-
Advances in Nutrition (Bethesda, Md.) Mar 2017Research findings over the past several decades have shown that inflammation is a prominent feature of many chronic diseases, with poor diet being one likely... (Review)
Review
Research findings over the past several decades have shown that inflammation is a prominent feature of many chronic diseases, with poor diet being one likely inflammatory stimulus. Specifically, a single high-fat meal (HFM) has been suggested to increase inflammation, although there is currently no consensus with regard to the specific changes in many of the proinflammatory markers that are frequently assessed after an HFM. The aim of this systematic review was to objectively describe the postprandial timing and magnitude of changes in 5 common inflammatory markers: interleukin (IL) 6, C-reactive protein (CRP), tumor necrosis factor (TNF) α, IL-1β, and IL-8. Ten relevant databases were searched, yielding 494 results, of which 47 articles met the pre-established inclusion criteria: ) healthy men and women aged 18-60 y, ) consuming a single HFM (≥30% fat, ≥500 kcal), and ) assessing relevant inflammatory markers postmeal for ≥2 h. The only marker found to consistently change in the postprandial period was IL-6: on average, from a baseline of ∼1.4 pg/mL, it peaked at ∼2.9 pg/mL ∼6 h post-HFM (an average relative change of ∼100%). CRP, TNF-α, IL-1β, and IL-8 did not change significantly in 79% (23 of 29), 68% (19 of 28), 67% (2 of 3), and 75% (3 of 4) of included studies, respectively. We conclude that there is strong evidence that CRP and TNF-α are not responsive at the usual time scale observed in postprandial studies in healthy humans younger than age 60 y. However, future research should further investigate the role of IL-6 in the postprandial period, because it routinely increases even in healthy participants. We assert that the findings of this systematic review on markers of inflammation in the postprandial period will considerably aid in informing future research and advancing clinical knowledge.
Topics: Adolescent; Adult; Biomarkers; C-Reactive Protein; Cytokines; Databases, Factual; Diet, High-Fat; Dietary Fats; Female; Humans; Inflammation; Male; Meals; Middle Aged; Postprandial Period; Young Adult
PubMed: 28298267
DOI: 10.3945/an.116.014431 -
Journal of the American Medical... Jun 2014Postprandial hypotension (PPH) is an important clinical problem, which has received inappropriately little attention. (Review)
Review
BACKGROUND
Postprandial hypotension (PPH) is an important clinical problem, which has received inappropriately little attention.
METHODS
A systematic search of the databases PubMed, Embase, Cochrane Library, and Web of Knowledge, from their inception to the present time, was conducted to identify studies relevant to the epidemiology, pathophysiology, and/or management of PPH.
RESULTS
A total of 417 full-text papers were retrieved from database searching and, following screening, 248 were retained. Of these, 167 papers were considered eligible for inclusion.
CONCLUSIONS
PPH occurs commonly in older people and represents a major cause of morbidity. Although the pathophysiology of PPH remains poorly defined, diverse factors, including impairments in sympathetic and baroreflex function, release of vasodilatory peptides, the rate of small intestinal nutrient delivery, gastric distension, and splanchnic blood pooling, appear important. Current pharmacologic and nonpharmacologic management is suboptimal. Research into the pathophysiology of PPH represents a priority so that management can be targeted more effectively.
