South Indian Cuisine with Low Glycemic Index Ingredients Reduces Cardiovascular Risk Factors in Subjects with Type 2 Diabetes
Abstract
:1. Introduction
1.1. Objectives of this study:
Primary Objective
- To compare the reductions in glycated hemoglobin (HbA1c) after 24 weeks of intervention with LGI diet
1.2. Secondary Objectives
- To examine changes in blood lipids and blood pressure in the intervention group on LGI diet, compared to the regular diet.
- To evaluate changes in inflammatory markers such as hs-CRP and apolipoprotein B (ApoB) between the LGI and control group.
- To measure reduction in fasting insulin and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) in the study groups, after intervention with the diet.
- To observe effects of LGI diet in reducing obesity and abdominal obesity
- To correlate weight changes and cardiovascular risk factors in subjects with type 2 diabetes
2. Methodology
2.1. Sample Size
2.2. Study Procedures
2.3. Biochemical Analysis
2.4. Dietary Intervention
2.5. Follow Up
2.6. Outcomes
2.7. Ethics
2.8. Statistical Analysis
3. Results
Correlation of Weight and Cardiovascular Risk Factors Postintervention in the Study Groups
4. Discussion
Limitations of the Study
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Breakfast | Red rice puttu (GI = 38) Whole wheat flour (GI = 45) puttu Rolled oats/Steel cut oats puttu (GI = 51/52) |
Lunch | Rose Matta rice (GI = 38) |
Dinner | Broken wheat (GI = 41) upma Broken wheat + green gram + fenugreek seeds kanji (porridge) Whole wheat flour (GI = 45) roti |
LGI (n = 40) | Control (n = 40) | |
---|---|---|
Age | 54.43 ± 7.57 | 51.93 ± 7.43 |
Gender | ||
Male | 25 (62.5%) | 27 (67.5%) |
Female | 15 (37.5%) | 13 (32.5%) |
Social habits | ||
Smoking | ||
Yes | 4 (10%) | 3 (7.5%) |
No | 36 (90%) | 37 (92.5%) |
Physical activity | ||
Sedentary | 6 (15%) | 4 (10%) |
Mild | 21 (52.5%) | 25 (62.5%) |
Moderate | 13 (32.5%) | 11 (27.5%) |
Comorbidities | ||
DLP | 22 (55%) | 25 (62.5%) |
HTN | 23 (57.5%) | 23 (57.5%) |
CAD | 11 (27.5%) | 6 (15%) |
Thyroid | 5 (12.5%) | 2 (5%) |
Variable | LGI Group (n = 40) | Control Group (n = 40) | p Value |
---|---|---|---|
Blood Pressure | |||
Systolic BP (mm Hg) | 132.9 ± 15.37 | 131.10 ± 13.28 | 0.577 |
Diastolic BP (mm Hg) | 79.90 ± 12.32 | 81.35 ± 8.45 | 0.541 |
Anthropometric measurement | |||
Height (cm) | 161.46 ± 7.51 | 163.98 ± 6.69 | 0.118 |
Weight (kg) | 69.12 ± 10.78 | 72.26 ± 10.52 | 0.191 |
BMI (kg/m2) | 26.40 ± 3.03 | 26.75 ± 3.29 | 0.623 |
Waist circumference (cm) | 95.34 ± 8.92 | 96.29 ± 8.99 | 0.631 |
Biochemical variables | |||
FBS (mg/dL) | 155.46 ± 36.10 | 150.01 ± 48.65 | 0.571 |
