A single supplement of a standardised bilberry (Vaccinium myrtillus L.) extract (36 % wet weight anthocyanins) modifies glycaemic response in individuals with type 2 diabetes controlled by diet and lifestyle

Nigel Hoggard, Morven Cruickshank, Kim-Marie Moar, Charles Bestwick, Jens J Holst, Wendy Russell, Graham Horgan, Nigel Hoggard, Morven Cruickshank, Kim-Marie Moar, Charles Bestwick, Jens J Holst, Wendy Russell, Graham Horgan

Abstract

Dietary strategies for alleviating health complications associated with type 2 diabetes (T2D) are being pursued as alternatives to pharmaceutical interventions. Berries such as bilberries (Vaccinium myrtillus L.) that are rich in polyphenols may influence carbohydrate digestion and absorption and thus postprandial glycaemia. In addition, berries have been reported to alter incretins as well as to have antioxidant and anti-inflammatory properties that may also affect postprandial glycaemia. The present study investigated the acute effect of a standardised bilberry extract on glucose metabolism in T2D. Male volunteers with T2D (n 8; BMI 30 (sd 4) kg/m(2)) controlling their diabetes by diet and lifestyle alone were given a single oral capsule of either 0·47 g standardised bilberry extract (36 % (w/w) anthocyanins) which equates to about 50 g of fresh bilberries or placebo followed by a polysaccharide drink (equivalent to 75 g glucose) in a double-blinded cross-over intervention with a 2-week washout period. The ingestion of the bilberry extract resulted in a significant decrease in the incremental AUC for both glucose (P = 0·003) and insulin (P = 0·03) compared with the placebo. There was no change in the gut (glucagon-like peptide-1, gastric inhibitory polypeptide), pancreatic (glucagon, amylin) or anti-inflammatory (monocyte chemotactic protein-1) peptides. In addition there was no change in the antioxidant (Trolox equivalent antioxidant capacity, ferric-reducing ability of plasma) responses measured between the volunteers receiving the bilberry extract and the placebo. In conclusion the present study demonstrates for the first time that the ingestion of a concentrated bilberry extract reduces postprandial glycaemia and insulin in volunteers with T2D. The most likely mechanism for the lower glycaemic response involves reduced rates of carbohydrate digestion and/or absorption.

Keywords: AUCi, incremental AUC; Anthocyanins; Bilberries; FRAP, ferric-reducing ability of plasma; GIP, gastric inhibitory polypeptide; GLP-1, glucagon-like peptide-1; Glycaemic response; MCP-1, monocyte chemotactic protein-1; OGTT, oral glucose tolerance test; T2D, type 2 diabetes; TEAC, Trolox equivalent antioxidant capacity; Type 2 diabetes.

Figures

Fig. 1.
Fig. 1.
(a) Plasma incremental glucose concentrations following consumption of a glucose load with either a single placebo control () or bilberry (Vaccinium myrtillus L.) extract () capsule. (b) Incremental AUC (AUCi) from 0 to 300 min, 0 to 60 min and 60 to 300 min for plasma glucose concentrations under the control (■) and bilberry extract () conditions. Values are means for eight subjects, with standard errors represented by vertical bars. Mean value was significantly different from that for the bilberry extract: *P < 0·05, **P < 0·01.
Fig. 2.
Fig. 2.
(a) Plasma incremental insulin concentrations following consumption of a glucose load with either a single placebo control () or bilberry (Vaccinium myrtillus L.) extract () capsule. (b) Incremental AUC (AUCi) from 0 to 300 min, 0 to 60 min and 60 to 300 min for plasma insulin concentrations under the control (■) and bilberry extract () conditions. Values are means for eight subjects, with standard errors represented by vertical bars. * Mean value was significantly different from that for the bilberry extract (P < 0·05).
Fig. 3.
Fig. 3.
Plasma incremental concentrations of (a) gastric inhibitory polypeptide (GIP), (b) glucagon-like peptide-1 (GLP-1), (c) glucagon and (d) amylin from 0 to 300 min following consumption of a glucose load with either a single placebo control () or bilberry (Vaccinium myrtillus L.) extract () capsule. Values are means for eight subjects, with standard errors represented by vertical bars.
Fig. 4.
Fig. 4.
Plasma concentrations for (a) monocyte chemotactic protein-1 (MCP-1), (b) ferric-reducing ability of plasma (FRAP) and (c) Trolox equivalent antioxidant capacity (TEAC) from 0 to 300 min following consumption of a glucose load with either a single placebo control () or bilberry (Vaccinium myrtillus L.) extract () capsule. Values are means for eight subjects, with standard errors represented by vertical bars.

