Valoración del índice glicémico, carga glicémica e insulínica de fórmulas enterales y con adición de fibra para diabéticos en adultos sanos y con diabetes mellitus tipo 2

Introducción: Recientemente, la Diabetes Mellitus se ha considerado un problema de salud pública a nivel mundial. Actualmente, en el tratamiento dietético, novedosos indicadores como el uso del índice glicémico (IG), y de la carga glicémica (CG), son útiles para predecir y reducir el impacto glicémico postprandial ante un determinado alimento. Debido a la gran variabilidad de la respuesta glicémica, se ha generado controversia con el uso de fórmulas enterales específicas con fructosa para diabéticos, en las que el (IG) y la (CG) aún no han sido ampliamente estudiados en Venezuela, concretamente en pacientes de este grupo. Por otro lado, el reciente interés hacia los componentes biológicamente activos de la linaza (Linum usitatissimum L.); y su potencial efecto hipoglicemiante, podría considerarse una alternativa útil en el área clínica y en la industria alimentaria para el diseño de fórmulas especializadas en el control glicémico. Objetivos: Valorar el índice glicémico y carga glicémica de fórmulas enterales específicas para Diabetes con distintos tipos de edulcorante y fibra dietética en adultos sanos y diabéticos tipo 2, y determinar si la incorporación de la fibra de linaza puede modificar el índice glicémico y la carga glicémica de una fórmula enteral con fructosa. Nuestra hipótesis propone que el índice glicémico y la carga glicémica de fórmulas nutricionales enterales edulcoradas con fructosa, puede ser modificado positivamente con una concentración de fibra derivada de la linaza (11 g, ≈ 40%); y una cantidad de fibra total en la fórmula de (3,33 g .100 ml), proporción que permitiría disminuir la respuesta glicémica e insulinémica post-prandial en adultos sanos y por consiguiente en sujetos diabéticos tipo 2. Diseño y metodología: Esta tesis se ha dividido en tres capítulos derivados de tres estudios: El primero, corresponde a un diseño controlado, aleatorizado y cruzado en 21 sujetos sanos, en quienes se determinó la respuesta glicémica e insulinémica a los carbohidratos que componen una fórmula edulcorada con fructosa (Glucerna SR®)(FN);para ello se utilizó el cálculo del incremento del área bajo la curva (IAUC) a través del método trapezoidal. En el segundo capítulo, se cuantificó y comparó el índice glicémico, y carga glicémica de dos fórmulas isoglucídicas Glucerna SR®)(FG) y (Enterex...Introduction: Recently, diabetes mellitus has been considered a public health problema worldwide. Currently, the dietary treatment, novel indicators such as the use of the glycemic index (GI) and glycemic load (GL), are useful in predicting and reducing postprandial glycemic impact to a certain food. Due to the great variability of the glycemic response, it has generated controversy with the use of specific enteral formulas with paragraph fructose diabetics, where the (IG ) and ( CG ) have not been extensively studied in Venezuela , particularly in patients group.. On the other hand, the recent interest in the biologically active components of flaxseed (Linum usitatissimum L.); and its potential hypoglycemic effect, could be considered a useful alternative in the clinical area and in the food industry for the design of specialized formulas in glycemic control. Objectives: To evaluate the glycemic index and glycemic load of Diabetes specific enteral formulas for different types of dietary fiber sweetener and healthy adults and type 2 diabetics, and determine whether the incorporation of fiber flaxseed can alter the glycemic index and glycemic load an enteral formula with fructose. Our hypothesis propone that the glycemic index and the glycemic load of enteral nutritional formulas sweetened with fructose, can be changed positively with a concentration of fiber derived from flax (11 g, ≈ 40%); and an amount of total fiber in formula 3.33 g 100 ml), the proportion that would reduce postprandial glycemic and insulinemic response in healthy adults and therefore in type 2 diabetic subjects. Design and methodology: To this end, this thesis has been divided into three chapters / studies: The first controlled, randomized, crossover, and insulinemic determined glycemic response to carbohydrates that make up a formula sweetened with fructose (Glucerna SR ®) (FN) 21 healthy subjects, by calculating the incremental area under the curve (IAUC) through the trapezoidal method. In the second chapter, it was quantified and compared the glycemic index and glycemic load two formulas isoglucídicas Glucerna SR ®) (FG) and (Enterex Diabetic®) (FE) with different types of sweeteners and fiber 17 subjects (11 healthy and 6 with diabetes type 2) in a controlled, randomized, double-blind..