PPBS (mg/dL) | 227.21 ± 43.18 | 223.17 ± 48.53 | 0.695 |
HbA1c (%) | 8.44 ± 0.96 | 8.27 ± 0.99 | 0.443 |
Insulin (mIU/L) | 31.70 ± 46.61 | 28.65 ± 58.38 | 0.796 |
HOMA-IR | 11.62 ± 14.63 | 8.99 ± 13.61 | 0.408 |
Total cholesterol (mg/dL) | 172.43 ± 34.84 | 163.42 ± 41.76 | 0.298 |
Triglycerides (mg/dL) | 147.54 ± 63.20 | 131.30 ± 42.96 | 0.183 |
HDL (mg/dL) | 42.48 ± 10.12 | 41.82 ± 10.48 | 0.775 |
LDL (mg/dL) | 119.60 ± 32.13 | 104.50 ± 34.99 | 0.048 * |
VLDL (mg/dL) | 27.52 ± 10.75 | 27.95 ± 12.87 | 0.872 |
hsCRP (mg/L) | 3.38 ± 3.83 | 2.79 ± 4.20 | 0.517 |
ApoB (mg/dL) | 94.44 ± 22.81 | 88.14 ± 24.61 | 0.239 |
Nutrient intake | |||
Calories | 1554.8 ± 233.25 | 1430.4 ± 182 | 0.010 ** |
Carbohydrate (%) | 15.71 ± 2.44 | 15.75 ± 2.09 | 0.940 |
Protein (%) | 64.62 ± 5.56 | 63.30 ± 6 | 0.313 |
Fat (%) | 22.6 ± 5.88 | 24.3 ± 5.37 | 0.181 |
Medications | |||
Sulfonylureas | 24 | 28 | |
Metformin | 33 | 42 | |
DPP4-inh | 15 | 20 | |
Insulin | 13 | 17 | |
Acarbose | 2 | 0 | |
Meglitinides (Repaglinide) | 1 | 0 | |
Statins | 20 | 26 | |
Antihypertensives | 22 | 20 |
Variable | Group | Baseline | 24 Weeks | Mean Difference | p Value | p Value (LGI vs. Control) at 24 Weeks |
---|---|---|---|---|---|---|
Blood Pressure | ||||||
Systolic pressure (mmHg) | LGI | 132.90 ± 15.32 | 130.35 ± 17.63 | −2.55 ± 16.6 | 0.337 | 0.683 |
Control | 131.1 ± 13.28 | 131.83 ± 14.43 | 0.72 ± 14.84 | 0.759 | ||
Diastolic pressure (mmHg) | LGI | 79.9 ± 12.32 | 77.63 ± 7.08 | −2.27 ± 12.67 | 0.263 | 0.068 |
Control | 81.35 ± 8.45 | 80.60 ± 7.29 | −0.75 ± 6.96 | 0.500 | ||
Anthropometric measurements | ||||||
Weight (kg) | LGI | 69.12 ± 10.78 | 67.25 ± 9.81 | −1.87 ± 2.63 | 0.000 ** | 0.020 * |
Control | 72.26 ± 10.52 | 72.79 ± 11.00 | 0.53 ± 1.96 | 0.094 | ||
BMI (kg/m2) | LGI | 26.40 ± 3.03 | 25.71 ± 2.77 | −0.70 ± 0.99 | 0.000 ** | 0.078 |
Control | 26.75 ± 3.29 | 26.95 ± 3.42 | 0.20 ± 0.70 | 0.083 | ||
Waist circumference (cm) | LGI | 95.34 ± 8.92 | 92.40 ± 8.99 | −2.94 ± 4.71 | 0.000 ** | 0.148 |
Control | 96.29 ± 8.99 | 95.45 ± 9.64 | −0.84 ± 4.47 | 0.244 | ||
Biochemical parameters | ||||||
FBS (mg/dL) | LGI | 155.46 ± 36.10 | 136.75 ± 27.54 | −21.21 ± 39.42 | 0.001 ** | 0.192 |
Control | 150.01 ± 48.65 | 146.63 ± 38.73 | −3.38 ± 34.57 | 0.540 | ||
PPBS (mg/dL) | LGI | 227.21 ± 43.18 | 189.33 ± 56.49 | −37.87 ± 59.36 | 0.000 ** | 0.063 |
Control | 223.17 ± 48.53 | 212.22 ± 52.13 | −10.94 ± 51.44 | 0.186 | ||
HbA1c (%) | LGI | 8.44 ± 0.96 | 7.52 ± 0.94 | −0.93 ± 0.92 | 0.000 ** | 0.003 ** |
Control | 8.27 ± 0.99 | 8.27 ± 1.20 | 0.012 ± 0.87 | 0.929 | ||
Insulin (mIU/L) | LGI | 31.70 ± 46.61 | 14.79 ± 15.89 | −16.91 ± 40.42 | 0.012 * | 0.030 * |
Control | 28.65 ± 58.38 | 33.57 ± 51.17 | 4.92 ± 57.67 | 0.592 | ||
