Carbohydrates for glycemic control: functional and microbiome aspects.

PURPOSE OF REVIEW: Glycemia goals are used as indicators of control and progression in prediabetes and diabetes. Adopting healthy eating habits is essential. It is worth considering the quality of carbohydrates to help with dietary glycemic control. The present article aims to review recent meta-analyses published in the years 2021-2022 on the effects of dietary fiber and low glycemic index/load (LGI/LGL) foods on glycemic control and how gut microbiome modulation contributes to glycemic control. RECENT FINDINGS: Data involving more than 320 studies were reviewed. The evidence allows us to infer that LGI/LGL foods, including dietary fiber intake, are associated with reduced fasting glycemia and insulinemia, postprandial glycemic response, HOMA-IR, and glycated hemoglobin, which are more evident in soluble dietary fiber. These results can be correlated with changes in the gut microbiome. However, the mechanistic roles of microbes or metabolites implicated in these observations continue to be explored. Some controversial data highlight the need for more homogeneity between studies. SUMMARY: The properties of dietary fiber are reasonably well established for their glycemic homeostasis effects, including the fermentation aspects. Findings of gut microbiome correlations with glucose homeostasis can be incorporated into clinical nutrition practice. Target dietary fiber interventions on microbiome modulation can offer options to improve glucose control and contribute to personalized nutritional practices.

Determination of glycaemic response to the consumption of two specialised formulas for glycaemic control.

To assess the glycaemic response after ingestion of two specialised oral and enteral nutrition formulas for glycaemic control. The participants were sixteen healthy volunteers, aged 21-49 years, with normal glucose tolerance. The volunteers attended the tests fasting for 10 h, for 5 weeks, and consumed the reference food - glucose solution - for 3 weeks, and the two formulas DiamaxO and DiamaxIG in the following weeks, in amounts equivalent to 25 g of available carbohydrates. During the period of 120 min, seven blood samples were taken through capillary blood sampling to determine the glycaemic response. The glycaemic index (GI) was calculated according to the trapezoidal rule, ignoring areas below the fasting line. The glycaemic load (GL) was determined by the formula GL = ((GI(glucose = reference) × 'g' of available carbohydrate per serving]/100. The formulas showed low GI and GL. GI = 37·8 and GL = 6·6 for DiamaxO and GI = 21·5 and GL = 3·5 for DiamaxIG. The peak of the glycaemic response occurred 30 min after ingestion, with a marked difference in blood glucose between the Diamax products in relation to glucose. Differences were also significant at times 15, 45, 60 and 90 min in relation to glucose (ANOVA with post hoc Bonferroni, P < 0·005), but not between the two products. However, the AUC and the GI of DiamaxIG are significantly smaller than that of the DiamaxO second t test (P = 0·0059). The glycaemic response to the products is quite reduced, presenting a curve with a little accentuated shape, without high peak, especially in the modified product.

The Effects of Soluble Dietary Fibers on Glycemic Response: An Overview and Futures Perspectives.

The properties of each food, composition, and structure affect the digestion and absorption of nutrients. Dietary fiber (DF), especially viscous DF, can contribute to a reduction in the glycemic response resulting from the consumption of carbohydrate-rich foods. Target and control of postprandial glycemic values are critical for diabetes prevention and management. Some mechanisms have been described for soluble DF action, from the increase in chyme viscosity to the production of short-chain fatty acids resulting from fermentation, which stimulates gastrointestinal motility and the release of GLP-1 and PYY hormones. The postprandial glycemic response due to inulin and resistant starch ingestion is well established. However, other soluble dietary fibers (SDF) can also contribute to glycemic control, such as gums, ß-glucan, psyllium, arabinoxylan, soluble corn fiber, resistant maltodextrin, glucomannan, and edible fungi, which can be added alone or together in different products, such as bread, beverages, soups, biscuits, and others. However, there are technological challenges to be overcome, despite the benefits provided by the SDF, as it is necessary to consider the palatability and maintenance of their proprieties during production processes. Studies that evaluate the effect of full meals with enriched SDF on postprandial glycemic responses should be encouraged, as this would contribute to the recommendation of viable dietary options and sustainable health goals.

Biodiversity food dataset: Centralizing chemical composition data to allow the promotion of nutrient-rich foods in Brazil.

