Eur J Nutr DOI 10.1007/s00394-014-0795-8
ORIGINAL CONTRIBUTION
The effect of consumption of low‑glycemic‑index and low‑glycemic‑load desserts on anthropometric parameters and inflammatory markers in patients with type 2 diabetes mellitus Vasiliki Argiana · Panagiotis Τ. Kanellos · Konstantinos Makrilakis · Ioanna Eleftheriadou · Georgios Tsitsinakis · Alexander Kokkinos · Despina Perrea · Nikolaos Tentolouris Received: 15 May 2014 / Accepted: 29 October 2014 © Springer-Verlag Berlin Heidelberg 2014
Abstract Purpose The aim of the present study was to examine the effects of consumption of desserts with low glycemic index (GI) and low glycemic load (GL), as part of a balanced hypo-caloric diet, on anthropometric and biochemical parameters in patients with type 2 diabetes mellitus (T2DM). Methods A total of 61 subjects with T2DM were randomly assigned to the intervention (n = 30) or to the control group (n = 31). Both groups followed the same hypocaloric (−500 kcal) diet for 12 weeks. Consumption of four portions of low-GI/low-GL desserts/week was included in the diet in the intervention group while one portion of a favorite usual sweet/week was allowed to be consumed in the control group. Results Thirty subjects in the control and 28 subjects in the intervention group completed the trial. Body weight, body mass index, and waist circumference were reduced significantly in both groups. Arterial blood pressure, fasting blood glucose, glycosylated hemoglobin, insulin, and γ-GT
V. Argiana · K. Makrilakis · I. Eleftheriadou · G. Tsitsinakis · A. Kokkinos · N. Tentolouris First Department of Propaedeutic and Internal Medicine, Laiko General Hospital, Athens University Medical School, 17 Agiou Thoma St., 11527 Athens, Greece P. Τ. Kanellos (*) Department of Dietetics and Nutritional Science, School of Health Science and Education, Harokopio University, 70 El. Venizelou Ave., 17671 Athens, Greece e-mail: [email protected] D. Perrea Laboratory of Experimental Surgery and Surgical Research “N.S. Christeas”, Athens University Medical School, 15B Agiou Thoma St., 11527 Athens, Greece
were reduced significantly only in the intervention group; however, there were no significant differences between the two groups at endpoint. C-reactive protein was reduced in the intervention, and HDL cholesterol was also reduced in the control group; the reductions were significantly different at the end of the trial. No significant changes were observed in the other plasma lipids, uric acid, leptin, adiponectin, and interleukin-6 in either study group. Conclusions Consumption of desserts with low GI/GL in a balanced hypo-caloric diet has a positive impact on anthropometric and metabolic parameters of patients with T2DM. Keywords Glycemic index · Glycemic load · Lipids · Low-grade inflammation · Type 2 diabetes mellitus
Introduction Mortality rates from cardiovascular diseases (CVD) are up to five times higher for patients with diabetes than the nondiabetic population [1] in part due to the coexistent atherogenic lipid profile and hypertension [2]. Additionally, obesity, a major global health problem, has been associated with serious disorders such as dyslipidemia, hypertension, type 2 diabetes mellitus (T2DM), hyperinsulinemia, atherosclerosis, and certain types of cancer [3]. Lifestyle factors, including nutrition, play an important role in the prevention and treatment of obesity and T2DM. Moreover, not only the total carbohydrate (CHO) intake but also the quality of CHO has been found to be important in glucose regulation [4]. In an attempt to describe the post-ingestion effect of different CHO-containing foods on blood glucose concentrations, Jenkins et al. [5] coined the term “glycemic index.” However, controversy exists about
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the utility of glycemic index (GI) or glycemic load (GL) value of foods, particularly concerning the prevention of CVD [6, 7]. An inverse relationship between GI and highdensity lipoprotein cholesterol (HDL-C) has been found in two large cross-sectional studies [8, 9]. Further epidemiological evidence suggests that there is a positive association between GI and triglycerides [10] but evidence for the effect of GI on total and low-density lipoprotein cholesterol (LDL-C) is less clear [8, 11]. The primary aim of the present study was to evaluate the effect of a 12-week intervention with low-GI and low-GL sweet consumption on physical measurements (body weight, body mass index, waist circumference, and blood pressure), blood biomarkers [fasting blood glucose and glycosylated hemoglobin (HbA1c)], and lipid profile in patients with T2DM. Also, we examined the impact of the intervention on high-sensitivity C-reactive protein (hsCRP) and inflammatory cytokines of patients.
