Assessment of Millet, Oat and Rye Porridge Breakfasts Glucose and Gastric Emptying
Condition: Healthy
Study type: Interventional

Summary: 
      Breakfast porridges are made from milled grains and are commonly eaten worldwide.
      Traditionally different grains are used in different countries. For example, oats are more
      common in the Anglo-Saxon countries; rye is favoured in the Scandinavian countries whilst
      millet is very common in parts of India and Africa. However the nutritional value and
      potential metabolic and health effects may vary dramatically between different grains. For
      example what is the effect of the different grains on blood sugar or on how fast the stomach
      empties after eating the porridge and how full people feel. All these physiological responses
      may differ between these grains resulting in potential health benefits.

      RESEARCH QUESTION: The investigators hypothesise that porridges made from different grains
      will behave differently during the digestion and cause differences in blood glucose levels,
      gastric emptying and appetite.

      This study, which is a 4-way, randomized, cross over pilot study in healthy participants,
      aims to answer this research question.

      The participants will be asked to eat a porridge breakfasts made with oats, rye and millet of
      different varieties (but containing the same amount of calories), in 4 morning studies one
      week apart. MRI will be used to monitor the gastrointestinal fate of the breakfasts and
      measure gastric emptying using MRI, blood glucose levels using a finger prick test and
      self-reported appetite scores.
    

Detailed description: 
      Background: Porridge breakfasts from various grains are a staple source of energy for many
      populations worldwide. The grains used in the porridges differ between regions, mostly due to
      the crops historically grown. For example, oats are more common in the Anglo-Saxon countries;
      rye is traditional in the Scandinavian countries whilst millet is very common in parts of
      India and Africa. Porridge consumption is very popular: 78% of South Africans eat porridge;
      49% of British people eat porridge with 23% doing so almost daily; 62% of U.S. households buy
      hot cereal breakfast and the hot cereal segment is the best performer within the breakfast
      cereals market in the UK. Consumption of whole grains has been associated with a variety of
      health benefits ranging from lower blood glucose levels, improved insulin responses, reduced
      cholesterol and increased diversity of the microbiota. Of particular interest to this study
      are recent suggestions that different grains, and particularly millet grains, may have
      enhanced health benefits on glucose and insulin metabolism. This may be due to different
      rates of digestion and absorption, for example, because of grain specific differences in
      starch digestibility. This could affect gastric emptying and, in turn, post prandial
      glycaemia and impact on satiety. However little is known about possible differences in
      gastric emptying between breakfast porridges from different grains and possible relationship
      with glucose, insulin and appetite.

      The hypothesis underlying this study is that porridges made from different grains (such as
      oats, rye and different millets) will produce different postprandial glucose levels and that
      these will correlate with gastric emptying and appetite in healthy volunteer participants.

      Aims: 1. to collect pilot data on postprandial glucose levels of isoenergetic breakfast
      porridges made from different grains, such as oats, rye and millets of different origin. 2.
      to collect initial pilot data on their gastric emptying and satiety. 3. to compare
      postprandial glucose levels, gastric emptying and satiety for the different treatments 4. to
      explore relationships between glucose levels, gastric emptying and satiety.

      Experimental protocol and methods: 16 healthy volunteers will participate in this 4-way
      study. They will attend one morning for each study, with the studies separated by 1 week.
      Before the test meal, and after that approximately every 15 min for 1 hour and after that
      approximately every 20 minutes for 1 hour the level of glucose in their blood will be
      measured using the finger prick method, as diabetics commonly do to monitor their blood
      sugars. The participants will also be scanned at baseline, immediately after the test meal
      and then every hour for 2 hours postprandially. Subjects will be scanned on a research
      dedicated 1.5T MRI scanner. At baseline and every time the subjects provide a blood glucose
      sample the participants will be asked to rate their feelings of fullness, hunger and appetite
      on 100mm VAS scales.

      The subject will be fed four isoenergetic breakfast porridges: Oat, Rye, Pearl (Bajra) millet
      and Finger (Ragi) millet porridge sourced from supermarkets or food shops. These will be
      cooked in water to avoid confounding factor with milk. The test breakfast will have 220 kcal.

      Statistical power. This is only a pilot study.
    

Intervention name(s): Breakfast porridge
Intervention type(s): Other
Intervention description(s): 220 kcal breakfast porridge served with 240 mL glass of water
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Basic Science
Keywords: MRI; blood glucose; satiety; breakfast; porridge; grains