title: Effect of long-term intake of Asian food with different glycemic indices on diabetic control and protein conservation in type 2 diabetic patients. Consumption of Whole Grain and Legume Powder Reduces Insulin Demand, Lipid Peroxidation, and Plasma Homocysteine Concentrations in Patients With Coronary Artery Disease: Randomized Controlled Clinical Trial Lupin kernel fibre-enriched foods beneficially modify serum lipids in men Slow release dietary carbohydrate improves second meal tolerance. Hormonal implications of the hypocholesterolemic effect of intake of field beans (Vicia faba L.) by young men with hypercholesterolemia. Effects of long-term consumption and single meals of chickpeas on plasma glucose, insulin, and triacylglycerol concentrations. International table of glycemic index and glycemic load values: 2002. Repeated consumption of high-fiber breakfasts: effects on postprandial glucose and insulin responses after breakfast and lunch. Low-glycemic-index starchy foods in the diabetic diet. The Canadian Trial of Carbohydrates in Diabetes (CCD), a 1-y controlled trial of low-glycemic-index dietary carbohydrate in type 2 diabetes: no effect on glycated hemoglobin but reduction in C-reactive protein. Glycemic index of foods: a physiological basis for carbohydrate exchange. Rate of digestion of foods and postprandial glycaemia in normal and diabetic subjects. The effect of flexible low glycemic index dietary advice versus measured carbohydrate exchange diets on glycemic control in children with type 1 diabetes. Long-term dietary treatment with increased amounts of fiber-rich low-glycemic index natural foods improves blood glucose control and reduces the number of hypoglycemic events in type 1 diabetic patients. Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial Beneficial Effect of a Low Glycaemic Index Diet in Type 2 Diabetes A randomized clinical trial comparing low-glycemic index versus ADA dietary education among individuals with type 2 diabetes. Comparison of 4 diets of varying glycemic load on weight loss and cardiovascular risk reduction in overweight and obese young adults: a randomized controlled trial. Five-week, low-glycemic index diet decreases total fat mass and improves plasma lipid profile in moderately overweight nondiabetic men. A prospective randomised trial to determine the efficacy of a low glycaemic index diet given in addition to healthy eating and weight loss advice in patients with coronary heart disease Hypocholesterolemic effects of oat-bran or bean intake for hypercholesterolemic men. Improved plasma glucose control, whole-body glucose utilization, and lipid profile on a low-glycemic index diet in type 2 diabetic men: a randomized controlled trial. Effects of a Controlled Diet Supplemented with Chickpeas on Serum Lipids, Glucose Tolerance, Satiety and Bowel Function A HIGH CARBOHYDRATE LEGUMINOUS FIBRE DIET IMPROVES ALL ASPECTS OF DIABETIC CONTROL Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus. Pinto Bean Consumption Reduces Biomarkers for Heart Disease Risk Beneficial Effect of Low-Glycemic Index Diet in Overweight NIDDM Subjects Can eating baked beans lower plasma cholesterol? Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Whole foods and increased dietary fibre improve blood glucose control in diabetic children. Effects of intensive glucose lowering in type 2 diabetes. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes.
abstract: The study was carried out in 10 females with type 2 diabetes aged 32 - 60 yrs . All of them were receiving weight-maintaining diets composed of 12 per cent protein , 30 per cent fat and 58 per cent carbohydrate . The only difference among all study -diets was the types of complex carbohydrate used . High-glycemic diet ( HG ) or low glycemic diet ( LG ) consisted mainly of glutinous rice or mungbean noodles and the intermediate-glycemic diet ( DM ) was solely white rice . After the metabolic evaluation of the baseline diet ( BL ) , each subject was placed on DM and followed r and omly by HG and LG or vice versa for 4 weeks each . The diurnal plasma glucose levels tended to be lowest after LG . The integrated plasma glucose levels among all diets were not different . The integrated insulin levels after DM and LG did not differ but they were lower than HG and BL . Long-term ingestion of all test-diets spilt less urinary glucose than BL , the lowest was LG . HbA1 levels and nitrogen balance after all diets were better than BL , the best was LG . It was concluded that in addition to strict dietary control , ingestion of mungbean noodles ( a low glycemic diet ) without increasing fiber intake , can improve diabetic control and protein conservation in type 2 diabetes Our objective was to evaluate whether isocaloric replacement of refined rice with whole grains and other plant products as a form of powder reduces coronary artery disease ( CAD ) risk factors , such as insulin dem and and lipid peroxidation in CAD patients . Seventy-six male patients with CAD were r and omly assigned to either a group ingesting a whole-grain meal daily or a control group for 16 weeks . In the whole-grain group , serum concentrations of glucose and insulin decreased by 24 % and 14 % , respectively , without altering body weight and energy intake , whereas daily intakes of fiber and vitamin E increased by 25 % and 41 % , respectively . Consumption of whole grains and legume powder in CAD patients without diabetes decreased fasting levels of glucose and insulin . The areas under the curve for insulin and glucose during the oral glucose tolerance test were also decreased . CAD patients with diabetes in the whole-grain group also showed reductions in fasting glucose and in the area under the curve for glucose . In the whole-grain group , plasma malondialdehyde and homocysteine and urinary 8-epi-prostagl and in F2&agr ; concentrations decreased by ≈28 % . Also , lipid-corrected concentrations of & agr;-carotene , retinol , tocopherols , and lycopene increased by 11 % to 40 % , and the percentage composition of n-6 fatty acids of serum phospholipid increased by 14 % in the whole-grain group . The replacement of refined rice with whole grain and legume powder as a source of carbohydrate in a meal showed significant beneficial effects on glucose , insulin , and homocysteine concentrations and lipid peroxidation in CAD patients . These effects are likely to substantially reduce the risk factors for CAD and diabetes Abstract Objective : To