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Background: Lack of insulin or the inability of cells to respond to insulin causes high blood glucose levels or hyperglycemia, a hallmark of diabetes. Consumption of foods with a low glycemic index and high fiber has been shown to provide the same benefits as pharmacological therapy in the control of postprandial hyperglycemia and can prevent the incidence of hypoglycemia in people with diabetes. Ganyong (Canna edulis) is a food source of carbohydrates and fiber. Kelor (Moringa oliefera) contains protein and some phytochemical compounds which have a hypoglycemic effect. Objective s : The objective of the study was to analyze the glycemic index of ganyong-kelor snack bars as a diet for diabetics. Materials and Method s : Ten respondents fasted for 10 hours and checked their fasting blood glucose levels, then consumed 105 grams of bread as the reference food. Every 30 minutes after eating, the blood glucose levels were checked. In the following week, after fasted, all respondents consumed 157 grams of a ganyong-kelor snack bar and checked their blood glucose levels every 30 minutes. Results : Every 100 grams of ganyong-kelor snack bar contains 230.13 kcal, 31.97 grams of carbohydrates, 9.25 grams of fat, and 4.75 grams of protein. In this study, bread was used as a reference food. If bread was corrected with glucose as a reference food, the glycemic index of the ganyong-kelor snack bar was 38.08. The calculation of the glycemic load used the converted-glycemic index and the total carbohydrates contained in 100 grams of the food. Ganyong-kelor snack bar had a glycemic load value of 12.10. Conclusions: Ganyong-kelor snack bar had good nutritional content and was categorized as food with a low glycemic index. The hypoglycemic effect of the ganyong-kelor snack bar came from its high fiber content. Ganyong-kelor snack bar can be consumed as a healthy snack for diabetic people.

This review investigated African yam beans (AYB) as a novel tropical food plant for human nutrition. AYB plants food potentials, its nutritional and amino acid compositions were also examined. In the same vein, the health benefits, utilization of AYB in starch and composite flour technology as well as its toxicological analysis were explored. Also, strategies to minimize processing difficulties and antinutritional factors were highlighted. It was revealed that AYB plant products are very rich in protein, minerals and antioxidants with low glycemic index (GI). Furthermore, viable processing techniques like fermentation, boiling and roasting can reduce AYB antinutritional factors and its toxicological effects. The result suggests that AYB plant products can meet dietary needs of people suffering from malnutrition, kwashiorkor, diabetes and other cardiovascular diseases, thus improving food security. Full utilization of AYB plants in food, drugs and health industries should be explored by carrying out further studies on ethno-pharmacological claims of AYB leaves and tubers. The findings revealed that AYB plant products hold great potential in improving food security globally. Key words: African yam beans, food security, nutritional factors, health benefits, limiting factors.

Acne is one of the most common dermatological conditions affecting millions of people worldwide. It is assumed that the main etiological factors acne are considered to be the excessive production of sebum and hormones, and the colonisation of P. acnes bacteria. The relationship between diet and acne lesions is still the subject of debate and scientific criticism. On the one hand, studies suggest that an elimination diet is of no benefit in the treatment of acne, while other studies indicate that there is a close a close relationship between diet and the occurrence of acne lesions. Already in the 1970s, some scientists claimed that the course of acne could be modified by specific dietary components. Several studies have confirmed, among others, the role of a diet with a high glycemic index diet in acne exacerbation and suggested that a low glycemic index diet for several weeks may lead to a reduction in the number of acne lesions. The effect of milk consumption was also investigated in terms for its potential role in acne pathogenesis, including its ability to increase insulin levels. In the last decade, studies have also emerged to determine the effect of dark chocolate on the exacerbation of acne symptoms. To date, it has not been conclusively established which component of chocolate may have a potentially adverse effects on the course of acne. The article summaries the current knowledge on the relationship between diet and acne lesions, and discusses the results of recent studies on selected dietary components that may exacerbate acne.

