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Controlling type-2 diabetes by inclusion of Cr-enriched yeast bread in the daily dietary pattern: a randomized clinical trial

Abstract

Purpose

Chromium (Cr)-enriched yeast supplementation to whole wheat bread (WWCrB) has been shown to ameliorate postprandial glycemic response in healthy subjects. The present study investigates the long-term benefit of WWCrB consumption for patients with type-2 diabetes mellitus (T2DM).

Methods

Thirty patients with T2DM were randomly assigned to a group receiving WWCrB or the plain whole wheat bread (WWB) group. Plasma glucose, insulin, glycosylated hemoglobin (HbA1c) and insulin resistance were determined, and oral glucose tolerance test (OGTT) was performed at the beginning and the end of the dietary intervention, which lasted for 12 weeks. Biochemical parameters related to the disease, markers of inflammation as well as body weight and energy balance were examined.

Results

At the end of the study, subjects of WWCrB group exerted lower levels of glucose, insulin and HbA1c and improved insulin resistance (P < 0.05 against before treatment). Area under the glucose curve attained during OGTT decreased after the intervention (28,117.5 ± 1266.4 vs. 31,588.5 ± 1187.5 mg min/dL before treatment, P < 0.05) with significantly lower values of glucose concentration at 0 and 60 min. A significant reduction in body weight and systolic blood pressure (SBP) was observed (P < 0.05 against before treatment). Markers of inflammation and lipid profiles were not affected by WWCrB consumption.

Conclusions

Inclusion of WWCrB in the daily dietary pattern of diabetic patients resulted in improvement of glucose tolerance and insulin resistance, significant reduction in HbA1c, weight loss and lower SBP. Patients with inadequate glycemic control may benefit from the consumption of WWCrB.

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References

  1. Shaw JE, Sicree RA, Zimmet PZ (2010) Global estimates for the prevalence of diabetes for 2010 and 2030. Diabet Res Clin Pract 87(1):4–14

    CAS  Article  Google Scholar 

  2. Frayn KN (2010) Diabetes Mellitus. Metabolic regulation: a human perspective, 3rd edn. Wiley-Blackwell, UK, pp 306–328

    Google Scholar 

  3. Suksomboon N, Poolsup N, Yuwanakorn A (2014) Systematic review and meta-analysis of the efficacy and safety of chromium supplementation in diabetes. Clin Pharm Therap 39:292–306

    CAS  Google Scholar 

  4. Thomas DE, Elliott EJ (2010) The use of low-glycaemic index diets in diabetes control. Br J Nutr 104(6):797–802

    CAS  Article  Google Scholar 

  5. Bhupathiraju SN, Tobias DK, Malik VS, Pan A, Hruby A, Manson JE, Willett WC, Hu FB (2014) Glycemic index, glycemic load, and risk of type 2 diabetes: results from 3 large US cohorts and an updated meta-analysis. Am J Clin Nutr 100(1):218–232

    CAS  Article  Google Scholar 

  6. Dyson PA, Kelly T, Deakin T, Duncan A, Frost G, Harrison Z, Khatri D, Kunka D, McArdle P, Mellor D, Oliver L, Worth J (2011) Diabetes UK Nutrition Working Group Diabetes UK evidence-based nutrition guidelines for the prevention and management of diabetes. Diabetes Med 28(11):1282–1288

    CAS  Article  Google Scholar 

  7. Evert AB, Boucher JL, Cypress M, Dunbar SA, Franz MJ, Mayer-Davis EJ, Neumiller JJ, Nwankwo R, Verdi CL, Urbanski P, Yancy WS Jr (2014) Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care 37(Suppl 1):S120–S143

    Article  Google Scholar 

  8. Cust AE, Skilton MR, van Bakel MM, Halkjaer J, Olsen A, Agnoli C, Psaltopoulou T, Buurma E, Sonestedt E, Chirlaque MD, Rinaldi S, Tjønneland A, Jensen MK, Clavel-Chapelon F, Boutron-Ruault MC, Kaaks R, Nöthlings U, Chloptsios Y, Zylis D, Mattiello A, Caini S, Ocké MC, van der Schouw YT, Skeie G, Parr CL, Molina-Montes E, Manjer J, Johansson I, McTaggart A, Key TJ, Bingham S, Riboli E, Slimani N (2009) Total dietary carbohydrate, sugar, starch and fibre intakes in the European prospective investigation into cancer and nutrition. Eur J Clin Nutr Suppl 4:S37–S60

    Article  Google Scholar 

  9. Fardet A, Leenhardt F, Lioger D, Scalbert A, Rémésy C (2006) Parameters controlling the glycaemic response to breads. Nutr Res Rev 19(1):18–25

    Article  Google Scholar 

  10. Hua Y, Clark S, Ren J, Sreejayan N (2012) Molecular mechanisms of chromium in alleviating insulin resistance. J Nutr Biochem 23(4):313–319

    CAS  Article  Google Scholar 

  11. Onakpoya I, Posadzki P, Ernst E (2013) Chromium supplementation in overweight and obesity: a systematic review and meta-analysis of randomized clinical trials. Obes Rev 14(6):496–507

    CAS  Article  Google Scholar 

  12. Jain SK, Croad JL, Velusamy T, Rains JL, Bull R (2010) Chromium dinicocysteinate supplementation can lower blood glucose, CRP, MCP-1, ICAM-1, creatinine, apparently mediated by elevated blood vitamin C and adiponectin and inhibition of NFkappaB, Akt and Glut-2 in livers of zucker diabetic fatty rats. Mol Nutr Food Res 54(9):1371–1380

