Effect of Nutrient Preload and Food Order on Glucose, Insulin, and Gut Hormones

Jae Hyun Bae; Young Min Cho

doi:10.4093/jkd.2018.19.4.193

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Bae and Cho: Effect of Nutrient Preload and Food Order on Glucose, Insulin, and Gut Hormones

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The Journal of Korean Diabetes 2018; 19(4): 193-199.

Published online: 28 December 2018

DOI: https://doi.org/10.4093/jkd.2018.19.4.193

Effect of Nutrient Preload and Food Order on Glucose, Insulin, and Gut Hormones

Jae Hyun Bae¹, Young Min Cho²

¹Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea.

²Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

Corresponding author: Young Min Cho. Department of Internal Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea, ymchomd@snu.ac.kr

Received 18 October 2018 Accepted 31 October 2018

Korean Diabetes Association

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Postprandial hyperglycemia is associated with the risk of diabetes mellitus, cardiovascular disease, and mortality. Nutrition therapy is an important component of the management of postprandial hyperglycemia. Postprandial glucose levels are determined by several factors, such as the quantity and composition of nutrients, gastric emptying rates, secretion of incretin hormones, insulin secretion, glucose uptake by peripheral tissues, and endogenous glucose production. Nutrient preload and food order (or meal sequence) are dietary approaches targeting these factors. Nutrient preload reduces postprandial glucose excursion by enhancing insulin secretion, augmenting the secretion of glucagonlike peptide-1, and delaying gastric emptying. Carbohydrates-last food order improves glycemic control, increases the secretion of glucagon-like peptide-1, and decreases insulin requirements. Therefore, both nutrient preload and manipulation of food order can be an effective, safe, and feasible strategy for treating hyperglycemia in individuals with diabetes mellitus.

Keywords: Carbohydrates, Diabetes mellitus, Food, Gastrointestinal hormones, Glucagon-like peptide-1, Incretins, Insulin, Meals, Postprandial hyperglycemia, Whey proteins

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