Topics: Baroreflex; Diet; Gastric Emptying; Gastrointestinal Hormones; Humans; Hypotension; Nitric Oxide; Postprandial Period; Prevalence; Splanchnic Circulation
PubMed: 24630686
DOI: 10.1016/j.jamda.2014.01.011 -
Applied Physiology, Nutrition, and... Oct 2020The purpose of this systematic review was to synthesize and evaluate current literature examining the effects of exercise on postprandial fat oxidation, as well as to... (Meta-Analysis)
Meta-Analysis
The purpose of this systematic review was to synthesize and evaluate current literature examining the effects of exercise on postprandial fat oxidation, as well as to provide future direction. A quantitative review was performed using meta-analytic methods. A moderator analysis was performed to investigate potential variables that could influence the effect of exercise on postprandial fat oxidation. Fifty-six effects from 26 studies were retrieved. There was a moderate effect of exercise on postprandial fat oxidation (Cohen's = 0.58 (95% CI, 0.39 to 0.78)). Moderator analysis revealed that sex, age, weight status, training status, exercise type, exercise intensity, timing of exercise, and composition of the meal challenge significantly affected the impact of prior exercise on postprandial fat oxidation. The moderator analysis also indicated that most previous studies have investigated the impact of prior moderate-intensity endurance exercise on postprandial fat oxidation in young, healthy, lean men. Suggested priorities for future research in this area include () an examination of sex differences in and/or female-specific aspects of postprandial metabolism; () a comprehensive evaluation of exercise modalities, intensities, and durations; and () a wider variety of test meal compositions, especially those with higher fat content. A systematic review of the impact of exercise on postprandial fat oxidation was performed using meta-analytic methods. Analysis revealed a moderate effect of exercise on postprandial fat oxidation. The presented data support a need for future studies to investigate sex differences and to include comprehensive evaluations of exercise modalities, intensities, and duration.
Topics: Dietary Fats; Energy Metabolism; Exercise; Humans; Postprandial Period
PubMed: 32208104
DOI: 10.1139/apnm-2019-0917 -
Journal of Immunology Research 2022This systematic review and meta-analysis was conducted to assess the efficacy of acupuncture treatment for postprandial distress syndrome (PDS). (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This systematic review and meta-analysis was conducted to assess the efficacy of acupuncture treatment for postprandial distress syndrome (PDS).
METHODS
Search the Web of Science, the Cochrane Library, PubMed, and Embase databases with acupuncture randomized controlled trials for the treatment of patients with PDS. Strictly according to inclusion and exclusion quality assessment standards, the qualified ones are used to study the optimum extraction and data by two independent reviewers. Stata 15.0 software was used for meta-analysis.
RESULT
We initially identified 63 studies, of which five (1253 participants) were eventually included in our analysis. There were 643 cases in the experimental group and 610 cases in the control group. Acupuncture had a significant effect on the total therapeutic effect (OTE) at week 4 (OR 4.74, 95% CI 02.88-7.83, = 6.10, = 0 < 0.05). Significantly improved NDI (Nepean dyspepsia index) scores of PDS patients at week 4 (SMD 0.61, 95% CI 0.48 to 0.74). Significantly improved NDI scores in PDS patients at week 16 (SMD 0.49, 95% CI 0.27 to 0.71). After acupuncture treatment, the SID (dyspepsia symptom index) score of PDS patients decreased significantly at week 4 (SMD-0.52, 95% CI -0.73 to -0.32) and week 16 (SMD-0.59, 95% CI -0.81 to -0.36). Postprandial satiety scores (SMD-0.63, 95% CI -0.76 to -0.50) and early satiety scores (SMD-0.51, 95% CI -0.64 to -0.37) were also significantly lower at week 4 after acupuncture.
CONCLUSION
This study highlighted that the acupuncture could significantly improve the overall therapeutic effect of PDS patients, alleviate the symptoms of postprandial fullness and early satiety, and improve the quality of life of patients. Our results supported that acupuncture was an effective therapeutic strategy for postprandial distress syndrome.
Topics: Acupuncture Therapy; Dyspepsia; Humans; Postprandial Period; Quality of Life; Stomach Diseases
PubMed: 35692506
DOI: 10.1155/2022/6969960 -
Journal of the American Nutrition... 2023Aberrations in glucose, insulin, and other postprandial (PP) markers are common in obesity and cardiometabolic disorders. One potentially simple lifestyle/dietary...
OBJECTIVE
Aberrations in glucose, insulin, and other postprandial (PP) markers are common in obesity and cardiometabolic disorders. One potentially simple lifestyle/dietary modification to manage these issues is to change the order in which foods are consumed within meals. Carbohydrate exerts the largest effect on PP glucose, and there is some evidence that ingesting dietary fat or protein before carbohydrate delays gastric emptying of carbohydrate and reduces PP glucose. Additionally, certain dietary proteins may augment insulin release if ingested with carbohydrate, thereby improving blood glucose clearance. This review aimed to systematically evaluate evidence from acute experiments that modified the order in which foods were consumed in isocaloric meals.
