Effect of fibre additions to flatbread flour mixes on glucose kinetics: a randomised controlled trial.

We previously found that guar gum (GG) and chickpea flour (CPF) added to flatbread wheat flour lowered postprandial blood glucose (PPG) and insulin responses dose dependently. However, rates of glucose influx cannot be determined from PPG, which integrates rates of influx, tissue disposal and hepatic glucose production. The objective was to quantify rates of glucose influx and related fluxes as contributors to changes in PPG with GG and CPF additions to wheat-based flatbreads. In a randomised cross-over design, twelve healthy males consumed each of three different 13C-enriched meals: control flatbreads (C), or C incorporating 15 % CPF with either 2 % (GG2) or 4 % (GG4) GG. A dual isotope technique was used to determine the time to reach 50 % absorption of exogenous glucose (T 50 %abs, primary objective), rate of appearance of exogenous glucose (RaE), rate of appearance of total glucose (RaT), endogenous glucose production (EGP) and rate of disappearance of total glucose (RdT). Additional exploratory outcomes included PPG, insulin, glucose-dependent insulinotropic peptide and glucagon-like peptide 1, which were additionally measured over 4 h. Compared with C, GG2 and GG4 had no significant effect on T 50 %abs. However, GG4 significantly reduced 4-h AUC values for RaE, RaT, RdT and EGP, by 11, 14, 14 and 64 %, respectively, whereas GG2 showed minor effects. Effect sizes over 2 and 4 h were similar except for significantly greater reduction in EGP for GG4 at 2 h. In conclusion, a soluble fibre mix added to flatbreads only slightly reduced rates of glucose influx, but more substantially affected rates of postprandial disposal and hepatic glucose production.

Complementary feeding with cow's milk alters sleeping metabolic rate in breast-fed infants.

Although it is widely accepted that energy expenditure in infants is a function of feeding pattern, the mechanism behind this is not well understood. The objectives of this observational study were as follows: 1) to compare minimal observable energy expenditure (MOEE) between 2 subgroups of breast-fed infants, a BM group in which breast milk was the only source of milk and a BCM group given cow's milk in addition to breast milk; and 2) to identify potential mediators of a feeding pattern effect. For this purpose, infants were classified by feeding group on the basis of a mother's recall. Respiration calorimetry was used to measure MOEE in 62 infants (n = 35 BM, n = 27 BCM) aged 8.7 mo in Pelotas, southern Brazil. Breast-milk intake was measured using deuterium oxide, complementary food intake by 1-d food weighing, total energy expenditure and total body water using doubly labeled water; anthropometric indices were calculated. MOEE was 1672 +/- 175 kJ/d in BM compared with 1858 +/- 210 kJ/d in BCM infants (P < 0.001). Mass-specific MOEE was 201 +/- 24.6 and 216 +/- 31.9 kJ/(kg . d) in BM and BCM infants, respectively (P = 0.041). MOEE (kJ/d) was mediated by protein intake and fat-free mass (R(2) = 41.4%). We conclude that complementary feeding with cow's milk alters the sleeping metabolic rate in breast-fed infants. These findings deserve attention in relation to "metabolic programming" and the development of obesity later in life.