods : A 7-year prospect i ve cohort analysis was performed in 1659 T1DM patients ( 52 % males , mean age 32.5 years ) participating in the EURODIAB Prospect i ve Complications Study .  Baseline dietary intake was assessed by 3- day records and physical activity , smoking status and alcohol intake by question naires . HbA1c during follow-up was central ly assessed by immunoassay . Analysis of variance ( ANOVA ) and restricted cubic spline regression analyses were performed to assess dose – response associations between diet and lifestyle variables and HbA1c levels , adjusted for age , sex , lifestyle and body composition measures , baseline HbA1c , medication use and severe hypoglycaemic attacks . Results : Mean follow-up of our study population was 6.8 ( s.d . 0.6 ) years . Mean HbA1c level was 8.25 % ( s.d . 1.85 ) ( or 66.6 mmol/mol ) at baseline and 8.27 % ( s.d . 1.44 ) at follow-up . Physical activity , smoking status and alcohol intake were not associated with HbA1c at follow-up in multivariable ANOVA models . Baseline intake below the median of vegetable protein ( < 29 g/day ) and dietary fibre ( < 18 g/day ) was associated with higher HbA1c levels . Restricted cubic splines showed nonlinear associations with HbA1c levels for vegetable protein ( P (nonlinear)=0.008 ) and total dietary fibre ( P (nonlinear)=0.0009 ) . Conclusions : This study suggests that low intake of vegetable protein and dietary fibre are associated with worse glycaemic control in type 1 diabetes Our purpose was to determine the effects of a pulse-based diet in individuals 50 years or older for reducing CVD risk factors . A total of 108 participants were  r and omised to receive pulse-based foods ( two servings daily of beans , chickpeas , peas or lentils ; about 150 g/d dry weight ) or their regular diet for 2 months , followed by a washout of 1 month and a cross-over to the other diet for 2 months . Anthropometric measures , body composition and biochemical markers ( i.e. serum LDL-cholesterol ( LDL-C ) , as the primary outcome , and other lipids , glucose , insulin and C-reactive protein ) were assessed before and after each diet phase . A total of eighty-seven participants ( thirty males and fifty-seven females ; 59·7 ( sd 6·3 ) years , body mass 76 ( sd 16 ) kg ) completed the study . Compared with the regular diet , the pulse-based diet  decreased total cholesterol by 8·3 % ( pulse , 4·57 ( sd 0·93 ) to 4·11 ( sd 0·91 ) mmol/l ; regular , 4·47 ( sd 0·94 ) to 4·39 ( sd 0·97 ) mmol/l ; P < 0·001 ) and LDL-C by 7·9 % ( pulse , 2·93 ( sd 0·84 ) to 2·55 ( sd 0·75 ) mmol/l ; regular , 2·96 ( sd 0·86 ) to 2·81 ( sd 0·83 ) mmol/l ; P = 0·01 ) . In a sub- analysis of individuals with high lipid levels at baseline ( twenty individuals with high cholesterol ) , the pulse-based diet  reduced cholesterol by 6 % compared with the regular diet ( pulse , 5·62 ( sd 0·78 ) to 5·26 ( sd 0·68 ) mmol/l ; regular , 5·60 ( sd 0·91 ) to 5·57 ( sd 0·85 ) mmol/l ; P = 0·05 ) . A pulse-based diet is effective for reducing total cholesterol and LDL-C in older adults and therefore reduces the risk of CVD AIMS The aim of this study is to compare the efficacy of low glycaemic index ( GI ) vs. conventional carbohydrate exchange ( CCE ) dietary advice on glycaemic control and metabolic parameters in patients with type 2 diabetes . METHODS A total of 104 patients with type 2 diabetes were r and omly assigned to either a low GI ( GI ) or CCE dietary advice over a 12-week period . The primary end-point was glycaemic control as assessed by glycated haemoglobin A1c ( HbA1c ) , fructosamine level and plasma glucose . The secondary end-points were anthropometric measurements and metabolic parameters that include blood pressure , lipid profile and insulin levels . The oral antidiabetic medications remained unchanged throughout the duration of the study . RESULTS A low-GI diet was associated with significant changes in the fructosamine level ( DeltaGI = -0.20 + /- 0.03 ; DeltaCCE = -0.08 + /- 0.03 mmol/l , p < 0.01 ) and waist circumference ( DeltaGI group = -1.88 + /- 0.30 cm ; DeltaCCE group : -0.36 + /- 0.4 cm , p < 0.05 ) at week 4 . At week 12 , the changes in fasting glucose ( DeltaGI = -0.03 + /- 0.3 ; DeltaCCE = 0.7 + /- 0.3 mmol/l ; p < 0.05 ) and waist circumference ( DeltaGI = -2.35 + /- 0.47 cm ; DeltaCCE group = -0.66 + /- 0.46 cm ; p < 0.05 ) in the GI group was significantly lower than the CCE group . With the low-GI diet , the changes in postpr and ial glycaemia at time 0 , 60 , 150 and 180 min after consuming the st and ard test meal was lower than with the CCE diet ( p < 0.05 ) . No significant differences were found between the groups for the remaining parameters that were measured . CONCLUSIONS Use of a low-GI diet result ed in significant changes of serum fructosamine level , plasma glucose and waist circumference in Asian patients with type 2 diabetes over a 12-week period compared with those following a CCE diet . The effect on HbA1c and other metabolic parameters was not significantly different between the two study groups but the improvement within the GI group was more pronounced and of clinical benefit Controversy exists about the optimal amount and source of dietary carbohydrate for managing insulin resistance . Therefore , we compared the effects on insulin sensitivity ( SI ) , pancreatic responsivity ( AIRglu ) and glucose disposition index of dietary advice aim ed at reducing the amount or altering the source of dietary carbohydrate in subjects with impaired glucose tolerance ( IGT ) . Subjects were r and omized to high-carbohydrate-high-glycaemic index ( GI ) ( high-GI , n 11 ) , high-carbohydrate-low-GI ( low-GI , n 13 ) , or