Acute effect of equicaloric meals varying in glycemic index and glycemic load on arterial stiffness and glycemia in healthy adults: a randomized crossover trial.

BACKGROUND/OBJECTIVES: Dietary carbohydrate quality and quantity fluctuate but it is unknown which attribute takes precedence in vascular health preservation. We investigated all four permutations of glycemic index (GI) and glycemic load (GL) on acute vascular and glycemic responses. SUBJECTS/METHODS: Twenty-one healthy adults were screened for this crossover trial. Seventeen (8 M:9 F; 26.7 ± 12.3 y; BMI 22.2 ± 2.8 kg/m2) entered randomization and completed the study, receiving four isocaloric meals, varying in GI and GL, in random order at least 3 days apart. The four meals included either chickpeas (GI = 28, GL = 14, 50 g available carbohydrates (CHO)), a small potato portion (GI = 85, GL = 14, CHO = 17 g), pasta (GI = 45, GL = 42, CHO = 94 g) or a large potato portion (GI = 85, GL = 42, CHO = 50 g) as the source of carbohydrate. Augmentation index (AIx) and central and peripheral blood pressure were measured fasting, 1, 2, 3, and 4 h post-consumption. Capillary blood glucose was analyzed fasting, 15, 30, 45, 60, 90, 120, 180, and 240 min. RESULTS: A reduction in AIx from baseline was observed 4 h following the chickpeas (low GI-low GL) (p = 0.046). The incremental area under blood glucose curves were significantly higher 2 h post-consumption following high compared with low GL meals (p < 0.001). Despite doubling carbohydrates, there was no difference in glycemic response between the large potato (high GI-high GL) and the pasta (low GI-high GL) meals. No significant differences in AIx or blood pressure were seen between meals. CONCLUSIONS: Low GI, low-carbohydrate meals may support a healthy vascular tone. Varying meal GI and GL results in different glycemic profiles, which are not necessarily predicted by carbohydrate content. Further investigations on cardiometabolic profiles to meals varying in GI and GL are warranted.

Reflections on Perceived Preparedness of Dietetic Internship Graduates Following Entry into Practice.

PURPOSE: To report on the perceived level of preparedness of dietetic internship (DI) graduates for entrance into practice as dietitians. METHODS: Graduates of an Ontario based, nonintegrated DI program from 2007-2011 who were at least 1 year postgraduation were surveyed to determine their level of perceived preparedness for practice using an electronic, content validated, self-administered questionnaire. RESULTS: Of 38 eligible graduates, 23 (61%) responded. Seventy-five percent of respondents were working as clinical dietitians, and 30% were working as community dietitians. Eighty-five percent of graduates reported feeling well or very well prepared for practice. Clinical and professional practice tasks were scored highest in terms of preparedness (ratings above 4.5/5) and research-related tasks such as using the research literature (4.1/5), making evidence-based decisions (4.2/5), and engaging in practice-based research (4.1/5) scored lower. Training gaps identified by 32% of respondents included community nutrition and management skill training. CONCLUSIONS: Overall, results indicate that this DI program provides a positive training experience that prepares its graduates for entrance into practice as dietitians. Qualitative comments identifying gaps and improvements have guided changes to the curriculum including strengthening community-based placements. Post-graduate surveys represent an important tool in assuring that training programs evolve to meet the needs of students entering the workforce.