Effect of Dietary Fibre and Whole Grain on the Metabolic Syndrome
Condition: Metabolic Syndrome
MeSH terms: Metabolic Syndrome; Syndrome
Study type: Interventional

Summary: 
      Sedentary lifestyles and increasing obesity are main causes of the global increase in the
      prevalence of the metabolic syndrome (Mets) and type 2 diabetic (T2DM). Diet quality,
      particularly composition of carbohydrate play also a significant role. The glycemic index
      (GI) describes in relative terms rise of blood glucose after ingestion of carbohydrate-rich
      food. Purified dietary fibre as β-glucan (BG) has been shown to reduce GI and affect levels
      of satiety hormones. In contrast, our knowledge of the physiological effects of arabinoxylans
      (AX), which constitute a substantial part of dietary fibre in cereal products, is limited.
      The investigators also lack a deeper understanding of the importance of whole grain (whole
      grain with whole kernels, and purified dietary fibre) in relation to Mets and T2DM.

      Hypothesis: The composition of dietary carbohydrates can be designed so that they improve the
      glycemic and insulinaemic responses and increase satiety feeling. This can be detected in
      metabolic parameters in subjects with Mets.

      The aim of our study is in subjects with Mets to compare the effect of acute consumption of
      bread rich in (a) purified AX, (b) purified BG, (c) rye bread with whole kernels (RK), with a
      (d) control group with consumption of white bread (WB).

      The primary endpoint is GI. Secondary endpoints are the following items: glycemic load,
      insulin index, glucose, insulin, glucagon, inflammatory markers, incretins, rate of gastric
      emptying, and metabolomics. Also satiety feeling will be measured.

      This project will improve opportunities for identifying and designing foods with low GI that
      is particularly suited to people who are at high risk of developing T2DM. The investigators
      also expect to gain a greater understanding of the metabolic fingerprint, as seen after
      ingestion of low-GI foods and thereby gain a molecular understanding of how low-GI foods
      affect health by altering metabolic processes. This will give us a deeper insight into the
      metabolic processes that are necessary for maintaining normal glucose homeostasis.
    

Detailed description: 
      Using a cross-over design, 12 subjects with Mets will consume test meals containing the four
      different bread types. Blood samples will be collected over 4,5 hours after ingestion of test
      meals containing around 145 g of each bread type, equivalent to 50 g available carbohydrate
      and 3 dl + 2 dl water on four different days in randomized order. Visual Analog Scale (VAS)
      will be used for determination of subjective satiety feeling and a subsequent meal will be
      served to estimate prospective food consumption.
    

Intervention name(s): Bread types
Intervention type(s): Other
Intervention description(s): Bread with 50 g available carbohydrate
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Arabinoxylan; Beta glucan; Whole grain; Dietary fibre; Metabolic syndrome; Glycemic index; Satiety