BACKGROUND & AIMS: Metabolic flexibility is the ability to adapt fuel oxidation to fuel availability. Metabolic inflexibility has been associated with obesity, the metabolic syndrome and insulin resistance, and can be improved by exercise or weight loss. Dietary changes can modulate metabolic flexibility; however, the effect of a whole diet approach on metabolic flexibility has never been studied. Therefore, our objective was to assess the effect of a healthy diet (HD), as compared to a typical Western diet (WD), on several fasting and postprandial markers of metabolic flexibility and insulin sensitivity.METHODS: In this parallel randomized trial, overweight or obese men and women (50-70 years; BMI 25-35 kg/m2) consumed a healthy diet (HD; high in fruits and vegetables, pulses, fibers, nuts, fatty fish, and low in high-glycemic carbohydrates; n = 19) or a typical Western diet (WD; n = 21) for six weeks, following a two-week run-in period. The change in respiratory quotient upon insulin stimulation (ΔRQ), and insulin sensitivity, expressed as the M-value, were both determined with a hyperinsulinemic euglycemic clamp. Additionally, other fasting and postprandial markers of metabolic flexibility were assessed during a 5-h high-fat high-glycemic mixed meal challenge.RESULTS: ΔRQ (p = 0.730) and insulin sensitivity (p = 0.802) were not significantly affected by diet. Postprandial RQ did also not show significant differences (p = 0.610), whereas postprandial glucose excursions were significantly higher in the HD group at T30 (p = 0.014) and T45 (p = 0.026) after mixed meal ingestion (p = 0.037). Fasting glucose (p = 0.530) and HbA1c (p = 0.124) remained unchanged, whereas decreases in fasting insulin (p = 0.038) and the HOMA-IR (p = 0.050) were significantly more pronounced with the HD.CONCLUSION: A healthy diet for six weeks, without further life-style changes, did not improve metabolic flexibility and whole-body insulin sensitivity, when compared to a Western-style diet. It remains to be determined whether the short time increase in postprandial glucose is physiologically relevant or detrimental to metabolic health. This trial was registered at clinicaltrials.gov as NCT02519127.

Refined carbohydrates, such as white rice and white flour, are the mainstay of the modern Asian Indian diet and may contribute to the rising incidence of Type- 2 diabetes and other life style diseases in this population. Low-glycemic index foods and high fibre content might play a significant role as functional foods in reducing the risk of such chronic diseases such as diabetes, cardiovascular diseases, obesity and cancer etc. In this study, two breakfast/ lunch items were targeted to modify and develop a low glycemic index recipe that can be consumed by diabetic individual. The prepared foods were investigated for organoleptic evaluation and proximate composition (moisture, protein, fat, crude fibre and ash content). Both the prepared products were organoleptically fell in the category of “liked very much” and nutritionally have a good potential for use as low glycemic food. The concept of glycemic index of various foods has emerged as a boon to dietary therapy of diabetes mellitus, indicating the beneficial aspect of foods consumed both individually and as mixed meals.

[This corrects the article DOI: 10.3389/fnut.2021.685648.].Copyright © 2021 Zhu, Fogelholm, Larsen, Poppitt, Silvestre, Vestentoft, Jalo, Navas-Carretero, Huttunen-Lenz, Taylor, Stratton, Swindell, Kaartinen, Lam, Handjieva-Darlenska, Handjiev, Schlicht, Martinez, Seimon, Sainsbury, Macdonald, Westerterp-Plantenga, Brand-Miller and Raben.

Opposed to whole wheat (WWP), traditional pizza (TP) is loved by patients with type 1 diabetes mellitus (T1DM) despite causing hyperglycemia. 50 well-trained T1DM patients had higher glucose levels after TP than after WWP or mixed flour pizza, which however was tasty, digestible and metabolically appropriate to break diet monotony.

In this article, the authors develop and analyze a linear programming model to obtain an ideal diet for individuals with diabetes by setting the glycemic load as the objective function. Additionally, a standardized system is used in order to facilitate the substitutability of foods present in a diet since those are classified according to their macronutrient content (proteins, lipids, and carbohydrates) and these values are, on average, very similar. Finally, the diet glycemic index is calculated with the model's outcome to corroborate that it is indeed a diet with low glycemic index and that, at the same time, it complies with the nutrient restrictions, which proves that the model can be a useful tool both to generate low glycemic index diets and to restrict certain nutrients from the diet.