examine the effect of a diet containing a novel legume food ingredient , Australian sweet lupin ( Lupinus angustifolius ) kernel fibre ( LKFibre ) , compared to a control diet without the addition of LKFibre , on  serum lipids in men . Design : R and omized crossover dietary intervention study . Setting : Melbourne , Australia — Free-living men . Subjects : A total of 38 healthy males between the ages of 24 and 64 y completed the intervention . Intervention : Subjects consumed an LKFibre and a control diet for 1 month each . Both diets had the same background menus with seven additional experimental foods that either contained LKFibre or did not . Depending on energy intake , the LKFibre diet was design ed to contain an additional 17 to 30 g/day fibre beyond that of the control diet . Results : Compared to the control diet , the LKFibre diet reduced total cholesterol ( TC ) ( mean±s.e.m . ; 4.5±1.7 % ; P=0.001 ) , low-density lipoprotein cholesterol ( LDL-C ) ( 5.4±2.2 % ; P=0.001 ) , TC : high-density lipoprotein cholesterol ( HDL-C ) ( 3.0±2.0 % ; P=0.006 ) and LDL-C : HDL-C ( 3.8±2.6 % ; P=0.003 ) . No effects on HDL-C , triacylglycerols , glucose or insulin were observed . Conclusions : Addition of LKFibre to the diet provided favourable changes to some serum lipid measures in men , which , combined with its high palatability , suggest this novel ingredient may be useful in the dietary reduction of coronary heart disease risk . Sponsorship : Grains Research and Development Corporation , Australian Research Council and the Department of Agriculture Western Australia Breakfasts of lentils or wholemeal bread of identical carbohydrate content were taken by seven healthy volunteers . The lentils produced a significant 71 % ( p less than 0.001 ) reduction in the blood glucose area and flattened the plasma insulin and gastric inhibitory polypeptide responses by comparison with the bread . In addition , the lentil breakfast was followed by a significantly flatter blood glucose response to the st and ard bread lunch which followed 4 h later ( by 38 % , p less than 0.01 ) . The blood glucose pattern was mimicked by feeding the bread breakfast slowly over the 4 h before lunch . Giving a bread breakfast containing a quarter of the carbohydrate reduced the breakfast glucose profile but result ed in a significantly impaired blood glucose response to lunch ( 168 % of control , p less than 0.01 ) . These results , together with breath hydrogen studies , performed on a separate group of four volunteers , indicate that the flattened response to lentils is not due to carbohydrate malabsorption . Slow release or " lente " carbohydrate foods such as lentils may form a useful part of the diets of those with impaired carbohydrate tolerance This study examined the hypocholesterolemic effect and hormonal changes result ing from 30 d of supplementation with Vicia faba L. ( field bean ) flour of diets of young men ( aged 18 - 21 y ; n = 40 ) with borderline-high or high serum cholesterol values . All subjects ( groups A-D ) consumed the same basic diet . Additionally , volunteers in the control group ( A ) consumed 90 g control flour/d whereas those in the three bean groups received either 90 g cooked field bean flour ( groups B and C ) or 90 g raw field bean flour ( group D ) daily . Groups A and B included volunteers with borderline-high cholesterol values [ 5.2 - 6.2 mmol total cholesterol/L and 3.4 - 4.1 mmol low-density-lipoprotein ( LDL ) cholesterol/L ] . Subjects in groups C and D had high serum cholesterol concentrations ( total cholesterol > 6.2 mmol/L and LDL cholesterol > 4.1 mmol/L ) . After 30 d , serum glucose , insulin , triacylglycerol , total , LDL-cholesterol , and very-low-density-lipoprotein (VLDL)-cholesterol values were significantly lower than initial values in all subjects who consumed diets containing field bean flour ( P < or = 0.0001 , except for LDL-cholesterol concentrations in group C , for which P < or = 0.0007 ) . Legume intake also result ed in a significant increase ( P < or = 0.0001 ) in glucagon and high-density-lipoprotein cholesterol . Neither cortisol nor thyroid hormone values changed significantly . The results suggest that the hypocholesterolemic effect of field bean intake depends at least partly on a concomitant increase in glucagon and decrease in insulin values . The more marked reduction in triacylglycerol and VLDL-cholesterol concentrations in subjects who consumed raw field beans indicates a coparticipation of their thermolabile components BACKGROUND Legumes are recommended for better glucose control in persons with diabetes . Whether subjects with normal insulin sensitivity would also benefit from legume consumption is not clear . OBJECTIVE Our goal was to compare the effects on insulin sensitivity of chickpea-based and wheat-based foods when eaten as single meals or over 6 wk . DESIGN Acute and long-term studies were conducted in healthy middle-aged men and women . In the acute study ( n = 19 ) , plasma glucose , insulin , and calculated homeostasis model assessment ( HOMA ; an index of insulin sensitivity ) were measured on 3 separated days over 3 h after the subjects consumed 50-g available carbohydrate loads from either chickpeas , wheat-based foods , or white bread . The long-term comparison ( n = 20 ) was a r and omized , crossover study in which chickpea-based and wheat-based foods were eaten for 6 wk each . Plasma glucose , insulin , and HOMA were measured in the fasting state and 2 h after a 75-g glucose load . RESULTS After single meals , plasma glucose was substantially lower 30 and 60 min after the chickpea meal than after the other 2 meals ( P < 0.05 ) , and plasma insulin and HOMA were lower at 120 min ( P < 0.05 for both ) . Despite this , the long-term study failed to show significant differences in plasma glucose , insulin , or HOMA either in the fasting state or after a glucose load . CONCLUSION Compared with a wheat-based meal , a single chickpea-based meal led to a lesser response in plasma glucose and insulin concentrations , but this was not translated into long-term improvement in insulin sensitivity over 6 wk , at least in healthy subjects Reliable tables of glycemic index ( GI ) compiled from the scientific literature are instrumental in improving the quality of research examining the relation between GI , glycemic load , and health . The GI has proven to be a more useful nutritional concept than is the chemical classification of