Complete nutrition drink with retrograded starch is low glycemic, and the individual glucose response to the low glycemic complete nutrition drink depends on fasting insulin levels and HOMA-IR in a randomized cross-over control trial

Abstract

Complete nutrition drinks with a low glycemic index (GI) provide nutritional support and prevent hyperglycaemia. The present study identified GI and factors predicting individual glucose response to a new complete nutrition drink. A randomised cross-over controlled trial was conducted in eighteen healthy volunteers (FPG < 100 mg/dl). Complete nutrition drinks containing retrograded starch, glucose solution and white bread were assigned in a random sequence with 14-day wash-out intervals. Plasma glucose and insulin levels were measured from baseline to 180 min after consuming each food. Results show the adjusted GIs of the drink was 48.2 ± 10.4 and 46.7 ± 12.7 with glucose and white bread as the reference, respectively. While the drink has low GI (<55), the individual glucose responses varied (GI: 7-149). Comparing characters in individual GI < 55 (n = 12) and GI ≥ 55 (n = 6) groups revealed significantly higher baseline insulin in the low GI group (14.86 ± 16.51 μIU/ml v. 4.9 ± 3.4 μIU/ml, P < 0·05). The correlation matrix confirms only two predictive factors for having individual GI <55 were baseline insulin (r = 0·5, P = 0·03) and HOMA-IR (r = 0·55, P = 0·02). ROC curve reveals fasting insulin above 1.6 μIU/ml and HOMA-IR above 1.05 as the cut-off values. The findings suggest that the complete nutrition drink has a low GI, but there was wide variability in individual responses partly explained by fasting insulin levels and HOMA-IR. Screening for fasting insulin and HOMA-IR may be encouraged to maximise the functional benefit of the drink.

Keywords: ALT, alanine aminotransferase; AST, aspartate aminotransferase; AUCi, incremental area under the curve; BMI, Body mass index; BUN, blood urea nitrogen; CI, confidence intervals; Clinical trial; Complete nutrition drink; DM, Diabetes Mellitus; ECLIA, electrochemiluminescence immunoassay; FPG, fasting plasma glucose; GI, Glycemic index; Glycemic index; HDL, high-density lipoprotein; HDL-C, high-density lipoprotein cholesterol; Healthy volunteers; IPAQ, International physical activity questionnaire; Insulin; LDL, low-density lipoprotein; MET, metabolic equivalent; Personalised nutrition; Postprandial glucose response; Retrograded starch; SD, standard deviation; SE, standard error; h, hour; min, minute.