Reducing Post Meal Glucose Levels With Complementary Foods

One of the most important aspects of managing diabetes is preventing postprandial hyperglycemia, which is an exaggerated blood sugar response following a meal. In general, the glycemic load (GL) gives a good idea of the glucose response that will occur after eating a given amount of a particular food. The GL is calculated by multiplying the glycemic index of a food by the amount of carbohydrate. So for example eating two large grapefruit (GI of 25 and 50g of carbs) would effect blood sugar levels in a similar way to eating one banana (GI of 50 and 25g of carbs).

The idea of complementary foods is a relatively new concept in diabetes management and it refers to certain foods, that when consumed in conjunction with a traditionally high GL meal, help reduce the exaggerated glucose response that would normally occur. Some of these complementary foods are discussed in detail below.

Cinnamon

A 2007 study, published in the American Journal of Clinical Nutrition looked at the effects of the addition of 6g of cinnamon to 300g of rice pudding in 14 healthy volunteers. The researchers found that the addition of cinnamon significantly reduced the blood glucose response to the meal as measured by the 2 hour area under the curve (AUC). The one hour and two hour blood glucose responses were 51.3% and 46.1% lower respectively in the cinnamon supplemented meal. Some of the improvement in glycemic response was due to a slight reduction in gastric emptying rate (37% in the control group vs 34.5% in the cinnamon group).

A second study found similar benefits from regular cinnamon supplementation. The 2003 study, which appears in Diabetes Care, a journal published by the American Diabetes Association, found that the addition of 1, 3, or 6 grams of cinnamon every day for 40 days resulted in significant fasting blood glucose and lipid profile improvements in a group of 60 type-2 diabetics. The researchers concluded that: “Because cinnamon would not contribute to caloric intake, those who have type 2 diabetes or those who have elevated glucose, triglyceride, LDL cholesterol, or total cholesterol levels may beneļ¬t from the regular inclusion of cinnamon in their daily diet.”

The mechanisms by which cinnamon improves glycemic control are not fully understood however cinnamon is believed to improve the function of the insulin receptor, which plays a keep role in the regulation of glucose levels. Cinnamon also contains MHCP, a phytochemical that in one laboratory study was shown to increase the metabolism of glucose by fat cells 20-fold.

Pectin And Vegetable Gums

Pectin, vegetable gums, and other forms of dietary fiber are indigestible and are therefore a great way to add bulk to a meal without increasing the amount of calories. This helps promote satiety (the feeling of fullness after a meal) and delays gastric emptying. Pectin and vegetable gums easily dissolve in water and leave no after taste. A few teaspoons of powdered pectin or gum is a great way to thicken casseroles, sauces, and dressings without increasing the caloric content.

A study, conducted in 1977 by researchers from the Medical Research Council Gastroenterology Unit, Central Middlesex Hospital, London, found that the addition of both guar gum and pectin to meals significantly reduced postprandial insulin and glucose levels. The additon of guar gum to a liquid test meal reduced blood glucose levels 30 minutes after the meal from an average of 114 mg/dL to 86 mg/dL. A second test, involving a breakfast of butter and marmalade on bread, produced glucose levels 15 minutes after the meal of 111 mg/dL however this was reduced to 102 mg/dL on the addition of 10g of pectin to the marmalade.

Vinegar

Numerous studies have found improvements in postprandial glycemia following vinegar supplementation. A Swedish study, published in the European Journal of Clinical Nutrition in 1998, looked at the effects of vinegar supplementation on postprandial glucose levels following a meal consisting of 122g of white bread, 23g of cheese and 8g of olive oil. The researchers found that the addition of 20g of white vinegar to the meal reduced the postprandial glucose response by 36%.

A second study, also published in the European Journal of Clinical Nutrition, found that pre-boiled potatoes, cooled overnight and served with a vinaigrette sauce containing 28g of vinegar, had a 43% lower glycemic index compared to freshly boiled potatoes not served with vinegar.

Finally, a study conducted by researchers at the Department of Nutrition at Arizona State University, found that the addition of either vinegar or a small amount of peanuts halved the 60-minute glucose response to both a high GL and medium GL test meal. Furthermore, after consumption of the high GL meal, energy consumption throughout the remainder of the day was around 200 to 275 kcal lower when the meal was consumed with either peanuts or vinegar suggesting that the two products increased satiety levels.

Almonds And Other Nuts

A 2007 study, published in the journal Metabolism found that the addition of 30g, 60g, or 90g of almonds to a high GI meal of white bread reduced postprandial glycemia in a dose dependant manner. The addition of 90g of almonds reduced the post meal glycemic response by 58% compared to white bread by itself.

A second study looked at the effects of a single serving of almonds (28g) added to a breakfast meal of bagel, juice, and butter in a group of 19 adults, including 7 type-2 diabetics. Although the almonds didn’t significantly affect the glucose response in healthy individuals, the diabetic group achieved a 30% reduction in postprandial glucose levels.

Frequent nut consumption (including peanuts), has also been shown to substantially reduce the risk of developing diabetes. A 2002 study, published in the Journal of the American Medical Association, found that consumption of 5 servings of nuts (including peanuts) a week reduced the risk of type-2 diabetes in women by 27% while 5 servings or more of peanut butter a week reduced diabetes risk by 21% compared to women who rarly or never consumed peanut butter.