carbohydrate ( as simple or complex , as sugars or starches , or as available or unavailable ) , permitting new insights into the relation between the physiologic effects of carbohydrate-rich foods and health . Several prospect i ve observational studies have shown that the chronic consumption of a diet with a high glycemic load ( GI x dietary carbohydrate content ) is independently associated with an increased risk of developing type 2 diabetes , cardiovascular disease , and certain cancers . This revised table contains almost 3 times the number of foods listed in the original table ( first published in this Journal in 1995 ) and contains nearly 1300 data entries derived from published and unpublished verified sources , representing > 750 different types of foods tested with the use of st and ard methods . The revised table also lists the glycemic load associated with the consumption of specified serving sizes of different foods The objective of this study was to evaluate the effects of repeated consumption of two high-fiber diets on postpr and ial glucose and insulin responses .  Two mixed-food breakfast meals composed predominantly of either red kidney beans or bran cereal were fed to six healthy young men . The meals provided equivalent levels of digestible carbohydrate , protein , fat , and fiber . Insulin responses measured after breakfast were lower with the bean diet than with the bran cereal diet but higher when measured after a st and ard lunch . No significant interactions were found between the diets and the length of the time the subjects were on the diets ( days 1 vs 7 ) . In comparison to the postpr and ial responses on day 1 of the diet periods , postpr and ial responses on day 7 showed reduced glucose and insulin responses to breakfast and reduced insulin responses to lunch . Responses to an oral glucose tolerance test were not affected by repeated consumption of these diets Eight patients with noninsulin-dependent diabetes underwent two 2-wk study periods in r and om order during which they were provided with carbohydrate foods with either a high or low glycemic index ( GI ) . Over both high-GI and low-GI periods there were significant reductions in body weight , serum fructosamine , and cholesterol . Reductions in fasting blood glucose , HbA1c , and urinary c-peptide-to-creatinine ratio were significant only over the low-GI period despite a smaller mean weight loss . Reductions in triglyceride were significant only over the high-GI diet . Inclusion of low-GI foods into diets of patients with diabetes may be an additional measure that favorably influences carbohydrate metabolism without increasing insulin dem and BACKGROUND The optimal source and amount of dietary carbohydrate for managing type 2 diabetes ( T2DM ) are unknown . OBJECTIVE We aim ed to compare the effects of altering the glycemic index or the amount of carbohydrate on glycated hemoglobin ( HbA1c ) , plasma glucose , lipids , and C-reactive protein ( CRP ) in T2DM patients . DESIGN Subjects with T2DM managed by diet alone ( n=162 ) were r and omly assigned to receive high-carbohydrate , high-glycemic-index ( high-GI ) , high-carbohydrate , low-glycemic-index ( low-GI ) , or low-carbohydrate , high-monounsaturated-fat ( low-CHO ) diets for 1 y. RESULTS The high-GI , low-GI , and low-CHO diets contained , respectively , 47 % , 52 % , and 39 % of energy as carbohydrate and 31 % , 27 % , and 40 % of energy as fat ; they had GIs of 63 , 55 , and 59 , respectively . Body weight and HbA1c did not differ significantly between diets . Fasting glucose was higher ( P=0.041 ) , but 2-h postload glucose was lower ( P=0.010 ) after 12 mo of the low-GI diet . With the low-GI diet , overall mean triacylglycerol was 12 % higher and HDL cholesterol 4 % lower than with the low-CHO diet ( P<0.05 ) , but the difference in the ratio of total to HDL cholesterol disappeared by 6 mo ( time x diet interaction , P=0.044 ) . Overall mean CRP with the low-GI diet , 1.95 mg/L , was 30 % less than that with the high-GI diet , 2.75 mg/L ( P=0.0078 ) ; the concentration with the low-CHO diet , 2.35 mg/L , was intermediate . CONCLUSIONS In subjects with T2DM managed by diet alone with optimal glycemic control , long-term HbA1c was not affected by altering the GI or the amount of dietary carbohydrate . Differences in total : HDL cholesterol among diets had disappeared by 6 mo . However , because of sustained reductions in postpr and ial glucose and CRP , a low-GI diet may be preferred for the dietary management of T2DM The determine the effect of different foods on the blood glucose , 62 commonly eaten foods and sugars were fed individually to groups of 5 to 10 healthy fasting volunteers .  Blood glucose levels were measured over 2 h , and expressed as a percentage of the area under the glucose response curve when the same amount of carbohydrate was taken as glucose . The largest rises were seen with vegetables ( 70 + /- 5 % ) , followed by breakfast cereals ( 65 + /- 5 % ) , cereals and biscuits ( 60 + /- 3 % ) , fruit ( 50 + /- 5 % ) , dairy products ( 35 + /- 1 % ) , and dried legumes ( 31 + /- 3 % ) . A significant negative relationship was seen between fat ( p less than 0.01 ) and protein ( p less than 0.001 ) and postpr and ial glucose rise but not with fiber or sugar content Carbohydrate portions ( 2 g ) of lentils , soya beans , and wholemeal bread were incubated for three hours with human digestive juices and the effect of digestibility on blood glucose examined . Lentils and soya beans released only 39 % and 8 % respectively of the sugars and oligosaccharides liberated from bread . In healthy volunteers 50 g carbohydrate portions of cooked lentils and soya beans raised blood glucose concentrations by only 42 % ( p < 0.001 ) and 14 % ( p < 0.001 ) of the bread value . There was a similar response in diabetics . These results suggest that rate of digestion might be a important factor determining the rise in blood glucose concentration after a meal and that supplementing chemical analysis with in-vitro and in-vivo food testing might permit identification of especially useful foods for diabetics OBJECTIVE To determine the long-term effect of low glycemic index dietary advice on metabolic control and quality of life in children with type 1 diabetes . RESEARCH DESIGN AND METHODS Children with type 1 diabetes ( n = 104 ) were recruited to a prospect i ve , stratified , r and omized , parallel study to examine the effects of a measured carbohydrate