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口腔处理增加和进食速度减慢会增加混合餐耐量试验的血糖、胰岛素和饱腹感反应。

Increased oral processing and a slower eating rate increase glycaemic, insulin and satiety responses to a mixed meal tolerance test.

机构信息

Clinical Nutrition Research Centre (CNRC), Singapore Institute for Food and Biotechnology Innovation, Agency for Science, Technology and Research (A*STAR), Singapore, 117599, Singapore.

Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.

出版信息

Eur J Nutr. 2021 Aug;60(5):2719-2733. doi: 10.1007/s00394-020-02466-z. Epub 2021 Jan 2.

Abstract

PURPOSE

Variations in specific oral processing behaviours may contribute to differences in glucose, insulin and satiety responses to a standardised test meal. This study tested how natural variations in oral processing between slower and faster eaters contribute to differences in post-prandial glucose (PP glucose), insulin response (PP insulin) and post-meal satiety for a standardised test meal.

METHODS

Thirty-three participants with higher risk for type 2 diabetes consumed a standardised test-meal while being video recorded to derive specific oral processing behaviours. Plasma glucose, insulin and satiety measures were collected at baseline, during and post meal. Participants were split into slower and faster eaters using median split based on their eating rates and individual bolus properties were analysed at the point of swallow.

RESULTS

There were large variations in eating rate (p < 0.001). While there was no significant difference in PP glucose response (p > 0.05), slower eaters showed significantly higher PP insulin between 45 and 60 min (p < 0.001). Slower eaters had longer oro-sensory exposure and increased bolus saliva uptake which was associated with higher PP glucose iAUC. Faster eating rate and larger bolus particle size at swallow correlated with lower PP glucose iAUC. A slower eating rate with greater chews per bite significantly increased insulin iAUC. Faster eaters also consistently rated their hunger and desire to eat higher than slower eaters (p < 0.05).

CONCLUSIONS

Natural variations in eating rate and the associated oral processing contributed to differences in PP glucose, PP insulin and satiety responses. Encouraging increased chewing and longer oral-exposure time during consumption, may promote early glucose absorption and greater insulin and satiety responses, and help support euglycaemia.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT04522063.

摘要

目的

特定口腔加工行为的变化可能导致对标准化测试餐的葡萄糖、胰岛素和饱腹感反应的差异。本研究测试了较慢和较快进食者之间口腔加工的自然变化如何导致标准化测试餐后的餐后血糖(PP 血糖)、胰岛素反应(PP 胰岛素)和餐后饱腹感的差异。

方法

33 名患有 2 型糖尿病风险较高的参与者在进食时被录像,以获得特定的口腔加工行为。在基线、进餐中和餐后采集血浆葡萄糖、胰岛素和饱腹感测量值。根据进食率的中位数将参与者分为较慢和较快进食者,并在吞咽时分析个体食团特性。

结果

进食率存在很大差异(p<0.001)。虽然餐后血糖反应无显著差异(p>0.05),但较慢进食者在 45 至 60 分钟时的餐后胰岛素明显更高(p<0.001)。较慢进食者的口-味觉暴露时间更长,吞咽时唾液吸收增加,与较高的餐后血糖 iAUC 相关。较快的进食率和较大的吞咽时食团粒径与较低的餐后血糖 iAUC 相关。每口咀嚼更多次与更高的胰岛素 iAUC 相关。较快的进食者也一直比较慢的进食者报告更高的饥饿感和进食欲望(p<0.05)。

结论

进食率和相关口腔加工的自然变化导致了 PP 血糖、PP 胰岛素和饱腹感反应的差异。在进食过程中鼓励增加咀嚼和延长口腔暴露时间,可能会促进早期葡萄糖吸收,并产生更大的胰岛素和饱腹感反应,有助于维持血糖正常。

临床试验注册号

NCT04522063。

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