Table 1.
Dietary approaches to reduce postprandial glycaemia.
| Strategy | Mechanism of action | Comments | |
|---|---|---|---|
| A. Nutrient Preload | Fat Preload Olive oil (41) | Delays gastric emptying. Triggers GLP-1 and GIP (~15 min post intervention) secretion. |
Delayed postprandial glucose peak in type 2 diabetes. Involves extra energy intake. May cause gastrointestinal intolerance like nausea and vomiting. May be culturally unacceptable by individuals. |
|
Protein Soy Protein (42) Whey Protein (42–45) |
Delays gastric emptyingTriggers GLP-1, GIP and insulin secretion. | Reduced post meal glycaemia by 40-50% in type 2 diabetes. Less/No extra energy intake. | |
| Artificial Sweetener Sucralose (46–49) | No impact on gastric emptying. No impact on postprandial glycaemia, GLP-1 or GIP secretion. |
Studies performed in healthy individuals.Not tested in type 2 diabetes. | |
| B. Altering Macronutrient Composition | Protein (50–52) | Delays gastric emptying Triggers insulin secretion. |
Reduced postprandial glycaemic excursion by 38-40%. Reduced HbA1c by 0.8-2.2% in type 2 diabetes. |
| Fat (53–56) | Delays gastric emptying. Increases insulin secretion and possibly, insulin sensitivity. |
Delayed peak blood glucose in healthy subjects. Reduced postprandial glucose excursion. High fat may entail extra energy intake. May cause gastrointestinal intolerance e.g., nausea and vomiting. |
|
| Dietary fiber (57–63) | Delays gastric emptying. Increases early phase insulin secretion. Delays intestinal glucose absorption. |
Reduced postprandial glycaemia by 35-43% in healthy subjects and type 2 diabetes. Reduced HbA1c level by ~0.5%. Dietary fiber does not involve additional energy intake. |
|
| C. Altering Sequence of Macronutrient Consumption | Protein followed by Carbohydrates (64–69) | Delays gastric emptying. Increases release GLP-1, GIP, Cholecystokinin (CCK) and peptide YY. Delays carbohydrate absorption. | Reduced postprandial glycaemia by 39-50% in healthy subjects and type 2 diabetes. Reduced postprandial insulin excursion by ~25% in type 2 diabetes. Does not involve additional energy intake. |
| Protein and Fat followed by Carbohydrates (64, 70) | Delays gastric emptying rate. Triggers GLP-1 secretion. |
Reduced postprandial glycaemic excursions by 78% and 60% after lunch and dinner respectively in type 2 diabetes. Reduced HbA1C by 0.3% in type 2 diabetes. | |