exchange ( CHOx ) diet versus a more flexible low-glycemic index ( GI ) dietary regimen on HbA(1c ) levels , incidence of hypo- and hyperglycemia , insulin dose , dietary intake , and measures of quality of life over 12 months . RESULTS At 12 months , children in the low-GI group had significantly better HbA(1c ) levels than those in the CHOx group ( 8.05 + /- 0.95 vs. 8.61 + /- 1.37 % , P = 0.05 ) . Rates of excessive hyperglycemia ( > 15 episodes per month ) were significantly lower in the low-GI group ( 35 vs. 66 % , P = 0.006 ) . There were no differences in insulin dose , hypoglycemic episodes , or dietary composition . The low-GI dietary regimen was associated with better quality of life for both children and parents . CONCLUSIONS Flexible dietary instruction based on the food pyramid with an emphasis of low-GI foods improves HbA(1c ) levels without increasing the risk of hypoglycemia and enhances the quality of life in children with diabetes OBJECTIVE To evaluate in type 1 diabetic patients 1 ) the long-term feasibility of a high-fiber ( HF ) diet composed exclusively of natural foodstuffs and 2 ) the efficacy of this diet in relation to blood glucose control and incidence of hypoglycemic episodes . RESEARCH DESIGN AND METHODS The study was r and omized with parallel groups . Participants were part of a larger multicenter study on the effects of acarbose on glucose control in diabetes .  A total of 63 type 1 diabetic patients , age 28 + /- 9 years , BMI 24 + /- 0.6 kg/m2 , after a 4-week run-in period on their habitual diet , were r and omized to either an HF ( n = 32 ) or a low-fiber ( LF ) diet ( n = 31 ) for 24 weeks . The two diets , composed exclusively of natural foodstuffs , were weight-maintaining and , aside from their fiber content , were similar for all nutrients . At the end of the run-in period and the dietary treatment , fasting blood sample s for the measurement of plasma cholesterol , HDL cholesterol , triglyceride , and HbA(1c ) were collected . A daily glycemic profile was performed on a day in which the participants had consumed a st and ard menu representative of their treatment diet ( HF or LF ) . RESULTS Of the 63 study subjects , 29 in the HF group ( 91 % ) and 25 in the LF group ( 81 % ) completed the study Compared with the LF diet , the HF diet after 24 weeks decreased both mean daily blood glucose concentrations ( P < 0.05 ) and number of hypoglycemic events ( P < 0.01 ) . When compliance to diet was taken into account , 83 % of the subjects on the HF diet and 88 % on the LF diet were compliant . In this subgroup , compared with the LF diet , the HF diet significantly reduced mean daily blood glucose concentrations ( P < 0.001 ) , HbA(1c ) ( P < 0.05 ) , and number of hypoglycemic events ( P < 0.01 ) . CONCLUSIONS In type 1 diabetic patients , an HF diet is feasible in the long term and , compared with an LF diet , improves glycemic control and reduces the number of hypoglycemic events BACKGROUND The worldwide increase in type 2 diabetes mellitus is becoming a major health concern . We aim ed to assess the effect of acarbose in preventing or delaying conversion of impaired glucose tolerance to type 2 diabetes . METHODS In a multicentre , placebo-controlled r and omised trial , we r and omly allocated patients with impaired glucose tolerance to 100 mg acarbose or placebo three times daily . The primary endpoint was development of diabetes on the basis of a yearly oral glucose tolerance test ( OGTT ) . Analyses were by intention to treat . FINDINGS We r and omly allocated 714 patients with impaired glucose tolerance to acarbose and 715 to placebo . We excluded 61 ( 4 % ) patients because they did not have impaired glucose tolerance or had no postr and omisation data . 211 ( 31 % ) of 682 patients in the  acarbose group and 130 ( 19 % ) of 686 on  placebo  discontinued treatment early . 221 ( 32 % ) patients r and omised to acarbose and 285 ( 42 % ) r and omised to placebo developed diabetes ( relative hazard 0.75 [ 95 % CI 0.63 - 0.90 ] ; p=0.0015 ) . Furthermore , acarbose significantly increased reversion of impaired glucose tolerance to normal glucose tolerance ( p<0.0001 ) . At the end of the study , treatment with placebo for 3 months was associated with an increase in conversion of impaired glucose tolerance to diabetes . The most frequent side-effects to acarbose treatment were flatulence and diarrhoea . INTERPRETATION Acarbose could be used , either as an alternative or in addition to changes in lifestyle , to delay development of type 2 diabetes in patients with impaired glucose tolerance Low glycaemic index foods produce low blood glucose and insulin responses in normal subjects , and improve blood glucose control in Type 1 and well‐controlled Type 2 diabetic patients . We studied the effects of a low glycaemic index diet in 15 Type 2 diabetic patients with a mean fasting blood glucose of 9.5 mmol I−1 using a r and omized , crossover design . Patients were given pre‐weighed diets ( 59 % energy as carbohydrate , 21 % fat , and 24 g 1000‐kcal−1 dietary fibre ) for two 2‐week periods , with a diet glycaemic index of 60 during one period and 87 during the other . On the low glycaemic index diet  , the blood glucose response after a representative breakfast was 29 % less than on the high glycaemic index diet ( 874 ± 108 ( ± SE ) vs ± 204 ± 112 mmol min I−1 ; p < 0.001 ) , the percentage reduction being almost identical to the 28 % difference predicted from the meal glycaemic index values . After the 2‐week low glycaemic index diet , fasting serum fructosamine and cholesterol levels were significantly less than after the high glycaemic index diet ( 3.17 ± 0.12 vs 3.28 ± 0.16 mmol I−1 p < 0.05 , and 5.5 ± 0.4 vs 5.9 ± 0.5 mmol I−1 , p < 0.02 , respectively . Urinary C‐peptide excretion , as an index of insulin secretion , was 30 % lower on the low than the high glycaemic index diet ( 2.05 ± 0.30 vs 2.93 ± 0.49 nmol mmol‐creatinine−1 ; p < 0.02 ) , urinary urea was reduced by 19 % ( 347 ± 27 vs 402 ± 39 mmol 24‐h−1 ; p < 0.025 ) , consistent with enhanced colonic fermentation . These results suggest that low glycaemic index starchy foods may be beneficial in the treatment of Type 2 diabetes OBJECTIVE We compared the effects of a low glycemic index ( GI ) diet with the American Diabetes Association ( ADA ) diet on glycosylated hemoglobin ( HbA1c ) among individuals with type 2 diabetes . METHODS Forty individuals with poorly controlled type 2 diabetes were r and omized to a low-GI or an ADA diet . The intervention , consisting of eight educational sessions ( monthly for the first 6 mo and then at months 8 and 10 ) , focused on a low-GI or an ADA diet .  