Pasta and Other Durum Wheat-based Products: Effects on Post-prandial Glucose Metabolism
Condition: Dietary Modification
Study type: Interventional

Summary: 
      Carbohydrate-based products can influence the post-prandial glycemic response differently
      based on their ability to be digested, absorbed and to affect rises in plasma glucose. Pasta
      is one of the major carbohydrate-rich foods consumed in Italy. Studies from the literature
      describe a lower glycemic response after the consumption of pasta compared with other
      wheat-based products, such as bread. Among the factors affecting post-prandial glycemia after
      consumption of carbohydrate-based products, the technological process represents a central
      one.In fact, the different technological processes alter the food matrix which can affect the
      post-prandial metabolism of glucose differently. Thus, the present study aims at
      investigating the effect induced by the principal steps of the process of pasta production on
      the reduction of post-prandial glycemic response (post-prandial glucose, insulin, GLP-1, GIP
      plasma concentrations).
    

Detailed description: 
      The different glycemic responses after the consumption of carbohydrate-based products are
      associated with different rates of digestion and absorption of the carbohydrates in the human
      body. Therefore, food products rich in carbohydrates can be classified based on their ability
      to be digested, absorbed and to affect post-prandial glycemia. Epidemiological studies
      suggest that following a diet including carbohydrate-based foods inducing a low and slow
      glycemic response is associated with reduced risk to develop some non-communicable diseases
      (such as type 2 diabetes (Livesey et al, 2013; Dong et al, 2011) and cardiovascular disease
      (Ludwig, 2002; Blaak et al, 2012)), to control inflammatory status (Ma et al, 2012; Sieri et
      al, 2010), which is the trigger of several pathologies, and to reduce fasting insulin
      (Schwingshackl & Hoffmann, 2013). Depending on the food composition, a low glycemic response
      is not always associated with a low plasma insulin concentration. For instance, high protein
      or lipid concentrations in the food matrix have been demonstrated to induce low post-prandial
      glycemic responses, but not a reduction in insulin secretion (Gannon et al, 1988; Gannon et
      al, 1993; Collier et al. 1988). Avoiding a high insulin post-prandial response after
      consumption of foods represents a preventive factor against the risk of overweight and
      hyperlipidemia (Ostlund et al, 1990), type 2 diabetes (Weyer et al, 2001), and cancer
      (Onitilo et al, 2014). Therefore, the evaluation of both glycemic and insulinemic
      post-prandial response curves is necessary in order to demonstrate the true beneficial effect
      of the consumption of low glycemic index foods. Among several factors which can influence the
      post-prandial glycemic and insulinemic responses (such as macronutrient composition and the
      cooking process), the technological aspects through which the foods are produced represent an
      important one. Several studies reported a low glycemic response after the consumption of
      pasta compared with bread (Jenkins et al, 1988; Jenkins et al, 1981; Wolever et al, 1986),
      and this is due to the technological structures characterizing the two matrices (Petitot et
      al, 2009). Pasta is one of the major sources of carbohydrates consumed in Italy. Therefore,
      the aim of the present study is to investigate the effect of pasta and other durum wheat
      based products on the plasma response of glucose, insulin, and other hormones related to the
      glucose metabolism (c-peptide, GLP-1 and GIP) in order to clearly discriminate the different
      biological effect induced by the technological process in the production of pasta, compared
      to foods beginning with the same ingredients. Moreover, the study aims to create a solid
      basis for future studies for evaluating the effect of pasta consumption, as the main source
      of carbohydrates, in a context of a balanced diet, for maintaining health.
    

Intervention name(s): Glucose; Semolina soup; Bread; Penne (fresh); Penne (dry); Spaghetti (dry)
Intervention type(s): Other; Other; Other; Other; Other; Other
Intervention description(s): Glucose monohydrate (55 g) dissolved with 500 mL of water; Semolina soup (322 g) eaten with 500 mL of water; Bread (122 g) eaten with 500 mL of water; Cooked penne (132 g) eaten with 500 mL of water; Cooked penne (142 g) eaten with 500 mL of water; Cooked spaghetti (142 g) eaten with 500 mL of water
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Basic Science