Download Effect of low glycaemic index diets on satiety

Survey
yes no Was this document useful for you?
   Thank you for your participation!

* Your assessment is very important for improving the work of artificial intelligence, which forms the content of this project

Document related concepts

Food politics wikipedia, lookup

Gastric bypass surgery wikipedia, lookup

Food studies wikipedia, lookup

Calorie restriction wikipedia, lookup

Abdominal obesity wikipedia, lookup

Academy of Nutrition and Dietetics wikipedia, lookup

Thrifty gene hypothesis wikipedia, lookup

Obesogen wikipedia, lookup

Low-carbohydrate diet wikipedia, lookup

Epidemiology of metabolic syndrome wikipedia, lookup

Obesity and the environment wikipedia, lookup

Human nutrition wikipedia, lookup

DASH diet wikipedia, lookup

Food choice wikipedia, lookup

Diet-induced obesity model wikipedia, lookup

Nutrition wikipedia, lookup

Childhood obesity in Australia wikipedia, lookup

Dieting wikipedia, lookup

Transcript
British Food Journal
Effect of low glycaemic index diets on satiety
Sonia Maria de Medeiros Batista Emilia Addison Machado Moreira Giovanna Medeiros Rataichesck Fiates
Maria Alice Altemburg de Assis Evanilda Teixeira
Article information:
Downloaded by UFSC At 19:47 17 March 2016 (PT)
To cite this document:
Sonia Maria de Medeiros Batista Emilia Addison Machado Moreira Giovanna Medeiros Rataichesck Fiates
Maria Alice Altemburg de Assis Evanilda Teixeira , (2014),"Effect of low glycaemic index diets on satiety",
British Food Journal, Vol. 116 Iss 8 pp. 1233 - 1246
Permanent link to this document:
http://dx.doi.org/10.1108/BFJ-08-2012-0208
Downloaded on: 17 March 2016, At: 19:47 (PT)
References: this document contains references to 75 other documents.
To copy this document: [email protected]
The fulltext of this document has been downloaded 181 times since 2014*
Users who downloaded this article also downloaded:
Corrado Finardi, Gianluca Tognon, (2014),"“Is ‘junk food’ an ‘healthy’ concept?” the challenges of the
current debate: From policy making back to science", British Food Journal, Vol. 116 Iss 8 pp. 1222-1232
http://dx.doi.org/10.1108/BFJ-06-2013-0155
Lynn J. Frewer, David Coles, Louis-Marie Houdebine, Gijs A. Kleter, (2014),"Attitudes towards genetically
modified animals in food production", British Food Journal, Vol. 116 Iss 8 pp. 1291-1313 http://
dx.doi.org/10.1108/BFJ-08-2013-0211
Arun Micheelsen, Lotte Holm, Katherine O’Doherty Jensen, (2014),"Living with the New Nordic Diet", British
Food Journal, Vol. 116 Iss 8 pp. 1247-1258 http://dx.doi.org/10.1108/BFJ-03-2013-0058
Access to this document was granted through an Emerald subscription provided by emerald-srm:478417 []
For Authors
If you would like to write for this, or any other Emerald publication, then please use our Emerald for
Authors service information about how to choose which publication to write for and submission guidelines
are available for all. Please visit www.emeraldinsight.com/authors for more information.
About Emerald www.emeraldinsight.com
Emerald is a global publisher linking research and practice to the benefit of society. The company
manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as
providing an extensive range of online products and additional customer resources and services.
Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee
on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive
preservation.
*Related content and download information correct at time of download.
The current issue and full text archive of this journal is available at
www.emeraldinsight.com/0007-070X.htm
Effect of low glycaemic index
diets on satiety
Sonia Maria de Medeiros Batista,
Emilia Addison Machado Moreira,
Giovanna Medeiros Rataichesck Fiates,
Maria Alice Altemburg de Assis and Evanilda Teixeira
Nutrition Department, Postgraduate Program in Nutrition,
Federal University of Santa Catarina, Florianopolis, Brazil
Low glycaemic
index diets
1233
Received 23 August 2012
Revised 14 August 2013
Accepted 22 August 2013
Downloaded by UFSC At 19:47 17 March 2016 (PT)
Abstract
Purpose – The purpose of the paper is to determine the effects of a hypocaloric diet with a
low-glycaemic index (GI) on weight loss and postprandial blood glucose and assess both the satiety
and palatability of the diet.
Design/methodology/approach – A clinical trial was conducted with ten women (mean age:
38.8711.3 years; body mass index: 27.273.5 kg/m2) submitted to a hypocaloric diet, assessments
were performed at baseline and after seven days of treatment.
Findings – Significant reductions were found in body weight (1.170.7 kg; p ¼ 0.001), triccipital
skinfold (2.8773.24 mm; p ¼ 0.021) and waist circumference (3.674.8 cm; p ¼ 0.041). Mean fasting
and postprandial blood glucose values were 88.776.1 mg/dL and 91.679.6 mg/dL, respectively.
Responses regarding satiety and palatability of the low-GI diet were predominantly “extremely
satisfied” and “I liked it very much,” respectively, for all meals and throughout all seven days of
the study.
Originality/value – The present study demonstrated the benefits of a low-GI diet with regard to
weight loss, blood glucose control and satiety. The diet proved to be palatable, which could favor
compliance with long-term treatment.
Keywords Adult, Low-glycaemic index diet, Palatability, Satiety, Weight loss
Paper type Research paper
Introduction
The glycaemic index (GI) is an indicator of the ability of carbohydrates (50 g) in a given
food to elevate postprandial blood glucose in comparison to a reference food, glucose or
white bread (Food and Agriculture Organization and World Health Organization
(FAO/WHO), 1998). The presence of soluble fiber, degree of food processing and
starch-protein and starch-fat interactions are among the factors that can affect the GI
( Jenkins et al., 1981).
The GI was initially proposed to control blood glucose in patients with diabetes