Data on demographics , diet , physical activity , psychosocial factors , and diabetes medication use were assessed at baseline and 6 and 12 mo . Generalized linear mixed models were used to compare the two groups on HbA1c , diabetic medication use , blood lipids , weight , diet , and physical activity .  RESULTS Participants ( 53 % female , mean age 53.5 y ) were predominantly white with a mean body mass index of 35.8 kg/m(2 ) . Although both interventions achieved similar reductions in mean HbA1c at 6 mo and 12 mo , the low-GI diet group was less likely to add or increase dosage of diabetic medications ( odds ratio 0.26 , P = 0.01 ) . Improvements in high-density lipoprotein cholesterol , triacylglycerols , and weight loss were similar between groups . CONCLUSION Compared with the ADA diet , the low-GI diet achieved equivalent control of HbA1c using less diabetic medication . Despite its limited size , this trial suggests that a low-GI diet is a viable alternative to the ADA diet . Findings should be evaluated in a larger r and omized controlled trial BACKGROUND Despite the popularity of low-glycemic index ( GI ) and high-protein diets , to our knowledge no r and omized , controlled trials have systematic ally compared their relative effects on weight loss and cardiovascular risk . METHODS A total of 129 overweight or obese young adults ( body mass index , > or = 25 [ calculated as weight in kilograms divided by the square of height in meters ] ) were assigned to 1 of 4 reduced-fat , high-fiber diets for 12 weeks . Diets 1 and 2 were high carbohydrate ( 55 % of total energy intake ) , with high and low GIs , respectively ; diets 3 and 4 were high protein ( 25 % of total energy intake ) , with high and low GIs , respectively . The glycemic load was highest in diet 1 and lowest in diet 4 . Changes in weight , body composition , and blood chemistry profile were studied . RESULTS While all groups lost a similar mean + /- SE percentage of weight ( diet 1 , -4.2 % + /- 0.6 % ; diet 2 , -5.5 % + /- 0.5 % ; diet 3 , -6.2 % + /- 0.4 % ; and diet 4 , -4.8 % + /- 0.7 % ; P = .09 ) , the proportion of subjects in each group who lost 5 % or more of body weight varied significantly by diet ( diet 1 , 31 % ; diet 2 , 56 % ; diet 3 , 66 % ; and diet 4 , 33 % ; P = .01 ) . Women on diets 2 and 3 lost approximately 80 % more fat mass ( -4.5 + /- 0.5 [ mean + /- SE ] kg and -4.6 + /- 0.5 kg ) than those on diet 1 ( -2.5 + /- 0.5 kg ; P = .007 ) . Mean + /- SE low-density-lipoprotein cholesterol levels declined significantly in the diet 2 group ( -6.6 + /- 3.9 mg/dL [ -0.17 + /- 0.10 mmol/L ] ) but increased in the diet 3 group ( + 10.0 + /- 3.9 mg/dL [ + 0.26 + /- 0.10 mmol/L ] ; P = .02 ) . Goals for energy distribution were not achieved exactly : both carbohydrate groups ate less fat , and the diet 2 group ate more fiber . CONCLUSION Both high-protein and low-GI regimens increase body fat loss , but cardiovascular risk reduction is optimized by a high-carbohydrate , low-GI diet OBJECTIVE To evaluate whether a 5-week low-glycemic index ( LGI ) diet versus a high-glycemic index ( HGI ) diet can modify glucose and lipid metabolism as well as total fat mass in nondiabetic men . RESEARCH DESIGN AND METHODS In this study , 11 healthy men were r and omly allocated to 5 weeks of an LGI or HGI diet separated by a 5-week washout interval in a crossover design . RESULTS The LGI diet result ed in lower postpr and ial plasma glucose and insulin profiles and areas under the curve ( AUCs ) than the HGI diet . A 5-week period of the LGI diet lowered plasma triacylglycerol excursion after lunch ( AUC , P < 0.05 LGI vs. HGI ) . These modifications were associated with a decrease in the total fat mass by approximately 700 g ( P < 0.05 ) and a tendency to increase lean body mass ( P < 0.07 ) without any change in body weight . This decrease in fat mass was accompanied by a decrease in leptin , lipoprotein lipase , and hormone-sensitive lipase RNAm quantities in the subcutaneous abdominal adipose tissue ( P < 0.05 ) . CONCLUSIONS We concluded that 5 weeks of an LGI diet ameliorates some plasma lipid parameters , decreases total fat mass , and tends to increase lean body mass without changing body weight . These changes were accompanied by a decrease in the expression of some genes implicated in lipid metabolism . Such a diet could be of benefit to healthy , slightly overweight subjects and might play a role in the prevention of metabolic diseases and their cardiovascular complications Objective : Recent epidemiological and prospect i ve trial evidence suggests that consumption of a low glycaemic index ( LGI ) diet will reduce coronary risk . We hypothesise that introduction of an LGI diet will improve the metabolic profile of patients who have undergone coronary artery bypass grafting . Design : We conducted a r and omised parallel group trial comparing a  control group ( n=29 , age 61.8±9 y ) ,  who received currently advocated healthy eating dietary advice only , to an intervention group , who received healthy eating advice emphasising LGI carbohydrates ( n=26 , age 63.6±9.4 y ) over a 12-week period in free-living patients with coronary heart disease . Outcome measures included fasting glucose , insulin , total cholesterol , high-density lipoprotein cholesterol , very low-density lipoprotein cholesterol , low density lipoprotein cholesterol and triglycerides . Results : A significant lower dietary glycaemic index was achieved in the group assigned to an LGI diet compared to the healthy eating control group ( 71±1 vs 81±1 ) ; fibre intake was also higher in the LGI group ( 20±1 vs 15±1 g ) . All biochemical markers of glucose and lipid metabolism measured were similar after 12 weeks of the LGI diet or control diet . Discussion : The LGI group achieved a significant LGI and a higher dietary fibre intake . However , there was no measurable significant effect of either the LGI diet or the health eating diet on lipid levels ; this may have been hidden by concurrent drug therapy Oat or bean products , rich in water-soluble fiber , have distinct hypocholesterolemic effects in humans . After a control diet , 20 hypercholesterolemic men were r and omly allocated to oat-bran or bean supplemented diets for 21 days on a metabolic