Consuming Carbohydrates after Meat or Vegetables Lowers Postprandial Excursions of Glucose and Insulin in Nondiabetic Subjects

We aimed to examine the effects of variable timing of carbohydrate intake on postprandial glucose and insulin excursion in a diet with the same levels of energy and balance of three major nutrients. The study subjects included 8 healthy individuals, mean age 20.0±1.2 y (4 males and 4 females; mean a...

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Published inJournal of Nutritional Science and Vitaminology Vol. 64; no. 5; pp. 316 - 320
Main Authors TAKAMURA, Toshinari, SAKURAI, Masaru, NISHINO, Kimiko, TAKESHITA, Yumie
Format Journal Article
LanguageEnglish
Published Japan Center for Academic Publications Japan 31.10.2018
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ISSN0301-4800
1881-7742
DOI10.3177/jnsv.64.316

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Abstract We aimed to examine the effects of variable timing of carbohydrate intake on postprandial glucose and insulin excursion in a diet with the same levels of energy and balance of three major nutrients. The study subjects included 8 healthy individuals, mean age 20.0±1.2 y (4 males and 4 females; mean age, 19.1±0.7 and 20.8±0.9 y, respectively), without a family history of diabetes. They consumed a test meal consisting of three separate plates of rice, vegetables, and meat after an overnight fast. The subjects consumed the three plates in different orders on three different days; the subsequent changes in glucose and insulin levels were measured over a 120-min period. The participants who consumed rice at the end showed a significantly lower increase in glucose and insulin levels after 30 min of consumption than that shown by participants who consumed rice first. The areas under the curves for both glucose and insulin responses over 120 min were the least when rice was consumed last, whereas they were the greatest when rice was consumed first. These findings suggested that consuming carbohydrates at the end of a meal is associated with lower postprandial excursions of glucose and insulin. In conclusion, consuming carbohydrates last following vegetables and meat protects against postprandial excursions of glucose and insulin levels.
AbstractList We aimed to examine the effects of variable timing of carbohydrate intake on postprandial glucose and insulin excursion in a diet with the same levels of energy and balance of three major nutrients. The study subjects included 8 healthy individuals, mean age 20.0±1.2 y (4 males and 4 females; mean age, 19.1±0.7 and 20.8±0.9 y, respectively), without a family history of diabetes. They consumed a test meal consisting of three separate plates of rice, vegetables, and meat after an overnight fast. The subjects consumed the three plates in different orders on three different days; the subsequent changes in glucose and insulin levels were measured over a 120-min period. The participants who consumed rice at the end showed a significantly lower increase in glucose and insulin levels after 30 min of consumption than that shown by participants who consumed rice first. The areas under the curves for both glucose and insulin responses over 120 min were the least when rice was consumed last, whereas they were the greatest when rice was consumed first. These findings suggested that consuming carbohydrates at the end of a meal is associated with lower postprandial excursions of glucose and insulin. In conclusion, consuming carbohydrates last following vegetables and meat protects against postprandial excursions of glucose and insulin levels.
Author SAKURAI, Masaru
TAKESHITA, Yumie
TAKAMURA, Toshinari
NISHINO, Kimiko
Author_xml – sequence: 1
  fullname: TAKAMURA, Toshinari
  organization: Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medical Sciences
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  fullname: SAKURAI, Masaru
  organization: Department of Social and Environmental Medicine, Kanazawa Medical University
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  fullname: NISHINO, Kimiko
  organization: Department of Health Nutrition and Human Health, Kanazawa Gakuin University
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  fullname: TAKESHITA, Yumie
  organization: Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medical Sciences
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Cites_doi 10.1111/jdi.12433
10.1079/BJN20031054
10.1016/j.metabol.2011.05.015
10.1007/s00125-015-3841-z
10.1111/dme.12073
10.1001/archinte.161.3.397
10.1016/j.diabres.2012.08.002
10.2337/diacare.20.12.1822
10.2337/dc15-0429
10.1093/ajcn/51.6.1007
10.1038/nutd.2016.33
10.1016/j.cmet.2009.08.001
10.1056/NEJM198910053211403
10.1056/NEJM200005113421903
10.2337/diacare.22.6.920
10.1016/j.amjmed.2009.03.015
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References_xml – reference: 11) Kuwata H, Iwasaki M, Shimizu S, Minami K, Maeda H, Seino S, Nakada K, Nosaka C, Murotani K, Kurose T, Seino Y, Yabe D. 2016. Meal sequence and glucose excursion, gastric emptying and incretin secretion in type 2 diabetes: a randomised, controlled, crossover, exploratory trial. Diabetologia 59: 453-461.