References

    1. Ceriello A & Testa R (2009) Antioxidant anti-inflammatory treatment in type 2 diabetes. Diabetes Care 32, Suppl. 2, S232–S236
    1. Zafra-Stone S, Yasmin T, Bagchi M, et al. (2007) Berry anthocyanins as novel antioxidants in human health and disease prevention. Mol Nutr Food Res 51, 675–683
    1. Tsuda T (2008) Regulation of adipocyte function by anthocyanins; possibility of preventing the metabolic syndrome. J Agric Food Chem 56, 642–646
    1. Neto CC (2007) Cranberry and blueberry: evidence for protective effects against cancer and vascular diseases. Mol Nutr Food Res 51, 652–664
    1. Basu A, Du M, Leyva MJ, et al. (2010) Blueberries decrease cardiovascular risk factors in obese men and women with metabolic syndrome. J Nutr 140, 1582–1587
    1. Stull AJ, Cash KC, Johnson WD, et al. (2010) Bioactives in blueberries improve insulin sensitivity in obese, insulin-resistant men and women. J Nutr 140, 1764–1768
    1. Karlsen A, Paur I, Bøhn SK, et al. (2010) Bilberry juice modulates plasma concentration of NF-κB related inflammatory markers in subjects at increased risk of CVD. Eur J Nutr 49, 345–355
    1. Prior RL, Wilkes SE, Rogers TR, et al. (2010) Purified blueberry anthocyanins and blueberry juice alter development of obesity in mice fed an obesogenic high-fat diet. J Agric Food Chem 58, 3970–3976
    1. DeFuria J, Bennett G, Strissel KJ, et al. (2009) Dietary blueberry attenuates whole-body insulin resistance in high fat-fed mice by reducing adipocyte death and its inflammatory sequelae. J Nutr 139, 1510–1516
    1. Prior RL, Wu X, Gu L, et al. (2008) Whole berries versus berry anthocyanins: interactions with dietary fat levels in the C57BL/6J mouse model of obesity. J Agric Food Chem 56, 647–653
    1. Guo H, Li D, Ling W, et al. (2011) Anthocyanin inhibits high glucose-induced hepatic mtGPAT1 activation and prevents fatty acid synthesis through PKCζ. J Lipid Res 52, 908–922
    1. Jayaprakasam B, Olson LK, Schutzki RE, et al. (2006) Amelioration of obesity and glucose intolerance in high-fat-fed C57BL/6 mice by anthocyanins and ursolic acid in Cornelian cherry (Cornus mas). J Agric Food Chem 54, 243–248
    1. Welsch CA, Lachance PA & Wasserman BP (1989) Dietary phenolic compounds: inhibition of Na+-dependent d-glucose uptake in rat intestinal brush border membrane vesicles. J Nutr 119, 1698–1704
    1. Matsui T, Tanaka T, Tamura S, et al. (2007) α-Glucosidase inhibitory profile of catechins and theaflavins. J Agric Food Chem 55, 99–105
    1. Hanamura T (2006) Antihyperglycemic effect of polyphenols from acerola (Malpighia emarginata DC.) fruit. Biosci Biotechnol Biochem 70, 1813–1820
    1. Hanamura T, Hagiwara T & Kawagishi H (2005) Structural and functional characterization of polyphenols isolated from acerola (Malpighia emarginata DC.) fruit. Biosci Biotechnol Biochem 69, 280–286
    1. Iwai K, Kim M, Onodera A, et al. (2006) α-Glucosidase inhibitory and antihyperglycemic effects of polyphenols in the fruit of Viburnum dilatatum Thunb. J Agric Food Chem 54, 4588–4592
    1. Kobayashi Y, Suzuki M, Satsu H, et al. (2000) Green tea polyphenols inhibit the sodium-dependent glucose transporter of intestinal epithelial cells by a competitive mechanism. J Agric Food Chem 48, 5618–5623
    1. Song J, Kwon O, Chen S, et al. (2002) Flavonoid inhibition of sodium-dependent vitamin C transporter 1 (SVCT1) and glucose transporter isoform 2 (GLUT2), intestinal transporters for vitamin C and glucose. J Biol Chem 277, 15252–15260
    1. Cermak R, Landgraf S & Wolffram S (2004) Quercetin glucosides inhibit glucose uptake into brush-border-membrane vesicles of porcine jejunum. Br J Nutr 91, 849–855
    1. Johnston K, Sharp P, Clifford M, et al. (2005) Dietary polyphenols decrease glucose uptake by human intestinal Caco-2 cells. FEBS Lett 579, 1653–1657
    1. Matsui T, Ebuchi S, Kobayashi M, et al. (2002) Anti-hyperglycemic effect of diacylated anthocyanin derived from Ipomoea batatas cultivar Ayamurasaki can be achieved through the α-glucosidase inhibitory action. J Agric Food Chem 50, 7244–7248
    1. Törrönen R, Sarkkinen E, Tapola N, et al. (2010) Berries modify the postprandial plasma glucose response to sucrose in healthy subjects. Br J Nutr 103, 1094–1097
