The Effects Of Specially Processed Mixed-Whole Grains Cereal On Glycemic Index (GI) In Healthy Korean: A Clinical Trial

Background and Objective: The implementation of effective dietary strategies is important for diabetes management.Recent studies have reported that concept of Glycemic Index(GI)has a positive effect on the management of diabetes.Moreover,Whole grain intake is inversely associated with risk of diabetes.Findings from previous studies consistently support that increasing consumption of whole grain is suitable for the prevention of diabetes and management of diabetes as dietary therapy.This study was aimed to demonstrate the nutritional advantages of specially processed mixed-whole grains cereal(SPMWGC),which is,improved the digestion and nutrition absorption and also to evaluate its effects on blood glucose and Glycemic Index(GI)when consumed.Methods: The subjects voluntarily consented to take part in this clinical trial after they were explained all the aims and procedures of this trial.A sample size of 10 adult individuals(five healthy Korean males and five healthy Korean females)has been chosen based on the results of the screening test: The average age at baseline was 28.4y for the males and 25.6y for the females.Screening tests were carried out before the initial start of the experiment having results as follows: 1)Weight ? 50 kg,Ideal Body Weight(IBW)of ± 30%,2)Non diabetic patients,Fasting Blood Glucose(FBS)<100mg/dl,2hr Postprandial Glucose(PP2)<140mg/dl,AST(aspartate aminotransferase)10-40IU/L,ALT(alanine aminotransaminase)6-40IU/L,TotalCholesterol?200mg/dl.Participants‘ fasting capillary blood samples were collected 30 min and 0 min before consumption of the reference food(-30 min,0min)after a 12 hour overnight fast.These two results were then compared;they are rescheduled for another session,if the difference between the two glucose levels were ? 48)2)/(97).The subjects were then given edible glucose reference and whole grains cereal reference containing 50 grams of available carbohydrate with 250 ml water over 4 weeks on a weekly frequency.In the first two weeks the subjects were given edible glucose exclusively and the only cereals were consumed for the remaining two weeks.To evaluate blood glucose level,blood samples were collected before food consumption and after at 15,30,45,60,90 and 120 min interval.The blood glucose was measured twice using blood glucose monitor(ACCU-CHEK,Roche,Swiss).The average blood glucose was hence calculated from the two values.The statistical significance of the mean blood glucose levels in the two different groups was obtained by T test.Separate T-test analyses were carried out for male and female subjects.To evaluate cereal reference we gathered Average under the Curve(AUC),Mean AUC and Standard Deviation(S.D)of AUC and Coefficient of Variation(C.V)of AUC.Cereal reference analyzed GI of Subject,Mean GI,S.D of GI and C.V GI.The blood glucose levels for both genders were complied using T Test.To evaluate GI of both the cereal reference and in the subjects,AUC,Mean AUC,S.D AUC and C.V AUC were calculated.According to Wolever,more accurate results will be obtained using the Incremental Area Under the Cure(iAUC)and is the most commonly used and recommended by ?Food and Agriculture Organization(1998)‘.All the GI data collected in this trial has been obtained using the method mentioned above.Results: From the data collected,we can observe that there were significant differences between the two test meals results,with a constant decline in postprandial glucose level in both the male and the female subjects.The average of both reference foods postprandial glucose were 132mg/dl(edible glucose),124mg/dl(whole grains cereal)in 15 min,155mg/dl,140mg/dl in 30 min,159 mg/dl,137mg/dl in 45 min,147mg/dl,122mg/dl in 60 min,113mg/dl,101mg/dl in 90 min and 88.9mg/dl,95.35mg/dl in 120 min.The highest blood glucose value for glucose reference food was recorded at 45 min postprandial showing value of 152.80mg/dl in male and 165.20mg/dl in females whereas,the highest blood glucose value for whole grains cereals was recorded at 30 min postprandial having peak value of 134.80mg/dl in males and 145.60mg/dl in females.This shows that there is a 15 min delay between the peak times of each reference food.T-test comparing 15,30,45,60,90 and 120 postprandial glucose level between edible glucose and whole grains cereal.Compared to edible glucose,the postprandial glucose of whole grains cereal produced a significantly lower glucose level in 30min(P=0.047),45min(P=0.001)and 60min(P=0.004).The reduction rate of iAUC in males was 40% compared to 38% in females.The Glycemic Index(GI)of the specially processed mixed whole grains cereal is 60.48,which is generally considered as ?Medium Glycemic Index? and includes 25.76g/100 g fiber and 1.2g/100 g sugar(very low).Conclusion: This study proves that specially processed mixed whole grains cereal which is,low-carbohydrate food can reduces excessive insulin secretion;prevents postprandial glucose to increase rapidly and also reduces the risk of hyperglycemia.Therefore,we can conclude that SPMWGC is beneficial for the prevention and treatment of Hyperglycemia.Also,a possible positive outcome can be expected through deeper research by carrying out systematic clinical trial on diabetes patients with impaired insulin secretion.Moreover,additional practical application methods of SPMWGC and watersoluble dietary fiber are essential for the management of diabetes in clinical settings.Using GI and increased consumption of whole grains might be beneficial for the prevention and control of diabetes.