– reference: 16) Japan Society of Clinical Chemistry Reagent Task Committee. 1991. Recommendation method for serum glucose measurement. Clinical Chemistry 20(4): 247-254 (in Japanese).
– reference: 5) Tominaga M, Eguchi H, Manaka H, Igarashi K, Kato T, Sekikawa A. 1999. Impaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glucose. The Funagata Diabetes Study. Diabetes Care 22: 920-924.
– reference: 19) Kesaniemi Ya, Tarpila S, Miettinen TA. 1990. Low vs high dietary fiber and serum, biliary, and fecal lipids in middle-aged men. Am J Clin Nutr 51: 1007-1012.
– reference: 12) Imai S, Matsuda M, Hasegawa G, Obayashi H, Ozasa N, Kajiyama S. 2011. A simple meal plan of “eating vegetables before carbohydrate” was more effective for achieving glycemic control than an exchange-based meal plan in Japanese patients with type 2 diabetes. Asia Pac J Clin Nutr 20: 161-168.
– reference: 2) Avignon A, Radauceanu A, Monnier L. 1997. Nonfasting plasma glucose is a belter marker of diabetic control than fasting plasma glucose in type 2 diabetes. Diabetes Care 20: 1822-1826.
– reference: 14) Shukla AP, Iliescu RG, Thomas CE, Aronne LJ. 2015. Food order has a significant impact on postprandial glucose and insulin levels. Diabetes Care 38: e98-e99.
– reference: 15) Trico D, Filice E, Trifiro S, Natali A. 2016. Manipulating the sequence of food ingestion improves glycemic control in type 2 diabetic patients under free-living conditions. Nutr Diabetes 6: e226.
– reference: 18) Wolever TM. 2004. Effect of blood sampling schedule and method of calculating the area under the curve on validity and precision of glycaemic index values. Br J Nutr 91: 295-301.
– reference: 9) Sakurai M, Nakamura K, Miura K, Takamura T, Yoshita K, Morikawa Y, Ishizaki M, Kido T, Suwazono Y, Kaneko S, Sasaki S, Nakagawa H. 2012. Dietary glycemic index and risk of type 2 diabetes mellitus in middle-aged Japanese men. Metabolism 61: 47-55.
– reference: 3) Ceriello A, Barakat M, Bahendeka S, Colagiuri S, Gerich J, Hanefeld M, Ji L, Lalic N, Leiter L, Monnier L, Owens D, Tajima N, Tuomilehto J. 2014. Guideline for management of post-meal glucose in diabetes. Diabetes Res Clin Pract 103: 256-268.
– reference: 20) Thomas C, Gioiello A, Noriega L, Strehle A, Oury J, Rizzo G, Macchiarulo A, Yamamoto H, Mataki M, Pruzanski M, Pellicciari R, Auwerx J, Schoonjans K. 2009. TGR5-mediated bile acid sensing controls glucose homeostasis. Cell Metab 10: 167-177.
– reference: 4) The DECODE Study Group on behalf of the EDEG. 2001. Glucose tolerance and cardiovascular mortality: comparison of fasting and 2-hour diagnostic criteria. Arch Intern Med 161: 397-405.