Glycemic Index Trends and Clinical Implications: Where Are We Going?

Glycemic index (GI) is currently consideredas an alternative system thatclassifies food according to the carbohydratequality (CHO), measuring its absorption speed;meanwhile, glycemic load GL is a more recent termthat relates the quality and quantity of the CHO pergram of the usual consumption portion. Glycemic indexand glycemic load reduce the post-prandial glycemicimpact without the total restriction of CHO in thediet. Initially, GI was used only in patients with diabetes,currently it is also considered as a risk indicator inother pathologies. However, there is great controversydue to an inaccurate interpretation of the knowledgeabout the methodology used for its determination.The aim of this review is to elucidate this currentdebate and to expand the relationship between the GIand the risk of diabetes and other chronic diseases;thus, highlighting new prospects for its applicability inthe dietary intervention for diabetic athletes and in theproduction of functional food designed for patients withdiabetes. There is strong evidence that this indicatorhas become an innovative system for various multidisciplinaryhealth programs

Effect of Oral Nutritional Supplements with Sucromalt and Isomaltulose versus Standard Formula on Glycaemic Index, Entero-Insular Axis Peptides and Subjective Appetite in Patients with Type 2 Diabetes: A Randomised Cross-Over Study

Oral diabetes-specific nutritional supplements (ONS-D) induce favourable postprandial responses in subjects with type 2 diabetes (DM2), but they have not been correlated yet with incretin release and subjective appetite (SA). This randomised, double-blind, cross-over study compared postprandial e ects of ONS-D with isomaltulose and sucromalt versus standard formula (ET) on glycaemic index (GI), insulin, glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide 1 (GLP-1) and SA in 16 individuals with DM2. After overnight fasting, subjects consumed a portion of supplements containing 25 g of carbohydrates or reference food. Blood samples were collected at baseline and at 30, 60, 90, 120, 150 and 180 min; and SA sensations were assessed by a visual analogue scale on separate days. Glycaemic index values were low for ONS-D and intermediate for ET (p < 0.001). The insulin area under the curve (AUC0–180 min) (p < 0.02) and GIP AUC (p < 0.02) were lower after ONS-D and higher GLP-1 AUC when compared with ET (p < 0.05). Subjective appetite AUC was greater after ET than ONS-D (p < 0.05). Interactions between hormones, hunger, fullness and GI were found, but not within the ratings of SA; isomaltulose and sucromalt may have influenced these factor

Glycemic index and glycemic response of corn starch porridge with addition of oats, flaxseed or soluble fiber isolated

Indexación: ScopusIntroduction: Fibers are commonly known to contribute in the improvement of glycemic and lipid profile, exerting a beneficial effect on health, but its effect on the glycemic index of food is still controversial. Objective: To evaluate the effect of adding high-fiber foods (oats and flaxseed) and a supplement of soluble fiber isolated on the glycemic index (GI) and glycemic response of a porridge of corn starch. Methodology: The study was of crossover, where six healthy subjects ingested preparations based on a maize porridge added to different foods rich in fiber, the GI of the preparations was calculated according to the methodology of FAO. Results: The preparation of linseed added resulting in a lesser glycemic response times 45-90 min and with the addition of oat preparation showed the best results at times 60 and 90 minutes. The mean area under the curve of the glycemic response and GI of the preparations did not differ. Conclusion: Oatmeal linseed seem foods with beneficial properties reduce the glycemic response to food.http://revista.nutricion.org/revista.asp?id=4

D-Tagatose Is a Promising Sweetener to Control Glycaemia: A New Functional Food

The objective of the current research was to review and update evidence on the dietary effect of the consumption of tagatose in type 2 diabetes, as well as to elucidate the current approach that exists on its production and biotechnological utility in functional food for diabetics. Articles published before July 1, 2017, were included in the databases PubMed, EBSCO, Google Scholar, and Scielo, including the terms “Tagatose”, “Sweeteners”, “Diabetes Mellitus type 2”, “Sweeteners”, “D-Tag”. D-Tagatose (D-tag) is an isomer of fructose which is approximately 90% sweeter than sucrose. Preliminary studies in animals and preclinical studies showed that D-tag decreased glucose levels, which generated great interest in the scientific community. Recent studies indicate that tagatose has low glycemic index, a potent hypoglycemic effect, and eventually could be associated with important benefits for the treatment of obesity. The authors concluded that D-tag is promising as a sweetener without major adverse effects observed in these clinical studies