Centralizing chemical composition data for biodiverse foods is an important strategy in promoting their consumption. To support this strategy, a dataset of foods based on Brazilian biodiversity was created. The set was based on data for foods produced or commercialized in Brazil; these data were previously compiled for the Brazilian Food Composition Table (TBCA), according to international guidelines. Inclusion criteria were based on the following indicators: (i) foods with description below species level; (ii) wild foods; and (iii) underutilized foods. The dataset contains 1,305 food entries, and the majority correspond to raw plant foods. Nutrient content in foods identified below species level exhibited a wide range of values. Underutilized foods presented similar or higher selected nutrient contents than commonly consumed foods. For instance, depending on the cultivar of sweet potato (Ipomoea batatas), vitamin A content ranged from a negligible amount to high content (0.33- to 3,637-µg retinol equivalents per 100-g edible portion on a fresh weight basis [EP]). Camu-camu (Myrciaria dubia), a fruit from Amazon, was identified as the richest source of vitamin C (2,300 mg of ascorbic acid per 100-g EP), corresponding to 48-fold the content of orange. The dataset provides evidence to promote nutrient-rich foods that may be integrated into more effective programmes and policies on nutrition and food security in Brazil. It can be accessed online, free of charge on the TBCA platform.

Effectiveness of carbohydrates as a functional ingredient in glycemic control

High postprandial glycemia in the non-diabetic population is one of the known universal mechanisms for the progression of noncommunicable diseases (NCDs), which have impacted the finances of both individuals and of health systems. In order to highlight the role of carbohydrates in glycemic control and its implications on health, the International Life Sciences Institute Brazil held an international workshop on "Carbohydrates, Glycemia and Health". Carbohydrate digestion rate is related to glycemic response, which mainly depends on the quality and amount of carbohydrate ingested, and thus it may be modulated by intrinsic and extrinsic factors. These effects can be verified by using different methods which evidence how physiology adapts in the uptake of glucose. Consumers can be aided with the knowledge/awareness of the benefits of high postprandial glycemia control in non-diabetic subjects. Multisectorial actions can contribute to decrease the onset and worsening of NCDs. A strategy indicated to the public in general to expand the availability of products that do not result in a sudden increase of postprandial plasma glucose and/or insulin would be to use alternative ingredients and/or technology in addition to making the legally allowed communication of benefits, which are supported by scientific studies.

Translation and validation of the brazilian portuguese version of the gastrointestinal symptom rating scale (gsrs) questionnaire / Tradução e validação da versão brasileira do questionário Gastrointestinal Symptom Rating Scale (GSRS)

ABSTRACT Background - Bowel function is a widely evaluated parameter in interventional and longitudinal studies since it is associated with good maintenance of health. The evaluation of intestinal function has been performed by many questionnaires, however, there are few options validated in Brazilian Portuguese. Objective - The aim of this work was to translate and validate into Brazilian Portuguese the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire. Methods - Translation and cultural adaptation were performed according to a previously established methodology followed by reliability calculations. Results - The final translated GSRS questionnaire showed an adequate value of overall reliability of Cronbach's alpha of 0.83, and its domains were classified from acceptable to adequate. The overall test-retest reliability by intraclass correlation coefficient (ICC) was 0.84, considered excellent. Conclusion - The GSRS was translated and validated into Brazilian Portuguese, with appropriate internal consistency and reliability and is available to be used in assessments of bowel function.

RESUMO Contexto - O funcionamento intestinal é um dos parâmetros amplamente avaliado em estudos intervencionais e longitudinais, pois está associado à manutenção da saúde. A avaliação do funcionamento intestinal tem sido realizada por diferentes questionários, mas são poucas as alternativas validadas em português. Objetivo - O objetivo deste trabalho foi traduzir e validar para a língua portuguesa (Brasil) o questionário Gastrointestinal Symptom Rating Scale (GSRS). Métodos - A tradução e adaptação cultural foram realizadas de acordo com metodologia previamente estabelecida, seguida dos cálculos de confiabilidade. Resultados - A aplicação do questionário GSRS traduzido apresentou valor de confiabilidade geral alfa de Cronbach de 0,83, classificado como adequado, e seus domínios foram classificados de aceitável a adequado; o teste-reteste geral apresentou coeficiente de correlação intraclasse de 0,84, considerado excelente. Conclusão - O GSRS foi traduzido e validado para Português (Brasil), apresentando confiabilidade e reprodutibilidade apropriadas, e está disponível para ser utilizado em avaliações de funcionamento intestinal.

TRANSLATION AND VALIDATION OF THE BRAZILIAN PORTUGUESE VERSION OF THE GASTROINTESTINAL SYMPTOM RATING SCALE (GSRS) QUESTIONNAIRE.

BACKGROUND: - Bowel function is a widely evaluated parameter in interventional and longitudinal studies since it is associated with good maintenance of health. The evaluation of intestinal function has been performed by many questionnaires, however, there are few options validated in Brazilian Portuguese. OBJECTIVE: - The aim of this work was to translate and validate into Brazilian Portuguese the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire. METHODS: - Translation and cultural adaptation were performed according to a previously established methodology followed by reliability calculations. RESULTS: - The final translated GSRS questionnaire showed an adequate value of overall reliability of Cronbach's alpha of 0.83, and its domains were classified from acceptable to adequate. The overall test-retest reliability by intraclass correlation coefficient (ICC) was 0.84, considered excellent. CONCLUSION: - The GSRS was translated and validated into Brazilian Portuguese, with appropriate internal consistency and reliability and is available to be used in assessments of bowel function.