(Pi-Sunyer, 2005; Lin et al., 2010). For such, foods with a high GI (X70) should be
replaced with foods with a GI of p55 (low GI) (Brand-Miller and Foster-Powell, 2003).
Diets with a moderate to high GI are reported to increase body weight (Beulens et al.,
2007; Ding and Malik, 2008). While the American Diabetes Association (ADA) (2012)
recommends considering both the type and amount of carbohydrates in the diet of
The authors are grateful to the professors of the Sensory Analysis Laboratory of the Department
of Food Science and Technology of the Federal University of Santa Catarina (Brazil) for financial
support in the purchasing of the foods used in the diet analyzed and the volunteers who
participated in this study.
British Food Journal
Vol. 116 No. 8, 2014
pp. 1233-1246
r Emerald Group Publishing Limited
0007-070X
DOI 10.1108/BFJ-08-2012-0208
BFJ
116,8
Downloaded by UFSC At 19:47 17 March 2016 (PT)
1234
individuals with diabetes, a number of researchers have reaffirmed the contribution of
the GI for controlling weight (Sampaio et al., 2007; Ding and Malik, 2008; Brand-Miller
et al., 2009; Youn et al., 2012).
The lipid content is another important aspect to consider in dietary planning,
as the proportion of fat contributes to the daily caloric intake as well as the amount
of carbohydrates and/or protein. The lipid content also affects the palatability and
variety of foods. Thus, certain diets can be monotonous, which hampers compliance
with treatment and long-term weight loss (Rolls et al., 2005, 2007). An adequate balance
in the chemical composition of a diet is fundamental to the treatment of obesity (WHO,
2000; ADA, 2012). Diets with a low energy density (Food and Agriculture Organization,
1997) and adequate satiety and palatability lead to gradual weight loss (Sampaio et al.,
2007). Such diets also lead to an improvement in insulin resistance, which is generally
high in obese individuals due to the greater number of adipocytes (Lara-Castro and
Garvey, 2004; Kahn et al., 2006; Karpe et al., 2011). Given the benefits of low-GI
diets for patients with type II diabetes, cardiovascular disease and obesity,
the scientific community has been proposing strategies that contribute in reducing
the risk of such diseases (Thondre and Henry, 2011). The role of the food industry in
developing palatable foods with low GI must be recognized (Hall et al., 2005;
Brand-Miller et al., 2012).
Recommendations of several international organizations have also been
proposing the use of GI when planning diets for people with diabetes (Diabetes
and Nutrition Study Group (DNSG, 2000); Wolever et al., 2000; Connor et al., 2003,
ADA, 2008, Diabetes Australia (DA), 2012/2013), the description of GI values in food
labels (Henry et al., 2007), and development of food guides that offer guidance about
the inclusion low-GI foods in people’s daily meals (DA, 2012/2013, Canadian Diabetes
Association (CDA), 2013).
The aims of the present study were to determine the effects of a hypocaloric diet
with a low GI on weight loss and postprandial blood glucose and assess both the
satiety and palatability of the diet.
Materials and methods
Study design
A clinical trial was conducted at the Sensory Analysis Laboratory of the Food Science
and Technology Department of the Federal University of Santa Catarina (Brazil), with
assessments performed at baseline and after seven days of treatment. This study
received approval from the Human Research Ethics Committee of the university
( process number 094/04) and was carried out in compliance with the Declaration
of Helsinki of the World Medical Association (2008). All participants were aware
of the objectives and procedures of the study and agreed to participate by signing
a statement of informed consent.
Subjects
Ten women (mean age: 38.8711.3 years; mean body mass index (BMI): 27.27
3.5 kg/m2) were selected through convenience sampling following a verbal invitation to
participate voluntarily in the study. The following inclusion criteria were considered:
excess weight (BMI between 25 and 35 kg/m2) and fasting blood glucose between 70
and 100 mg/dL). The following exclusion criteria were considered: infectious disease,
cardiovascular disease, diabetes mellitus, neurological disease, kidney failure, current
pregnancy or nursing, current smoking habit, high-impact physical activity, use of
Downloaded by UFSC At 19:47 17 March 2016 (PT)
drugs that modify food intake or eating behavior (antidepressant, appetite suppressor)
and use of anti-inflammatory or antibiotic agents (except oral birth control medication)
in previous six months.
Anthropometric evaluation
Anthropometric measurements were performed by a registered dietitian based on the
recommendations of the World Health Organization WHO (1995). Body weight was
assessed on a balance-beam platform scale (Martes SM 160, SP, Brazil) to the nearest
50 g. Stature was measured with a stadiometer (Alturaexatas, Belo Horizonte, MG,
Brazil) to the nearest 0.01 m. Arm circumference (AC) and waist circumference (WC)
were measured with an non-elastic 150 cm tape measure. Triceps skinfold (TSF) was
measured using a Lang Skinfold Calipers (Beta Technology, Santa Cruz, CA, USA).
Cut-off points for AC and TSF were established by gender and age (Frisancho, 1981)
and the cutoff point for WC was based on recommendations stated by the WHO (2000).
Nutritional status was categorized by the BMI (kg/m2) based on recommendations
stated by the WHO (2006).
Diet
The low-GI diet studied (55) was manufactured by Substâncias Foods (Porto Alegre,
RS, Brazil) (Foster-Powell et al., 2002). Meal distribution was planned as follows:
breakfast, mid-morning snack, lunch, afternoon snack, dinner and bedtime snack.
Except for dinner and bedtime snack, the remaining meals were all ingested at the
Sensory Analysis Laboratory of the Federal University of Santa Catarina. The mean
(7SD) caloric content of the diet was 1,130790 kcal, with the following chemical