Materials and methods Study population Sixty one men and postmenopausal women with T2DM were recruited for the study from the diabetes outpatient clinic of “Laiko” University Hospital. Diagnosis of diabetes was based on the American Diabetes Association criteria [12]. Recruitment was based on the following inclusion criteria: age 40–65 years, acceptable glycemic control (HbA1c
ORIGINAL CONTRIBUTION
The effect of consumption of low‑glycemic‑index and low‑glycemic‑load desserts on anthropometric parameters and inflammatory markers in patients with type 2 diabetes mellitus Vasiliki Argiana · Panagiotis Τ. Kanellos · Konstantinos Makrilakis · Ioanna Eleftheriadou · Georgios Tsitsinakis · Alexander Kokkinos · Despina Perrea · Nikolaos Tentolouris Received: 15 May 2014 / Accepted: 29 October 2014 © Springer-Verlag Berlin Heidelberg 2014
Abstract Purpose The aim of the present study was to examine the effects of consumption of desserts with low glycemic index (GI) and low glycemic load (GL), as part of a balanced hypo-caloric diet, on anthropometric and biochemical parameters in patients with type 2 diabetes mellitus (T2DM). Methods A total of 61 subjects with T2DM were randomly assigned to the intervention (n = 30) or to the control group (n = 31). Both groups followed the same hypocaloric (−500 kcal) diet for 12 weeks. Consumption of four portions of low-GI/low-GL desserts/week was included in the diet in the intervention group while one portion of a favorite usual sweet/week was allowed to be consumed in the control group. Results Thirty subjects in the control and 28 subjects in the intervention group completed the trial. Body weight, body mass index, and waist circumference were reduced significantly in both groups. Arterial blood pressure, fasting blood glucose, glycosylated hemoglobin, insulin, and γ-GT
V. Argiana · K. Makrilakis · I. Eleftheriadou · G. Tsitsinakis · A. Kokkinos · N. Tentolouris First Department of Propaedeutic and Internal Medicine, Laiko General Hospital, Athens University Medical School, 17 Agiou Thoma St., 11527 Athens, Greece P. Τ. Kanellos (*) Department of Dietetics and Nutritional Science, School of Health Science and Education, Harokopio University, 70 El. Venizelou Ave., 17671 Athens, Greece e-mail: [email protected] D. Perrea Laboratory of Experimental Surgery and Surgical Research “N.S. Christeas”, Athens University Medical School, 15B Agiou Thoma St., 11527 Athens, Greece
were reduced significantly only in the intervention group; however, there were no significant differences between the two groups at endpoint. C-reactive protein was reduced in the intervention, and HDL cholesterol was also reduced in the control group; the reductions were significantly different at the end of the trial. No significant changes were observed in the other plasma lipids, uric acid, leptin, adiponectin, and interleukin-6 in either study group. Conclusions Consumption of desserts with low GI/GL in a balanced hypo-caloric diet has a positive impact on anthropometric and metabolic parameters of patients with T2DM. Keywords Glycemic index · Glycemic load · Lipids · Low-grade inflammation · Type 2 diabetes mellitus
Introduction Mortality rates from cardiovascular diseases (CVD) are up to five times higher for patients with diabetes than the nondiabetic population [1] in part due to the coexistent atherogenic lipid profile and hypertension [2]. Additionally, obesity, a major global health problem, has been associated with serious disorders such as dyslipidemia, hypertension, type 2 diabetes mellitus (T2DM), hyperinsulinemia, atherosclerosis, and certain types of cancer [3]. Lifestyle factors, including nutrition, play an important role in the prevention and treatment of obesity and T2DM. Moreover, not only the total carbohydrate (CHO) intake but also the quality of CHO has been found to be important in glucose regulation [4]. In an attempt to describe the post-ingestion effect of different CHO-containing foods on blood glucose concentrations, Jenkins et al. [5] coined the term “glycemic index.” However, controversy exists about
13
the utility of glycemic index (GI) or glycemic load (GL) value of foods, particularly concerning the prevention of CVD [6, 7]. An inverse relationship between GI and highdensity lipoprotein cholesterol (HDL-C) has been found in two large cross-sectional studies [8, 9]. Further epidemiological evidence suggests that there is a positive association between GI and triglycerides [10] but evidence for the effect of GI on total and low-density lipoprotein cholesterol (LDL-C) is less clear [8, 11]. The primary aim of the present study was to evaluate the effect of a 12-week intervention with low-GI and low-GL sweet consumption on physical measurements (body weight, body mass index, waist circumference, and blood pressure), blood biomarkers [fasting blood glucose and glycosylated hemoglobin (HbA1c)], and lipid profile in patients with T2DM. Also, we examined the impact of the intervention on high-sensitivity C-reactive protein (hsCRP) and inflammatory cytokines of patients.
Materials and methods Study population Sixty one men and postmenopausal women with T2DM were recruited for the study from the diabetes outpatient clinic of “Laiko” University Hospital. Diagnosis of diabetes was based on the American Diabetes Association criteria [12]. Recruitment was based on the following inclusion criteria: age 40–65 years, acceptable glycemic control (HbA1c
