Wholegrain Particle Size Influences Postprandial Glycemia in Type 2 Diabetes: A Randomized Crossover Study Comparing Four Wholegrain Breads

Diabetes Care. 2020 Feb;43(2):476-479. doi: 10.2337/dc19-1466. Epub 2019 Nov 19.

Abstract

Objective: Wholegrain foods vary in the extent of processing. We investigated whether wholegrain particle size in bread influences postprandial glycemia in type 2 diabetes.

Research design and methods: Postprandial glycemia (incremental area under the blood glucose curve [iAUC]) was measured after consumption of three breads made with roller-milled wholegrain flour and added grains and a fourth made with stone-ground flour. All flours and grains were 100% wholegrain wheat. Breads were nutrient matched.

Results: Fifteen adults (64 ± 10 years, HbA1c 58 ± 13 mmol/mol) completed the study. iAUC for the three breads made with roller-milled flour ranged from 376 to 641 mmol-1min-1, inverse linear trend for grain particle size P = 0.039. The iAUC for stone-ground wholegrain bread (503) was smaller than predicted from mean particle size.

Conclusions: Wholegrain structural integrity in bread is a determinant of glycemic response. These findings have implications for dietary advice and the definition of the term "'wholegrain."

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood Glucose / analysis
  • Blood Glucose / metabolism*
  • Bread* / analysis
  • Cross-Over Studies
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / diet therapy
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / metabolism
  • Female
  • Flour / analysis
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Male
  • Middle Aged
  • New Zealand
  • Particle Size
  • Postprandial Period*
  • Triticum / chemistry
  • Whole Grains* / chemistry
  • Young Adult

Substances

  • Blood Glucose
  • Hypoglycemic Agents

Associated data

  • ANZCTR/ACTRN12617000328370