Mela David J, Cao Xiu-Zhen, Dobriyal Rajendra, Fowler Mark I, Lin Li, Joshi Manoj, Mulder Theo J P, Murray Peter G, Peters Harry P F, Vermeer Mario A, Zhang Zhang
Unilever R&D, Wageningen, the Netherlands.
Unilever R&D Shanghai, Shanghai, China.
Nutr Metab (Lond). 2020 Jul 6;17:51. doi: 10.1186/s12986-020-00471-x. eCollection 2020.
Lower post-prandial glucose (PPG) and insulin (PPI) responses to foods are associated with reduced diabetes risk and progression. Several plant extracts have been proposed to reduce PPG or PPI by inhibiting enzymes or transporters involved in carbohydrate digestion and uptake. This study evaluates a range of such extracts, consumed with a carbohydrate load, for their effects on PPG, PPI and indicators of (gastrointestinal) tolerance.
Interventions were extracts of mulberry fruit (MFE, 1.5 g), mulberry leaf (MLE, 1.0 g), white bean (WBE, 3.0 g), apple (AE, 2.0 g), elderberry (EE, 2.0 g), turmeric (TE, 0.18 g), AE + TE, and EE + TE. Each of these 8 individual extracts or combinations were added to a rice porridge containing ~ 50 g available carbohydrate (control). In a within-subject (randomised, balanced incomplete block) design, individual subjects received the control and a subset of 4 of the 8 extracts or combinations. Participants were 72 apparently healthy adults (mean [SD] age 31.2 [5.5] yr, body mass index 22.1 [2.0] kg/m). The primary outcome was the percentage change in 2-h PPG (positive incremental area under the curve) relative to control. Secondary measures were the 2-h PPI response, 7-h breath hydrogen, measures of gastrointestinal discomfort, and urine glucose.
In the 65 subjects who completed the control and at least one intervention treatment, additions of AE, MFE and MLE produced statistically significant reductions in PPG vs control ( < 0.05; mean effect - 24.1 to - 38.1%). All extracts and combinations except TE and WBE significantly reduced PPI ( < 0.01; mean effect - 17.3% to - 30.4%). Rises in breath hydrogen > 10 ppm were infrequent, but statistically more frequent than control only for MLE ( = 0.02). Scores for gastrointestinal discomfort were extremely low and not different from control for any treatment, and no glucosuria was observed.
Additions of AE, MFE and MLE to rice robustly reduced PPG and PPI. EE significantly reduced only PPI, while TE and WBE showed no significant efficacy for PPG or PPI. Breath hydrogen responses to MLE suggest possible carbohydrate malabsorption at the dose used, but there were no explicit indications of intolerance to any of the extracts.
ClinicalTrials.gov identifier NCT04258501. Registered 6 February 2020 - Retrospectively registered.
餐后血糖（PPG）和胰岛素（PPI）对食物的反应较低与糖尿病风险降低及病情进展减缓相关。已有多种植物提取物被认为可通过抑制参与碳水化合物消化和吸收的酶或转运蛋白来降低PPG或PPI。本研究评估了一系列此类提取物与碳水化合物负荷一起食用时，对PPG、PPI及（胃肠道）耐受性指标的影响。
干预措施为桑椹提取物（MFE，1.5克）、桑叶提取物（MLE，1.0克）、白豆提取物（WBE，3.0克）、苹果提取物（AE，2.0克）、接骨木果提取物（EE，2.0克）、姜黄提取物（TE，0.18克）、AE + TE以及EE + TE。这8种单一提取物或组合中的每一种都添加到一份含有约50克可利用碳水化合物的米粥中（对照）。采用受试者内（随机、平衡不完全区组）设计，个体受试者接受对照以及8种提取物或组合中的4种。参与者为72名表面健康的成年人（平均[标准差]年龄31.2[5.5]岁，体重指数22.1[2.0]千克/平方米）。主要结局是2小时PPG相对于对照的变化百分比（曲线下正增量面积）。次要指标包括2小时PPI反应、7小时呼气氢气、胃肠道不适指标以及尿糖。
在完成对照和至少一种干预治疗的65名受试者中，添加AE、MFE和MLE后，PPG相对于对照有统计学显著降低（P < 0.05；平均效应 - 24.1%至 - 38.1%）。除TE和WBE外，所有提取物和组合均显著降低了PPI（P < 0.01；平均效应 - 17.3%至 - 30.4%）。呼气氢气升高超过10 ppm的情况不常见，但仅MLE在统计学上比对照更频繁（P = 0.02）。胃肠道不适评分极低，任何治疗与对照相比均无差异，且未观察到糖尿。
在米饭中添加AE、MFE和MLE可显著降低PPG和PPI。EE仅显著降低了PPI，而TE和WBE对PPG或PPI未显示出显著疗效。MLE引起的呼气氢气反应表明在所使用的剂量下可能存在碳水化合物吸收不良，但没有明确迹象表明对任何提取物不耐受。
ClinicalTrials.gov标识符NCT04258501。2020年2月6日注册 - 追溯注册。