Background A low-glycemic index (GI) diet may modulate adipocyte-produced adipokines linking to insulin resistance. Methods The stored plasma samples from the RCT of a low-GI vs. conventional diet in obese children were analyzed for adipokines: leptin, adiponectin, resistin, and visfatin. Their relationships with clinical outcomes were assessed. Results Fifty-two participants completed the 6-month intervention trial (mean age: 12.0 ± 2.0 years, 35 boys). Both groups had significantly decreased BMI z-scores from baseline whereas the low-GI group had significant reduction in fasting insulin and HOMA-IR. There were no differences in adipokines between the groups before and after the intervention. However, there was an association between baseline leptin and the change of fat mass index (FMI) but not the insulin resistance in both groups. The higher the baseline leptin was, the lower the changes were for FMI after the intervention. Conclusion Despite no demonstrable effect of low-GI diet on plasma adipokines, the higher baseline leptin was correlated with lower reduction of fat mass. Leptin resistance may have a detrimental effect on the reduction of adiposity in obese children. Baseline leptin could be a useful predictor of the change in body composition in an obesity intervention trial. Impact Leptin resistance may have a detrimental effect in reducing the adiposity in obese children. This study is the first of its kind to compare the plasma adipokine concentrations of obese children on low-GI diet and conventional diet. We found that serum leptin was significantly correlated with the reduction of BMI z-score and FMI in both groups. Baseline leptin could be a useful predictor of the change in body composition in an obesity intervention trial.

Background: Low Glycemic Index (GI) and high Satiety Index (SI) foods have been associated with the decreased risk of chronic diseases and obesity. Objectives: The present study examined the effect of oak flour on GI, Glycemic Load (GL), and SI of white bread. Methods: This randomized crossover trial was conducted at Ahvaz University of Medical Sciences, Ahvaz, Iran, during the year 2017. To determine the GI, 10 healthy subjects consumed three bread types (white bread, bread containing 25% oak flour, and bread containing 50% oak flour) and reference food (glucose) containing 50 g of carbohydrates on separate occasions. Finger-prick blood samples were collected at fasting (0 min) and at 15, 30, 45, 60, 90, and 120 min after meal consumption. To determine the SI, 20 healthy individuals consumed 240 kcal portions of test bread types (white bread, bread containing 25% oak flour, and bread containing 50% oak flour) on separate occasions. The satiety ratings were collected at fasting and every 15 min for over 2 h after food ingestion to evaluate the SI. Results: There were no significant differences in the mean of blood glucose Incremental Areas Under the Curve (IAUC) between the test bread types (white bread: 2,883.2 ± 353.7 vs. 25% oak flour bread: 3,163.1 ± 214.7 vs. 50% oak flour bread: 3,245.1 ± 255.9) (P > 0.05). Also, no significant differences were observed between the mean of bread GIs (P > 0.05). The satiety IAUCs of both oak bread types (25% oak flour bread: 377.17 ± 59.83, 50% oak flour bread: 427.87 ± 55.46) were significantly greater than that of white bread (248.55 ± 46.45) (P < 0.001). The SI of both oak bread samples (25% oak flour bread: 202.48 ± 7.92, 50% oak flour bread: 266.25 ± 11.66) was significantly greater than that of white bread (100) (P < 0.001). Conclusions: The addition of oak flour did not modify the GI; however, it increased the SI of white bread and created a greater feeling of satiety.

Background and aims Our recent data document that a low glycemic index (LGI) Neapolitan pizza prepared with a mix of Kamut and whole wheat flours plus Glucomannan, (i) has a lower impact on postprandial hyperglycemic spikes than pizza made of whole wheat flour, (ii) is pleasant and appreciated as traditional one and (iii) does not cause any gastro-intestinal troubles. The aim of our study was to describe the validation process underlying the identification of the right mix of those elements for a LGI pizza preventing gastro-intestinal disturbances. Methods we described all procedures followed to make good products with different combinations of the three components and a series of tests made by four well-experienced professional pasta-making masters, one nutritionist, five diabetologists, one nurse and twenty volunteers with T1DM. Results we could identify the best workable and most suitable flour mix to achieve both pleasant taste and low glycemic impact proving to be efficient in real-life twin paper providing results from diabetic patients. Conclusions this kind of food will certainly help people with diabetes eat pizza without risking any serious deterioration of their own glucose control while fully enjoying socially active life.

Background: A meal replacement (MR) with a low glycemic index (GI) is possibly beneficial for glycemic control. However, the effects of MR on diabetes mellitus have not been studied among Thai patients with type 2 diabetes (T2DM). Aim: To compare metabolic outcomes between T2DM patients receiving the new MR formula (ONCE PRO) and normal controlled diets. Methods: A multicenter, open-labeled, randomized controlled trial was conducted. Eligible patients received either ONCE PRO for one meal daily with controlled diets or only controlled diets for 3 months. The differences in metabolic profile between the baseline and end point of each group and between groups were measured. Results: 110 participants were enrolled; the mean difference and standard deviation in hemoglobin A1C (HbA1c) (%) from baseline were –0.21 ± 0.78 ( p = 0.060) and –0.27 ± 0.60 ( p = 0.001) in the MR and control groups, respectively; however, there was no significant difference between groups ( p = 0.637). Patients consuming a MR instead of breakfast had a significant decrease in HbA1c ( p = 0.040). Body weight (BW) and body mass index (BMI) were significantly reduced in both groups. There were no significant change in waist circumference, fasting plasma glucose, total cholesterol and triglycerides. Low-density lipoprotein cholesterol (LDL-C) was significantly decreased in the MR group compared with the control group ( p = 0.049). Conclusions: Short-term conventional diet control and the low-GI MR product were associated with a decreased BW and BMI. Changes in the other metabolic outcomes, HbA1c, total cholesterol and triglycerides, were comparable despite ONCE PRO as the MR having a better effect on LDL-C lowering.