METHODS
Outcomes of interest were PP glucose and insulin (including area under the curve for both), C-peptide, gut hormones, and perceptual responses. Three databases were searched (PubMed, Cochrane CENTRAL, Web of Science) in February 2022. Additionally, reference lists of identified reports were searched, and an author of several studies was consulted to verify that relevant literature was included. The review included acute interventions that administered isocaloric meals of the same foods but with foods eaten in different orders. Studies were not excluded based on participant characteristics.
RESULTS
Eleven reports were identified. All reports that assessed glucose and insulin showed a tendency toward lower levels, at least over parts of the PP period, by consuming carbohydrates last. GLP-1 tended to be higher in carbohydrate-last conditions, though this was only measured in a few studies. Perceptual responses (hunger, fullness, etc.) were not consistently different between conditions in two studies, but the certainty of evidence was very low.
CONCLUSIONS
Findings indicate that, at least acutely, there may be benefits to eating carbohydrate after vegetable and/or protein-rich foods. The most consistent effect (judged as moderate certainty) is that carbohydrate-last meal orders tend to lower blood glucose and insulin excursions.
PubMed: 36574255
DOI: 10.1080/27697061.2022.2161664 -
Clinical Nutrition (Edinburgh, Scotland) Nov 2020To synthesize the evidence of the effect of small doses (≤30-g/meal) of fructose and its epimers (allulose, tagatose, and sorbose) on the postprandial glucose and... (Meta-Analysis)
Meta-Analysis
AIMS
To synthesize the evidence of the effect of small doses (≤30-g/meal) of fructose and its epimers (allulose, tagatose, and sorbose) on the postprandial glucose and insulin response to carbohydrate-containing meals.
METHODS
MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched through to April 9, 2019. We included randomized (RCTs) and non-randomized acute, single-meal, controlled feeding trials that added ≤30-g of fructose or its epimers either prior to or with a carbohydrate-containing meal compared with the same meal alone. Outcomes included the incremental area under the curve (iAUC) for glucose and insulin, the Matsuda Insulin Sensitivity Index, and the Early Insulin Secretion Index. Data were expressed as ratio of means (RoM) with 95% CIs and pooled using the inverse variance method. The overall certainty of the evidence was evaluated using GRADE.
RESULTS
Forty trial comparisons (n = 400) were included (none for sorbose). Allulose significantly reduced the postprandial iAUC glucose response by 10% (0.90 [0.84 to 0.96], P < 0.01). Tagatose significantly reduced the postprandial iAUC insulin response by 25% (0.75 [0.62 to 0.91], P < 0.01) and showed a non-significant 3% reduction in the postprandial iAUC glucose response (0.97 [0.94 to 1.00], P = 0.07). There was no effect of fructose on any outcome. The certainty of the evidence was graded as low to moderate for fructose, moderate for allulose, and low for tagatose.
CONCLUSIONS
Small doses of allulose and tagatose, but not fructose, lead to modest improvements on postprandial glucose and insulin regulation. There is a need for long-term RCTs to confirm the sustainability of these improvements.
Topics: Adult; Blood Glucose; Carbohydrate Metabolism; Diet, Carbohydrate Loading; Female; Fructose; Hexoses; Humans; Insulin; Male; Meals; Postprandial Period; Randomized Controlled Trials as Topic; Sorbose; Young Adult
PubMed: 32220498
DOI: 10.1016/j.clnu.2020.03.002 -
The British Journal of Nutrition Oct 2015Rice is an important staple food for more than half of the world's population. Especially in Asian countries, rice is a major contributor to dietary glycaemic load (GL).... (Review)
Review
Rice is an important staple food for more than half of the world's population. Especially in Asian countries, rice is a major contributor to dietary glycaemic load (GL). Sustained consumption of higher-GL diets has been implicated in the development of chronic diseases such as type 2 diabetes mellitus. Given that a reduction in postprandial glycaemic and insulinaemic responses is generally seen as a beneficial dietary change, it is useful to determine the variation in the range of postprandial glucose (PPG) and insulin (PPI) responses to rice and the primary intrinsic and processing factors known to affect such responses. Therefore, we identified relevant original research articles on glycaemic response to rice through a systematic search of the literature in Scopus, Medline and SciFinder databases up to July 2014. Based on a glucose reference value of 100, the observed glycaemic index values for rice varieties ranged from 48 to 93, while the insulinaemic index ranged from 39 to 95. There are three main factors that appear to explain most of the variation in glycaemic and insulinaemic responses to rice: (1) inherent starch characteristics (amylose:amylopectin ratio and rice cultivar); (2) post-harvest processing (particularly parboiling); (3) consumer processing (cooking, storage and reheating). The milling process shows a clear effect when compared at identical cooking times, with brown rice always producing a lower PPG and PPI response than white rice. However, at longer cooking times normally used for the preparation of brown rice, smaller and inconsistent differences are observed between brown and white rice.
