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Title: Effect of prior meal macronutrient composition on postprandial glycemic responses and glycemic index and glycemic load value determinations

Author
item MENG, HUICUI - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item MATTHAN, NIRUPA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item AUSMAN, LYNNE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item LICHTENSTEIN, ALICE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University

Submitted to: The American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/18/2017
Publication Date: 9/13/2017
Citation: Meng, H., Matthan, N., Ausman, L., Lichtenstein, A.H. 2017. Effect of prior meal macronutrient composition on postprandial glycemic responses and glycemic index and glycemic load value determinations. American Journal of Clinical Nutrition. 106(5):1246-1256.

Interpretive Summary: It has become common practice to recommend people select foods with lower glycemic index (GI) values. GI is a ranking system based on the effect an individual food has on blood sugar levels. The potential impact of prior meal composition on after meal glycemic response and GI and glycemic load (GL, or GI value corrected for portion size) value determinations remains unclear. To address this issue we determined the effect of meals varying in macronutrient composition on glycemic response and GI and GL values of a subsequent standard test food (white bread). Twenty healthy participants were given each of three types of breakfast meals (high carbohydrate, high fat or high protein) on separate days in random order, followed by a standard white bread challenge, to determine GI values and calculate GL values. Consuming the high protein breakfast prior to the white bread challenge lessened the rise in after meal serum glucose response and resulted in lowered GI and GL values compared to the high carbohydrate and high fat breakfasts. The high protein breakfast resulted in lower serum insulin concentrations for white bread compared to the high fat and high carbohydrate breakfasts. The three breakfasts resulted in similar serum lipid responses to the white bread challenge. These data indicate that macronutrient composition of the prior meal influences glycemic response and determination of GI and GL values for white bread. Future studies are needed to determine whether background food macronutrient composition influences average dietary GI and GL values calculated for eating patterns, which may alter the interpretation of the associations between these values and chronic disease risk.

Technical Abstract: Background: The potential impact of prior meal composition on the postprandial glycemic response and glycemic index (GI) and glycemic load (GL) value determinations remains unclear. Objective: We determined the effect of meals that varied in macronutrient composition on the glycemic response and determination of GI and GL values of a subsequent standard test food. Design: Twenty healthy participants underwent 6 test sessions within 12 wk. The subjects received each of 3 isocaloric breakfast meals (i.e., high carbohydrate, high fat, or high protein) on separate days in a random order, which was followed by a standard set of challenges (i.e., white bread and a glucose drink) that were tested on separate days in a random order 4 h thereafter. Each challenge provided 50 g available carbohydrate. Arterialized venous blood was sampled throughout the 2-h postchallenge period. GI, GL, and insulin index (II) values were calculated with the use of the incremental area under the curve (AUCi) method, and serum lipids were determined with the use of standard assays. Results: The consumption of the high-protein breakfast before the white-bread challenge attenuated the rise in the postprandial serum glucose response (P < 0.0001) and resulted in lower glucose AUCi (P < 0.0001), GI (P = 0.0096), and GL (P = 0.0101) values than did the high-carbohydrate and high-fat breakfasts. The high-protein breakfast resulted in a lower insulin AUCi (P = 0.0146) for white bread than did the high-fat breakfast and a lower II value (P = 0.0285) than did the high-carbohydrate breakfast. The 3 breakfasts resulted in similar serum lipid responses to the white-bread challenge. Conclusions: These data indicate that the macronutrient composition of the prior meal influences the glycemic response and the determination of GI and GL values for white bread. Future studies are needed to determine whether the background food macronutrient composition influences mean dietary GI and GL values that are calculated for eating patterns, which may alter the interpretation of the associations between these values and chronic disease risk.