Background Markers of subclinical cardiac injury are elevated in individuals with type 2 diabetes mellitus (T2DM) compared to healthy individuals. Low glycemic index (LGI) diets may improve both diabetes and cardiovascular risk but their effects on cardiac injury and fibrosis have not been previously studied. To test the effect of a LGI diet on markers of subclinical cardiac injury and fibrosis, we assessed the effect of a LGI compared with a high-cereal fibre diet on high-sensitivity cardiac troponin I (hs-cTnI) and galectin-3 in otherwise healthy individuals with T2DM in an exploratory analysis of a completed randomized trial. Methods A total of 201 participants completed the trial and had measurements of hs-cTnI and galectin-3 at baseline and at trial completion. Participants were randomized to follow a LGI or a high-cereal fibre diet over a 6-month period. Treatment differences were tested using Analysis of Covariance (ANCOVA) with sex, baseline values, and diet x sex interaction included as covariates. Results In a completer's analysis, no significant differences were observed for change in hs-cTnI (− 0.16 ng/L vs. − 0.22 ng/L, p = 0.713) and galectin-3 levels (0.64 μg/L vs. 0.14 μg/L, p = 0.166) when a LGI diet was compared to a high-cereal fibre diet. Conclusions The effect of a LGI diet was similar to a high-cereal fibre diet on hs-cTnI and galectin-3 levels in otherwise healthy individuals with T2DM over a 6-month period. Nevertheless, in the absence of any adverse effects, LGI diets remain an option for diabetes and cardiovascular disease risk management. ClinicalTrials.gov identifier: NCT00438698

Lifestyle modification, including a healthy diet, is of paramount importance in the management of diabetes mellitus. To this end, diets have been proposed with low glycemic index (an index of carbohydrate food expressing how quickly this nutrient can increase blood glucose) and glycemic load (an index obtained by multiplying the glycemic index by the grams of carbohydrate, then dividing by 100). The aim of this review was to discuss the potential contribution of diets with low glycemic index and glycemic load in diabetic microvascular complications. Currently, their role to the prevention and delay of microvascular complications in diabetes mellitus remains unclear, and further knowledge is desirable.

Active lifestyle and qualitative and quantitative diets are the best way to lose weight. In our study we have assessed the effectiveness and tolerability of a soluble powder rich in fibers and at low glycemic index and used, with a portion of fresh fruit, as replacement meal (for a total calorie intake ranging from a minimum of about 130 kcal to a maximum of 260 kcal) in 52 overweight/obese subjects of the outpatient clinic of the Italian National Research Council (CNR) of Rome already in treatment with a low-fat low-carbohydrates qualitative diet. The study was a parallel, prospective trial of two randomized sample groups, “intervention” (26 subjects) and “control” (26 subjects). After 8 weeks, the treatment based on the replacement meal has improved the results obtained through the qualitative diet alone above all in the overweight subjects: 11/16, versus only 2/16 in the control group, became ranged within normal weight. On the contrary, the majority of obese subjects didn’t change their BMI classification suggesting that, in case of obesity, a controlled quantitative correction with weighing food portions could be a better strategy than low-calorie replacement meal.