– reference: 8) Imai S, Matsuda M, Fujiawa S, Miyatani S, Hasegawa G, Fukui M, Morigami M, Ozasa N, Kajiyama S. 2010. Crossover study of the effect of “eating vegetables before carbohydrate” on reducing postprandial glucose and insulin in Japanese subjects with type 2 diabetes mellitus. J Japan Diab Soc 53: 112-115.
– reference: 13) Imai S, Fukui M, Ozasa N, Ozeki T, Kurokawa M, Komatsu T, Kajiyama S. 2013. Eating vegetables before carbohydrates improves postprandial glucose excursions. Diabet Med 30: 370-372.
– reference: 1) Kendall DM, Cuddihy RM, Bergenstal RM. 2009. Clinical application of incretin-based therapy: therapeutic potential, patient selection and clinical use. Am J Med 122: S37-S50.
– reference: 7) Jenkins DJ, Wolever TM, Vuksan V, Brighenti F, Cunnane S, Rao A, Jenkins A, Buckley G, Patten R, Singer W. 1989. Nibbling versus gorging: metabolic advantages of increased meal frequency. N Engl J Med 321: 929-934.
– reference: 17) Karasawa M, Turue M, Takenami K, Kikuti M, Wakabayashi H. 2006. Study of basic performance and standard value of Lumipulse prestin insulin measuring reagent using Lumipulse Prest II. J Clin Lab Inst Reag 29(5): 479-484 (in Japanese).
– reference: 10) Chandalia M, Garg A, Lutjohann D, Von Bergmann K, Grundy SM, Brinkley LJ. 2000. Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus. N Engl J Med 342: 1392-1398.
– reference: 6) Sakurai M, Nakamura K, Miura K, Takamura T, Yoshita K, Nagasawa S, Morikawa Y, Ishizaki M, Kido T, Naruse Y, Nagawa K, Nakashima Y, Nogawa K, Sasaki S, Nakagawa H. 2016. Dietary carbohydrate intake, presence of obesity and the incident risk of type 2 diabetes in Japanese men. J Diabetes Investig 7: 343-351.
– ident: 6
  doi: 10.1111/jdi.12433
– ident: 17
– ident: 18
  doi: 10.1079/BJN20031054
– ident: 9
  doi: 10.1016/j.metabol.2011.05.015
– ident: 12
– ident: 11
  doi: 10.1007/s00125-015-3841-z
– ident: 13
  doi: 10.1111/dme.12073
– ident: 4
  doi: 10.1001/archinte.161.3.397
– ident: 3
  doi: 10.1016/j.diabres.2012.08.002
– ident: 16
– ident: 2
  doi: 10.2337/diacare.20.12.1822
– ident: 14
  doi: 10.2337/dc15-0429
– ident: 19
  doi: 10.1093/ajcn/51.6.1007
– ident: 15
  doi: 10.1038/nutd.2016.33
– ident: 20
  doi: 10.1016/j.cmet.2009.08.001
– ident: 7
  doi: 10.1056/NEJM198910053211403
– ident: 10
  doi: 10.1056/NEJM200005113421903
– ident: 5
  doi: 10.2337/diacare.22.6.920
– ident: 8
– ident: 1
  doi: 10.1016/j.amjmed.2009.03.015
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SubjectTerms Adult
Blood Glucose - metabolism
carbohydrate
Dietary Carbohydrates - administration & dosage
Dietary Carbohydrates - pharmacology
eating order
Energy Intake
Feeding Behavior
Female
Gastric Inhibitory Polypeptide
Glucagon-Like Peptide 1
glucose excursion
Humans
insulin
Insulin - blood
Male
Meals
Meat
Oryza
Postprandial Period
Reference Values
Vegetables
Young Adult
Title Consuming Carbohydrates after Meat or Vegetables Lowers Postprandial Excursions of Glucose and Insulin in Nondiabetic Subjects
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