Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore.
Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Department of Endocrinology, Tan Tock Seng Hospital, Singapore; Cardiovascular and Metabolic Diseases Program, Duke-NUS Medical School, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
Clin Nutr. 2020 Mar;39(3):950-957. doi: 10.1016/j.clnu.2019.04.001. Epub 2019 Apr 27.
Previous studies have shown that the sequential order of consuming different food components significantly impacts postprandial glucose and insulin excursions in prediabetes and type 2 diabetes, but the causative mechanisms in healthy humans remain ill-defined.
Using a typical Asian meal comprising vegetables, protein (chicken breast), and carbohydrate (white rice), the aim of this study was to examine the effect of food intake sequence on postprandial glucose, insulin and incretin secretions in healthy adults.
Sixteen healthy Chinese adults participated in a randomized, controlled, crossover meal trial. Subjects consumed in random order 5 experimental isocaloric meals that differed in the food intake sequence of vegetables, protein and carbohydrate. Glucose, insulin, incretins and satiety markers were measured over 3 h.
There were significant food intake sequence × time interaction effects on plasma glucose, insulin, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) concentrations (P < 0.001). In comparison with rice consumed first followed by vegetable and meat (R-VM), the overall postprandial glucose response was significantly attenuated after the food intake sequence of vegetable first, followed by meat and rice (V-MR) or meat first, followed by vegetable and rice (M-VR) or vegetable first followed by meat and rice (V-M-R) or vegetable, meat and rice consumed together (VMR). The insulin iAUC (0-60) was significant lower after V-M-R than M-VR, VMR and R-VM. V-M-R food intake sequence stimulated higher GLP-1 release than other meal sequences. However, GIP response was lower after V-MR and V-M-R than M-VR and R-MR food intake sequences.
Food macronutrient intake sequence can considerably influence its glycemic, insulinemic and incretin responses. V-M-R food intake sequence attenuates the glycemic response to a greater degree with accentuated GLP-1 stimulation without any increased demand for insulin. The sequence of food intake has great potential as a novel and simple behavioral strategy to modulate glycemic response in healthy adults. The trial was registered at clinicaltrials.gov as NCT03533738.
先前的研究表明，不同食物成分的摄入顺序会显著影响糖尿病前期和 2 型糖尿病患者的餐后血糖和胰岛素波动，但健康人群中的因果机制仍不清楚。
本研究采用典型的亚洲餐，包括蔬菜、蛋白质（鸡胸肉）和碳水化合物（白米饭），旨在研究进食顺序对健康成年人餐后血糖、胰岛素和肠促胰岛素分泌的影响。
16 名健康的中国成年人参与了一项随机、对照、交叉膳食试验。受试者随机摄入 5 种等热量的实验餐，这些餐在蔬菜、蛋白质和碳水化合物的摄入顺序上有所不同。在 3 小时内测量血糖、胰岛素、肠促胰岛素和饱腹感标志物。
不同的进食顺序对血浆葡萄糖、胰岛素、葡萄糖依赖性胰岛素释放肽（GIP）和胰高血糖素样肽-1（GLP-1）浓度有显著的进食顺序×时间交互作用（P<0.001）。与先吃米饭再吃蔬菜和肉（R-VM）的情况相比，先吃蔬菜，再吃肉和米饭（V-MR）或先吃肉，再吃蔬菜和米饭（M-VR）或先吃蔬菜，再吃肉和米饭（V-M-R）或蔬菜、肉和米饭一起吃（VMR）的餐后血糖反应显著降低。V-M-R 后的胰岛素 AUC（0-60）显著低于 M-VR、VMR 和 R-VM。V-M-R 进食顺序刺激 GLP-1 释放高于其他餐序。然而，V-MR 和 V-M-R 后的 GIP 反应低于 M-VR 和 R-MR 餐序。
食物宏量营养素的摄入顺序会显著影响其血糖、胰岛素和肠促胰岛素反应。V-M-R 进食顺序能更大程度地减轻血糖反应，同时增强 GLP-1 刺激，而不增加胰岛素需求。进食顺序具有很大的潜力成为一种新的简单行为策略，以调节健康成年人的血糖反应。该试验在 clinicaltrials.gov 注册为 NCT03533738。
