Glycemic and Hormone Responses After the Intake of Four Types of Bread.
Condition: Hyperglycemia; Insulin Sensitivity
MeSH terms: Insulin Resistance; Hyperglycemia
Study type: Interventional

Summary: 
      The purposes of the present study are to determine the glycemic and insulinemic responses,
      the satiety rate and the postprandial plasma concentrations of free fatty acids,
      triglycerides and satiety hormones after the ingestion of four types of breads: handcrafted
      bread made with wheat organic flour; handcrafted bread with wheat flour of large-scale retail
      distribution; handcrafted bread with organic einkorn flour and a commercial wheat bread.
    

Detailed description: 
      The postprandial blood glucose concentration appears to play a critical role in the
      development of diabetes and cardiovascular diseases; it is largely influenced by the
      carbohydrate load of a meal. Thus, advocating carbohydrate (CHO) foods that promote favorable
      glycemic and insulinemic responses, with maintenance of satiety high over a longer period,
      may be a beneficial approach against many chronic diseases.

      Bread is a basic food in Italian feeding. The industrial production of bread is gradually
      replacing the craft production by small bakeries. It is possible to buy daily bread obtained
      by completing baking carried out directly at the point of sale from pre-cooked and frozen
      dough. The use of "improver" as enzyme preparations such as alpha-amylase, improves the
      quality of bread. A study has found that trestatin, an amylase inhibitor incorporated into
      bread, produced lower glycemic and insulinemic responses; another has reported that bread
      made from the ancient wheat Einkorn (Triticum monococcum) elicited a reduced production of
      glucose-dependent insulinotrophic polypeptide (GIP).

      The objectives of the present study are to determine the glycemic and insulinemic responses
      (area-under the curve, AUCs), the satiety rate and the AUCs of free fatty acids (FFA),
      triglycerides and ghrelin after the ingestion of four types of breads, each containing 50g of
      available CHO:

        -  97 g handcrafted bread made with wheat organic flour;

        -  97 g handcrafted bread with wheat flour of large-scale retail distribution;

        -  94 g handcrafted bread with organic einkorn flour

        -  86 g commercial precooked-frozen white bread.

           16 healthy volunteers participated to this randomized cross-over trial. Each participant
           consumed the specific portion of a type of bread in the morning, after 8-12 h fasting.
           The other 3 types of bread are consumed by participants in the order determined by the
           randomization procedure, after a week each other.

      At enrollment, all participants meet the inclusion criteria (see below). Nutrition and
      exercise advices are given for the day before each bread test. Participants should consume
      the bread portion in 15 minutes.

      Blood samples are drawn every 30-min from fasting until 120-min after bread consumption. The
      following variables are evaluated at each time point: glucose, insulin, FFA, triglycerides,
      acylated ghrelin. The satiety rate is estimated every 30-min by the Satiety Labeled Intensity
      Magnitude scales.
    

Intervention name(s): intake of the specific kind of bread
Intervention type(s): Other
Intervention description(s): To determine the glycemic and insulinemic responses (area-under the curve, AUCs), the satiety rate and the AUCs of free fatty acids (FFA), triglycerides and ghrelin after the ingestion of four types of breads, each containing 50g of available carbohydrates
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention