TITLE:
Glycemic Indices of Multiple Oral Nutritional Supplements: A Randomized Cross-Over Study in Indian Adults
AUTHORS:
Deepti Khanna, Jaladhi Bhatt, Jayanti Gupta, Simran Sethi, Parth Joshi, Manoj Pareek, Divya Agrawal
KEYWORDS:
Glycemic Index, Oral Nutritional Supplements, Incremental Area under the Curve, Diabetes
JOURNAL NAME:
Food and Nutrition Sciences,
Vol.14 No.10,
October
31,
2023
ABSTRACT: Background: A
randomized cross-over study was conducted to assess the glycemic index (GI) of
seven Oral Nutritional Supplements (ONSs). These ONSs are designed to support
the nutritional requirements of different age-groups, physiological states, or health conditions
among Indian adults. Methods: The study had two phases viz., phase1 (n = 18) studied two ONSs: A1 and B1 and
phase 2 (n = 20) studied five ONSs: A2, B2,
C2, D2 & E2. The subjects were healthy, non-diabetic adults, aged between 20 - 44 years with a mean Body Mass Index of 21.2 ± 1.52 kg/m2 (Phase 1) and 21.0 ± 1.45
kg/m2 (Phase
2). All these ONSs were compared with reference drinks
(glucose). The carbohydrates in one serving of each ONS were matched to
carbohydrates from 25 grams of glucose following ISO 2010 guidelines. Capillary blood was assessed for blood glucose response at
baseline, 15, 30, 45, 60, 90 and 120 minutes. GI was calculated as the
incremental area under the curve (iAUC) for the test drinks and expressed as a
percentage of the average iAUC from glucose. Results: Phase 1 indicated that the high fiber diabetes-specific nutrition
supplement A1 with higher protein (23% energy), higher fat (25% energy) and
reduced carbohydrates (40% energy) had a significantly (p = 0.002) lower GI [34 (±6)] as compared to B1 [63 (±7)] (protein 19%, fat
7% and carbohydrates 60% energy) even with similar amount (22%) and type of fiber. Phase 2 reported that all test products [A2
(32 ± 5), B2 (37 ± 4), C2 (31 ± 5), D2 (31 ± 5) and E2 (55 ± 4)] had a low GI. As compared to phase 1, ONSs in phase 2 had lower fiber
content (1.6% - 4.6% energy). Conclusion: The glycemic index of oral nutrition supplements is influenced not only
by their fiber content, but also by the overall macronutrient composition including protein (≥17%
energy), fat (≥10% - 27% energy) and carbohydrates (40% - 57.5% energy).