Starchy foods in the prevention of type 2 diabetes mellitus:Effects of food structure and composition on starch digestibility and the postprandial metabolic response

Consumption of starchy foods, such as bread and pasta, affects the glucose response in the blood after the meal. A repeated high glucose response may play a role in the development of insulin resistance and type 2 diabetes (T2DM). Development of starchy foods with slow starch digestibility (slow intestinal glucose release and thereby a low glucose response), is therefore essential. We compared several wheat products with different structures or ingredients. We found in healthy individuals however that a slow release of glucose from the pasta meal resulted in a similar glycemic response compared to bread with rapid starch digestibility. The slow glucose release after pasta additionally resulted in a low response of insulin and the gastrointestinal hormone GIP (which can potentiate the insulin response), resulting in more gradual uptake of glucose from the blood into tissues and a longer presence of glucose in the blood. These moderate underlying processes could also be beneficial in the prevention of insulin resistance and T2DM; glucose is not always a good reflection of these beneficial metabolic aspects. Consumption of a more compact structured bread (flat bread) gave a similar beneficial response, whereas the addition of special bran or broken wheat kernels to bread did not affect the glucose fluxes. However, the gut hormone GLP-1, relevant in the prevention and management of T2DM, seemed affected by the addition of wheat kernels, which deserves further research. Product modification, e.g. compact bread structure which could be obtained by traditional bread making, may affect the response after a meal and thereby play a role in the prevention of the development of T2DM