Factores de riesgo de enfermedad cardiovascular en asistentes a un Hospital de Cali, Colombia

Introducci&oacute;n: las enfermedades cardiovasculares (ECV)son patolog&iacute;as que lideran las muertes a nivel global y suprevalencia est&aacute; influenciada por factores de riesgo (FRCV)modificables como hipertensi&oacute;n arterial, tabaquismo, diabetestipo 2, sedentarismo y obesidad. La mayor&iacute;a de lasECV, pueden prevenirse si se act&uacute;a sobre FRCV.Objetivo: Establecer el riesgo de presentar FRCV en pacientesinscritos al Programa de Riesgo Cardiovascular delHospital San Juan de Dios en la ciudad de Cali, Colombia.Materiales y m&eacute;todos. Se realiz&oacute; un estudio descriptivo,de corte transversal con informaci&oacute;n obtenida de 1507historias cl&iacute;nicas. La significancia estad&iacute;stica de las variablesse estableci&oacute; mediante la prueba de chi-cuadrado..El OR fue determinado con un el 95% de confianza paracada factor en relaci&oacute;n a ECV o en relaci&oacute;n al grupo etario.Resultados. Los FRCV m&aacute;s prevalentes fueron: HTA(88,7%), obesidad (72,2%), tabaquismo (45,2%) y DMtipo 2 (23,8%). Pacientes con cLDL elevados presentaronalto riesgo de sufrir ECV (OR: 9,708), seguido por ser mayorde 75 a&ntilde;os (OR: 8,411). Otros factores como triglic&eacute;ridosTG, colesterol total, cHDL, obesidad y Diabetes MellitusDM tipo 2 fueron relacionados con ECV.Cuando se analiz&oacute; la probabilidad de presentar alg&uacute;nFRCV por grupos etario, se observ&oacute; que pacientes entre46 y 74 y &gt;75 a&ntilde;os de edad presentaron mayor riesgo detener TG y cLDL altos, cHDL bajos o ser obesos.Conclusi&oacute;n. Se determin&oacute; que los FRCV m&aacute;s relevantesfueron cLDL elevado, ser mayor de 75 a&ntilde;os, TG, colesteroltotal, cHDL, obesidad y DM tipo 2

Índice Glicémico: Tendencias e implicaciones clínicas ¿Hacia dónde vamos?

Glycemic index (GI) is currently considered as an alternative system that classifies food according to the carbohydrate quality (CHO), measuring its absorption speed; meanwhile, glycemic load GL is a more recent term that relates the quality and quantity of the CHO per gram of the usual consumption portion. Glycemic index and glycemic load reduce the post-prandial glycemic impact without the total restriction of CHO in the diet. Initially, GI was used only in patients with diabetes, currently it is also considered as a risk indicator in other pathologies. However, there is great controversy due to an inaccurate interpretation of the knowledge about the methodology used for its determination. The aim of this review is to elucidate this current debate and to expand the relationship between the GI and the risk of diabetes and other chronic diseases; thus, highlighting new prospects for its applicability in the dietary intervention for diabetic athletes and in the production of functional food designed for patients with diabetes. There is strong evidence that this indicator has become an innovative system for various multidisciplinary health programs.Actualmente el índice glicémico (IG) se considera como un sistema alternativo que clasifica los alimentos según la calidad de los carbohidratos (CHO), midiendo su velocidad de absorción; por otra parte, la carga glicémica (CG) es un término más reciente que relaciona la calidad y la cantidad de CHO por gramo de la porción de consumo habitual. El índice glcémico y la carga glucémica reducen el impacto glicémico posprandial sin la restricción total de CHO en la dieta. Inicialmente, el IG era utilizado solo en pacientes diabéticos, actualmente también se considera un indicador de riesgo en otras patologías. Sin embargo, existe una gran controversia debido a una interpretación incorrecta del conocimiento sobre la metodología utilizada para su determinación. El objetivo de esta revisión es dilucidar este debate actual y ampliar la relación entre el IG y el riesgo de diabetes y otras enfermedades crónicas; así, se destacan nuevas perspectivas de su aplicabilidad en la intervención dietética para deportistas diabéticos y en la producción de alimentos funcionales diseñados para pacientes con diabetes. Existen fuertes evidencias de que este indicador se ha convertido en un sistema innovador para varios programas de salud multidisciplinarios

Glycemic Index Trends and Clinical Implications: Where Are We Going?

