In Vitro and In Vivo Investigations of Carbohydrates with Different Digestibilities for Improved Satiety and Metabolic Health

Obesity and nutrition-related non-communicable diseases continue to be major challenges that are increasing in severity worldwide. Science-centered carbohydrate dietary strategies may be a viable approach to help address such challenges. Recent reports from our laboratory indicate that certain carbohydrates with slow digestion profiles have the ability to trigger the gut-brain axis and reduce food intake and to slow gastric emptying and potentially affect appetite. Slow carbohydrate digestion may have other impacts on energy metabolism that have not been explored. In the current investigations, we sought to better understand the delayed gastric emptying profile of pearl millet-based foods as well as to understand how altering carbohydrate digestion rate impacts substrate utilization for energy. In the first study, the physical breakdown of pearl millet couscous particles in a simulated gastric environment (Human Gastric Simulator) was studied compared to wheat couscous matched in particle size, and select physicochemical properties of each type of couscous were characterized. Because we previously showed that pearl millet couscous had a marked delay in gastric emptying compared to white rice, boiled potatoes, and pasta in a human study in Mali, the objective of the first investigation was to test the hypothesis that pearl millet couscous was more resistant to breakdown in the stomach than wheat couscous and would take longer to empty. Our findings indicated that pearl millet couscous instead broke down into smaller, more numerous particles than wheat couscous. However, pearl millet had a slower starch hydrolysis property compared to wheat couscous per unit surface area. Pearl millet also had a smaller amylose chain length (839-963 DP) compared to wheat (1225-1563 DP), which may enable a denser packing of millet starch molecules that hinders hydrolysis. We also visually observed that the pearl millet particles formed a paste while breaking down that could reasonably generate viscosity in the stomach to potentially delay gastric emptying. Based off the findings from simulated gastric digestion, we next conducted a human study (n=14) in the U.S. to test the hypothesis that pearl millet-based foods (couscous – commercial and self-made, thick porridge) would reduce glycemic response, increase satiety, and delay gastric emptying compared to wheat couscous and white rice. We complemented this human study with additional in vitrowork using an advanced gastrointestinal digestion system (TIMagc) to determine if the viscosity of pearl millet couscous particles as they were breaking down in the stomach was contributing to a decrease in gastric emptying. Our findings indicated that all the pearl millet-based foods and wheat couscous had lower overall glycemic response than white rice, but only the self-made millet couscous showed higher satiety through subjective appetitive response ratings. Surprisingly, there were no differences in gastric emptying among the foods. Additionally, the half-emptying times for these foods were all ~3 h, which is similar to the comparably low half-emptying times observed for white rice, boiled potatoes, and pasta in the previous Mali study. We now hypothesize that there may be diet-induced changes in gut-brain axis signaling when slowly digestible carbohydrates are consumed repeatedly over time, perhaps through modulating the number or sensitivity of small intestinal L-cells. We also found that millet couscous did not exhibit high viscosity in the TIMagc, suggesting that viscosity was not impacting its rate of gastric emptying