The effect of particle size of whole-grain flour on plasma glucose, insulin, glucagon and thyroid-stimulating hormone in humans.

OBJECTIVE: Although it is well known that consumption of whole-grain foods with higher fiber content results in beneficial health effects, most Americans usually prefer bread made with white flour. Changes in bread texture and undesirable intestinal responses have been reported as reasons for avoiding consumption of whole-grain foods or high-fiber menus. The purpose of this study was to determine whether consumption of bread made with ultra-fine-ground whole-grain wheat flour retained beneficial effects while reducing undesirable effects. METHODS: Twenty-six men and women, 31 to 55 years of age, consumed glucose solutions or bread made with traditional white, conventional whole-grain wheat (WWF), or ultra-fine whole-grain wheat (UFWF) flour (1 g carbohydrate/kg body weight) in a Latin square design after two days of controlled diet. The effect on glycemic response was determined by comparing blood variables, after a tolerance test with white bread, WWF bread, and UFWF bread, with those after a glucose tolerance test. RESULTS: Men and women had similar responses to all tolerances except postprandial TSH. Glucose and insulin levels one half hour after the glucose load were significantly higher than after any of the bread tolerances. Glucose, but not insulin, areas under the curve were significantly higher after the glucose load than areas after the three breads. Consumption of UFWF resulted in glucose and insulin responses, as well as areas under the curve, similar to those after consumption of conventional whole-wheat bread. CONCLUSION: The particle size of whole grain wheat flour did not substantially affect glycemic responses.

Breath hydrogen and methane expiration in men and women after oat extract consumption.

Oat extract has been shown to modify blood glucose response and fasting lipids after dietary incorporation although some abdominal discomfort and increased flatulence were noted. To determine the extent of gas production, hydrogen and methane were determined after tolerance tests containing cooked and uncooked oat extract and after dietary incorporation. Breath gases were determined before and periodically after tolerance tests. Study 1: While consuming a maintenance diet, 24 subjects (55.3-112.5 kg body weight) underwent a tolerance test (1 g carbohydrate/kg body wt) of glucose (GTT, 1700 kJ/100 g) or uncooked, baked, or boiled pudding [2191 kJ/100 g carbohydrate, (0.67 glucose and 0.33 oat extract containing 10 g/100 g beta-glucan)]. Hydrogen and methane expiration after all tolerance tests with the oat extract puddings, regardless of cooking method, was significantly higher than expirations after the GTT. Cooking the oat extract did not significantly change hydrogen or methane expiration. Study 2: Twenty-three subjects consumed a maintenance diet followed by the incorporation of oat extracts (50 g/8.33 MJ, 1 or 10 g/100 g beta-glucan) to the diet in a crossover pattern. A GTT and a tolerance test containing 0.67 g glucose and 0.33 g of the respective oat extract/kg body weight were consumed after the maintenance and oat extract diet periods. Breath hydrogen was significantly higher after both oat extract tolerance tests than after the GTT. Hydrogen excretion after the 10% beta-glucan oat extract was higher at 4, 5 and 6 h than after the 1% beta-glucan oat extract; breath methane was not significantly different. These data indicate that cooking did not alter the influence of oat extracts on intestinal function, and increased beta-glucan marginally increased hydrogen expiration.

Effect of beta-glucan level in oat fiber extracts on blood lipids in men and women.

OBJECTIVE: An active hypolipidemic component in oats, the soluble fiber beta-glucan, has been concentrated in an oat fiber extract. The oat fiber extract has been used to replace fat in food products. This study was designed to determine if moderate levels of oat fiber extract could be incorporated into a typical diet and whether plasma lipids could be reduced by the amount of beta-glucan added to the diet. METHODS: Oat fiber extracts containing low (1% by weight) or high (10% by weight) beta-glucan were fed to 23 mildly hypercholesterolemic subjects (seven men and 16 women). A maintenance diet was fed for 1 week followed by diet containing an oat extract for 5 weeks each in a crossover pattern. Five percent of the energy from fat in the maintenance diet was replaced with the oat extract in the experimental diets. Caloric intake was adjusted to try to maintain each subject's initial weight. Fasting blood was collected several days apart after separate 12 hour fasts the end of each period. Plasma was analyzed for triglycerides, total cholesterol, and lipoprotein cholesterol fractions. RESULTS: HDL, HDL2, and VLDL cholesterol, and triglyceride levels after the oat extract diets were not significantly different from those after the maintenance diet. Total and LDL cholesterol levels decreased significantly (p < 0.001) from maintenance levels after both diets containing the oat extracts. Total cholesterol levels after the higher beta-glucan extract diet were significantly lower than those after the low beta-glucan diet. CONCLUSIONS: Beneficial reduction of cholesterol was obtained with modest amounts of oat extract incorporated into the diet. A significant dose response due to beta-glucan concentration in the oat extract was observed in total cholesterol levels.

