Metabolic Responses to Isomaltulose by Malaysian Chinese Adults: A Pilot Study. Chan Chee Shan

Transcription

1 Metabolic Responses to Isomaltulose by Malaysian Chinese Adults: A Pilot Study Chan Chee Shan

2 Introduction - What is isomaltulose?

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4 Change in blood glucose (mmol/l) Isomaltulose vs. sucrose* sucrose isomaltulose Time (mins)

5 Isomaltulose-containing products in Malaysia Child growingup formula Oral nutritional supplement Musclebuilding supplement Health supplement Sports supplement

6 Isomaltulose-containing products in Malaysia Child growingup formula Oral nutritional supplement Consumption of isomaltulose is expected to increase in Malaysia in the future Health supplement Muscle-building supplement Sports supplement

7 Research questions I. What is the maximum bolus of isomaltulose that is well-tolerated by young healthy adults in Malaysia? II. Is the claimed difference between the blood glucose responses to isomaltulose and sucrose valid? III. Will isomaltulose induce a drop in faecal ph, suggestive of prebiotic activity?

8 Study objectives I. To determine the degree of spill-over of different doses of isomaltulose into the colon among Malaysian healthy adults by means of a breath hydrogen test. II. To determine the dose-dependent increase in glycaemic response to bolus administration of isomaltulose, in comparison to sucrose. III.To examine the potential prebiotic activity of isomaltulose.

9 Methodology

10 Process This study was approved by the IMU-Joint Committee for ethics approval. Data collection was done at IMU, Bukit Jalil campus. Subjects were recruited by group and targeted presentations to individuals (convenient sampling).

11 Inclusion criteria i. Age: years old ii. BMI: kg/m 2 iii. Exclusive hydrogen producers

12 Exclusion criteria i. Alcohol consumption within the previous 24 hours ii. Smoking a cigarette within 48 hours iii. Antibiotics taken within 1-month prior to the test v. iv. Pregnancy Active medical conditions involving major organs vi. Exclusive methane producers (non-hydrogen producers)

13 Methodology - Study flow chart

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15 Determination of intolerance 20 ppm Gastro+ Gastrolyzer (Bedfont Scientific Ltd) Gastrointestinal symptoms

16 Discussion Interaction? - Co-consumption of starch and isomaltulose indigestion Glycaemic response: - The involvement of incretin hormones? Suggested prebiotic activity

17 1. Interaction - Co-consumption of starch & isomaltulose digestion Amylose and amylopectin maltose + isomaltose Isomaltose and maltose are competitive inhibitors of isomaltulose. The digestion of starch and isomaltulose need to be investigated. Sucrase Isomaltase Connecting segment (stalk) Transmembrane segment

18 2. Glycaemic response: [The action of incretin hormones?] No significant differences between iauc of tolerant and intolerant subjects to isomaltulose. Incretins effect?

19 In isomaltulose-tolerant subjects rapid insulin release GIP secretion high [glucose]

20 3. Prebiotic activity Production of SCFAs in the colon and faeces tends to reduce faecal ph. Changes in pre- and post-test faecal ph: Spill-over of isomaltulose into the colon followed by anaerobic fermentation. Increase in acidification of faecal samples

21 Selected references 1. Lina BA, Jonker D, Kozianowski G: Isomaltulose (Palatinose): a review of biological and toxicological studies. Food Chem. Toxicol. 2002;40: Ghoshal UC: How to interpret hydrogen breath tests. Journal of Neurogastroenterology and Motility 2011;17: Holub I, Gostner A, Theis S, Nosek L, Kudlich T, Melcher R, Scheppach W: Novel findings on the metabolic effects of the low glycaemic carbohydrate isomaltulose (Palatinose). British Journal of Nutrition 2010;103: Maeda A, Miyagawa J, Miuchi M, Nagai E, Konishi K, Matsuo T, et al. Effects of the naturally occurring disaccharides, palatinose and sucrose, on incretin secretion in healthy non obese subjects. Journal of diabetes investigation 2013;4(3): Keyhani-Nejad F, Kemper M, Schueler R, Pivovarova O, Rudovich N, Pfeiffer AF. Effects of palatinose and sucrose intake on glucose metabolism and incretin secretion in subjects with type 2 diabetes. Diabetes Care 2016 Mar;39(3):e38-9.

22 Selected references 6. Hira T, Muramatsu M, Okuno M, Hara H. GLP-1 secretion in response to oral and luminal palatinose (isomaltulose) in rats. J Nutr Sci Vitaminol (Tokyo) 2011;57(1): Tonouchi H, Yamaji T, Uchida M, Koganei M, Sasayama A, Kaneko T, et al. Studies on absorption and metabolism of palatinose (isomaltulose) in rats. Br J Nutr 2011;105(01): Roberfroid M, Gibson GR, Hoyles L, McCartney AL, Rastall R, Rowland I, et al. Prebiotic effects: metabolic and health benefits. Br J Nutr 2010;104(S2):S1-S Rana SV, Malik A. Hydrogen breath tests in gastrointestinal diseases. Indian Journal of Clinical Biochemistry 2014;29(4): Food Standards Australia New Zealand. Application A578- Isomaltulose as a novel food. 2015; Available at: aspx. Accessed May 14th, 2017.

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