Impact of dietary fiber energy on the calculation of food total energy value in the Brazilian Food Composition Database.

Dietary fiber (DF) contributes to the energy value of foods and including it in the calculation of total food energy has been recommended for food composition databases. The present study aimed to investigate the impact of including energy provided by the DF fermentation in the calculation of food energy. Total energy values of 1753 foods from the Brazilian Food Composition Database were calculated with or without the inclusion of DF energy. The energy values were compared, through the use of percentage difference (D%), in individual foods and in daily menus. Appreciable energy D% (⩾10) was observed in 321 foods, mainly in the group of vegetables, legumes and fruits. However, in the Brazilian typical menus containing foods from all groups, only D%<3 was observed. In mixed diets, the DF energy may cause slight variations in total energy; on the other hand, there is appreciable energy D% for certain foods, when individually considered.

Colonic Fermentation of Unavailable Carbohydrates from Unripe Banana and its Influence over Glycemic Control.

The aim of this study was to evaluate the effect of the colonic fermentation of unavailable carbohydrates from unripe banana (mass - UBM - and starch - UBS) over parameters related to glucose and insulin response in rats. Wistar male rats were fed either a control diet, a UBM diet (5 % resistant starch - RS) or a UBS diet (10 % RS) for 28 days. In vivo (oral glucose tolerance test) and in vitro (cecum fecal fermentation, pancreatic islet insulin secretion) analyses were performed. The consumption of UBM and UBS diets by Wistar rats for 28 days improved insulin/glucose ratio. Also, pancreatic islets isolated from the test groups presented significant lower insulin secretion compared to the control group, when the same in vitro glucose stimulation was done. Total short chain fatty acids produced were higher in both experimental groups in relation to the control group. These findings suggest that UBM and UBS diets promote colonic fermentation and can influence glycemic control, improving insulin sensitivity in rats.

[Brazilian Food Composition Database (TBCA-USP): Data compilation to serve the public good]. / Tabela brasileira de Composição de Alimentos-USP: compilação de dados a serviço do bem publico.

The article shows the evolution of the Brazilian Food Composition Database (TBCA-USP), since its creation until its next update. The article characterizes the TBCA-USP database like a public good and highlights the importance of the food composition data compilation as a high cost-effective activity. It reports the social relevance of the information about food composition and the importance of this database in the national context. It also indicates extension and update strategies of the TBCA-USP.

Application of Choices criteria in Brazil: impact on nutrient intake and adequacy of food products in relation to compounds associated to the risk of non-transmissible chronic diseases.

One of the aims of this work was to evaluate the impact of introducing products that are in agreement with the Choices criteria in the usual diet of the Brazilian population. However, due to the insufficient information on key compounds related to non-transmissible chronic diseases (NTCD) in the national food composition database, the nutritional information of food labels was collected. A food composition database of industrialized products was created (1720 products) and their data were evaluated according to the Choices criteria. The replacement of typical products by products that are in accordance to the Choices criteria may cause a decrease in the intake of saturated (52%) and trans fatty acids (92%), energy (14%) and sodium (47%), as well as an increase in the intake of DF (87%); improving the diet nutritional profile. This procedure can be used as important part in a strategy for decreasing the risk for NTCD.

Codex dietary fibre definition - Justification for inclusion of carbohydrates from 3 to 9 degrees of polymerisation.

The main controversy about the DF definition, adopted by the commission of Codex Alimentarius, refers to the inclusion of carbohydrates of 3-9 degrees of polymerisation (DP), decision which may be made individually by the authorities of each country. Due to the possibility of having two definitions and the negative impact it would cause over the harmonisation of nutritional information, a bibliographic review was carried, from 2009 to 2011, aiming to gather justifications for the inclusion of carbohydrates of 3-9 DP in the definition. The current review presents scientific bases that are directed to three topics: physiological aspects; repercussion over the analytical method; and impact on consumers and other users. The decision of including unavailable carbohydrates of 3-9 DP in the definition of DF may cause effective global harmonisation in the nutritional labelling, considering that the main goal is to help consumers choose healthy foods.