Development and characteristics of a new strain of obese hyperinsulinemic and hyperlipidemic Dahl salt-sensitive rat. The Dahl salt-sensitive/NIH-corpulent rat.

A new congenic rat strain, the Dahl salt-sensitive/NIH-corpulent (DSS/N-cp) rat, has been developed to study the role of obesity and type of dietary carbohydrate in the development of hypertension and its complications. Three groups (n = 6) of young male obese and lean DSS/N-cp rats were fed diets containing either 54% sucrose, 18% sucrose plus 36% starch, or 54% starch, with 0.1% dietary sodium for 12 weeks. Regardless of the diet, obese and lean rats showed mildly elevated systolic blood pressure (SBP), being significantly higher in obese than in lean rats (SBP 156 +/- 5 mm Hg v 141 +/- 3 mm Hg, P < .05). However, SBP was not different between the three diet groups. Levels of serum insulin, triglyceride, and cholesterol as well as urinary protein excretion were significantly higher in obese than in lean rats. Obese rats fed the sucrose diets as compared to the starch diet, had higher serum insulin and lipid levels, but had lower body weights and higher serum creatinine levels. Histopathologic examination of tissues from different organs revealed a vasculopathy seen almost exclusively in obese rats fed the sucrose diets. Vascular lesions were characterized by subintimal fibrin deposition, fibrinoid necrosis, and cell proliferation with "onion skinning" in small arteries and arterioles of kidneys, intestine, pancreas, and testes.(ABSTRACT TRUNCATED AT 250 WORDS)

Diets containing soluble oat extracts improve glucose and insulin responses of moderately hypercholesterolemic men and women.

The high amount of soluble beta-glucans in oats may be responsible for beneficial effects on glucose tolerance and blood lipids. We studied 16 women and 7 men (aged 38-61y) with moderately high cholesterol concentrations who consumed normal diets to which oat extracts with either 1% or 10% soluble beta-glucans were added. Oat extracts comprised 10% of energy and were consumed in a 5-wk crossover design after a 1-wk equilibration period. At the end of the equilibration period and each 5-wk period, a carbohydrate tolerance test was conducted and responses to glucose, glucose plus oat extract containing 1% glucan, or glucose plus oat extract containing 10% glucan were determined. Glucose responses were reduced by both extracts in both men and women; however, in women, responses to the 10% extract were lowest. Insulin responses did not differ between men and women, but were lower after oat extracts. Glucagon responses were higher initially in men and were lowered after oat extracts in men but not in women. Modest amounts of oat extracts can be incorporated into normal diets with beneficial effects on glucose tolerance factors.

Comparison of renal calcium concentration in obese, lean, diabetic, and non-diabetic Zucker rats fed a magnesium-deficient fructose diet.

In order to determine the effects of hypoinsulinaemia or hyperinsulinaemia on nephrocalcinosis induced by the interaction between fructose and magnesium (Mg) deficiency, we compared kidney calcification in obese versus lean, and non-diabetic versus diabetic female Zucker rats fed a magnesium-deficient fructose diet. One half of the obese and lean animals, respectively, was injected with streptozotocin to produce diabetes, and the other half was injected with citrate buffer alone. Diabetic, non-diabetic, obese, and lean animals were divided into two dietary groups, consisting of high starch or high fructose without added Mg. After a four week period, 24 hour urine was collected for urinary output, protein, oxalate, citrate, MG, and calcium (Ca) measurements. The animals were then decapitated, and blood was collected for glucose, Mg, and Ca determinations, and kidneys were removed to determine their Mg and Ca contents. All fructose-fed animals exhibited significantly more kidney Ca then the starch-fed animals. Lean non-diabetic rats fed fructose showed the greatest kidney Ca along with the greatest urinary protein excretion among all experimental groups. The significant finding in the present study is that diabetes or obesity reduced nephrocalcinosis regardless of the insulin status of the rats. Diuresis and hypercitraturia in diabetic and/or obese animals may cause a reduction in nephrocalcinosis induced by the interaction between fructose and magnesium deficiency. Hyperproteinuria (uromucoid) in combination with hypercalciuria and hypomagnesuria may be responsible for greater nephrocalcinosis in the fructose than the starch group. The possible mechanisms for this interaction on nephrocalcinosis have been discussed.

