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Higher adiposity predicts greater intra-individual inconsistencies in postprandial glycemic measurements—an analysis of three randomized controlled trials in Asian populations

Abstract

Background/objectives

Acute glycemic responses offer important insights into glucose homeostasis although the repeatability of these measurements particularly in Asian populations remains unclear. This research aimed to critically investigate the inconsistencies of the postprandial glycemic profile within individuals, and identify potential variables predicting greater inconsistencies.

Subjects/methods

This was a secondary analysis of three randomized controlled trials which fed subjects with glucose (and other carbohydrate-rich foods), and measured postprandial blood glucose at regular intervals. Intra-individual rank-order consistency in the glycemic profile between acute glucose treatments was evaluated and compared against demographic, anthropometric and cardio-metabolic health related indicators to delineate potential confounding variables. Correlations between the incremental area under curve at 120 min (iAUC120 min) for glucose and the carbohydrate-rich foods were further explored.

Results

Rank-order consistency was identified to be moderate, with intra-individual inconsistencies marginally lower than inter-individual inconsistencies. Notably, greater inconsistencies within individuals were directly correlated with BMI and fat-mass index (P < 0.01) albeit non-significant for age, ethnicity, and other cardio-metabolic health-related risk indicators. Across the trials, there were positive monotonic correlations between the iAUC120 min for glucose and simple sugars (sucrose, isomaltulose), as well as different varieties of rice (jasmine white, Bapatla brown, Bapatla white; p < 0.05). However, there were a lack of associations between iAUC120 min for glucose with pastas (semolina and wholegrain penne, spaghetti) and mee pok noodles.

Conclusion

There are inherent inconsistencies in postprandial glycemic measurements within individuals, particularly among those with higher adiposity. These confounders need to be kept in mind for appropriate and meaningful interpretations of glycemia.

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Fig. 1: Flow diagram of population selection process for secondary analysis of acute feeding trials.
Fig. 2: Rank-order associations between iAUC120 min of glucose and intervention foods in NCT04653207.
Fig. 3: Rank-order associations between iAUC120 min of glucose and intervention foods in NCT03646812.
Fig. 4: Rank-order associations between iAUC120 min of glucose and intervention foods in NCT04228341.

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Data availability

Data described in the manuscript, code book, and analytic code will be made available upon request pending application and approval.

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Funding

Funding

This research was funded by the A*STAR Industry Alignment Fund – Pre-Positioning Programme (IAF-PP) – Food Structure Engineering for Nutrition and Health Programme (Grant ID no: H17/01/a0/A11 & H18/01/a0/B11).

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Authors and Affiliations

Authors

Contributions

The authors’ responsibilities were as follows – DWKT, SP, and CJH conceptualized and designed the research; SGC, JL, MXNK, and CJH conducted the original clinical trials and provided essential data for the secondary analysis; DWKT, SP, and CJH analyzed the data; DWKT, SP and JL wrote the original manuscript under the supervision of CJH; DWKT and CJH have primary responsibility for final content; all authors read, reviewed and approved of the final manuscript.

Corresponding authors

Correspondence to Darel Wee Kiat Toh or Christiani Jeyakumar Henry.

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Competing interests

The authors declare no competing interests.

Ethical approval

This secondary analysis was performed in accordance with the Declaration of Helsinki, and was reviewed by the Agency for Science, Technology and Research Institutional Review Board (A*STAR IRB; reference number: 2022-067). The 3 acute trials selected were approved by the National Healthcare Group Domain Specific Review Board (NHG DSRB; reference numbers: 2018/00025, 2018/00622 and 2018/01079 respectively). Written informed consent was obtained from all participants.

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Toh, D.W.K., Ponnalagu, S., Camps, S.G. et al. Higher adiposity predicts greater intra-individual inconsistencies in postprandial glycemic measurements—an analysis of three randomized controlled trials in Asian populations. Eur J Clin Nutr (2024). https://doi.org/10.1038/s41430-024-01457-1

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