Background: Inflammation plays an important role in pathogenesis of cystic fibrosis, and diet is considered as an effective factor in controlling inflammation. Low glycemic index diet seems to be effective for improving glycemic control and reducing the inflammation and lipid profile. Hence, this study was planned to compare the effects of a low glycemic index/high fat, high calorie diet with the high fat, high calorie diet on glycemic status, lipid profile, and inflammatory markers in patients with cystic fibrosis. Methods: A total of 60 children and adolescence with cystic fibrosis will be randomized to receive a high fat, high calorie diet (n=30) or low glycemic index/high fat, high calorie diet (n=30) with similar calorie and macronutrients composition, for three months. Patients in high fat, high calorie diet arm will be able to use all sources of carbohydrates with different glycaemic indices; while those in another arm will be received their carbohydrate from low glycemic index sources. Before and after the intervention, serum levels of lipid profile (triglyceride, total cholesterol, HDL cholesterol, LDL cholesterol), insulin, glucose, HbA1c, the homeostasis model assessment-estimated insulin resistance index, and some inflammatory markers (IL-6, IL-10, IL-17A, and IFNγ) will be measured. Discussion: To our knowledge, this study will be the first to examine the effects of a low glycemic index/high fat, high calorie diet compared to the high fat, high calorie diet in cystic fibrosis patients. The findings of this study might provide evidence to improve the nutritional status and immune system as well as to prevent the disease complications in these patients.

One-third of patients with epilepsy do not respond to antiepileptic drugs and may seek complementary and alternative treatment modalities. Dietary therapies such as the ketogenic diet (KD), the modified Atkins, the medium-chain triglyceride, and the low glycemic index diet have been successfully implemented in some forms of epilepsy and are growing in utilization. The KD is a high-fat, low-protein, low-carbohydrate diet that has been used for various conditions for over a century. Insights into the mechanism of action of these diets may provide more targeted interventions for patients with epilepsy. Knowledge of these mechanisms is growing and includes neuroprotective effects on oxidative stress, neuroinflammation, potassium channels in the brain, and mitochondrial function.

Background Up to 30% of children with epilepsy show a poor therapeutic response to pharmacologic treatment. Ketogenic diets, including the less strict low glycemic index treatment (LGIT), may improve seizure control in pharmacoresistant epilepsy. However, little is known about the quality of life (QoL) in children on LGIT. To explore psychosocial implications of the LGIT on pediatric patients and their caregivers, we have conducted a pilot study to explore the QoL of children and adolescents on the diet. Methods Pediatric patients on LGIT and their parents completed standardized, validated QoL questionnaires (Pediatric Quality of Life Epilepsy Module), one retrospectively and one while being on LGIT. An additional questionnaire included two open-ended questions in order to gain a better understanding of personal experiences of families. Results We enrolled six patients with epilepsy on LGIT between the age of 3 and 13 years. Self-reported QoL decreased in all adolescents, regardless of improvement in seizure control. Parent-reported QoL improved in three of six participants, remained stable in one, and decreased in two patients (both displayed no seizure improvement). Parents and adolescents reported positive experiences of trying new foods and being more health conscious, as well as negative themes such as social isolation and meal preparation difficulties. Conclusions The lack of improvement in patient-reported QoL points towards an overall negative impact of the LGIT on patient well-being, despite positive effects on seizure control. Our preliminary results indicate that the benefits of seizure control may subjectively be outweighed by adverse social effects of the LGIT. Families should be made aware of psychosocial risks of the diet. Whenever possible, children should be part of the therapeutic decision-making process. Larger prospective studies are required to fully assess the overall impact of the LGIT.

Over the last decades, the ketogenic diet (KD) has become a valuable weapon in the management of intractable seizures [1,2]. However not all of patients truly benefit from this therapy.

The ketogenic diet (KD) has been used for a long time as a therapeutic approach for drug-resistant epilepsy. It is a high-fat, low-carbohydrate, and adequate protein diet. There are various types of KD with some differences in their compositions that mainly include classic KD, medium-chain triglyceride diet, modified Atkins diet, and low glycemic index treatment. The anti-seizure mechanisms of KDs have not yet completely understood but, some possible mechanisms can be theorized. The aim of the present study was to review the various types of KD and explain the probable biochemical mechanisms involved in its anti-seizure property.

Low glycemic index (GI) and/or low glycemic load (GL) are associated with decreased risks of type-2 diabetes and cardiovascular disease. It is therefore relevant to consider GI and GL in the early phases of the development of packaged foods and beverages. This paper proposes a model that predicts GI and GL from macronutrient composition, by quantifying both the impact of glycemic carbohydrates and the GI-lowering effects of nutrients such as proteins, fats and fibers. The precision of the model is illustrated using data on 42 breakfast cereals. The predictions of GI (r = 0.90, median residual = 2.0) and GL (r = 0.96, median residual = 0.40 g) compete well with the precision of the underlying in-vivo data (Standard Error SE = 3.5 for GI). This model can guide product development towards lowering GI and GL, before final confirmation by in vivo testing.