Dietary copper, simple sugars, and metabolic changes in pigs.

Inadequate dietary copper is known to result in undesirable metabolic changes in rats and humans. Abnormal cardiac function, leading to sudden death, is a common finding when copper deficient rats are fed a 62% fructose diet. To further study the apparent mineral-carbohydrate relationship to cardiac physiology, 3 male and 3 female swine were randomly assigned to four groups (6 pigs per group) which were fed low copper (1.5 ppm) or copper supplemented (40 ppm) diets with 20% of calories from either fructose or glucose for 10 weeks. In agreement with results from other animal studies, copper deficient swine exhibited decreased plasma ceruloplasmin, erythrocyte superoxide dismutase and plasma lysyl oxidase activities and lowered serum copper. The copper deficient fructose group had the lowest aortic lysyl oxidase activity and hematocrit when compared to the other groups. The relative heart weight in the copper deficient fructose group was 93% greater than the other three dietary groups. The livers of copper deficient fructose fed pigs were also significantly larger. Two enzymes related to cardiac and hepatic function, aspartate and alanine aminotransferase were also measured. Copper deficiency significantly lowered alanine aminotransferase but there was no dietary effect on aspartate amino-transferase. The results of this project indicate that the pig is a sensitive model for the study of cardiovascular abnormalities which occur when fructose is consumed with a low copper diet.

Day-long glucose, insulin, and fructose responses of hyperinsulinemic and nonhyperinsulinemic men adapted to diets containing either fructose or high-amylose cornstarch.

Ten hyperinsulinemic and 11 nonhyperinsulinemic men consumed a typical American diet containing 20% of calories either as fructose or as high-amylose cornstarch for 5 wk in a crossover design to determine their effects on indices of glucose tolerance. Blood glucose, insulin, and fructose were determined before and 30, 60, 90, 120 and 180 min after breakfast, lunch, and dinner. Glucose responses were significantly lower 60 and 120 min and the insulin response lower 60 min after the meals containing fructose. Hyperinsulinemic men showed a tendency toward decreased insulin sensitivity after consuming fructose on the basis of an increased insulin-to-glucose ratio and decreased insulin binding to erythrocytes. These results generally show a beneficial effect of fructose on glucose tolerance; however, recommendations for including large amounts of fructose in the diet should also be based on a complete evaluation of the effect on other metabolic risk factors.

Blood lipids, lipoproteins, apoproteins, and uric acid in men fed diets containing fructose or high-amylose cornstarch.

Ten hyperinsulinemic and 11 nonhyperinsulinemic men consumed for 5 wk each in a cross-over design a diet, similar to one currently consumed in the United States, with 20% of the kilocalories from either fructose or high-amylose cornstarch to determine the effects of the two diets on various blood metabolites considered to be risk factors associated with heart disease. In the hyperinsulinemic men the intake of fructose as compared with cornstarch significantly increased total triglycerides and their lipoprotein distribution; total and very-low-density lipoprotein cholesterol; apoproteins B-100, C-II, C-III; and uric acid. In the nonhyperinsulinemic men total triglycerides, total and low-density lipoprotein cholesterol and uric acid were significantly greater after the consumption of fructose than after cornstarch. The results indicate that in a diet high in saturated fatty acids and cholesterol, fructose increases the levels of risk factors associated with heart disease, especially in hyperinsulinemic men.

Effect of guar gum on mineral balances in NIDDM adults.

The self-selected diet of 16 subjects with non-insulin-dependent diabetes mellitus (NIDDM) was supplemented for 6 mo with either a granolalike bar containing 35.5 g carbohydrate and 6.6 g guar gum/bar or a placebo bar containing carbohydrate but no guar gum. Subjects consumed a mean of 4.8 bars/day. Average guar gum consumption at the end of the study was 31.7 g/day. One week before and at the end of the study, subjects were admitted to a metabolic ward and fed a controlled diet similar to their self-selected diet. Food, feces, and urine were composited for analysis of iron, zinc, copper, calcium, magnesium, and manganese. Eight subjects consuming the guar gum supplement and 6 subjects consuming the placebo bar completed collections for mineral balance. Neither consumption of guar gum nor placebo bar significantly changed apparent mineral balance for iron, copper, zinc, calcium, manganese, or magnesium from prestudy levels to 6-mo levels, and no significant differences were observed between the two groups. With the exception of copper, men consumed significantly more minerals than women. We conclude that consumption of guar gum by patients with NIDDM does not adversely affect apparent mineral balance.

