title: Effect of cereal test breakfasts differing in glycemic index and content of indigestible carbohydrates on daylong glucose tolerance in healthy subjects.
abstract: BACKGROUND
  Frequent hyperglycemic episodes are increasingly being associated with an increased risk of type 2 diabetes and cardiovascular disease.
  
  
  OBJECTIVE
  We studied the extent to which acute glycemia and glycemia after subsequent meals can be modulated by the characteristics of cereal foods, such as glycemic index (GI) and content of indigestible carbohydrates.
  
  
  METHODS
  Twelve healthy subjects consumed test meals in a random order. In series 1, the test meals were consumed at breakfast, and postprandial blood glucose incremental areas under the curve (IAUCs) were calculated after the test breakfast, standardized lunch, and standardized dinner. In series 2, the subjects consumed test evening meals and IAUCs were calculated after a subsequent standardized breakfast. Breath hydrogen was measured as an indicator of colonic fermentation.
  
  
  RESULTS
  Barley or rye kernel breakfasts lowered the blood glucose IAUC (0-120 min) at breakfast, at a subsequent lunch, and the cumulative IAUCs (breakfast+lunch+dinner) when compared with white-wheat bread (P < 0.05). The lunch blood glucose IAUCs were positively correlated with breakfast IAUCs (r = 0.30, P < 0.05). Breath hydrogen excretion was negatively correlated with blood glucose IAUCs after lunch (r = -0.33, P < 0.05) and dinner (r = -0.22, P < 0.05). A barley kernel evening meal resulted in lower IAUCs (P < 0.05) and higher breath hydrogen (P < 0.001) after a subsequent breakfast compared with white-wheat bread.
  
  
  CONCLUSIONS
  Glucose tolerance at subsequent meals can be notably improved during the course of a whole day or overnight by choosing specific low-GI, whole-grain cereal products. A low GI may be sufficient to achieve a second-meal effect from breakfast to lunch. A specific indigestible carbohydrate mixture appears to be required to show benefits on glucose tolerance in a longer time frame (9.5 h), most likely mediated through colonic fermentation.
authors.affiliation: Division of Applied Nutrition and Food Chemistry, Department of Food Technology, Engineering and Nutrition, Lund University, Sweden. anne.nilsson@inl.lth.se
authors.forename: Anne C
authors.initials: AC
authors.lastname: Nilsson
authors.forename: Elin M
authors.initials: EM
authors.lastname: Ostman
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Granfeldt
authors.forename: Inger M E
authors.initials: IM
authors.lastname: Björck
mesh_terms: D000328:Adult; D019540:Area Under Curve; D001786:Blood Glucose / Q000378:metabolism*; D001944:Breath Tests; D003106:Colon / Q000378:metabolism / Q000382:microbiology; D018592:Cross-Over Studies; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000378:metabolism*; D004043:Dietary Fiber / Q000008:administration & dosage / Q000378:metabolism*; D004063:Digestion; D004305:Dose-Response Relationship, Drug; D002523:Edible Grain; D005260:Female; D005285:Fermentation; D038321:Glycemic Index; D001467:Hordeum; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D008297:Male; D012434:Secale; D012995:Solubility; D018709:Statistics, Nonparametric
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004043:Dietary Fiber