composition (g7SD: 140.077.0 g of carbohydrates (49.372.4 percent), 70.073.8 g
of proteins (24.971.2 percent), 30.078.0 g of fat (25.875.9 percent) and 26.471.7 g of
fiber (USP), 2006. Foods and mixed dishes consumed at each meal are described below.
Breakfast: coffee with skim milk, linseeds, whole-grain bread, white cheese, lean ham
or muffin (oatmeal, honey and whole-grain flour). Morning snack: fruit (orange,
banana, pear, apple or peach). Lunch and dinner: raw vegetables (lettuce, tomatoes,
carrots, beets), cooked vegetables (carrots, spinach, broccoli, eggplant), rice and
legumes (beans, peas or lentils) or whole-grain pasta, beef, chicken or fish. Afternoon
snack and bedtime snack: cereal bar, yogurt, whole-grain bread and white cheese.
The meals were thawed in a microwave oven (Consul Facilite Middis 18L, Manaus,
AM, Brazil) just prior to eating. The foods were cleaned at the Sensory Analysis
Laboratory of the university and stored at 201C (Consuls S~ao Paulo, SP, Brazil) until
served. The vegetables were served either raw or cooked and the fruits were served
“in natura.”
Assessment of fasting and postprandial blood glucose
Blood collection was performed when the women were not menstruating. Blood
glucose was determined after ten hours of fasting at baseline and at the end of the
study. Postprandial blood glucose was determined two hours after breakfast, lunch and
dinner every day, with the subsequent calculation of the mean value. Blood was
collected from the index finger of the right hand through a perforation with the aid of
an automatic lancet with a disposable tip (Accu-Check Active, Roches Diagnostics
GmbH, Mannheim, Germany). Blood glucose was evaluated using a specific reagent
strip and portable blood glucose reader (Accu-Check Active, Roches Diagnostics
GmbH, Mannheim, Germany) (FAO/WHO, 1998).
Low glycaemic
index diets
1235
BFJ
116,8
Downloaded by UFSC At 19:47 17 March 2016 (PT)
1236
Assessment of satiety and palatability
The perception of satiety and palatability was assessed based on the method
described by Holt et al. (1995) immediately following breakfast, lunch and dinner
throughout the seven days of the study. A seven-point visual analog scale was used,
with the terms “extremely hungry” and “extremely satisfied” at the two ends of the
scale for the determination of satiety and the terms “I liked it very much” and
“I disliked it very much” at the two ends of the scale for the determination of
palatability.
Statistical analysis
The results were expressed as mean7standard deviation (SD) of the mean. The
paired Student’s t-test was used to determine differences in weight, WC and fasting
blood glucose between baseline and the final evaluation. Postprandial blood glucose
was compared between the first and second days as well as the first and fourth days
of the study. The Wilcoxon test was used to determine differences in satiety and
palatability among the different days of the study. The level of significance was set
to 5 percent ( po0.05). The Statistical Package for the Social Sciencess (SPSS Inc.,
2006, Chicago, IL, USA) for Windows (version 16.0) was employed for the data
analysis.
Findings
Mean age (7SD) of the participants was 38.8711.3 years (range: 23-50 years). Initial
mean weight was significantly higher than mean weight at the end of the study
(67.4711.3 kg and 66.3711.0, respectively) ( p ¼ 0.001), with a mean weight loss of
1.170.7 kg. Mean initial BMI (7SD) was higher than the final BMI (28.1273.50 kg/m2
and 27.9573.69 kg/m2, respectively), but this difference did not achieve statistical
significance ( p ¼ 0.375). Mean initial TSF (7SD) was significantly higher than the
final mean TSF (22.6576.78 mm and 19.7876.25, respectively) ( p ¼ 0.021). Mean
initial WC (7SD) was significantly higher than final WC (86.70711.69 cm and
83.05708.64 cm, respectively) ( p ¼ 0.041). No statistically significant difference was
found in mean AC between the baseline and final evaluations (31.8073.39 cm and
30.1172.47 cm, respectively) ( p ¼ 0.046).
Mean fasting blood glucose (7SD) was similar at baseline and at the end of the
study (88.776.0 mg/dL and 86.975.6, respectively ( p ¼ 0.343), ranging from 75 mg/dL to
91 mg/dL. Postprandial blood glucose (7SD) was also in the normal range (below 140
mg/dL) throughout the study (mean: 91.679.6 mg/dL; range: 115 mg/dL to 77 mg/dL)
(Table I).
Variables
Mean7SD
Baseline fasting blood glucose
Final fasting blood glucose
Postprandial blood glucose – Day
Postprandial blood glucose – Day
Postprandial blood glucose – Day
Postprandial blood glucose – Day
88.776.0
86.975.6
88.678.8
89.8712.7
94.579.7
93.577.3
1
2
4
7
p
0.343a
0.761b
Table I.
0.062c
Comparative analysis of
0.048d
fasting and postprandial
blood glucose at baseline Notes: a ¼ (baseline vs final); b ¼ (Day1 vs Day 2); c ¼ (Day 1 vs Day 4); d ¼ (Day 1 vs Day 7).
and at the end of the study Wilcoxon test
Downloaded by UFSC At 19:47 17 March 2016 (PT)
Responses regarding satiety after the three meals were predominantly “extremely
satisfied” and “satisfied” throughout the seven days of the study. Two participants
reported being “hardly satisfied” after breakfast on Days 2 and 6, and one
participant reported feeling “a little hungry” after breakfast on Day 4. One of
the participants reported being “hardly satisfied” after lunch on Days 4, 5 and 6.
One participant reported feeling “partially satisfied” and another reported feeling
“a little hungry” after dinner on Day 1; one reported feeling “a little hungry” on Days 3
and 6; and one participant reported feeling “hungry” and another reported feeling
“a little hungry” after dinner on Day 7. No statistically significant differences in satiety
were found among the six times of the day at which the participants had meals or
snacks throughout the study (Figure 1).
Responses regarding the palatability of the meals were predominantly “I liked it
very much” and “I liked it” for all meals throughout the seven days of the study.
A statistically significant difference in palatability was found for breakfast between
Days 1 and 4. Palatability of the lunch was significantly higher on Day 1 in comparison
to Days 6 and 7. Statistically significant differences in the palatability of dinner were
found between Days 1 and 5, Days 1 and 6 and Days 4 and 6. There were no responses
of “I disliked it very much” or “I disliked it” for any of the meals throughout the entire
seven days of the study (Figure 2).
Discussion
The hypocaloric diet with a low GI contributed to weight loss at the end of the study.
Similar findings were reported in a study involving ten individuals, in which two
diets were analyzed over a 12-month period: one with a low GI and another with only
a reduced lipid content. The reduction in calories was not restricted and the results
demonstrated that the low-GI group achieved a greater reduction in BMI and
percentage of body mass than the group with reduced fat intake alone (Ebbeling et al.,
2003). Other recent studies comparing the effects of low- and high-GI diets on body
weight reported that a low-GI diet contributes to weight loss, greater satiety
and lower postprandial blood glucose (Perälä et al., 2011; Youn et al., 2012; Dong
et al., 2012).
A significant reduction in WC was found after seven days of consuming the low-GI
diet. This is an important finding, as a higher WC is risk factor for the development
of cardiovascular disease and type 2 diabetes mellitus (FAO/WHO, 1998; Pitanga
and Lessa, 2005; Rosini et al., 2006). Previous studies reported similar findings
in adults without diabetes (McMillan-Price et al., 2006), diabetic adults (Karter et al.,
2005; Schulz et al., 2006; Hare-Bruun et al., 2006; Jiménez-Cruz et al., 2005; Rosini et al.,
2006) and obese adolescents (Buyken et al., 2001) due either to the effect of the
low GI alone or the fact that the majority of such foods have a high-fiber content
(Sartorelli and Cardoso, 2006).
Fasting and postprandial blood glucose remained below 100 mg/dL among all
participants throughout the entire study, which is similar to findings reported in
previous studies (Bellisle et al., 2007; Esposito et al., 2010; Perälä et al., 2011). This may
be due to the predominance of low-GI foods (fiber-rich whole grains), despite the
ingestion of foods with a medium to high GI. The predominance of foods with a low GI
lowers the GI of the overall diet, thereby slowing the increase in postprandial blood
glucose (Batista et al., 2007; Gellar and Nansel, 2009; Perälä et al., 2011; Brand-Miller
et al., 2012). The FAO/WHO (1998) recommend balanced dietary planning with regard
to the GI for better control and prevention of chronic diseases. Reduced frequency of
Low glycaemic
index diets
1237
1238
(a)
10
No. of participants
BFJ
116,8
8
6
4
2
0
Day 1
Day 2
Day 3
Day 4
No particular feeling
Satisfied
Day 5
Day 6
Day 7
Partially satisfied
Extremely satisfied
(b)
Downloaded by UFSC At 19:47 17 March 2016 (PT)
No. of participants
10
8
6
4
2
0
Day 1
Day 2
Partially satisfied
No. of participants
(c)
Day 3
Day 4
Satisfied
Day 5
Day 6
Day 7
Extremely satisfied
10
8
6
4
2
0
Day 1
Figure 1.
Satiety after breakfast,
lunch and dinner
throughout the study
Day 2
Day 3
Day 4
Day 5
Day 6
Hungry
Partially hungry
Partially satisfied
Satisfied
Day 7
Extremely satisfied
Notes: (a) Distribution of participants according to satiety after breakfast; (b) distribution
of participants according to satiety after lunch; and (c) distribution of participants
according to satiety after dinner
consumption of high GI foods and their substitution for low GI ones has been
a recommended strategy in order to reduce the meals’ GI and consequently achieve
the health benefits proportioned by low-GI foods, according to the CDA (2013). The
scientific community has published works with the aim of alerting government
agencies for the need of planning public policies regarding the practical use of GI in
individuals’ food plans, and the inclusion of GI values on food labels. Countries
that already adopt this strategy are Canada, Australia, UK, China and the USA
Low glycaemic
index diets
1239
8.0
Day 1
Palatability scale
Downloaded by UFSC At 19:47 17 March 2016 (PT)
(Thondre and Henry, 2011). Researchers have also been investing in divulging the
benefits of low-GI foods publishing books to the general population, that include
orientation about foods’ GI, recommended frequency of ingestion and recipes that can
improve palatability and increase satiety (Brand-Miller et al., 2003). In Brazil, some
studies have determined the GI of typical foods, listing 41 of them in the Brazilian Food
Composition Table (USP, 2000), and exploring their benefit in the prevention of chronic
non-transmissible diseases (Menezes et al., 1996, 2002, 2009, 2011). Some low-GI foods
that have been studied are “carioca” beans (GI 38), rice and beans (GI 55), chickpea
(GI 24), apple (GI 25), banana (GI 27), manioc (GI 40), manioc flour (GI 52), oat flakes
(GI 39), corn on the cob (IG 55) (TACO/USP, 1998; Menezes et al., 1996). Thus, foods
with a high GI do not need to be excluded from the diet, but rather consumed as part
of a diet in which the total caloric intake allows a lower and gradual blood
glucose response.
Ludwig et al. (1999) compared three types of low-calorie meals made up of foods
with low, medium and high GIs and found an 81 percent increase in calorie intake
following a meal with a high GI in comparison to meals with a medium or low GI.
In studies carried out to assess the association between weight and foods with a low
GI in Mexico, one investigation found reductions in body weight, total cholesterol and
low-density lipoproteins among a group of volunteers over a three-week period
( Jiménez-Cruz et al., 2003) and another investigation found a reduction in body
weight and an increase in satiety among a groups of adults evaluated on a single
occasion ( Jiménez-Cruz et al., 2005). Other studies confirm these findings and report
that foods with a predominance of carbohydrates with a low GI have a greater effect
on reducing one’s appetite, with a consequent reduction in calorie intake (Burani
and Longo, 2006; McMillan-Price and Brand-Miller, 2006; Nilsson et al., 2008;
Sieri et al., 2010).
Greater loss of adiposity and body weight among adults on a low-GI diet
associated with a lesser sensation of hunger and/or greater satiety is reported to be
due to the lesser calorie intake (Ebbeling et al., 2003; Hare-Bruun et al., 2006). Warren
et al. (2003) studied the effect of GI on satiety analyzing three meals involving
foods with different GIs (55, 75 and 100) and found that the calorie intake in the
following meal was lower after a meal with a low GI in comparison to a meal with
a high GI. In another study, lower calorie intake was found at a time following the
ingestion of a low-GI diet in comparison to a high-GI diet; in the comparison of two
different types of muffins (one with a low GI and one with a high GI), lower blood
glucose responses and greater satiety were found after the ingestion of the muffins
Day 2
Day 3
6.0
Day 4
Day 5
Day 6
Day 7
4.0
A
B
C
D
E
F
G
Volunteers
H
I
J
Figure 2.
Distribution of
participants according
to palatability of the
diet throughout the
seven days of the study
BFJ
116,8
Downloaded by UFSC At 19:47 17 March 2016 (PT)
1240
with a low GI (Quilez et al., 2007). The choice of a low-GI diet over a high-GI diet is
a strategy that benefits health, as such foods enhance satiety and reduce both hunger
and voluntary ingestion. There is a consensus among researchers that a change
in eating behavior can lead to a reduction in the risk of overweight and obesity
as well as the consequences of these conditions, such as type 2 diabetes mellitus
(McMillan-Price et al., 2006; Esposito et al., 2010; Louie et al., 2012).
Quite satisfactory results were achieved with regard to palatability, as responses
of “I like it very much” and “I like it” predominated throughout the study. Palatability
was directly associated with satiety, for which responses of “extremely satisfied”
and “satisfied” predominated. The composition of the diet was similar from day to day,
with the maintenance of the same percentage of macronutrients and calories. These
data are in agreement with those reported in previous studies, which also
demonstrated satisfactory satiety when diets offered the same caloric density and
palatability, suggesting that calorie intake is influenced more by the caloric density
of the diet than its chemical composition (McCrory et al., 2006; Rumpler et al., 2006).
Regarding the influence of chemical components on palatability, studies have
shown that individuals have a lesser sensation of hunger, lower calorie intake and
greater satiety after ingesting protein in comparison to the ingestion of carbohydrates
and lipids (Maarmonier et al., 2000; Hermsdorff et al., 2007).
Rumpler et al. (2006) report findings similar to those described in other studies,
supporting the hypothesis that foods with a low GI have a positive effect on satiety,
allow greater postprandial blood glucose control, assist in reducing body weight
and also exhibit a high degree of palatability (Bao et al., 2011; Brand-Miller et al.,
2012). The main characteristics of foods with a low GI are low calorie density and
high-fiber and protein content (Holt et al., 2001; Pai et al., 2005; Jiménez-Cruz et al.,
2005; Feskens and Du, 2006; Beulens et al., 2007; Sampaio et al., 2007).
Several factors contribute to the different findings found in the assessment of
the effects of diet on satiety and appetite, such as palatability, the composition of
macronutrients, energy density and the volume of food offered. However, conflicting
findings are reported in investigations regarding the influence of macronutrients
on calorie intake and the GI of foods ( Jiménez-Cruz et al., 2005; Bellisle et al., 2007;
Yeomans and Chambers, 2011).
Conclusion and practical implications
The foods that made up the meals of the diet evaluated in the present study are
easily found in the market and most of them are part of the Brazilian eating
habits. This favors the development of public policies that stimulate the consumption
of such foods to prevent and control the occurrence of non-transmissible chronic
diseases in the general population. In the long run, such policies could positively
affect people’s life quality. From a clinical standpoint, the diet’s palatability could
favor compliance with treatment aimed at weight reduction and long-term follow up.
Study’s participants could experience aspects that contradict myths regarding “weight
loss diets.” They showed good compliance to the non-restrictive dietetic plan proposed
during the seven consecutive days. Brazilian public policies could emphasize the
importance of ingesting accessible low-GI foods such as the ones mentioned in this
manuscript. The government could also sponsor research to determine GI values
of other foods usually ingested, promoting a healthier diet and better quality of life
for the individuals.
References
American Diabetes Association (2008), “Nutrition recommendations and interventions for
diabetes a position statement of the American Diabetes Association”, Diabetes Care,
Vol. 31, No. 1, pp. 561-578.
American Diabetes Association (ADA) (2012), “Executive summary: standards of medical care
in diabetes-2012”, Diabetes Care, Vol. 35 No. 1, pp. S4-S8.
Bao, J., Atkinson, F., Petocz, P., Willet, W.C. and Brand-Miller, J.C. (2011), “Prediction of
postprandial glycemia and insulinemia in lean, young, healthy adults: glycemic load
compared with carbohydrate content alone”, American Journal of Clinical Nutrition,
Vol. 93 No. 5, pp. 984-996.
Downloaded by UFSC At 19:47 17 March 2016 (PT)
Batista, S.M.M., Assis, M.A.A., Teixeira, E. and Damian, C. (2007), “Avaliac¸~ao da resposta
glicemica, saciedade e palatabilidade apos o consumo de dietas de alto e baixo ı́ndice
glicemico”, Alimentos e Nutric¸~
ao, Vol. 18 No. 3, pp. 315-323.
Bellisle, F., Dalix, A.M., De Assis, M.A.A., Kupek, E., Gerwig, U., Slama, G. and Oppert, J.M.
(2007), “Motivational effects of 12-week moderately restrictive diets with or without special
attention to the Glycaemic Index of foods”, British Journal of Nutrition, Vol. 97 No. 4,
pp. 790-798.
Beulens, J.W.J., Bruijne, L.M., Stolk, R.P., Peeters, P.H.M., Bots, M.L. and De Van Der, S.Y.T. (2007),
“High dietary glycemic load and glycemic index increase risk of cardiovascular disease
among middle-aged women”, J Am Coll Card, Vol. 50 No. 1, pp. 14-21.
Brand-Miller, J.C. and Foster-Powell, K. (2003), “Glycemic load and chronic disease”, Nutrition
Reviews, Vol. 61 No. S5, pp. S56-S60.
Brand-Miller, J.C., McMillan-Price, J., Steinbeck, K. and Caterson, I. (2009), “Dietary glycemic
index: health implications”, Journal of the American College of Cardiology, Vol. 28,
Supplement, pp. 446S-449S.
Brand-Miller, J.C., Atkinson, F.S., Gahler, R.J., Kacinik, V., Lyom, M.R. and Wood, S. (2012),
“Effects of added PGXRs, a novel functional fibre, on the glycemic index of starchy
foods”, British Journal of Nutrition, Vol. 108 No. 2, pp. 245-248.
Brand-Miller, J., Wolever, T.M.S., Foster-Powel, K. and Colagiuri, S. (2003), The New Glucose
Revolution: The Authoritative Guide to the Glycemic Index, Marlowe & Company,
New York, NY.
Burani, J. and Longo, P.J. (2006), “Low-glycemic index carbohydrates an effective behavioral
change for glycemic control and weight management in patients with type 1 and 2
diabetes”, Diabetes Education, Vol. 32 No. 1, pp. 78-88.
Buyken, A.E., Toeller, M., Heitkamp, G., Karamanos, B., Rottiers, R., Muggeo, M. and
Fuller, J.H. (2001), “Glycemic index in the diet of European outpatients with type 1 diabetes:
relations to glycated hemoglobin and serum lipids”, American Journal of Clinical
Nutrition, Vol. 73 No. 3, pp. 574-581.
Canadian Diabetic Association (CDA) (2013), “Clinical practice guidelines expert
committee”, Dworatzek, P.D., Arcudi, K., Gougeon, R., Husein, N., Sievenpiper, J.L.
and Williams, S.L., “Nutrition Therapy”. Canadian Journal of Diabetes, Vol. 37 No. 1,
pp. 45-55.
Connor, H., Annan, F., Bunn, E., Frost, G., McGough, N., Sarwar, T., Thomas, B. and Nutrition
Subcommittee of the Diabetes Care Advisory Committee of Diabetes UK (2003), “The
implementation of nutritional advice for people with diabetes”, Diabetic Medicine, Vol. 20
No. 10, pp. 786-807.
Low glycaemic
index diets
1241
BFJ
116,8
Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study
of Diabetes (EASD) (2000), “Recommendations for the nutritional management of
patients with diabetes mellitus”, European Journal of Clinical Nutrition, Vol. 54 No. 4,
pp. 353-355.
Diabetes Australia (2012/2013), Diabetes Management in General Practice, 8th ed., Canberra,
available at: www.diabetesaustralia.com.au (accessed 6 May 2014).
1242
Ding, E.L. and Malik, V.S. (2008), “Convergence of obesity and high glycemic diet on
compounding diabetes and cardiovascular risks modernizing China: an emerging public
health dilemma”, Globalization and Health, Vol. 4 No. 4, pp. 1-8.
Dong, J.Y., Zhang, Y.H., Wang, P. and Qin, L.Q. (2012), “Meta-analysis of dietary glycemic
load and glycemic index in relation to risk of coronary heart disease”, American Journal of
Cardiology, Vol. 109 No. 11, pp. 1608-1613.
Downloaded by UFSC At 19:47 17 March 2016 (PT)
Ebbeling, C.B., Leidig, M.M., Sinclair, K.B., Hangen, J.P. and Ludwig, D.S. (2003),
“A reduced-glycemic load diet in the treatment of adolescent obesity”, Archives of
Pediatrics and Adolescent, Vol. 157 No. 8, pp. 773-779.
Esposito, K., Maiorino, M.I., Di Palo, C. and Giugliano, D. (2010), “Dietary glycemic index and
glycemic load are associated with metabolic control in type 2 diabetes: the CAPRI
Experience”, Metabolic Syndrome and Relat Disorders, Vol. 8 No. 3, pp. 1-8.
Feskens, E.J.M. and Du, H. (2006), “Dietary glycaemic index from an epidemiological point of
view”, International Journal of Obesity, Vol. 30 No. S3, pp. S66-S71.
Frisancho, A.R. (1981), “New norms of upper limb fat and muscle areas for assessment of
nutritional status”, American Journal of Clinical Nutrition, Vol. 34 No. 11, pp. 2540-2545.
Food and Agriculture Organization (1997), “Carbohydrates in human nutrition”, Report of a joint
FAO/WHO Expert Consultation and Carbohydrates, FAO, Rome, April 14-18.
FAO/WHO (1998), “Food and Agriculture Organization/World Health Organization”,
Carbohydrates in Human Nutrition, Report of a joint FAO/WHO Expert Consultation
and Carbohydrates, FAO/WHO, Rome.
Foster-Powell, K., Holt, S.H.A. and Brand-Miller, J.C. (2002), “International table of glycemic index
and glycemic load values: 2002”, American Journal of Clinical Nutrition, Vol. 76 No. 1,
pp. 5-56.
Gellar, L. and Nansel, T.R. (2009), “High and low glycemic index mixed meals and blood glucose
in youth with type 2 diabetes or impaired glucose tolerance”, Journal of Pediatics, Vol. 154
No. 3, pp. 455-458.
Hall, R.S., Johnson, S.K., Baxter, A.L. and Ball, M.J. (2005), “Lupin kernel fibre-enriched foods
beneficially modify serum lipids in men”, European Journal of Clinical Nutrition, Vol. 59,
No. 3, pp. 325-333.
Hare-Bruun, H., Flint, A. and Heitmann, B.L. (2006), “Glycemic index and glycemic
load in relation to changes in body weight, body fat distribution, and body
composition in adult Danes1’2’3”, American Journal of Clinical Nutrition, Vol. 84 No. 4,
pp. 871-879.
Henry, C.J.K., Lightowler, H.J., Strik, C.M., Renton, H. and Hails, S. (2007), “Glycaemic index and
glycaemic load values of commercially available products in the UK”, British Journal of
Nutrition, Vol. 94 No. 6, pp. 922-930.
Hermsdorff, H.M., Volp, H.P., Carolina, A. and Bressan, J. (2007), “O perfil de macronutrientes
influencia a termogenese induzida pela dieta e a ingestao calorica”, Archivos
Latinoamericanos de Nutricion, Vol. 57 No. 1, pp. 33-42.
Holt, S.H.A., Brand-Miller, J.C. and Stitt, P.A. (2001), “The effect of equal-energy portions of
different breads on blood glucose levels, feelings of fullness and subsequent food intake”,
Journal of American Dietetic Association, Vol. 101 No. 7, pp. 767-773.
Low glycaemic
index diets
Holt, S.H.A., Brand-Miller, J.C., Petocz, P. and Farmakalidis, E. (1995), “A satiety index of common
foods”, European Journal of Clinical Nutrition, Vol. 49 No. 9, pp. 675-690.
Jenkins, D.J., Wolever, T.M., Taylor, R.H., Barker, H., Fielden, H., Baldwing, J.,
Bowlig, A., Newman, H., Jenkins, A. and Goff, D. (1981), “Glycemic index of foods:
a physiological basis for carbohydrate exchange”, American Journal of Clinical Nutrition,
Vol. 34 No. 3, pp. 363-366.
Downloaded by UFSC At 19:47 17 March 2016 (PT)
Jimenez-Cruz, A., Gutierrez-Gonzalez, A.N. and Gascon-Bacardi, M. (2005), “Low glycemic index
lunch on satiety in overweight and obese people with type 2 diabetes”, Nutricion
Hospitalaria, Vol. 20 No. 5, pp. 348-350.
Jimenez-Cruz, A., Gascon-Bacardi, M., Turnbull, W.H., Rosales-Garaes, P. and Severino-Lugo, I.
(2003), “Flexible, low glycemic index Mexican style diet in overweight and obese with type
2 diabetes improves metabolic parameters during a 6-week treatment period”, Diabetes
Care, Vol. 26 No. 7, pp. 1967-1970.
Kahn, S.E., Hull, R.L. and Utzschneider, K.M. (2006), “Mechanisms linking obesity to insulin
resistance and type 2 diabetes”, Nature, Vol. 444 No. 7121, pp. 840-846.
Karpe, F., Dickmann, J.R. and Frayn, K.N. (2011), “Fatty acids, obesity, and insulin resistance:
time for a reevaluation”, Diabetes, Vol. 60 No. 10, pp. 2441-2449.
Karter, A.J., D’Agostino, R.B. Jr, Mayer-Davis, E.J., Wagenknecht, L.E., Hanley, A.J.,
Hamman, R.F., Bergman, R., Saad, M.F. and Haffner, S.M. (2005), “Abdominal
obesity predicts declining insulin sensitivity in non-obese normoglycaemics: the
Insulin Resistance Atherosclerosis Study (IRAS)”, Diabetes Obesity and Metabolism, Vol. 7
No. 3, pp. 230-238.
Lara-Castro, C. and Garvey, W.T. (2004), “Diet, insulin resistance, and obesity: zoning in on data
for Atkins dieters living in South Beach”, Journal of Clinical Endocrinology and Metabolism,
Vol. 89 No. 9, pp. 4197-4205.
Lin, M.H.A, Wu, M.C. and Lin, S.L.J. (2010), “Glycemic index, glycemic load and
insulinemic index of Chinese starchy foods”, World Journal of Gastroenterology, Vol. 16
No. 39, pp. 4973-4979.
Louie, J.C.Y., Gwynn, J., Turner, N., Cochrane, J., Wiggers, J. and Flood, V. (2012), “Dietary glycemic
index and glycemic load among Indigenous and non-Indigenous children aged 10-12 years”,
Nutrition, Vol. 28 Nos 7/8, pp. 14-22.
Ludwig, D.S., Masijoub, J.A., Al-Zahrani, A., Dallal, G.E., Blanco, I. and Roberts, S.B.
(1999), “High glycemic index foods, overeating and obesity”, Pediatric, Vol. 103 No. 3,
pp. 1-6.
McCrory, M.A., Saltzman, E., Rolls, B.J. and Roberts, S.B. (2006), “A twin study of the effects of
energy density and palatability on energy intake of individual foods”, Physiology and
Behavior, Vol. 87 No. 3, pp. 451-459.
McMillan-Price, J. and Brand-Miller, J. (2006), “Low-glycaemic index diets and body weight
regulation”, International Journal of Obesity, Vol. 30 No. S3, pp. S40-S46.
McMillan-Price, J., Petocz, P., Atkinson, F., O’Neill, K., Samman, S., Steinbeck, K.,
Caterson, I. and Brand-Miller, J. (2006), “Comparison of 4 diets of varying glycemic
load on weight loss and cardiovascular risk reduction in overweight and obese young
adults a randomized controlled trial”, Archives of Internal Medicine, Vol. 166 No. 14,
pp. 1466-1475.
1243
BFJ
116,8
Maarmonier, C., Chapelot, D. and Louis-Sylvestre, J. (2000), “Effects of macronutrient content
and energy density of snacks consumed in a satiety state on the onset of the next meal”,
Appetite, Vol. 43 No. 2, pp. 161-168.
Menezes, E.W., Goncalves, F.A., Giuntini, E.B. and Lajolo, F.M. (2002), “Brazilian Food
Composition Database: internet dissemination and other recent developments”, Journal of
Food Composition and Analysis, Vol. 15 No. 4, pp. 453-464.
1244
Menezes, E.W., Giuntini, E.B., Dan, M.C.T. and Lajolo, F.M. (2009), “New information on
carbohydrates in the Brazilian Food Composition Database”, Journal of Food Composition
and Analysis, Vol. 22 No. 5, pp. 446-452.
Downloaded by UFSC At 19:47 17 March 2016 (PT)
Menezes, E.W., Giuntini, E.B., Dan, M.C.T., Santos, N.C., Melo, A.T. and Lajolo, F.M. (2011),
“Brazilian network of food data systems and LATINFOODS regional technical compilation
committee: food composition activities (2006-2009)”, Journal of Food Composition and
Analysis, Vol. 24 Nos 4/5, pp. 678-681.
Menezes, E.W., Lajolo, F.M., Seravalli, E.A.G., Vannucchi, H. and Moreira, E.A.M. (1996), “Starch
availability in Brazilian foods. ‘in vivo’ and ‘in vitro’ assays”, Nutrition Research, Vol. 16
No. 8, pp. 142-1436.
Nilsson, A.C., Ostman, E.N., Holst, J.J. and Bjorck, I.M.E. (2008), “Including indigestible
carbohydrates in the evening meal of healthy subjects improves glucose tolerance, lowers
inflammatory markers, and increases satiety after a subsequent standardized breakfast”,
Journal of Nutrition, Vol. 138 No. 4, pp. 732-739.
Pai, S., Ghugre, P.S. and Udipi, S.A. (2005), “Udipi Satiety from rice-based, wheat-based and
rice-pulse combination preparations”, Appetite, Vol. 44 No. 3, pp. 263-271.
Perälä, M.M., Hätönen, K.A., Virtamo, J., Eriksson, J.G., Sinkko, H.K., Sundvall, J. and Valsta, L.M.
(2011), “Impact of overweight and glucose tolerance on postprandial responses
to high- and low-glycemic index meals”, British Journal of Nutrition, Vol. 105 No. 11,
pp. 1627-1634.
Pi-Sunyer, X. (2005), “Do glycemic index, glycemic load, and fiber play a role in insulin
sensitivity, disposition index, and type 2 diabetes?”, Diabetes Care, Vol. 28 No. 12,
pp. 2978-2979.
Pitanga, F.J.G. and Lessa, I. (2005), “Indicadores antropometricos de obesidade como instrumento
de triagem para risco coronariano elevado em adultos na cidade de Salvador – Bahia”,
Arquivos Brasileiros de Cardiologia, Vol. 85 No. 1, pp. 26-31.
Quilez, J., Bullo, M. and Salas-Salvado, J. (2007), “Improved postprandial response and feeling
of satiety after consumption of low-calorie Muffins with maltitol and high-amylose corn
starch”, Journal of Food Science, Vol. 72 No. 6, pp. S407-S411.
Rolls, B.J., Roe, L.S. and Meengs, J.S. (2007), “The effect of large portion sizes on energy intake is
sustained for 11 days”, Obesity, Vol. 15 No. 6, pp. 1535-1543.
Rolls, B.J., Roe, L.S., Beach, A.M. and Kris-Etherton, P.M. (2005), “Provision of foods differing
in energy density affects long-term weight loss”, Obesity Research., Vol. 13 No. 6,
pp. 1052-1060.
Rosini, N., Machado, M.J. and Xavier, H.T. (2006), “Estudo de prevalencia e multiplicidade de
fatores de risco cardiovascular em hipertensos do municı́pio de Brusque/SC”, Arquivos
Brasileiros de Cardiologia, Vol. 86 No. 3, pp. 219-222.
Rumpler, W.V., Kramer, M., Rhodes, D.G. and Paul, D.R. (2006), “The impact of the
covert manipulation of macronutrient intake on energy intake and the variability
in daily food intake in no obese men”, International Journal of Obesity, Vol. 30 No. 5,
pp. 774-781.
Sampaio, H.A.C., Sabry, M.O.D., Matos, M.R.T., Passamai, M.P.B., Passos, T.U. and
Rego, J.M.C. (2007), “Indice glicemico de dietas consumidas por escolares com excesso
de peso e eutroficos: existe diferenca?”, Revista Brasileira de Nutric¸~
ao Clinica, Vol. 22 No. 6,
pp. 127-132.
Sartorelli, D.S. and Cardoso, M.A. (2006), “Associac¸~ao entre carboidratos da dieta habitual
e diabetes mellitus tipo 2: evidencias epidemiologicas”, Arquivos Brasileiro de
Endocrinololia and Metabologia, Vol. 50 No. 3, pp. 415-426.
Schulz, M., Liese, A.D., Fang, F., Gilliard, T.S. and Karter, A.J. (2006), “Is the association between
dietary glycemic index and type 2 diabetes modified by waist circumference?”, Diabetes
Care, Vol. 29 No. 5, pp. 1102-1104.
Downloaded by UFSC At 19:47 17 March 2016 (PT)
Sieri, S., Krogh, V., Berrino, F., Evangelista, A., Agnoli, C., Brighenti, F., Pellegrini, N., Palli, D.,
Masala, G., Sacerdote, C., Veglia, F., Tumino, R., Frasca, G., Grioni, S., Pala, V., Mattiello, A.,
Chiodini, P. and Panico, S. (2010), “Dietary glycemic load and index and risk of coronary
heart disease in a large Italian cohort the EPICOR study”, Archives of Internal Medicine,
Vol. 170 No. 7, pp. 640-647.
Thondre, P.S. and Henry, C.J. (2011), “Effect of a low molecular weight, high-purity b-glucan on in
vitro digestion and glycemic response”, International Journal of Food Sciences and
Nutrition, Vol. 62 No. 7, pp. 678-684.
Universidade de S~ao Paulo, USP (2006), “Faculdade de Ciências Farmacêuticas. Departamento
de Alimentos e Nutric¸~ao Experimental”, Tabela Brasileira de Composic¸~
ao de
Alimentos-USP, Version 5.0, available at: www.fcf.usp.br/tabela/lista.asp?base¼r
(accessed August 5, 2013).
Universidade de S~ao Paulo (USP) (1998), “Faculdade de Ciências Farmacêuticas. Departamento
de Alimentos e Nutric¸~ao Experimental”, Tabela Brasileira de Composic¸~
ao de
Alimentos-USP. Version 5.0, available at: www.fcf.usp.br/tabela/lista.asp?base¼r
(accessed August 5, 2013).
Warren, J.M., Henry, C.J. and Simonite, V. (2003), “Low glycemic index breakfasts and reduced
food intake in preadolescent children”, Pediatrics, Vol. 112 No. 5, pp. 414-419.
Wolever, T.M.S., Barbeau, M.C., Charron, S., Harrington, K., Leung, S., Madrick, B., Taillefer, T.
and Stero, C. (2000), “Guidelines for the nutritional management of diabetes mellitus
in the new millennium: a position by the Canadian Diabetes Association”, Canadian
Journal Diabetes Association, Vol. 23 No. 3, pp. 56-69.
World Health Organization (WHO) (1995), Physical Status: The Use and Interpretation of
Anthropometry, WHO Technical Report Series, 854, WHO, Geneva.
World Health Organization (WHO) (2000), “Obesity: preventing and managing the global
epidemic”, WHO Technical Report Series No. 894, WHO, Geneva.
World Health Organization (WHO) (2006), “Global database on body mass index”, report, available
at: http://apps.who.int/bmi/index.jsp?introPage¼intro_3.html (accessed 28 May 2012).
WMA (2008), “World Medical Association”, Declaration of Helsinki. Ethical Principles for Medical
Research Involving Human Subjects, 64th WMA General Assembly, Fortaleza, October 2013,
available at: www.wma.net/en/30publications/10policies/b3/ (accessed August 7, 2014).
Yeomans, M.R. and Chambers, L. (2011), “Satiety-relevant sensory qualities enhance the
satiating effects of mixed carbohydrate-protein preloads”, American Journal of Clinical
Nutrition, Vol. 94 No. 6, pp. 1410-1417.
Youn, S., Woo, H.D., Cho, Y.A., Shin, A., Chag, N. and Kim, J. (2012), “Association between dietary
carbohydrate, glycemic index, glycemic load, and the prevalence of obesity in Korean men
and women”, Nutrition Research, Vol. 32 No. 3, pp. 153-159.
Low glycaemic
index diets
1245
BFJ
116,8
Downloaded by UFSC At 19:47 17 March 2016 (PT)
1246
About the author
Professor Sonia Maria de Medeiros Batista received as Undergraduate Degree in Nutrition from
the Federal University of Rio Grande do Norte (1981); a Master’s Degree (1995) and a Doctoral
Degree (2008) in Food Science from the Federal University of Santa Catarina. Batista since 1986,
is a Nutrition Professor at the Federal University of Santa Catarina, teaching diet therapy
and supervising practical training in clinical nutrition. Batista has experience in clinical
nutrition, with an emphasis on non-communicable chronic diseases and conducts research and
extension projects on diabetes mellitus, obesity and hypertension. Sonia Batista published works
in Brazilian and foreign scientific journals. Professor Sonia Maria de Medeiros Batista can be
contacted at: [email protected]
To purchase reprints of this article please e-mail: [email protected]
Or visit our web site for further details: www.emeraldinsight.com/reprints