Copper status in the rat is affected by modes of copper delivery.

The purpose of this study was to determine whether the interaction between fructose and copper status can be affected by the mode of copper administration. Male Sprague-Dawley rats (n = 94) were fed from weaning diets that contained 0.65-0.85 mg copper/kg diet for 42 d. The experimental design of the study was a 2 x 2 x 3 analysis of variance: two types of carbohydrate (fructose, corn starch), two modes of copper delivery (orally or subcutaneously) and three different extrinsic copper levels (0, 1.5 or 3 mg/kg diet or 0, 11.25 or 22.5 micrograms Cu/d by injection). In the rats fed fructose, direct indicators of copper status such as plasma copper and tissue superoxide dismutase activity were increased to a much greater extent when copper was supplied subcutaneously rather than orally as part of the diet. In the starch-fed rats the effect of the mode of copper delivery on the levels of these indices was usually not significantly different. As a result, the feeding of fructose as compared to starch produced lower levels of direct indicators of copper status when copper was supplied in the diet but not subcutaneously. It appears that ingestion of fructose as compared to starch increases the requirement for copper and that the mode of copper administration that circumvents the gastrointestinal tract attenuates the fructose-copper interaction. Thus, the fructose-copper interaction occurs either during intestinal digestion and absorption, hepatic uptake of copper via the portal blood or its hepatic utilization.

Diets containing high amylose vs amylopectin starch: effects on metabolic variables in human subjects.

Twelve men consumed a diet containing 34% of calories as 70% amylose or amylopectin starch to determine if the structure of starch could influence metabolic factors associated with abnormal states. Each starch was fed to subjects for 5 wk in a crossover design. No significant differences were observed in glucose or insulin levels when a glucose tolerance was given after 4 wk on each starch. However, glucose and insulin responses were significantly lower when a meal containing amylose compared with amylopectin was consumed after 5 wk on each starch. Summation of 0.5 through 2-h levels of insulin but not glucose were significantly lower after amylose compared with levels after amylopectin. Mean fasting triglyceride and cholesterol levels were significantly lower during the period when amylose was consumed. Long-term intake of dietary amylose may be valuable in decreasing insulin response while maintaining proper control of glucose tolerance and low levels of blood lipids.

Effect of starch structure on glucose and insulin responses in adults.

Twelve women and 13 men were given meals containing cornstarch with 70% of the starch in the form of amylopectin or amylose to determine if differences in glycemic response result from different chemical structure. Blood was drawn before and 30, 60, 120, and 180 min after each meal. The meals consisted of starch crackers fed at the rate of 1 g carbohydrate from starch per kilogram body weight. The amylose meal resulted in a significantly lower glucose peak at 30 min than did the amylopectin meal. Plasma insulin response was significantly lower 30 and 60 min after amylose than after the amylopectin meal. Summed insulin above fasting was significantly lower after amylose while summed glucose was not significantly different between the two meals. The sustained plasma glucose levels after the amylose meal with reduced insulin requirement suggest amylose starch may be of potential benefit to carbohydrate-sensitive or diabetic individuals.

A study on Asian Indian and American vegetarians: indications of a racial predisposition to glucose intolerance.

Sixty-two Asian Indian and American vegetarians participated in a 3-h glucose tolerance test after an overnight fast to study clinical indices of glucose homeostasis. The Asian Indians had a higher (p less than 0.0035) insulinogenic score than the Americans. The Asian Indians had significantly higher insulin levels than the Americans at every sampling time during the glucose tolerance test except for the 3-h sample. The Indian men had significantly higher (p less than 0.05) plasma glucose than the other three groups at 2 h after the glucose load. American subjects had higher (p less than 0.0008) insulin binding to erythrocytes than the Asian Indian subjects. Scatchard analysis and competition-inhibition plots of the insulin-receptor data indicated that decreased binding in the Indian group results from a lowered number and decreased affinity of erythrocyte receptors. These results suggest that Asian Indians exhibit several clinical indications associated with an increased risk for the development of insulin-independent diabetes.

Mineral balance in adult men: effect of four refined fibers.

Eleven men consumed a basal diet alone and with cellulose (Na-carboxymethylcellulose, locust bean gum, or karaya gum) added at 7.5 g fiber per 1000 calories for 4 wk each. Food, urine, and fecal composites were collected during the last 8 d of each feeding period. Bowel transit time was not significantly affected; however, total dry fecal weight was significantly increased after the refined fibers compared with that after the basal diet. Adding refined fibers to the basal diet did not significantly affect apparent mineral balance of calcium, magnesium, manganese, iron, copper, or zinc, with the exception of a negative mineral balance for manganese with carboxymethylcellulose. Karaya gum had a mean positive balance for all minerals tested. These results indicate that the hypocholesterolemic effect of the fibers that form gels occurs without compromising mineral balance in those subjects consuming Recommended Dietary Allowance levels of the minerals studied.