Topics: Amylopectin; Amylose; Blood Glucose; Chemical Phenomena; Cooking; Food Handling; Glycemic Index; Glycemic Load; Humans; Insulin; Oryza; Postprandial Period; Randomized Controlled Trials as Topic; Starch; Whole Grains
PubMed: 26310311
DOI: 10.1017/S0007114515001841 -
Obesity Reviews : An Official Journal... Aug 2022We performed a meta-analysis to investigate the effects of high-intensity interval exercise (HIIE) as compared to moderate-intensity exercise (MIE) and a control... (Meta-Analysis)
Meta-Analysis Review
We performed a meta-analysis to investigate the effects of high-intensity interval exercise (HIIE) as compared to moderate-intensity exercise (MIE) and a control condition (CON) on postprandial glucose (PPG) and insulin (PPI) responses. PubMed, Web of Science, and Scopus were comprehensively searched to identify relevant studies until October 2021. Separate analyses were conducted for HIIE versus MIE and HIIE versus CON. A total of 30 studies comprising 36 intervention arms and involving 467 participants (350 adults) were included in the meta-analysis. HIIE reduced PPG and PPI when compared with CON. Based on subgroup analyses, reductions in PPG and PPI were significant for both children and adult participants, as well as for healthy participants and participants with metabolic disorders, with larger effects in those with metabolic disorders. There were no significant differences between HIIE and MIE for PPG or PPI. However, when comparing studies matched for total work performed, HIIE was more effective for decreasing PPG as compared with MIE. HIIE is effective for reducing PPG and PPI in both children and adult participants, particularly in those with metabolic disorders. In addition, HIIE has superior effects for reducing PPG as compared with MIE, when equivalent work was performed at both intensity levels.
Topics: Adult; Blood Glucose; Child; Exercise; Glucose; High-Intensity Interval Training; Humans; Insulin; Postprandial Period
PubMed: 35535401
DOI: 10.1111/obr.13459 -
Diabetology & Metabolic Syndrome 2019Strict glucose control using multiple doses of insulin is the standard treatment for type 1 diabetes mellitus (T1DM), but increased risk of hypoglycemia is a frequent... (Review)
Review
INTRODUCTION
Strict glucose control using multiple doses of insulin is the standard treatment for type 1 diabetes mellitus (T1DM), but increased risk of hypoglycemia is a frequent drawback. Regular insulin in multiple doses is important for achieving strict glycemic control for T1DM, but short-acting insulin analogues may be better in reducing hypoglycemia and postprandial glucose levels.
OBJECTIVE
We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the effects of short-acting insulin analogues regular human insulin on hypoglycemia and postprandial glucose in patients with T1DM.
METHODS
Searches were run on the electronic databases MEDLINE, Cochrane-CENTRAL, EMBASE, ClinicalTrials.gov, LILACS, and DARE for RCTs published until August 2017. To be included in the study, the RCTs had to cover a minimum period of 4 weeks and had to assess the effects of short-acting insulin analogues regular human insulin on hypoglycemia and postprandial glucose levels in patients with T1DM. Two independent reviewers extracted the data and assessed the quality of the selected studies. The primary outcomes analyzed were hypoglycemia (total episodes, nocturnal hypoglycemia, and severe hypoglycemia) and postprandial glucose (at all times, after breakfast, after lunch, and after dinner). Glycated hemoglobin (HbA1c) levels and quality of life were considered secondary outcomes. The risk of bias of each RCT was assessed using the Cochrane Collaboration Risk of Bias table, while the quality of evidence for each outcome was assessed using the GRADEpro software. The pooled mean difference in the number of hypoglycemic episodes and postprandial glucose between short-acting insulin analogues vs. regular human insulin was calculated using the random-effects model.