    CAS  Article  Google Scholar 

  13. Jain SK, Rains JL, Croad JL (2007) Effect of chromium niacinate and chromium picolinate supplementation on lipid peroxidation, TNF-alpha, IL-6, CRP, glycated hemoglobin, triglycerides, and cholesterol levels in blood of streptozotocin-treted diabetic rats. Free Rad Biol Med 43(8):1124–1131

    CAS  Article  Google Scholar 

  14. Chen Y, Lin J, Hsia T, Mao FC, Hsu C, Pei D (2014) The effect of chromium on inflammatory markers, 1st and 2nd phase insulin secretion in type 2 diabetes. Eur J Nutr 53:127–133

    CAS  Article  Google Scholar 

  15. Chen G, Liu P, Pattar GR, Tackett L, Bhonagiri P, Strawbridge AB, Elmendorf JS (2006) Chromium activates glucose transporter 4 trafficking and enhances insulin-stimulated glucose transport in 3T3-L1 adipocytes via cholesterol-dependent mechanism. Mol Endocrinol 20:857–870

    CAS  Article  Google Scholar 

  16. Hoffman NJ, Penque BA, Habegger KM, Sealls W, Tackett L, Elmendorf JS (2014) Chromium enhances insulin responsiveness via AMPK. J Nutr Biochem 25(5):565–572

    CAS  Article  Google Scholar 

  17. Nakatani Y, Kaneto H, Kawamori D, Yoshiuchi K, Hatazaki M, Matsuoka TA, Ozaka K, Ogawa S, Hori M, Yamasaki Y, Matsuhisa M (2005) Involvement of endoplasmic reticulum stress in insulin resistance and diabetes. J Biol Chem 280:847–851

    CAS  Article  Google Scholar 

  18. Yanni AE, Stamataki N, Stoupaki M, Konstantopoulos P, Pateras I, Tentolouris N, Perrea D, Karathanos VT (2016) Cr-enriched yeast: beyond fibers for the management of postprandial glycemic response to bread. Eur J Nutr. doi:10.1007/s00394-016-1190-4

  19. Groff JL, Gropper SS (1999) Chromium. In: Laura G (eds) Advanced nutrition and human metabolism. Wadsworth/Thomson Learning, Belmont, USA, pp 446–451

    Google Scholar 

  20. Peng M, Yang X (2015) Controlling diabetes by chromium complexes: the role of the ligands. J Inorg Biochem 146:97–103

    CAS  Article  Google Scholar 

  21. Preuss HG, Grojec PL, Lieberman S, Anderson RA (1997) Effects of different chromium compounds on blood pressure and lipid peroxidation in spontaneously hypertensive rats. Clin Nephrol 47(5):325–330

    CAS  Google Scholar 

  22. Pei D, Hsieh CH, Hung YJ, Li JC, Lee CH, Kuo SW (2006) The influence of chromium chloride-containing milk to glycemic control of patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled trial. Metabolism 55(7):923–927

    CAS  Article  Google Scholar 

  23. Cefalu WT, Rood J, Pinsonat P, Qin J, Sereda O, Levitan L, Anderson RA, Zhang XH, Martin JM, Martin CK, Wang ZQ, Newcomer B (2010) Characterization of the metabolic and physiologic response to chromium supplementation in subjects with type 2 diabetes mellitus. Metabolism 59:755–762

    CAS  Article  Google Scholar 

  24. Sharma S, Agrawal RP, Choudhary M, Jain S, Goyal S, Agarwal V (2011) Beneficial effect of chromium supplementation on glucose, HbA1C and lipid variables in individuals with newly onset type-2 diabetes. J Trace Elem Med Biol 25:149–153

    CAS  Article  Google Scholar 

  25. Sallé A, Ryan M, Ritz P (2006) Underreporting of food intake in obese diabetic and non diabetic patients. Diabetes Care 29(12):2726–2727

    Article  Google Scholar 

  26. Tian H, Guo X, Wang X, He Z, Sun R, Ge S, Zhang Z (2013) Chromium picolinate supplementation for overweight or obese adults. Cochrane Database Syst Rev 11:CD010063

    Google Scholar 

  27. Sobrino Crespo C, Perianes Cachero A, Puebla Jiménez L, Barrios V, Arilla Ferreiro E (2014) Peptides and food intake. Front Endocrinol (Lausanne) 24(5):58

    Google Scholar 

  28. Whitfield P, Parry-Strong A, Walsh E, Weatherall M, Krebs JD (2016) The effect of a cinnamon-, chromium- and magnesium-formulated honey on glycaemic control, weight loss and lipid parameters in type 2 diabetes: an open-label cross-over randomized controlled trial. Eur J Nutr 55(3):1123–1131

    CAS  Article  Google Scholar 

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Acknowledgments

Authors are grateful to the volunteers who participated in the study and all the persons involved in the conduct of the study. This work was supported by a research grant from the Greek General Secretariat for Research and Technology (PAVET 2013) and ELBISCO S.A.

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Correspondence to Amalia E. Yanni.

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On behalf of all the authors, corresponding author states that there is no conflict of interest.

Ethical standard

All human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to their inclusion in the study.

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Yanni, A.E., Stamataki, N.S., Konstantopoulos, P. et al. Controlling type-2 diabetes by inclusion of Cr-enriched yeast bread in the daily dietary pattern: a randomized clinical trial. Eur J Nutr 57, 259–267 (2018). https://doi.org/10.1007/s00394-016-1315-9

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  • DOI: https://doi.org/10.1007/s00394-016-1315-9

Keywords

  • Bread
  • Type-2 diabetes mellitus
  • Cr-enriched yeast
  • Glucose tolerance
  • Insulin resistance
  • Weight management