ward . Control and test diets provided equivalent energy , fat , and cholesterol but test diets had twice more total and 3-fold more soluble fiber . Oat-bran diets decreased serum cholesterol concentrations by 19 % ( p less than 0.0005 ) and calculated low-density lipoprotein cholesterol by 23 % ( p less than 0.0025 ) . Bean diets decreased serum cholesterol concentrations by 19 % ( p less than 0.0005 ) and low-density lipoprotein cholesterol by 24 % ( p less than 0.0005 ) . Oat-bran increased fecal weight by 43 % but beans did not . While oat-bran increased fecal bile acid excretion , beans had the opposite effect . Oat-bran or bean supplements may have an important role in nutritional management of selected hypercholesterolemic patients OBJECTIVE To determine whether a chronic low-glycemic index ( LGI ) diet , compared with a high-glycemic index ( HGI ) diet , has beneficial effects on plasma glucose control , lipid metabolism , total fat mass , and insulin resistance in type 2 diabetic patients . RESEARCH DESIGN AND METHODS Twelve type 2 diabetic men were r and omly allocated to two periods of 4 weeks of an LGI or HGI carbohydrate diet separated by a 4-week washout interval , in a crossover design . RESULTS The LGI diet induced lower postpr and ial plasma glucose and insulin profiles and areas under the curve than after the HGI diet . At the end of the two dietary periods , the 7-day dietary records demonstrated equal daily total energy and macronutrient intake . Body weight and total fat mass were comparable . Four-week LGI versus HGI diet induced improvement of fasting plasma glucose ( P < 0.01 , Delta changes during LGI vs. HGI ) , HbA(1c ) ( P < 0.01 ) , and whole-body glucose utilization measured by the euglycemic-hyperinsulinemic clamp ( P < 0.05 ) . LGI diet induced a decrease in fasting plasma total and LDL cholesterol ( Delta changes LGI vs. HGI , P < 0.01 ) , free fatty acids ( P < 0.01 ) , apolipoprotein B , and plasminogen activator inhibitor 1 activity . CONCLUSIONS Only 4 weeks of an LGI diet was able to improve glycemic control , glucose utilization , some lipid profiles , and the capacity for fibrinolysis in type 2 diabetes . Even if changes in glycemic control were modest during the 4-week period , the use of an LGI diet in a longer-term manner might play an important role in the treatment and prevention of diabetes and related disorders Objective : To compare the effect of a diet supplemented with chickpeas to a wheat-based diet of similar fibre content on serum lipids , glucose tolerance , satiety and bowel function . A third , lower-fibre wheat diet provided further information on dietary fibre quantity and bowel function and satiety . Method : Twenty-seven free-living adults followed two r and omized , crossover dietary interventions each of five weeks duration . The chickpea diet included canned drained chickpeas , bread and shortbread biscuits containing 30 % chickpea flour . The wheat diet included high-fibre wheat breakfast cereals and wholemeal bread . The diets were isoenergetic to the participants ’ usual diet , matched for macronutrient content and controlled for dietary fibre . Following on from the second r and omised intervention , a sub-group of 18 participants underwent a third , isoenergetic lower-fibre wheat diet that included low-fibre breakfast cereals and bread . Results : Repeated measures ANOVA revealed reductions in serum TC of 0.25 mmol/L ( p < 0.01 ) and LDL-C of 0.20 mmol/L ( p = 0.02 ) following the chickpea diet compared to the wheat . An unintended significant increase in PUFA and corresponding decrease in MUFA consumption occurred during the chickpea diet and statistical adjustment for this reduced but did not eliminate the effect on serum lipids . There was no significant difference in glucose tolerance . Perceived general bowel health improved significantly during the chickpea diet although there was considerable individual variation . Some participants reported greater satiety during the chickpea diet . Conclusions : The small but significant decrease in serum TC and LDL-C during the chickpea diet compared to the equivalent fibre wheat diet was partly due to unintentional changes in macronutrient intake occurring because of chickpea ingestion . If dietary energy and macronutrients were not controlled , chickpea consumption might result in greater benefits via influence on these factors In a r and omised cross-over study 18 nondependent ( NIDDM ) and 9 insulin-dependent ( IDDM ) diabetics were put on to a high carbohydrate diet containing leguminous fibre ( HL ) for 6 weeks , and also a st and ard low carbohydrate diet ( LC ) for 6 weeks . During two identical 24 h metabolic profiles mean prepr and ial and mean 2 hour postpr and ial blood glucoses were significantly lower on HL in both groups , as were also several overall measures of diabetic control , including the degree of glycosuria . Total cholesterol was reduced significantly on HL in both groups , and the HDL/LDL cholesterol ratio increased significantly on HL in the NIDDM group . A diet high in complex carbohydrate and leguminous fibre improves all aspects of diabetic control , and continued use of a low carbohydrate diet no longer appears justified BACKGROUND The effect of increasing the intake of dietary fiber on glycemic control in patients with type 2 diabetes mellitus is controversial . METHODS In a r and omized , crossover study , we assigned 13 patients with type 2 diabetes mellitus to follow two diets , each for six weeks : a diet containing moderate amounts of fiber ( total , 24 g ; 8 g of soluble fiber and 16 g of insoluble fiber ) , as recommended by the American Diabetes Association ( ADA ) , and a high-fiber diet ( total , 50 g ; 25 g of soluble fiber and 25 g of insoluble fiber ) , containing foods not fortified with fiber ( unfortified foods ) . Both diets , prepared in a research kitchen , had the same macronutrient and energy content . We compared the effects of the two diets on glycemic control and plasma lipid concentrations . RESULTS Compliance with the diets was excellent . During the sixth week , the high-fiber diet , as compared with the the sixth week of the ADA diet , mean daily prepr and ial plasma glucose concentrations were 13 mg per deciliter [ 0.7 mmol per liter ] lower ( 95 percent confidence interval , 1 to 24 mg per deciliter [ 0.1 to 1.3 mmol per liter ] ; P=0.04 ) and mean median difference , daily urinary glucose excretion 1.3 g ( 0.23 ; 95 percent confidence interval , 0.03 to 1.83 g ; P= 0.008 ) . The high-fiber diet also lowered the area under the curve for 24-hour plasma glucose and insulin concentrations , which were measured every two hours , by 10 percent ( P=0.02 ) and 12 percent ( P=0.05 ) , respectively . The high-fiber diet reduced plasma total cholesterol concentrations by 6.7 percent ( P=0.02 ) , triglyceride concentrations by 10.2 percent ( P=0.02 ) , and very-low-density lipoprotein cholesterol concentrations by 12.5 percent ( P=0.01 ) . CONCLUSIONS A high intake of dietary fiber , particularly of the soluble type , above the level recommended by the ADA , improves glycemic control , decreases hyperinsulinemia , and lowers plasma lipid concentrations in patients with type 2 diabetes Objective : To determine effects of daily intake of 1/2 cup pinto beans , black-eyed peas or carrots ( placebo ) on risk factors for  coronary heart disease ( CHD ) and diabetes mellitus ( DM ) in free-living , mildly insulin resistant adults over an 8 week period . Methods : R and omized , crossover 3 × 3 block design . Sixteen participants ( 7 men , 9 women ) received each treatment for eight-weeks with two-week washouts .  Fasting blood sample s collected at beginning and end of periods were analyzed for total cholesterol ( TC ) , low density lipoprotein cholesterol ( LDL-C ) , high density lipoprotein cholesterol , triacylglycerols , high-sensitivity C-reactive protein , insulin , glucose , and hemoglobin A1c . Results : A significant treatment-by-time effect impacted serum TC ( p = 0.026 ) and LDL ( p = 0.033 ) after eight weeks . Paired t-tests indicated that pinto beans were responsible for this effect ( p = 0.003 ; p = 0.008 ) . Mean change of serum TC for pinto bean , black-eyed pea and placebo were −19 ± 5 , 2.5 ± 6 , and 1 ± 5 mg/dL , respectively ( p = 0.011 ) . Mean change of serum LDL-C  for pinto bean , black-eyed pea and placebo were −14 ± 4 , 4 ± 5 , and 1 ± 4 mg/dL , in that order ( p = 0.013 ) . Pinto beans differed significantly from placebo ( p = 0.021 ) . No significant differences were seen with other blood concentrations across the 3 treatment periods . Conclusions : Pinto bean intake should be encouraged to lower serum TC and LDL-C , thereby reducing risk for CHD Objectives To determine whether low-glycemic index ( GI ) diets have clinical utility in overweight patients with non-insulin-dependent diabetes mellitus ( NIDDM ) . Research Design and Methods Six patients with NIDDM were studied on both high- and low-GI diets of 6-wk duration with metabolic diets with a r and omized crossover design . Both diets were of similar composition ( 57 % carbohydrate , 23 % fat , and 34 g/day dietary fiber ) , but the low-GI diet had a GI of 58 compared with 86 for the high-GI diet . Results Small and similar amounts of weight were lost on both diets : 2.5 kg on high-GI diet and 1.8 kg on low-GI diet . On the low-GI diet , the mean level of serum fructosamine , as an index of overall blood glucose control , was lower than on the high-GI diet by 8 % ( P < 0.05 ) , and total serum cholesterol was lower by 7 % ( P < 0.01 ) . Conclusions In overweight patients with NIDDM , reducing diet GI improves overall blood glucose and lipid control The plasma cholesterol lowering potential of canned baked beans was examined in a cross-over comparison with canned spaghetti . The difference in total dietary non-starch polysaccharide ( NSP ) of 12 g daily ( 6.6 g difference in soluble NSP ) , was insufficient to alter the plasma cholesterol , HDL cholesterol , triglyceride and glucose concentrations in 20 mildly hyper-cholesterolaemic men . Thus , eating an average of six 440 g cans of this source of baked beans per week , large servings , does not lower the plasma cholesterol when dietary fat is not displaced OBJECTIVE Several methods have been proposed to evaluate insulin sensitivity from the data obtained from the oral glucose tolerance test ( OGTT ) . However , the validity of these indices has not been rigorously evaluated by comparing them with the direct measurement of insulin sensitivity obtained with the euglycemic insulin clamp technique . In this study , we compare various insulin sensitivity indices derived from the OGTT with whole-body insulin sensitivity measured by the euglycemic insulin clamp technique . RESEARCH DESIGN AND METHODS In this study , 153 subjects ( 66 men and 87 women , aged 18 - 71 years , BMI 20 - 65 kg/m2 ) with varying degrees of glucose tolerance ( 62 subjects with normal glucose tolerance , 31 subjects with impaired glucose tolerance , and 60 subjects with type 2 diabetes ) were studied . After a 10-h overnight fast , all subjects underwent , in r and om order , a 75-g OGTT and a euglycemic insulin clamp , which was performed with the infusion of [3 - 3H]glucose . The indices of insulin sensitivity derived from OGTT data and the euglycemic insulin clamp were compared by correlation analysis . RESULTS The mean plasma glucose concentration divided by the mean plasma insulin concentration during the OGTT displayed no correlation with the rate of whole-body glucose disposal during the euglycemic insulin clamp ( r = -0.02 , NS ) . From the OGTT , we developed an index of whole-body insulin sensitivity ( 10,000/square root of [ fasting glucose x fasting insulin ] x [ mean glucose x mean insulin during OGTT ] ) , which is highly correlated ( r = 0.73 , P < 0.0001 ) with the rate of whole-body glucose disposal during the euglycemic insulin clamp . CONCLUSIONS Previous methods used to derive an index of insulin sensitivity from the OGTT have relied on the ratio of plasma glucose to insulin concentration during the OGTT . Our results demonstrate the limitations of such an approach . We have derived a novel estimate of insulin sensitivity that is simple to calculate and provides a reasonable approximation of whole-body insulin sensitivity from the OGTT In prescribing a diabetic diet more attention has traditionally been paid to the amount of dietary carbohydrate than to its type or structure . We have compared the effect on blood glucose of substituting unrefined , whole foods for refined , processed foods in liberal carbohydrate diets ( 50 - 55 % of dietary energy ) eaten by 10 diabetic children in a r and omised crossover study . All measurements were made at home . The unrefined diet used whole foods ( including ) dried beans ) supplying 60 g/day of dietary fibre . The refined diet used processed foods