Tabela brasileira de composiçao de alimentos TBCA-USP (versoes 3 e 4) no contexto internacional / Brazilian food composition table TBCA-USP (versions 3 and 4) in the international context

A Tabela Brasileira de Composiçao de Alimentos-USP (TBCA-USP) tem como meta divulgar informaçoes de qualidade sobre a composiçao química de alimentos brasileiros. Para isso adota padroes internacionais que definem diretrizes e critérios para a área de composiçao de alimentos, através de guias e manuais com protocolos a serem usados na geraçao e compilaçao de dados, o que amplia a comunicaçao e o intercâmbio entre laboratórios. Entre os anos de 2001 a 2004, foram introduzidos 863 novos dados na TBCA-USP, totalizando 1838, sendo 1200 referente à composiçao centesimal. Durante este período foram desenvolvidas e disponibilizadas na Internet as versoes TBCA-USP 3.0, 4.0 e 4.1, que apresentaram inúmeras modificaçoes estruturais e de layout em relaçao às versões anteriores. A versao 3.0 da TBCA-USP apresentava uma tabela blocada com os alimentos separados por grupos, devido ao grande número de informaçoes. Como esse número continuou aumentando, as versoes 4.0/4.1 passaram a apresentar os dados dos alimentos de maneira individualizada, acessada por busca, pelo nome do alimento (em português, inglês ou nome científico). Os dados sao apresentados por 100g/alimento e medidas caseiras usuais. Está disponível um formulário para compilaçao de dados de composiçao de alimentos, para incentivar o envio e a publicaçao de dados que possam ser avaliados de maneira adequada. A TBCA-USP está estruturada de forma similar às demais tabelas internacionais que seguem padroes da rede INFOODS (International Network of Food Data Systems); e está centralizando esforços para a criaçao de bancos específicos de nutrientes ou alimentos com propriedade funcional

Tabela brasileira de composição de alimentos TBCA-USP: 2001-2004 / Brazilian food composition database: TBCA-USP 2001-2004

A informação em relação ao conteúdo de nutrientes e de outros componentes de alimentos in natura e processados é necessária para a elaboração de programas nos campos da nutrição, saúde e educação, além de agricultura, indústria e marketing de alimentos. A Tabela Brasileira de Composição de Alimentos-USP (TBCA-USP) tem como meta divulgar informações de qualidade sobre a composição química de alimentos brasileiros, para isso adota padrões internacionais que definem diretrizes e critérios para a área de composição de alimentos, através de guias e manuais com protocolos a serem usados na geração e compilação de dados, o que amplia a comunicação e o intercambio entre laboratórios. A implementação de dados é uma busca constante...

A questão da variabilidade e qualidade de dados de composição de alimentos / Quality and variability of food composition data

Dados de composição de alimentos não podem ser considerados absolutos, pois se referem a material biológico, apresentam variações em função de inúmeros fatores como safra, variedade, solo, clima, formulação, preparação e outros; além disso, os valores apresentados em uma tabela representam uma estimativa média, referente a um determinado número de amostras ou alimentos compilados. O presente trabalho visa identificar aspectos básicos necessários para a comparação de dados analíticos. Fatores como a falta de similaridade entre alimentos, falta de análise de certos componentes e a omissão, ou não utilização, de determinadas informações resultam em estimativas incorretas, além de inviabilizar qualquer comparação...

Estudos do potencial ibero-americano de fibra alimentar: produtos, alimentos e resíduos / Study of Ibero-American dietary fiber potential: products, foods and residues

A reduzida ingestäo de fibra alimentar (FA) tem sido relacionada com o aumento de doenças crônico-degenerativas. Nos países ibero-americanos muitos pesquisadores, já vêm caracterizando a FA em alimentos e em resíduos industriais, buscando tecnologia para produzir concentrados, além de desenvolver e testar produtos enriquecidos a partir de alimentos regionais. Estes estudos foram reunidos, descritos e analisados a fim de avaliar o potencial de alimentos e formulaçöes ricas em FA em nove países ibero-americanos. Muitos alimentos regionais contêm quantidades significativas de FA, o mesmo acontece com frutas e hortaliças, porém as leguminosas e cereais merecem destaque. Resíduos industriais säo fontes concentradas de FA (por centagem na base seca) que podem ser utilizadas no enriquecimento de alimentos, como a casca do abacaxi (85 por cento), resíduo de beterraba (58 por cento) e farelo de trigo (32 por cento). Alimentos enriquecidos vêm sendo testados, como biscoitos com torta de milho na Colômbia (16,8 por cento) e macarräo com fibra de tremoço no Chile (11,2 por cento), e no mercado cubano já se encontram produtos como päo de trigo integral (12 por cento), produtos para fins especiais como comprimidos de fibra de cítricos (55 por cento) e alimentos para dieta enteral (1-1,9por cento). Há um grande potencial de FA nos países ibero-americanos em resíduos industriais, que já vem sendo utilizados como fontes concentradas, que podem ser explorados näo apenas por profissionais de saúde e indústria, mas também pela populaçäo