Female rats are protected against the fructose induced mortality of copper deficiency.

Experiments were conducted in copper deficient male and female rats fed diets containing fructose or starch in order to determine whether the same type of interaction between copper status and dietary carbohydrate found in male rats also occurs in the female rat. Mortality occurred only in the male rats fed the fructose diet deficient in copper with 40% of the animals dying during the 8 week study. Only anemia, hypercholesterolemia, increased BUN, heart hypertrophy and reduced body weight were observed in these animals which could be related to their mortality. Despite the increased mortality, plasma ceruloplasmin, erythrocyte SOD and hepatic copper concentrations were reduced to a similar extent in all rats regardless of the sex of the animals or of the type of dietary carbohydrate fed. The results of the present study indicate that although direct measurements of copper status of female rats fed fructose diet deficient in copper are similar to their male counterpart, they are apparently protected from the lethal consequences of the deficiency.

Indices of copper status in humans consuming a typical American diet containing either fructose or starch.

Twenty-four male subjects originally participated in a study to determine the effects of feeding diets comparatively low in copper (1.03 mg/day/2850 kcal) and containing either 20% fructose or starch on indices of copper status. During the course of feeding the diets for 11 wk, four of the subjects exhibited heart-related abnormalities and were removed from the study. Fructose ingestion had no effect on serum ceruloplasmin activity or serum copper concentration but did significantly reduce cuprozinc superoxide dismutase (SOD) activity of erythrocytes as compared to starch. Repletion of the subjects with 3 mg copper/day for 3 wk significantly increased SOD levels in subjects previously fed fructose but not starch. Apparent copper balance was significantly greater when the subjects consumed the fructose as compared to the starch diet. These results suggest that the type of dietary carbohydrate fed can differentially affect indices of copper status in humans.

Seasonal variation in plasma glucose and hormone levels in adult men and women.

Twenty-nine men and women collected diet records for 1 yr. Fasting blood samples were collected four times during the year so that each season of the year was represented. An oral glucose tolerance test was given in the spring and in the fall. Regardless of season men consumed significantly more kilocalories, carbohydrate, sugar, and starch than did the women. Men consumed more simple sugars in the fall than in the spring. No seasonal effect was observed for calories, total carbohydrate, or starch intake. Fasting glucose and insulin were higher in the fall than in the spring. Summed insulin levels after the oral glucose tolerance were significantly different by age and season. Summed insulin levels were significantly higher in older than younger subjects; men and older subjects had higher levels in the spring than in the fall. Fasting levels of thyroxine, free thyroxine, triiodothyronine, and glucagon varied significantly with the season. A significant sex by season interaction was observed in the thyroid hormones. It appears that seasonal variation as well as diurnal variation should be considered in evaluating hormone levels.

Metabolic responses of Zucker fatty and lean rats fed carbohydrate diets ad libitum or in meals.

In order to study the metabolic effects of dietary sucrose on Zucker rats, young male fatty and lean rats were fed ad libitum or in meals (2 hours/day) for 4 weeks. Diets contained 54% carbohydrate as either sucrose, invert sugar or cooked cornstarch. A genotype effect (fatty versus lean) occurred with the activities of liver and adipose tissue lipogenic enzymes, relative total fat pad size and soluble adipose tissue protein levels in both ad libitum- and meal-fed rats, whereas a genotype effect occurred with food intake and relative liver size only in meal-fed rats and with body weight gain only in ad libitum-fed rats. The significance of diet effects varied with genotype and feeding pattern. The sucrose effect (sucrose versus starch) occurred with food efficiency and body weight gain, activities of liver lipogenic and gluconeogenic enzymes, relative liver size, relative total fat pad size and soluble adipose tissue protein levels in both ad libitum- and meal-fed rats, and with adipose lipogenic enzyme activities in meal-fed rats. The disaccharide effect (sucrose versus invert sugar) occurred with the activities of liver lipogenic enzymes, relative total fat pad size and soluble adipose tissue protein levels in ad libitum-fed rats and was greater in lean than in fatty rats. The data demonstrate that the Zucker fatty and lean rat can be used as sensitive models to study differential effects of dietary carbohydrate.