supplying 20 g/day of dietary fibre . Diets were isocaloric for carbohydrate , fat , and protein . Glycaemic control was assessed by daily urine analysis for glucose , home blood glucose measurements , glycosylated haemoglobin , and by a 24-hour profile of blood and urinary glucose carried out at home after 6 weeks on each diet . Glycaemic control was significantly better on the unrefined diet . On profile days mean blood glucose levels on the unrefined and refined diets respectively were : prepr and ial : 5.5 and 8.4 mmol/l ; postpr and ial 8.5 and 12.2 mmol/l . The mean 24-hour urinary glucose excretion on the unrefined diet was 9.3 g and on the refined diet was 38.0 g. Six months after the study the children were eating appreciably more  dietary fibre  than before ( mean increase 13.6 g/day ) . Attention to food type and structure can improve blood glucose control in diabetic children and should provide an acceptable and more rational basis for dietary prescription than one based on carbohydrate quantity alone BACKGROUND Epidemiologic studies have shown a relationship between glycated hemoglobin levels and cardiovascular events in patients with type 2 diabetes . We investigated whether intensive therapy to target normal glycated hemoglobin levels would reduce cardiovascular events in patients with type 2 diabetes who had either established cardiovascular disease or additional cardiovascular risk factors . METHODS In this r and omized study , 10,251 patients ( mean age , 62.2 years ) with a median glycated hemoglobin level of 8.1 % were assigned to receive intensive therapy ( targeting a glycated hemoglobin level below 6.0 % ) or st and ard therapy ( targeting a level from 7.0 to 7.9 % ) . Of these patients , 38 % were women , and 35 % had had a previous cardiovascular event . The primary outcome was a composite of nonfatal myocardial infa rct ion , nonfatal stroke , or death from cardiovascular causes . The finding of higher mortality in the intensive-therapy group led to a discontinuation of intensive therapy after a mean of 3.5 years of follow-up . RESULTS At 1 year , stable median glycated hemoglobin levels of 6.4 % and 7.5 % were achieved in the intensive-therapy group and the st and ard-therapy group , respectively . During follow-up , the primary outcome occurred in 352 patients in the intensive-therapy group , as compared with 371 in the st and ard-therapy group ( hazard ratio , 0.90 ; 95 % confidence interval [ CI ] , 0.78 to 1.04 ; P=0.16 ) . At the same time , 257 patients in the intensive-therapy group died , as compared with 203 patients in the st and ard-therapy group ( hazard ratio , 1.22 ; 95 % CI , 1.01 to 1.46 ; P=0.04 ) . Hypoglycemia requiring assistance and weight gain of more than 10 kg were more frequent in the intensive-therapy group ( P<0.001 ) . CONCLUSIONS As compared with st and ard therapy , the use of intensive therapy to target normal glycated hemoglobin levels for 3.5 years increased mortality and did not significantly reduce major cardiovascular events . These findings identify a previously unrecognized harm of intensive glucose lowering in high-risk patients with type 2 diabetes . ( Clinical Trials.gov number , NCT00000620 . BACKGROUND In patients with type 2 diabetes , the effects of intensive glucose control on vascular outcomes remain uncertain . METHODS We r and omly assigned 11,140 patients with type 2 diabetes to undergo either  st and ard glucose control or intensive glucose control , defined as the use of gliclazide ( modified release ) plus other drugs as required to achieve a glycated hemoglobin value of 6.5 % or less . Primary end points were composites of major macrovascular events ( death from cardiovascular causes , nonfatal myocardial infa rct ion , or nonfatal stroke ) and major microvascular events ( new or worsening nephropathy or retinopathy ) , assessed both jointly and separately . RESULTS After a median of 5 years of follow-up , the mean glycated hemoglobin level was lower in the intensive-control group ( 6.5 % ) than in the st and ard-control group ( 7.3 % ) . Intensive control reduced the incidence of combined major macrovascular and microvascular events ( 18.1 % , vs. 20.0 % with st and ard control ; hazard ratio , 0.90 ; 95 % confidence interval [ CI ] , 0.82 to 0.98 ; P=0.01 ) , as well as that of major microvascular events ( 9.4 % vs. 10.9 % ; hazard ratio , 0.86 ; 95 % CI , 0.77 to 0.97 ; P=0.01 ) , primarily because of a reduction in the incidence of nephropathy ( 4.1 % vs. 5.2 % ; hazard ratio , 0.79 ; 95 % CI , 0.66 to 0.93 ; P=0.006 ) , with no significant effect on retinopathy ( P=0.50 ) . There were no significant effects of the type of glucose control on major macrovascular events ( hazard ratio with intensive control , 0.94 ; 95 % CI , 0.84 to 1.06 ; P=0.32 ) , death from cardiovascular causes ( hazard ratio with intensive control , 0.88 ; 95 % CI , 0.74 to 1.04 ; P=0.12 ) , or death from any cause ( hazard ratio with intensive control , 0.93 ; 95 % CI , 0.83 to 1.06 ; P=0.28 ) . Severe hypoglycemia , although uncommon , was more common in the intensive-control group ( 2.7 % , vs. 1.5 % in the st and ard-control group ; hazard ratio , 1.86 ; 95 % CI , 1.42 to 2.40 ; P<0.001 ) . CONCLUSIONS A strategy of intensive glucose control , involving gliclazide ( modified release ) and other drugs as required , that lowered the glycated hemoglobin value to 6.5 % yielded a 10 % relative reduction in the combined outcome of major macrovascular and microvascular events , primarily as a consequence of a 21 % relative reduction in nephropathy . ( Clinical Trials.gov number , NCT00145925 .
target: Conclusions /interpretationPooled analyses demonstrated that pulses , alone or in low-GI or high-fibre diets , improve markers of longer term glycaemic control in humans , with the extent of the improvements subject to significant inter- study heterogeneity .
background: Aims /hypothesisDietary non-oil-seed pulses ( chickpeas , beans , peas , lentils , etc . )
  are a good source of slowly digestible carbohydrate , fibre and vegetable protein and a valuable means of lowering the glycaemic-index ( GI ) of the diet .
  To assess the evidence that dietary pulses may benefit glycaemic control , we conducted a systematic review and meta- analysis of r and omised controlled experimental trials investigating the effect of pulses , alone or as part of low-GI or high-fibre diets , on markers of glycaemic control in people with and without diabetes .