title: Inconsistency between glycemic and insulinemic responses to regular and fermented milk products.
abstract: BACKGROUND
  Foods with a low glycemic index are increasingly being acknowledged as beneficial in relation to the insulin resistance syndrome. Certain organic acids can lower the glycemic index of bread products. However, the possible effect of acids in fermented milk products on the glycemic index and on insulinemic characteristics has not been addressed. The metabolic effects of fermented milk or pickled products used as additives to mixed meals have also not been addressed.
  
  
  OBJECTIVE
  One objective was to characterize the glycemic and insulinemic responses after intake of regular or fermented milk products (study 1). In addition, the acute metabolic effect of fermented milk (yogurt) and pickled cucumber as supplements to a traditional breakfast based on a high-glycemic index bread was evaluated (study 2).
  
  
  METHODS
  Ten healthy volunteers were served different breakfast meals after an overnight fast. Capillary blood samples were collected before and during 2 (study 1) or 3 (study 2) h after the meal. White-wheat bread was used as a reference meal in both studies.
  
  
  RESULTS
  The lactic acid in the fermented milk products did not lower the glycemic and insulinemic indexes. Despite low glycemic indexes of 15-30, all of the milk products produced high insulinemic indexes of 90-98, which were not significantly different from the insulinemic index of the reference bread. Addition of fermented milk (yogurt) and pickled cucumber to a breakfast with a high-glycemic index bread significantly lowered postprandial glycemia and insulinemia compared with the reference meal. In contrast, addition of regular milk and fresh cucumber had no favorable effect on the metabolic responses.
  
  
  CONCLUSIONS
  Milk products appear insulinotropic as judged from 3-fold to 6-fold higher insulinemic indexes than expected from the corresponding glycemic indexes. The presence of organic acids may counteract the insulinotropic effect of milk in mixed meals.
authors.affiliation: Department of Applied Nutrition and Food Chemistry, Center for Chemistry and Chemical Engineering, Lund University, Sweden. elin.ostman@inl.lth.se
authors.forename: E M
authors.initials: EM
authors.lastname: Ostman
authors.forename: H G
authors.initials: HG
authors.lastname: Liljeberg Elmståhl
authors.forename: I M
authors.initials: IM
authors.lastname: Björck
mesh_terms: D000328:Adult; D000818:Animals; D019540:Area Under Curve; D001786:Blood Glucose / Q000378:metabolism*; D001939:Bread; D003611:Dairy Products; D004040:Dietary Carbohydrates / Q000494:pharmacology*; D005260:Female; D005285:Fermentation; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D019344:Lactic Acid / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D008892:Milk
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D007328:Insulin; D019344:Lactic Acid