low-carbohydrate-high-monounsaturated fat ( MUFA , n 11 ) dietary advice , with SI , AIRglu and DI measured using a frequently sample d , intravenous glucose tolerance test before and after 4 months treatment . Carbohydrate and fat intakes and diet GI , respectively , were : high-GI , 53 % , 28 % , 83 ; low-GI , 55 % , 25 % , 76 ; MUFA , 47 % , 35 % , 82 . Weight changes on each diet differed significantly from each other : high-GI , -0.49 ( sem 0.29 ) kg ; low-GI , -0.19 ( sem 0.40 ) kg ; MUFA + 0.27 ( sem 0.45 ) kg . Blood lipids did not change , but glycated haemoglobin increased significantly on MUFA , 0.02 ( sem 0.11 ) % , relative to low-GI , -0.19 ( sem 0.08 ) % , and high-GI , -0.13 ( sem 0.14 ) % . Diastolic blood pressure fell by 8 mmHg on low-GI relative to MUFA ( P=0.038 ) . Although SI and AIRglu did not change significantly , DI , a measure of the ability of beta-cells to overcome insulin resistance by increasing insulin secretion , increased on low-GI by > 50 % ( P=0.02 ) . After adjusting for baseline values , the increase in DI on low-GI , 0.17 ( sem 0.07 ) , was significantly greater than those on MUFA , -0.09 ( sem 0.08 ) and high-GI , -0.03 ( sem 0.02 ) ( P=0.019 ) . Thus , the long-term effects of altering the source of dietary carbohydrate differ from those of altering the amount . High-carbohydrate-low-GI dietary advice improved beta-cell function in subjects with IGT , and may , therefore , be useful in the management of IGT Background / Objectives : A high prevalence of Type 2 diabetes exists in Saudi Arabia . Epidemiological evidence suggests that low glycaemic index ( GI ) diets reduce diabetes risk . Yet , little is known about the GI of traditional Saudi Arabian staples such as Hassawi rice ( HR ) . HR was evaluated in terms of its GI and insulinaemic index ( II ) . Comparisons were made in vitro assessing glucose released enzymatically . A long-grain rice variety available in both United Kingdom and Saudi Arabia was studied as a comparison . Subjects/ Methods : For GI and II measurements , HR , Uncle Ben 's rice ( UBR ) and a st and ard glucose solution were consumed by healthy subjects ( n=13 ) on seven r and omised occasions . Capillary bloods were collected at specific times over 2 h after food intake . Food and Agriculture Organization/World Health Organization protocol s were used to determine GI and II . For the in vitro studies , cooked rice was incubated with hydrolytic enzymes under st and ardised conditions . Sample s were taken at t=20 and t=120 min and rapidly available glucose ( RAG ) and slowly available glucose ( SAG ) were computed . Results : Values of RAG and SAG were lower for HR compared with their respective values for UBR ( P<0.001 and P=0.011 , respectively ) . However , no significant difference was observed for GI ( P>0.05 ) despite a lower insulin response noted for HR ( P=0.007 ) . Conclusions : HR had a similar GI to UBR , although a lower insulin response was evident . RAG and SAG values were different for the two rice varieties despite similar GI values . These differences may be important in terms of their metabolic impact and outcome on diabetes The applicability of the glycaemic index ( GI ) in the context of mixed meals and diets is still debatable . The objective of the present study was to investigate the predictability of measured GI in composite breakfast meals when calculated from table values , and to develop prediction equations using meal components . Furthermore , we aim ed to study the relationship between GI and insulinaemic index ( II ) . The study was a r and omised cross-over meal test including twenty-eight healthy young men . Thirteen breakfast meals and a reference meal were tested . All meals contained 50 g available carbohydrate , but differed considerably in energy and macronutrient composition . Venous blood was sample d for 2 h and analysed for glucose and insulin . Prediction equations were made by regression analysis . No association was found between predicted and measured GI . The meal content of energy and fat was inversely associated with GI ( R(2 ) 0.93 and 0.88 , respectively ; P<0.001 ) . Carbohydrate content ( expressed as percentage of energy ) was positively related to GI ( R(2 ) 0.80 ; P<0.001 ) . Using multivariate analysis the GI of meals was best predicted by fat and protein contents ( R(2 ) 0.93 ; P<0.001 ) . There was no association between GI and II . In conclusion , the present results show that the GI of mixed meals calculated by table values does not predict the measured GI and furthermore that carbohydrates do not play the most important role for GI in mixed breakfast meals . Our prediction models show that the GI of mixed meals is more strongly correlated either with fat and protein content , or with energy content , than with carbohydrate content alone . Furthermore , GI was not correlated with II
Conclusions /interpretationPooled analyses demonstrated that pulses , alone or in low-GI or high-fibre diets , improve markers of longer term glycaemic control in humans , with the extent of the improvements subject to significant inter- study heterogeneity .
Aims /hypothesisDietary non-oil-seed pulses ( chickpeas , beans , peas , lentils , etc . )
are a good source of slowly digestible carbohydrate , fibre and vegetable protein and a valuable means of lowering the glycaemic-index ( GI ) of the diet .
To assess the evidence that dietary pulses may benefit glycaemic control , we conducted a systematic review and meta- analysis of r and omised controlled experimental trials investigating the effect of pulses , alone or as part of low-GI or high-fibre diets , on markers of glycaemic control in people with and without diabetes .