Glycemic index (GI) is currently consideredas an alternative system thatclassifies food according to the carbohydratequality (CHO), measuring its absorption speed;meanwhile, glycemic load GL is a more recent termthat relates the quality and quantity of the CHO pergram of the usual consumption portion. Glycemic indexand glycemic load reduce the post-prandial glycemicimpact without the total restriction of CHO in thediet. Initially, GI was used only in patients with diabetes,currently it is also considered as a risk indicator inother pathologies. However, there is great controversydue to an inaccurate interpretation of the knowledgeabout the methodology used for its determination.The aim of this review is to elucidate this currentdebate and to expand the relationship between the GIand the risk of diabetes and other chronic diseases;thus, highlighting new prospects for its applicability inthe dietary intervention for diabetic athletes and in theproduction of functional food designed for patients withdiabetes. There is strong evidence that this indicatorhas become an innovative system for various multidisciplinaryhealth programs

Consumo de Stevia según nivel socioeconómico y sexo en universitarios chilenos

La Stevia es un edulcorante no cal&oacute;rico de origen natural. En Chile, se ha convertido en uno de los edulcorantes m&aacute;s populares y de mayor consumo. El objetivo del estudio fue comparar la ingesta de Stevia seg&uacute;n nivel socioecon&oacute;mico (NSE) y sexo en una muestra de 473 estudiantes universitarios chilenos durante el periodo abril-junio 2014; 67% de sexo femenino y edad promedio de 20,4 &plusmn; 2,5 a&ntilde;os. El consumo de Stevia fue de 0,85 mg/kg/d&iacute;a, no super&oacute; la ingesta diaria admisible (IDA) y, el mayor consumo fue de 83,7% del IDA. Se encontr&oacute; una mayor ingesta de Stevia en mujeres de NSE alto y medio-alto que se consumieron a trav&eacute;s de la ingesta de alimentos y gotas (p&lt;0,05). Al comparar por sexo y NSE, las mujeres de NSE alto presentaron un mayor consumo (0,64 &plusmn; 1,4), en comparaci&oacute;n con los hombres (0,26 &plusmn; 0,48) (p&lt;0,05). Mientras que en los estratos bajos las diferencias entre mujeres y hombres fueron (0,42 &plusmn; 0,41) y (0,11 &plusmn; 0,42) respectivamente. El principal resultado de este estudio es que el consumo de Stevia es mayor en estudiantes universitarias de mayor nivel socioecon&oacute;mico, espec&iacute;ficamente alto y medio alto. Se esperar&iacute;a un incremento en el consumo ENCs post incorporaci&oacute;n de la nueva ley de etiquetado nutricional (Ley 20.606) del a&ntilde;o 2016. Se sugieren nuevas investigaciones acerca del consumo de edulcorantes en grupos poblacionales de distintos estratos socioecon&oacute;micos.Stevia is a non-caloric sweetener of natural origin. In Chile, it has become one of the most popular and widely consumed non-caloric sweeteners. The objective of this study was to compare Stevia intake according to socioeconomic level (SES) and sex in a sample of 473 Chilean university students from Abril to June 2014; 67% female with an average age of 20.4 &plusmn; 2.5 years. Stevia consumption did not exceed the Acceptable Daily Intake (ADI) and the highest consumption reached 83.7% of the ADI. A higher intake of Stevia was found in women with high and medium-high SES consumed in food and drops (p&lt;0.05). Comparing by sex and SES, women with high SES had a higher intake compared to men (p&lt;0.05). While in the lower strata the difference between women and men were (0,42 &plusmn; 0,41) and (0,11 &plusmn; 0,42) respectively. The main result of this study is that the intake of Stevia is highest in University students in a higher socioeconomic class, specifically high and upper middle classes. This study suggests further research focuses on the consumption of sweeteners in this particular group. An ENCs intake increase would be expected after the incorporation of the new law of nutritional labels in 2016. New investigations of sweeteners intake are suggested in different socioeconomic groups in the population