The Ketogenic Diet (KD) is a modality of treatment used since the 1920s as a treatment for intractable epilepsy. It has been proposed as a dietary treatment that would produce similar benefits to fasting, which is already recorded in the Hippocratic collection. The KD has a high fat content (90%) and low protein and carbohydrate. Evidence shows that KD and its variants are a good alternative for non-surgical pharmacoresistant patients with epilepsy of any age, taking into account that the type of diet should be designed individually and that less-restrictive and more-palatable diets are usually better options for adults and adolescents. This review discusses the KD, including the possible mechanisms of action, applicability, side effects, and evidence for its efficacy, and for the more-palatable diets such as the Modified Atkins Diet (MAD) and the Low Glycemic Index Diet (LGID) in children and adults.

Background: Low-glycemic index (GI) diet might be beneficial for gestational diabetes. However, the results remained controversial. We conducted a systematic review and meta-analysis to exp...

Post-bariatric hypoglycemia (PBH) is an increasingly recognized long-term complication of bariatric surgery. The nutritional treatment of PBH includes a high-fiber diet and the restriction of soluble and high-glycemic index carbohydrates; however, these measures are not always enough to prevent hypoglycemia. We evaluated the efficacy of uncooked cornstarch, a low-glycemic index carbohydrate characterized by slow intestinal degradation and absorption, in addition to a high-fiber diet, for the treatment of PBH. We report the cases of two young women suffering from severe postprandial and fasting hypoglycemia following Roux-en-Y gastric bypass (RYGB). The patients underwent Continuous Glucose Monitoring (CGM) before and 12–16 weeks after the administration of uncooked cornstarch (respectively 1.25 g/kg b.w. and 1.8 g/kg b.w.) in addition to a high-fiber diet. In both patients, CGM showed more stable glucose levels throughout monitoring, a remarkable reduction of the time spent in hypoglycemia (

Diet is the first line and the main therapeutic strategy in the treatment of gestational diabetes (GDM) with the primary objective to achieve normal blood glucose levels while promoting adequate ma...

The Canadian Diabetes Association recommends that people with diabetes choose foods with low-glycemic index (GI). This study developed a questionnaire measuring Theory of Planned Behaviour (TPB) constructs relative to consuming a low-GI diet by people with diabetes so as to achieve a better understanding of which TPB constructs, demographic characteristics and diabetes-related variables best predict intention to consume a low-GI diet.A questionnaire to measure intentions to consume a low-GI diet was developed based on TPB constructs and was administered to 369 adults (30 to 75 years) with type 1 or type 2 diabetes. Responses were analyzed using multiple linear regression.More than 90% of participants (mean age, 56.5±10.8 years; mean body mass index, 30.5±7.2 kg/m(2)) cited reduction and maintenance of healthy blood glucose levels as an advantage of eating low-GI foods. Older age, higher income, female gender, having type 2 diabetes, diabetes treatment (diet only) and understanding of the GI were positively associated with intention to eat a low-GI diet. TPB constructs that significantly predicted intentions to eat a low-GI diet were instrumental attitude (beta = 0.24, p0.001); subjective norms (beta = 0.13, p=0.007); and perceived behavioural control (beta = 0.55, p0.001).This new questionnaire is a valid tool to assess TPB constructs contributing to intentions to eat a low-GI diet by people with diabetes. Future studies that use this questionnaire can shed light on how TPB concepts in clinical practice can help people with diabetes to change their dietary intake.

Dietary therapy is the mainstay of treatment for diabetes. This study examined the effect of a low glycemic index (GI) multi-nutrient supplement, consumed in place of breakfast, on glycemic control in patients with type 2 diabetes mellitus (T2DM). A total of 71 participants were randomized at a 2:1 ratio into either a breakfast replacement group or a normal breakfast group for a 12-week interventional study. The primary outcome measure was change in hemoglobin A1c (HbA1c). Nutrition status and somatometry were studied as secondary outcomes. The breakfast replacement group displayed a −0.2% absolute reduction in HbA1c (95% CI (confidence interval), −0.38% to −0.07%, p = 0.004), while the HbA1c of the control group increased 0.3% (95% CI, 0.1% to 0.5%, p = 0.005). The baseline Mini Nutritional Assessment score for both groups was 26.0 and no significant changes occurred following intervention. However, there was a statistically significant difference in body mass index between the treatment and control groups (p = 0.032) due to the weight gain in the control group (increased 0.5 kg, 95% CI was 0.2 to 0.9, p = 0.007). These data suggest that breakfast replacement with a low GI multi-nutrient supplement can improve glycemic and weight control in T2DM.