    1. Wilson T, Singh AP, Vorsa N, et al. (2008) Human glycemic response and phenolic content of unsweetened cranberry juice. J Med Food 11, 46–54
    1. Orskov C, Rabenhoj L, Wettergren A, et al. (1994) Tissue and plasma concentrations of amidated and glycine-extended glucagon-like peptide I in humans. Diabetes 43, 535–539
    1. Benzie IF & Strain JJ (1996) The ferric reducing ability of plasma (FRAP) as a measure of “antioxidant power”: the FRAP assay. Anal Biochem 239, 70–76
    1. Dragsted LO, Pedersen A, Hermetter A, et al. (2004) The 6-a-day study: effects of fruit and vegetables on markers of oxidative stress and antioxidative defense in healthy nonsmokers. Am J Clin Nutr 79, 1060–1072
    1. Törrönen R, Kolehmainen M, Sarkkinen E, et al. (2012) Postprandial glucose, insulin, and free fatty acid responses to sucrose consumed with blackcurrants and lingonberries in healthy women. Am J Clin Nutr 96, 527–533
    1. Johnston KL, Clifford MN & Morgan LM (2002) Possible role for apple juice phenolic compounds in the acute modification of glucose tolerance and gastrointestinal hormone secretion in humans. J Sci Food Agric 82, 1800–1805
    1. Törrönen R, Sarkkinen E, Niskanen T, et al. (2012) Postprandial glucose, insulin and glucagon-like peptide 1 responses to sucrose ingested with berries in healthy subjects. Br J Nutr 107, 1445–1451
    1. Panee J (2012) Monocyte chemoattractant protein 1 (MCP-1) in obesity and diabetes. Cytokine 60, 1–12
    1. Adisakwattana S, Ngamrojanavanich N, Kalampakorn K, et al. (2004) Inhibitory activity of cyanidin-3-rutinoside on α-glucosidase. J Enzyme Inhib Med Chem 19, 313–316
    1. Akkarachiyasit S, Yibchok-Anun S, Wacharasindhu S, et al. (2011) In vitro inhibitory effects of cyandin-3-rutinoside on pancreatic α-amylase and its combined effect with acarbose. Molecules 16, 2075–2083
    1. Adisakwattana S, Charoenlertkul P & Yibchok-Anun S (2009) α-Glucosidase inhibitory activity of cyanidin-3-galactoside and synergistic effect with acarbose. J Enzyme Inhib Med Chem 24, 65–69
    1. Buchert J, Koponen JM, Suutarinen M, et al. (2005) Effect of enzyme-aided pressing on anthocyanin yield and profiles in bilberry and blackcurrant juices. J Sci Food Agric 85, 2548–2556
    1. Schäfer A & Högger P (2007) Oligomeric procyanidins of French maritime pine bark extract (Pycnogenol®) effectively inhibit α-glucosidase. Diabetes Res Clin Pract 77, 41–46
    1. Kumar S, Narwal S, Kumar V, et al. (2011) α-Glucosidase inhibitors from plants: a natural approach to treat diabetes. Pharmacogn Rev 5, 19–29
    1. Cai H, Thomasset SC, Berry DP, et al. (2011) Determination of anthocyanins in the urine of patients with colorectal liver metastases after administration of bilberry extract. Biomed Chromatogr 25, 660–663
    1. Cooke DN, Thomasset S, Boocock DJ, et al. (2006) Development of analyses by high-performance liquid chromatography and liquid chromatography/tandem mass spectrometry of bilberry (Vaccinium myrtilus) anthocyanins in human plasma and urine. J Agric Food Chem 54, 7009–7013
    1. Levin RJ (1994) Digestion and absorption of carbohydrates – from molecules and membranes to humans. Am J Clin Nutr 59, Suppl. 3, 690S–698S
    1. Määttä-Riihinen KR, Kamal-Eldin A, Mattila PH, et al. (2004) Distribution and contents of phenolic compounds in eighteen Scandinavian berry species. J Agric Food Chem 52, 4477–4486
    1. Määttä-Riihinen KR, Kamal-Eldin A & Törrönen AR (2004) Identification and quantification of phenolic compounds in berries of Fragaria and Rubus species (family Rosaceae). J Agric Food Chem 52, 6178–6187
    1. Mattila P, Hellström J & Törrönen R (2006) Phenolic acids in berries, fruits, and beverages. J Agric Food Chem 54, 7193–7199
    1. Wood PJ (2007) Cereal β-glucans in diet and health. J Cereal Sci 46, 230–238
    1. Thom E (2007) The effect of chlorogenic acid enriched coffee on glucose absorption in healthy volunteers and its effect on body mass when used long-term in overweight and obese people. J Int Med Res 35, 900–908
    1. Johnston KL, Clifford MN & Morgan LM (2003) Coffee acutely modifies gastrointestinal hormone secretion and glucose tolerance in humans: glycemic effects of chlorogenic acid and caffeine. Am J Clin Nutr 78, 728–733

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit