Kiwifruit's Double Role in Glycemic Control and Nutrition
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Kiwifruit may help manage blood sugar levels and provide nutrients. Clinical trials showed: 1) Eating kiwifruit with or before carbohydrates reduced blood sugar spikes compared to carbohydrates alone. 2) Partially substituting kiwifruit for starchy foods like bread or rice lowered the overall rise in blood sugar. 3) Kiwifruit exchanges in meals did not increase hunger and provided vitamins, minerals, and fiber. Next steps are longer trials examining kiwifruit's effects on diabetes risks, metabolism, and cardiovascular health.
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Kiwifruit's Double Role in Glycemic Control and Nutrition
- 1. Kiwifruit - A Double Agent for Glycaemic Control and Nutrient Enhancement Dr John Monro Plant & Food Research, New Zealand
- 2. Acknowledgements • Zespri • Carbohydrate Digestion and Metabolism Team, Plant & Food Research: – Kerry Bently-Hewitt – Sue Middlemiss-Krak – Suman Mishra • Jinny Willis, Don Bevan Centre, Christchurch • All participants in the clinical trials
- 3. Plan of talk • Measuring the properties of kiwifruit that could be beneficial • Testing the role of kiwifruit properties in clinical trials • Measuring the glycaemic potency of kiwifruit • Exchanging kiwifruit for other carbohydrate foods – glycaemic and nutritional consequences • Next steps – the HVN/Zespri phase
- 4. Aim • Help Zespri to sell kiwifruit in an increasingly diabetic, sugar averse market, by showing that they are safe and healthy • HVN $1 million over 3 years • Zespri $100,000 over 3 years Project funding
- 5. Problems and possibilities for kiwifruit Market is becoming fearful of sugars Kiwifruit are sugar-rich Kiwifruit sugars are about 50% fructose (fruit sugar) - fructose is bad news +- Kiwifruit are a rich source of vitamin C Kiwifruit may aid digestion Kiwifruit appear to stimulate laxation Used the right way, kiwifruit may reduce glycaemia and protect against its effects - - + + +
- 6. >400 million diabetic by 2030 A problem and opportunity facing the kiwifruit industry • A “tsunami of diabetes” in the major markets for kiwifruit Best quality kiwifruit > 400 million diabetic by 2030 Best quality kiwifruit
- 7. Challenges • Showing that kiwifruit, even in the diets of consumers at risk for diabetes, are nutritionally beneficial – Short term (postprandial) – Long term (metabolic and diverse diabetic complications) • Incorporating kiwifruit into the diet in ways that lead to a net health benefit to consumers
- 8. Kiwifruit have favourable properties 2 kiwifruit ↓ 900 ml disperse hydrated solids volume Stomach is distensible 50 (empty)-1500 ml Therefore dietary fibre dispersion from one or two kiwifruit, easily fills gastric space surrounding and interacting with other foods. Kiwifruit settled bed volume increased about 4x after digestion Residues occupied a large volume after digestion Post-digestion volume per unit of pulp digested and settled overnight
- 9. Reduced rate of glucose absorption in vivo? Luminal mixingLuminal diffusionDigestion Altered postprandial blood glucose response? Disperse kiwifruit cell wall remnants retarded processes involved in glycaemic response
- 10. Wheat biscuit + 2 kiwifruit (WB+KF), compared with Wheat biscuit + 2 kiwifruit’s sugars (WB+Sug) (n = 20) Non-carbohydrate components of kiwifruit moderated glycaemic response in vivo • Reduced amplitude • Sustained availability • No hypoglycaemia Means ± sem Conclusion: Non-carbohydrate components of kiwifruit may improve glucose homeostasis
- 11. Equal carbohydrate partial substitution of kiwifruit for starchy food reduced glycaemic response Mean blood glucose responses to equal (40 g) available carbohydrate meals: Glucose Wheat biscuit (WB), WB + ‘Hayward’ kiwifruit (WB+GR) WB + SunGold kiwifruit (WB+SG) Recommended limit Incorporating KF into a diet without increasing carbohydrate or energy intake – the dietetic approach Benefits confirmed
- 12. Areas within measurement periods showed improved glucose homeostasis 0-180 min: (full period) LSD 26.8, p = 0.012, 0-120 min: LSD = 22.7, p <.001 120-180 min LSD = 11.5, p < 0.001 SunGold and Hayward improved glycaemic response over 3 h.
- 13. Relative glycaemic potency (RGP) Allows the glycaemic potency of a food to be expressed as grams of glucose equivalents (GGE) per 100 g food. The glycaemic effects of SunGold and Hayward were measured relative to a 40 g glucose reference. IAUCfood/IAUCgluc x WtGluc/Wtfood x 100 = RGP (g glucose equivts./100 g) = GGE/100 g
- 14. Kiwifruit has a low relative glycaemic potency (GGE/100 g) (Means ± sem) (LSD = 4.9, p < 0.001) GGE per 100 g food One kiwifruit had the same effect on blood glucose as 6.6 g glucose
- 15. Relative glycaemic impact expressed as a virtual food component (GGE (g) /given quantity) GGE per serving Relative glycaemic impact can be expressed in gram units, so behaves like a nutrient. Because it is expressed as if it were a nutrient, but represents an effect, it has been termed a virtual food component.
- 16. Kiwifruit Serving size – 100 g (Approx) Per serving PER 100 g Energy-kJ Protein (g) Fat (g) Carbohydrate - Total - Sugars Dietary fibre (g) Sodium (mg) Potassium (mg) Vitamin C (mg) Β-carotene equiv. (µg) Glycaemic impact (glucose equiv.) (g) 202 0.9 0.6 11 10 2.3 4 236 120 18 6 202 0.9 0.6 11 10 2.3 4 236 120 18 6 Relative glycaemic impact: LOW Potential role of GGE in showing relative glycaemic impact in food labels
- 17. Effect of equi-carbohydrate substitution by kiwifruit on estimated GGE dose. Kiwifruit exchanges Serve GI CHOAVL GGE Exchange 1 KF Exchange 2 KF (g) (%) (g/serve) (g) New GGE % Decr New GGE % Decr Bread white 60 75 30 22.5 18.9 16 15.3 32 Cornflakes 30 80 25 20.0 15.8 21 11.5 43 Rice Bubbles 30 88 26 22.9 17.6 23 12.4 46 Rice, white (China) 150 83 36 29.9 25.3 15 20.6 31 Rice, Jasmine (Japan) 150 109 42 45.8 37.9 17 30.0 34 Rice, Japonica (Japan) 150 75 46 34.5 30.9 11 27.3 21 Mashed potato (China) 150 73 20 14.6 11.2 23 7.9 46 Sweet potato (China) 150 77 21 16.2 12.3 24 8.4 48 1 Kiwifruit 100 46 12.5 5.8 5.8 0 5.8 0 2 Kiwifruit 200 46 25 11.5 11.5 0 11.5 0
- 18. Equal carbohydrate, partial exchange of whole kiwifruit for starchy staple improves nutrient intake Effect of partially replacing the available carbohydrate in starchy staple foods by the amount of available carbohydrate in one whole kiwifruit.
- 19. Timing of kiwifruit ingestion relative to carbohydrate food may be important SunGold kiwifruit consumed 30 min before wheat biscuit (WB) decapitated the blood glucose spike WB alone WB + SG together WB 30m post SG (40% less than WB) Equi-carbohydrate comparison
- 20. Kiwifruit has a role in appetite control during glycaemia management Kiwifruit-substituted Wheat Biscuit was as satiating as Wheat Biscuit alone at the same CHO intake
- 21. Next steps: The HVN-Zespri phase • Consumer safety: Insulin response, fructose effects • Customary food consumption: Realistic meals, customary diets • Plausable mechanisms: Metabolic, hormonal, pancreatic, physiological-metabolic syndrome • Relevant endpoints: CVD, circulatory, β-cell function • Relevant biomarkers: Plasma lipids, glycation, oxidative stress, inflammation, endothelial dysfunction When to eat kiwifruit: clinical Kiwifruit exchanges in realistic European and Asian meals (postprandial) (2016) Kiwifruit exchange tables (2016) Metabolic effects of long-term KF consumption (KRIP pilot study) (2016) Long-term consumption metabolic effects (healthy) (2017) Long-term consumption metabolic and risk factor effects (prediabetic) (2018) Intake patterns for optimal effect HVN