Biomedical subjects

F Q Nuttall

Publications and source records attributed to F Q Nuttall.

168 records · Page 10Linked to original sources

PubMedDate not supplied

Factors affecting interpretation of postprandial glucose and insulin areas.

Recently there has been an increased interest in determining the circulating glucose concentration after the ingestion of various individual foods and mixed meals. The purpose of these determinations is to systematically rank foods with respect to their quantitative effect on postmeal glucose concentration. Potentially such data could be useful in designing a diet for individuals with diabetes. We believe this concept is good. However, several factors that may affect interpretation of the data used to develop this ranking need to be considered before the utility of this approach to dietary management can be assessed: 1) duration of time over which the data are collected and analyzed; 2) use of absolute versus incremental areas in the determinations; 3) inclusion or exclusion of negative areas if incremental areas are used; 4) differences in response to a given food in males compared with females; 5) severity of diabetes; 6) confounding effects of oral agents or insulin treatment; 7) reproducibility of data; 8) differences in collection of blood sample; 9) food composition, processing, and preparation; 10) the dose-response relationship to ingestion of a given carbohydrate; 11) the meal being studied, i.e., first, second, or third meal of the day; and 12) a possible effect of the composition of the previous meal, if the response is tested to any meal other than the first meal of the day.

Blood Glucose↗

PubMedDate not supplied

Sucrose and disease.

Data currently available indicate that high sucrose consumption does not contribute significantly to the prevalence of cardiovascular disease, diabetes mellitus, obesity, or micronutrient deficiency. It may contribute, however, to dental caries formation by cariogenic bacteria.

Adolescent↗

PubMedDate not supplied

Diet and the diabetic patient.

At the present time, our knowledge regarding the metabolic consequences of various dietary regimens is incomplete and in need of further research. In addition, the composition of a diet for diabetic persons that will result in the best blood glucose control is uncertain and controversial. Whether dietary changes can significantly delay or prevent the long-term complications of diabetes also is not known. Thus, the insistence that certain foods be avoided by the diabetic person or that a specified diet be adhered to rigidly cannot be defended scientifically. In view of the above limitations in our knowledge, perhaps the best approach should be to allow diabetic persons to select their own diet and daily meal plan, as long as the nutrient content is adequate. A diabetic person being treated with insulin or a hypoglycemic drug will have to comply with a dietary regimen consistent in carbohydrate content and time of meal ingestion. This continues to be of vital importance in the management plan. Nevertheless, an insulin or drug regimen usually can be designed to accommodate the individual's usual eating habits and food preferences. Such a flexible approach to diet management should lead to better patient compliance and overall management of the diabetic patient.

Adolescent↗

PubMedDate not supplied

The glycemic effect of different meals approximately isocaloric and similar in protein, carbohydrate, and fat content as calculated using the ADA exchange lists.

The effect on plasma glucose concentration of four different, approximately isocaloric breakfasts designed using the American Diabetes Association food exchange lists was studied in eight type II diabetic patients. The meals were estimated to contain similar amounts of carbohydrate, protein, and fat and were given in random order. The plasma glucose responses to the different meals were similar except for one meal. This meal resulted in a greater glucose increase but the latter could be explained by the substitution of banana for orange juice in the meal. Banana contains starch as well as fructose and glucose, whereas orange juice contains glucose, fructose, and sucrose. In regard to the postmeal glucose response, these data indicate that the ADA food exchange list is useful in meal planning, at least for breakfast.

Aged↗

PubMedDate not supplied

Effect of protein ingestion on the glucose and insulin response to a standardized oral glucose load.

Type II diabetic subjects were given 50 g protein, 50 g glucose, or 50 g glucose with 50 g protein as a single meal in random sequence. The plasma glucose and insulin response was determined over the subsequent 5 h. The plasma glucose area above the baseline following a glucose meal was reduced 34% when protein was given with the glucose. When protein was given alone, the glucose concentration remained stable for 2 h and then declined. The insulin area following glucose was only modestly greater than with a protein meal (97 +/- 35, 83 +/- 19 microU X h/ml, respectively). When glucose was given with protein, the mean insulin area was considerably greater than when glucose or protein was given alone (247 +/- 33 microU X h/ml). When various amounts of protein were given with 50 g glucose, the insulin area response was essentially first order. Subsequently, subjects were given 50 g glucose or 50 g glucose with 50 g protein as two meals 4 h apart in random sequence. The insulin areas were not significantly different for each meal but were higher when protein + glucose was given. After the second glucose meal the plasma glucose area was 33% less than after the first meal. Following the second glucose + protein meal the plasma glucose area was markedly reduced, being only 7% as large as after the first meal. These data indicate that protein given with glucose will increase insulin secretion and reduce the plasma glucose rise in at least some type II diabetic persons.

Adult↗

PubMedDate not supplied

Prediction of the relative blood glucose response of mixed meals using the white bread glycemic index.

Unexpected plasma glucose responses to different mixed meals fed to normal and diabetic volunteers have recently been reported. We have therefore examined in normal volunteers the effect of mixing carbohydrate foods of different glycemic indices (GIs) without the addition of fat and protein. The observed GI of the mixed meal was within 2% of the expected value. In studies in the literature where fat and protein were added to mixed meals, the observed blood glucose responses also related significantly to the meal GIs calculated from the individual foods. Addition of fat and protein in the quantities used did not obscure this relationship. Studies to determine sources of error in comparing glycemic responses showed that type II diabetic patients displayed the least within-individual variation, and type I diabetic patients the most. Expression of results as the GI rather than as absolute glycemic response areas reduced by 50% the between-subject variation. The mean GI values of rice tested in type I and type II patients were similar (82 +/- 22 compared with 74 +/- 19) and the reproducibility 22 mo later in the same group of subjects was excellent (81 +/- 15 compared with 83 +/- 15). However, the lack of precise GI values for all foods fed in the test meals indicates a need for GI values to be derived for a wider range of individual foodstuffs. The GI approach to classifying foods according to physiologic effect may play a useful role in planning meals and diets in which specific blood glucose profiles are required.

Adult↗