RESULTS
Of the 2897 articles retrieved, 22 (6235 patients) were included. Short-acting insulin analogues were associated with a decrease in total hypoglycemic episodes (risk rate 0.93, 95% CI 0.87-0.99; 6235 patients; I = 81%), nocturnal hypoglycemia (risk rate 0.55, 95% CI 0.40-0.76, 1995 patients, I = 84%), and severe hypoglycemia (risk rate 0.68, 95% CI 0.60-0.77; 5945 patients, I = 0%); and with lower postprandial glucose levels (mean difference/MD - 19.44 mg/dL; 95% CI - 21.49 to - 17.39; 5031 patients, I = 69%) and lower HbA1c (MD - 0,13%; IC 95% - 0.16 to - 0.10; 5204 patients; I = 73%) levels.
CONCLUSIONS
Short-acting insulin analogues are superior to regular human insulin in T1DM patients for the following outcomes: total hypoglycemic episodes, nocturnal hypoglycemia, severe hypoglycemia, postprandial glucose, and HbA1c.
PubMed: 30622653
DOI: 10.1186/s13098-018-0397-3 -
Chronobiology International Mar 2020Current dietary trends show that humans consume up to 40% of their energy intake during the night. Those who habitually eat during the night are observed to have an... (Meta-Analysis)
Meta-Analysis Review
Current dietary trends show that humans consume up to 40% of their energy intake during the night. Those who habitually eat during the night are observed to have an increased risk of metabolic conditions such as type-2 diabetes and cardiovascular disease. Increasing evidence suggest that a biological consequence of eating during the night is a larger postprandial glucose response, compared to meals eaten earlier in the day. However, findings from individual acute postprandial studies have been inconsistent, due to variations in protocols. Therefore, this review aimed to systematically summarize findings from acute postprandial studies and investigate whether postprandial glucose and insulin response at night differs to during the day in healthy adults. This would indicate a possible physiological mechanism linking habitual nighttime eating and increased risk of metabolic conditions. Seven electronic databases were searched in February 2018. Included studies met the following criteria: had a day-time test between 0700 - 1600h, a nighttime test between 2000 and 0400h, the test meals were identical and consumed by the same participant at both day and night time points, preceded by a 3-h fast (minimum). Primary outcome measures were postprandial glucose and insulin incremental area under the curve (iAUC) or area under the curve (AUC). Studies that reported numerical data were included in the meta-analyses, conducted using Stata statistical software (version 13.0, StataCorp, College Station, TX, USA). For eligible studies that did not report numerical data, their authors' conclusions on the effect of time of day on the primary outcome measures were summarized qualitatively. Full text of 172 articles were assessed for eligibility. Fifteen studies met the eligibility criteria, ten of which were included in the meta-analyses. Meta-analysis for glucose showed a lower postprandial glucose response in the day compared to during the night, after an identical meal (SMD = -1.66; 95% CI, -1.97 to -1.36; < .001). This was supported by the findings from included studies ineligible for meta-analysis. Meta-analysis also showed a lower postprandial insulin response in the day compared to during the night (SMD = -0.35; 95% CI, -0.63 to -0.06; = .016). However, findings from included studies ineligible for meta-analysis were inconsistent. Our results suggest poor glucose tolerance at night compared to the day. This may be a contributing factor to the increased risk of metabolic diseases observed in those who habitually eat during the night, such as shift workers.
Topics: Adult; Blood Glucose; Circadian Rhythm; Cross-Over Studies; Glucose; Humans; Insulin; Postprandial Period; Work Schedule Tolerance
PubMed: 31782659
DOI: 10.1080/07420528.2019.1683856