Background and objective Since ancient times, honey has been used due to its nutritional and therapeutic value. The role of honey has been acknowledged in the scientific literature however, its use has been controversially discussed and has not been well accepted in modern medicine especially for diabetic patients. This study aimed to investigate the role of honey in diabetic patients. Methods In this study, we identified 107 research articles from data based search engines including “PubMed”, “ISI-Web of Science”, “Embase” and “Google Scholar”. The research papers were selected by using the primary key-terms including “Honey”, “Honey bee” and “Diabetes Mellitus”. The research documents in which “Honey” and “Diabetes Mellitus” were debated are included. After screening, we reviewed 66 papers and finally we selected 35 studies which met the inclusion criteria and the remaining documents were excluded. Results This study investigated the preclinical, clinical, human and animal model studies on honey and diabetes mellitus and found that honey decreases the fasting serum glucose, increases the sting C-peptide and 2-h postprandial C-peptide. Although, there is a dearth of data and literature also contrary discussed the use of honey in diabetic patients. Conclusion Honey decreases the fasting serum glucose, increases fasting C-peptide and 2-h postprandial C-peptide. Honey had low glycemic index and peak incremental index in diabetic patients. The use of honey in diabetic patients still has obstacles and challenges and needs more large sample sized, multi-center clinical controlled studies to reach better conclusions.

When asked about the GI familiarity, the standard of education, the relationships between diseases and GI, the diabetes group was better able to answer correctly than the other groups. However, the diabetes group showed either no difference or less correct responses for general knowledge of GI. With respect to their usual consideration and low GI dietary practice, the diabetes group provided higher responses than the other groups. On the whole, the diabetes group was better than the other groups for GI relative factor but none of the groups showed high levels for perspective, education, dietary practice of GI.

The ketogenic diet is a high-fat, low-carbohydrate, and restricted protein diet that is useful in patients with refractory epilepsy. The efficacy of the ketogenic diet is better than most of the new antiepileptic drugs. Other modifications of the diet are also beneficial, such as the modified Atkins diet and the low glycemic index treatment. There is a lack of awareness of the ketogenic diet as a treatment modality for epilepsy amongst pediatricians and neurologists. In this review, the use of the ketogenic diet and other dietary treatments in refractory epilepsy is discussed. The Indian experience with the use of these dietary treatments is also briefly reviewed.

Buckwheat represents araw material interesting in term of its nutritional and health beneficial suitability. Buckwheat grain is asource of valuable proteins, starch with low glycemic index or high amount of unsaturated fatty acids. It contains compounds with prophylactic value, too. Buckwheat is one of the richest sources of flavonoids. The highest content of dietary fibre is in bran fraction, where it counts for 40 %. Present phytosterols are usefull in lowering blood cholesterol. Buckwheat is better source of magnesium, potassium, phosphorus, zinc, manganese and copper than other cereals. Among vitamins the most abundant is pyridoxin. Buckwheat is effective in management of many diseases, mainly cardiovascular and digestion disorders, cancer, diabetes and obesity. In the last decades buckwheat is an interesting material not only for development of new functional foods, but for the preparation of concentrates with healing buckwheat components, too.doi:10.5219/206

The use of dietary treatments for epilepsy (ketogenic, modified Atkins, and low glycemic index diets) has been in continuous use since 1921. These treatments have been well studied in the short term, with approximately half of children having at least a 50% reduction in seizures after 6 months. Approximately one third will attain >90% reduction in their seizures. Animal studies confirm these findings, with broad evidence demonstrating acute anticonvulsant effects of the diet. Furthermore, the diet appears to maintain its efficacy in humans when provided continuously for several years. Interestingly, benefits may be seen long term even when the diet is discontinued after only a few months of use, suggesting neuroprotective effects. This potential antiepileptogenic activity has been recently demonstrated in some animal studies as well. This review discusses the animal and human evidence for both short- and long-term benefits of dietary therapies.

Despite the substantial efficacy of the ketogenic diet (KD) in treating refractory epilepsy, use of the KD remains limited because of difficulties in implementation and tolerability. An effective alternative dietary approach is a low glycemic index treatment (LGIT), which liberalizes the extreme carbohydrate restriction of the KD but restricts the type of carbohydrate-containing foods to those that produce relatively small changes in blood glucose. Foods with a "glycemic index" of less than 50 produce less than half the area-under-the-curve elevation of blood glucose compared to a reference food. The LGIT approach produces comparable efficacy to the classic KD, but tolerability is improved and implementation is much simpler. The LGIT appears to be a viable first-line dietary therapy for epilepsy.

