Recent scientific findings support new nutritional prevention strategies for type 2 diabetes
The number of people suffering from diabetes is on the rise (1). Dietary means to lower postprandial glycemic responses are urgently needed for the prevention of type 2 Diabetes mellitus. Viscous dietary ﬁbers, including high molecular weight (HMW) oat beta-glucan, are one of the most effective classes of functional food ingredients for reducing postprandial glucose (2) and so a potential solution. The mechanism of action is understood to be via an increase in viscosity of the stomach contents that delays gastric emptying and reduces the mixing of food with digestive enzymes. This, in turn, inhibits glucose absorption (3).
Previous studies have suggested that taking viscous ﬁbers separate from a main meal may not be effective in reducing postprandial glycemia (4). One potential solution to this problem may, however, be to consume a ﬁber “preload” before eating. This develops viscosity slowly, so that it can be consumed in a palatable form. It also remains liquid in the stomach long enough to be able to mix effectively with the main meal, but becomes viscous by the time the stomach starts to empty the meal.
In a recent study by Steinert et al. (5), this strategy was tested: healthy normal weight and overweight subjects consumed a preload of a commercially available oat-bran mixed in water before a test-meal of white bread and the effect on blood glucose was evaluated. Oat-bran includes 44% dietary ﬁber and 22% HMW oat beta-glucan, which forms a palatable drink when mixed with water and becomes viscous after several minutes.
It was found that oat-bran signiﬁcantly lowered postprandial blood glucose. The effect was dose dependent with each gram of oat beta-glucan reducing the blood glucose area under the curve (AUC) by about 4%, up to a peak rise of about 6%. These data support the use of oat-bran as a nutritional preload strategy in the management of postprandial glycemia.
Type 2 diabetes (formerly called non-insulin-dependent or adult-onset diabetes) is caused by the body’s ineffective use of insulin. It often results from excess body weight and physical inactivity. According to the World Health Organization (WHO), the number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014. Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation (6). WHO projects that diabetes will be the 7th leading cause of death in 2030 (7). A healthy diet is one of the most important factors to prevent or delay the onset of type 2 diabetes, alongside regular physical activity, maintaining a normal body weight and avoiding smoking.
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1. World Health Organization, Geneva, 2016 http://www.who.int/diabetes/global-report/en/
2. Tosh, S.M. Review of human studies investigating the post-prandial blood-glucose lowering ability of oat and barley food products. Eur. J. Clin. Nutr. 2013, 67, 310–317.
3. Würsch, P.; Pi-Sunyer, F.X. The role of viscous soluble ﬁber in the metabolic control of diabetes: A review with special emphasis on cereals rich in beta-glucan. Diabetes Care 1997, 20, 1774–1780.
4. Fuessl, S.; Adrian, T.E.; Bacarese-Hamilton, A.J.; Bloom, S.R. Guar in NIDD: Effect of different modes of administration on plasma glucose and insulin responses to a starch meal. Pract. Diabetes Int. 1986, 3, 258–260.
5. Steinert RE, Raederstorff D, Wolever TM. Effect of Consuming Oat Bran Mixed in Water before a Meal on Glycemic Responses in Healthy Humans-A Pilot Study. Nutrients. 2016 Aug 26;8(9). pii: E524.
6. World Health Organization, Geneva, 2016 http://www.who.int/diabetes/global-report/en/
7. Mathers et al., “Projections of global mortality and burden of disease from 2002 to 2030”, PLoS Med 2006, 3(11):e442.