Pomegranate juice, but not an extract, confers a lower glycemic response on a high-glycemic index food: randomized, crossover, controlled trials in healthy subjects.
Asimina KerimiHilda Nyambe-SilavweJulia S GauerFrancisco Abraham Tomás-BarberánGary WilliamsonPublished in: The American journal of clinical nutrition (2017)
Background: Low-glycemic index diets have demonstrated health benefits associated with a reduced risk of developing type 2 diabetes.Objectives: We tested whether pomegranate polyphenols could lower the glycemic response of a high-glycemic index food when consumed together and the mechanism by which this might occur.Design: We compared the acute effect of a pomegranate juice and a polyphenol-rich extract from pomegranate (supplement) on the bread-derived postprandial blood glucose concentration in 2 randomized, crossover, controlled studies (double-blinded for the supplements), each on 16 healthy volunteers. An additional randomized, crossover, controlled study on 16 volunteers consuming constituent fruit acids in a pH-balanced solution (same pH as pomegranate) and bread was conducted to determine any contributions to postprandial responses caused by acidic beverages.Results: As primary outcome, the incremental area under the curve for bread-derived blood glucose (-33.1% ± 18.1%, P = 0.000005) and peak blood glucose (25.4% ± 19.3%, P = 0.0004) were attenuated by pomegranate juice, compared with a control solution containing the equivalent amount of sugars. In contrast, the pomegranate supplement, or a solution containing the malic and citric acid components of the juice, was ineffective. The pomegranate polyphenol punicalagin was a very effective inhibitor of human α-amylase in vitro, comparable to the drug acarbose. Neither the pomegranate extract nor the individual component polyphenols inhibited 14C-D-glucose transport across differentiated Caco-2/TC7 cell monolayers, but they inhibited uptake of 14C-glucose into Xenopus oocytes expressing the human glucose transporter type 2. Further, some of the predicted pomegranate gut microbiota metabolites modulated 14C-D-glucose and 14C-deoxy-D-glucose uptake into hepatic HepG2 cells.Conclusions: These data indicate that pomegranate polyphenols, when present in a beverage but not in a supplement, can reduce the postprandial glycemic response of bread, whereas microbial metabolites from pomegranate polyphenols exhibit the potential to further modulate sugar metabolism much later in the postprandial period. This trial was registered at clinicaltrials.gov as NCT02486978, NCT02624609, and NCT03242876.
Keyphrases
- blood glucose
- glycemic control
- type diabetes
- open label
- double blind
- placebo controlled
- blood pressure
- phase iii
- weight loss
- phase ii
- healthcare
- oxidative stress
- endothelial cells
- emergency department
- randomized controlled trial
- mental health
- magnetic resonance imaging
- cell therapy
- ms ms
- insulin resistance
- intensive care unit
- single cell
- metabolic syndrome
- stem cells
- study protocol
- climate change
- ionic liquid
- human health
- mesenchymal stem cells
- skeletal muscle
- bone marrow
- computed tomography
- extracorporeal membrane oxygenation
- cardiovascular disease
- machine learning
- adipose tissue
- health promotion
- acute respiratory distress syndrome
- electronic health record
- liver failure
- induced pluripotent stem cells
- respiratory failure