Effect of fibre additions to flatbread flour mixes on glucose kinetics: a randomised controlled trial

Br J Nutr. 2017 Nov;118(10):777-787. doi: 10.1017/S0007114517002781. Epub 2017 Nov 7.

Abstract

We previously found that guar gum (GG) and chickpea flour (CPF) added to flatbread wheat flour lowered postprandial blood glucose (PPG) and insulin responses dose dependently. However, rates of glucose influx cannot be determined from PPG, which integrates rates of influx, tissue disposal and hepatic glucose production. The objective was to quantify rates of glucose influx and related fluxes as contributors to changes in PPG with GG and CPF additions to wheat-based flatbreads. In a randomised cross-over design, twelve healthy males consumed each of three different 13C-enriched meals: control flatbreads (C), or C incorporating 15 % CPF with either 2 % (GG2) or 4 % (GG4) GG. A dual isotope technique was used to determine the time to reach 50 % absorption of exogenous glucose (T 50 %abs, primary objective), rate of appearance of exogenous glucose (RaE), rate of appearance of total glucose (RaT), endogenous glucose production (EGP) and rate of disappearance of total glucose (RdT). Additional exploratory outcomes included PPG, insulin, glucose-dependent insulinotropic peptide and glucagon-like peptide 1, which were additionally measured over 4 h. Compared with C, GG2 and GG4 had no significant effect on T 50 %abs. However, GG4 significantly reduced 4-h AUC values for RaE, RaT, RdT and EGP, by 11, 14, 14 and 64 %, respectively, whereas GG2 showed minor effects. Effect sizes over 2 and 4 h were similar except for significantly greater reduction in EGP for GG4 at 2 h. In conclusion, a soluble fibre mix added to flatbreads only slightly reduced rates of glucose influx, but more substantially affected rates of postprandial disposal and hepatic glucose production.

Keywords: T 50 %abs time to reach 50 % absorption of exogenous glucose; BF barley flour; C control; CPF chickpea flour; EGP endogenous glucose production; GCR glucose clearance rate; GG guar gum; GG2 2 % GG; GG4 4 % GG; GIP glucose-dependent insulinotropic peptide; GLP-1 glucagon-like peptide 1; PPG postprandial plasma glucose; PPI postprandial plasma insulin; RaE rate of appearance of exogenous glucose; RaT rate of appearance of total glucose; RdT rate of disappearance of total glucose; dAUC decremental area under the curve; Dual stable isotope technique; Flatbreads; Glucose fluxes; Legume flours; Viscous fibres.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Area Under Curve
  • Blood Glucose / metabolism
  • Bread*
  • Carbon Isotopes
  • Cicer*
  • Cyamopsis*
  • Dietary Fiber / pharmacology*
  • Flour
  • Galactans
  • Gastric Inhibitory Polypeptide / blood
  • Glucagon-Like Peptide 1 / blood
  • Gluconeogenesis / drug effects
  • Glucose / metabolism*
  • Glucose / pharmacokinetics
  • Glycemic Index*
  • Humans
  • Insulin / blood
  • Intestinal Absorption / drug effects
  • Liver
  • Male
  • Mannans
  • Plant Gums
  • Plant Preparations / pharmacology
  • Postprandial Period*
  • Triticum
  • Young Adult

Substances

  • Blood Glucose
  • Carbon Isotopes
  • Dietary Fiber
  • Galactans
  • Insulin
  • Mannans
  • Plant Gums
  • Plant Preparations
  • Gastric Inhibitory Polypeptide
  • Glucagon-Like Peptide 1
  • guar gum
  • Glucose