Efficacy of different fibres and flour mixes in South-Asian flatbreads for reducing post-prandial glucose responses in healthy adults

Hanny M Boers, Katrina MacAulay, Peter Murray, Jack Seijen Ten Hoorn, Anne-Roos Hoogenraad, Harry P F Peters, Maria A M Vente-Spreeuwenberg, David J Mela, Hanny M Boers, Katrina MacAulay, Peter Murray, Jack Seijen Ten Hoorn, Anne-Roos Hoogenraad, Harry P F Peters, Maria A M Vente-Spreeuwenberg, David J Mela

Abstract

Purpose: Type 2 diabetes (T2DM) is increasing, particularly in South-East Asia. Intake of high-glycaemic foods has been positively associated with T2DM, and feasible routes to reduce the glycaemic response to carbohydrate-rich staple foods are needed. The research question was whether different fibre and legume flour mixes in flatbreads lower postprandial glucose (PPG) responses.

Methods: Using a balanced incomplete block design, we tested the inclusion of guar gum (GG), konjac mannan (KM) and chickpea flour (CPF) in 10 combinations (2/4/6 g GG; 2/4 g KM; 15 g CPF, and 10 or 15 g CPF plus 2 or 4 g GG) in 100 g total of a control commercial high-fibre flatbread flour mix ("atta") on PPG in 38 normal-weight adults. Self-reported appetite was an additional exploratory outcome. An in vitro digestion assay was adapted for flatbreads and assessed for prediction of in vivo PPG.

Results: Flatbreads with 6 g GG, 4 g KM, and 15 g CPF plus 2 or 4 g GG reduced PPG ≥30 % (p < 0.01), while no other combinations differed significantly from the control. A statistical model with four in vitro parameters (rate of digestion, %RDS, AUC, carbohydrate level) was highly predictive of PPG results (adjusted R 2 = 0.89). Test products were similar to the control for appetite-related measures.

Conclusions: The results confirm the efficacy of specific additions to flatbread flour mixes for reducing PPG and the value of the in vitro model as a predictive tool with these ingredients and product format. This trial is registered at ClinicalTrials.gov with identifier NCT02671214.

Keywords: Appetite; Atta; Glycaemic response; In vitro digestion; Viscous fibre.

Conflict of interest statement

Conflict of interest

All authors are employees of Unilever, which manufactures and markets consumer food products, including the flour used for the flatbreads in this study.

Ethical standards

This human study has been approved by the East Kent Local Research Committee (UK), and therefore, the study was conducted according to the principles of Good Clinical Practice, the Declaration of Helsinki (2008) and applicable local laws and regulations concerning studies conducted on human subjects, not testing a medical product or device. Each participant provided written informed consent prior to his/her inclusion in the study.

Figures

Fig. 1
Fig. 1
Flow diagram of participants throughout the study
Fig. 2
Fig. 2
Effect of flatbreads consumption with different amounts of viscous fibres and legume flour on postprandial glucose (mean ± SEM) (HFF high-fibre flatbread control). a Effect of flatbread consumption with different amounts of guar gum on postprandial plasma glucose (mean ± SEM) (HFF high-fibre flatbread control). b Effect of flatbread consumption with different amounts of chickpea flour (15 g) without or with guar gum on postprandial plasma glucose (mean ± SEM) (HFF high-fibre flatbread control). c Effect of flatbread consumption with different amounts of konjac mannan on postprandial plasma glucose (mean ± SEM) (HFF high-fibre flatbread control). d Effect of flatbread consumption with chickpea flour (10 g) and different amounts of guar gum on postprandial plasma glucose (mean ± SEM) (HFF high-fibre flatbread control)
Fig. 3
Fig. 3
Percentage change (mean ± SEM) in PPG (+iAUC2hr) of flatbreads with different amounts of viscous fibres and/or legume flour and p value for change relative to the control flatbread without additions of viscous fibres or legume flour
Fig. 4
Fig. 4
Observed in vivo response (+iAUC) for postprandial plasma glucose response versus the value predicted based on in vitro data (statistical model as described in text and Online Resource). HFF high-fibre flour (control), CPF chickpea flour, GG guar gum and KM konjac mannan

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