Metabolic Responses to Isomaltulose by Malaysian Chinese Adults: - - PowerPoint PPT Presentation

Metabolic Responses to Isomaltulose by Malaysian Chinese Adults: A Pilot Study

Chan Chee Shan

Introduction

• What is isomaltulose?

Chan Chee Shan 2018 NSM Conference

Chan Chee Shan 2018 NSM Conference

Isomaltulose vs. sucrose*

• 0.5

0.0 0.5 1.0 1.5 2.0 2.5 3.0 30 60 90 120 Change in blood glucose (mmol/L) Time (mins)

sucrose isomaltulose

Chan Chee Shan 2018 NSM Conference

Isomaltulose-containing products in Malaysia

Oral nutritional supplement

Sports supplement Child growing- up formula Muscle- building supplement Health supplement

Chan Chee Shan 2018 NSM Conference

Isomaltulose-containing products in Malaysia

Oral nutritional supplement Sports supplement Child growing- up formula Muscle-building supplement Health supplement

Chan Chee Shan 2018 NSM Conference

Consumption of isomaltulose is expected to increase in Malaysia in the future

Research questions

• I. What is the maximum bolus of isomaltulose

that is well-tolerated by young healthy adults in Malaysia?

• II. Is the claimed difference between the blood

glucose responses to isomaltulose and sucrose valid?

III.Will isomaltulose induce a drop in faecal pH,

suggestive of prebiotic activity?

Chan Chee Shan 2018 NSM Conference

Study objectives

• I. To determine the degree of spill-over of

different doses of isomaltulose into the colon among Malaysian healthy adults by means of a breath hydrogen test.

• II. To determine the dose-dependent increase in

glycaemic response to bolus administration of isomaltulose, in comparison to sucrose.

III.To examine the potential prebiotic activity of

isomaltulose.

Chan Chee Shan 2018 NSM Conference

Methodology

Chan Chee Shan 2018 NSM Conference

Process

 This study was approved by the IMU-Joint

Committee for ethics approval.

 Data collection was done at IMU, Bukit

Jalil campus.

 Subjects were recruited by group and

targeted presentations to individuals (convenient sampling).

Chan Chee Shan 2018 NSM Conference

Inclusion criteria

Age: 18 – 40 years old BMI: 15.0 – 26.9 kg/m2 Exclusive hydrogen producers i. ii. iii.

Chan Chee Shan 2018 NSM Conference

Exclusion criteria

Alcohol consumption within the previous 24 hours Smoking a cigarette within 48 hours Antibiotics taken within 1-month prior to the test Pregnancy Active medical conditions involving major organs Exclusive methane producers (non-hydrogen producers)

i. ii. iii. iv. v. vi.

Chan Chee Shan 2018 NSM Conference

Methodology

• Study flow chart

Chan Chee Shan 2018 NSM Conference

Chan Chee Shan 2018 NSM Conference

Determination of intolerance

Gastro+ Gastrolyzer (Bedfont Scientific Ltd)

≥ 20 ppm

Gastrointestinal symptoms

Chan Chee Shan 2018 NSM Conference

Discussion

❑ Interaction?

• Co-consumption of starch and

isomaltulose indigestion

❑ Glycaemic response:

• The involvement of incretin hormones?

❑ Suggested prebiotic activity

Chan Chee Shan 2018 NSM Conference

• 1. Interaction
• Co-consumption of starch & isomaltulose digestion

 Amylose and amylopectin → maltose + isomaltose  Isomaltose and maltose are competitive inhibitors of

isomaltulose.

 The digestion of starch and isomaltulose need to be

investigated.

Sucrase Isomaltase Connecting segment (stalk) Transmembrane segment

Chan Chee Shan 2018 NSM Conference

• 2. Glycaemic response:

[The action of incretin hormones?]

 No significant differences between iAUC of

tolerant and intolerant subjects to isomaltulose.

Incretins effect?

Chan Chee Shan 2018 NSM Conference

high [glucose] GIP secretion rapid insulin release

In isomaltulose-tolerant subjects…

Chan Chee Shan 2018 NSM Conference

• 3. Prebiotic activity

 Production of SCFAs in the colon and

faeces tends to reduce faecal pH.

 Changes in pre- and post-test faecal pH:

 Spill-over of isomaltulose into the colon

followed by anaerobic fermentation.

 Increase in acidification of faecal samples

Chan Chee Shan 2018 NSM Conference

Selected references

1.

Lina BA, Jonker D, Kozianowski G: Isomaltulose (Palatinose): a review of biological and toxicological studies. Food Chem. Toxicol. 2002;40:1375-1381.

2.

Ghoshal UC: How to interpret hydrogen breath tests. Journal of Neurogastroenterology and Motility 2011;17:312-317.

3.

Holub I, Gostner A, Theis S, Nosek L, Kudlich T , Melcher R, Scheppach W: Novel findings on the metabolic effects of the low glycaemic carbohydrate isomaltulose (Palatinose). British Journal of Nutrition 2010;103:1730-1737.

4.

Maeda A, Miyagawa J, Miuchi M, Nagai E, Konishi K, Matsuo T , et al. Effects of the naturally‐occurring disaccharides, palatinose and sucrose, on incretin secretion in healthy non‐obese subjects. Journal of diabetes investigation 2013;4(3):281-286.

5.

Keyhani-Nejad F , Kemper M, Schueler R, Pivovarova O, Rudovich N, Pfeiffer AF . Effects of palatinose and sucrose intake on glucose metabolism and incretin secretion in subjects with type 2 diabetes. Diabetes Care 2016 Mar;39(3):e38-9.

Chan Chee Shan 2018 NSM Conference

6.

Hira T , Muramatsu M, Okuno M, Hara H. GLP-1 secretion in response to oral and luminal palatinose (isomaltulose) in rats. J Nutr Sci Vitaminol (Tokyo) 2011;57(1):30-35.

7.

Tonouchi H, Yamaji T , Uchida M, Koganei M, Sasayama A, Kaneko T , et al. Studies

• n absorption and metabolism of palatinose (isomaltulose) in rats. Br J Nutr

2011;105(01):10-14.

8.

Roberfroid M, Gibson GR, Hoyles L, McCartney AL, Rastall R, Rowland I, et al. Prebiotic effects: metabolic and health benefits. Br J Nutr 2010;104(S2):S1-S63.

9.

Rana SV , Malik A. Hydrogen breath tests in gastrointestinal diseases. Indian Journal of Clinical Biochemistry 2014;29(4):398-405.

• 10. Food Standards Australia New Zealand. Application A578- Isomaltulose as a novel
• food. 2015; Available at:

http://www.foodstandards.gov.au/code/applications/Pages/applicationa578isoma 3297.aspx. Accessed May 14th, 2017.

Selected references

Chan Chee Shan 2018 NSM Conference

Chan Chee Shan 2018 NSM Conference