Diabetes continues to be an overwhelmingly prevalent disease worldwide, and its occurrence continues to increase. It is well established that medical nutrition therapy is effective for glycemic control, but the exact diet recommended to diabetics remains unknown. The relatively new glycemic index (GI) and the low-glycemic index (LGI) diets are gaining momentum, but their place in diabetic therapy continues to be controversial. This article presents a review of the current literature on the LGI diet and its relation to glycemic control in diabetics. There is ample evidence that the LGI diet significantly improves glycemic control in diabetics, but there is also much criticism. Nurse practitioners need to educate themselves on the GI concept and the LGI diet to educate patients and accurately identify who will most benefit from the LGI diet.

As Western populations age, the burden of associated chronic diseases, including diabetes, cardiovascular disease (CVD), and cancer will increase dramatically. In the United States in the next 50 years, it is projected that the percentage of adults with type 2 diabetes will exceed 30%, with the vast majority older than 65 years. It is therefore important to determine the best possible dietary and lifestyle modifications to prevent and control this disease and its associated complications. Although few data are available regarding the optimal nutritional regimen for the elderly with type 2 diabetes, as a general rule, the use of nutrient-dense, low glycemic index, high-dietary fiber foods with possibly higher protein intake is recommended.

A sixty-six year-old patient with liver cirrhosis and diabetes was nutritionally treated by administration of the low glycemic index liquid food (Inslow) as a late evening sack (LES) for 6 weeks. The mean energy intake increased from 825+/-48 kcal/d to 1567+/-66 kcal/d after the 6-week treatment period. The fasting glucose level did not change, remaining at about 100 mg/dl throughout this period. Interestingly, the amount of insulin administered was reduced from 38 units before treatment to 28 units in the fifth week of treatment without a change in the fasting glucose level. This indicates a marked improvement in insulin sensitivity due to Inslow administration in this patient. In conclusion, the long-term administration of Inslow as an LES may be an effective treatment for cirrhotic patients.

Aims: Larger glycemic excursions are linked to greater oxidative stress and low GI diets have been shown to improve glycemic control. We therefore assessed the effect of a low glycemic index (GI) d...

The present study investigated the effect of the glycemic index of an evening meal on responses to a standard high glycemic index (HGI) breakfast the following morning. The metabolic responses to exercise 3 h after breakfast were also investigated. Seven active males completed 2 trials. In each trial, participants were provided with an evening meal on day 1, which was composed of either HGI or LGI (high or low glycemic index) carbohydrates. On day 2, participants were provided with a standard HGI breakfast and then performed a 60 min run at 65% VO2max 3 h later. Plasma glucose and serum insulin concentrations following breakfast were higher in the HGI trial compared to the LGI trial (P < 0.05). During exercise, there were no differences in substrate utilization. The results suggest that consuming a single LGI evening meal can improve glucose tolerance at breakfast but the metabolic responses to subsequent exercise were not affected.

Background.— The prevalence of overweight children is increasing. Experimental evidence and specialty clinic trials suggest that a low glycemic index (LGI) diet could be an effective primary care–based treatment for overweight children. Objective.— Conduct a pilot study to determine whether parents of overweight children can lower the glycemic index (GI) of their child's diet after receiving brief instructions and a handout from their pediatrician; and the diet's impact on body mass index (BMI). Patients.— Children 5–12 years with BMIs greater than the 95th percentile. Intervention.— Brief description of the LGI diet and a handout categorizing foods based on their GI and sample meals. Design.— Nonrandomized, 12-week pilot study. Measures.— BMI, 24-hour recall, and food frequency questionnaire (FFQ) at entry; 3-day food records at 3, 6, and 9 weeks; BMI, FFQ, and questionnaire at 12 weeks. A GI score derived from standard GI tables. Results.— Of 34 children initially enrolled, 15 completed the study. Of these, 14 lowered their GI score (mean initial score=26.6; mean score at 12 weeks 15.6; P P P Conclusion.— This pilot study suggests that implementing the LGI diet is feasible in primary care for some patients. Further study is warranted with larger study and comparison groups.

Summary Retrospective chart review of 15 patients with tuberous sclerosis complex (TSC) who initiated the low glycemic index treatment (LGIT) for epilepsy management at Massachusetts General Hospital over a five-year period. Prior to dietary therapy, this cohort (average age: 8.5 years) had tried an average of 5.8 anti-epileptic drugs with incomplete seizure control. At 6 months on the LGIT, 7/15 (47%) patients experienced >50% reduction in seizure frequency.