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Increased oral processing and a slower eating rate increase glycaemic, insulin and satiety responses to a mixed meal tolerance test

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Abstract

Purpose

Variations in specific oral processing behaviours may contribute to differences in glucose, insulin and satiety responses to a standardised test meal. This study tested how natural variations in oral processing between slower and faster eaters contribute to differences in post-prandial glucose (PP glucose), insulin response (PP insulin) and post-meal satiety for a standardised test meal.

Methods

Thirty-three participants with higher risk for type 2 diabetes consumed a standardised test-meal while being video recorded to derive specific oral processing behaviours. Plasma glucose, insulin and satiety measures were collected at baseline, during and post meal. Participants were split into slower and faster eaters using median split based on their eating rates and individual bolus properties were analysed at the point of swallow.

Results

There were large variations in eating rate (p < 0.001). While there was no significant difference in PP glucose response (p > 0.05), slower eaters showed significantly higher PP insulin between 45 and 60 min (p < 0.001). Slower eaters had longer oro-sensory exposure and increased bolus saliva uptake which was associated with higher PP glucose iAUC. Faster eating rate and larger bolus particle size at swallow correlated with lower PP glucose iAUC. A slower eating rate with greater chews per bite significantly increased insulin iAUC. Faster eaters also consistently rated their hunger and desire to eat higher than slower eaters (p < 0.05).

Conclusions

Natural variations in eating rate and the associated oral processing contributed to differences in PP glucose, PP insulin and satiety responses. Encouraging increased chewing and longer oral-exposure time during consumption, may promote early glucose absorption and greater insulin and satiety responses, and help support euglycaemia.

Trial Registration

ClinicalTrials.gov identifier: NCT04522063.

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Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Code availability

Software application are available from the corresponding author on reasonable request.

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Funding

The study was supported by the Singapore Ministry of Health’s National Medical Research Council under its Centre Grant Programme (NMRC/CG/M009/2017_NUH/NUHS). GAT, CJYM, PS and FCG were supported by the Singapore Biomedical Research Council Food Structure Engineering for Nutrition and Health (Sub-grant Grant no. H18/01/a0/E11, Awarded to PI: Forde, C. G.).

Author information

Authors and Affiliations

  1. Clinical Nutrition Research Centre (CNRC), Singapore Institute for Food and Biotechnology Innovation, Agency for Science, Technology and Research (A*STAR), Singapore, 117599, Singapore

    Goh Ai Ting, Choy Jie Ying Michelle, Shalini Ponnalagu & Ciarán Gerard Forde

  2. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

    Chua Xin Hui, Clare Whitton & Rob Martinus van Dam

  3. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Khoo Chin Meng

  4. Department of Medicine, National University Hospital, Singapore, Singapore

    Khoo Chin Meng

  5. Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117593, Singapore

    Ciarán Gerard Forde

Authors
  1. Goh Ai Ting
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  2. Choy Jie Ying Michelle
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  3. Chua Xin Hui
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  4. Shalini Ponnalagu
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  5. Khoo Chin Meng
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  6. Clare Whitton
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  7. Rob Martinus van Dam
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  8. Ciarán Gerard Forde
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Contributions

KCM, WC, VDRM and FCG Study design. GAT, CJYM and CXH Data collection. GAT, CJYM, PS, FCG Data analysis. GAT, CJYM, FCG Writing. CXH, PS, KCM, WC, VDRM, FCG Review and edit. FCG Overall responsibility for the final manuscript.

Corresponding author

Correspondence to Ciarán Gerard Forde.

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Conflict of interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Ethical approval

This study was approved by the National Healthcare Group Domain Specific Review Board (NHG DSRB, Ref: 2018/01220), Singapore.

Informed consent to participate

All participants gave written informed consent and were compensated for their time.

Informed consent for publication

All authors have seen and approved the final version of the manuscript. The article is the authors’ original work and has not received prior publication and is not under consideration for publication elsewhere.

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Goh, A.T., Choy, J.Y.M., Chua, X.H. et al. Increased oral processing and a slower eating rate increase glycaemic, insulin and satiety responses to a mixed meal tolerance test. Eur J Nutr 60, 2719–2733 (2021). https://doi.org/10.1007/s00394-020-02466-z

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  • DOI: https://doi.org/10.1007/s00394-020-02466-z

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