HOMA-IR | LGI | 11.62 ± 14.63 | 5.10 ± 6.06 | −6.51 ± 12.11 | 0.002 ** | 0.017 * |
Control | 8.99 ± 13.61 | 10.83 ± 13.50 | 1.84 ± 15.76 | 0.464 | ||
Total Cholesterol (mg/dL) | LGI | 172.43 ± 34.84 | 159.12 ± 33.68 | −13.30 ± 37.37 | 0.030 * | 0.422 |
Control | 163.42 ± 41.76 | 152.97 ± 34.41 | −10.45 ± 31.77 | 0.044 * | ||
Triglycerides (mg/dL) | LGI | 147.54 ± 63.20 | 120.65 ± 44.80 | −26.89 ± 48.37 | 0.001 ** | 0.025 * |
Control | 131.30 ± 42.96 | 153.06 ± 77.60 | 21.76 ± 56.69 | 0.020 * | ||
HDL (mg/dL) | LGI | 42.48 ± 10.12 | 41.92 ± 11.22 | −0.56 ± 5.64 | 0.531 | 0.886 |
Control | 41.82 ± 10.48 | 42.27 ± 10.50 | 0.44 ± 6.86 | 0.683 | ||
LDL (mg/dL) | LGI | 119.60 ± 32.13 | 105.02 ± 26.80 | −14.57 ± 27.42 | 0.002 ** | 0.979 |
Control | 104.50 ± 34.99 | 104.85 ± 33.13 | 0.34 ± 28.44 | 0.939 | ||
VLDL (mg/dL) | LGI | 27.52 ± 10.75 | 25.62 ± 11.24 | −1.90 ± 10.28 | 0.249 | 0.254 |
Control | 27.95 ± 12.87 | 28.79 ± 13.34 | 0.84 ± 9.71 | 0.588 | ||
hs-CRP (mg/L) | LGI | 3.38 ± 3.83 | 1.46 ± 1.04 | −1.92 ± 3.83 | 0.003 ** | 0.026 * |
Control | 2.79 ± 4.20 | 3.16 ± 4.61 | 0.36 ± 3.21 | 0.479 | ||
ApoB (mg/dL) | LGI | 94.44 ± 22.81 | 81.88 ± 19.83 | −12.55 ± 19.50 | 0.000 ** | 0.007 ** |
Control | 88.14 ± 24.61 | 95.05 ± 22.27 | 6.90 ± 16.15 | 0.010 ** | ||
Nutrient intake | ||||||
Calories (kcal) | LGI | 1430.4 ± 182 | 1511 ± 137.5 | 80.6 ± 243 | 0.043 * | 0.010 ** |
Control | 1554.8 ± 233.3 | 1450.4 ± 157.1 | 104.4 ± 250.1 | 0.012 | ||
Protein (g) | LGI | 55.8 ± 8.49 | 61.8 ± 10.1 | 6.02 ± 14.95 | 0.015 * | 0.025 * |
Control | 61.3 ± 12.8 | 58.5 ± 11.7 | −2.88 ± 8.15 | 0.221 | ||
Carbohydrate (g) | LGI | 230.9 ± 33.9 | 232.7 ± 28.4 | 1.85 ± 47.11 | 0.807 | 0.081 |
Control | 245.1 ± 37.5 | 238.4 ± 26.4 | −6.69 ± 46.2 | 0.365 | ||
Fat (g) | LGI | 36.1 ± 10.4 | 40.9 ± 7.71 | 1.77 ± 7.47 | 0.036 * | 0.019 * |
Control | 42.4 ± 12.7 | 34.2 ± 10.1 | −8.15 ± 17.2 | 0.005 ** |
Nutrient Intake | Baseline | 24 Weeks | p Value | |
---|---|---|---|---|
Calories (kcal) | LGI | 1430.4 ± 182 | 1511 ± 137.5 | 0.07 |
Control | 1554.8 ± 233.3 | 1450.4 ± 157.1 | ||
Protein (%) | LGI | 15.71 ± 2.44 | 16.38 ± 2.44 | 0.571 |
Control | 15.75 ± 2.09 | 16.07 ± 2.53 | ||
Carbohydrate (%) | LGI | 64.62 ± 5.56 | 61.6 ± 4.62 | <0.001 ** |
Control | 63.3 ± 6 | 65.93 ± 5.14 | ||
Fat (%) | LGI | 22.6 ± 5.88 | 24.37 ± 3.9 | 0.003 ** |
Control | 24.3 ± 5.37 | 21.12 ± 5.4 |
Table 4 Variables | Weight | p Value | |
---|---|---|---|
Pearson Correlation Coefficient (r) | |||
Waist circumference | 0.735 ** | <0.01 | |
Postprandial blood sugar | 0.251 * | <0.05 | |
HbA1c | 0.241 * | <0.05 |
Variables | ApoB | p Value |
---|---|---|
Pearson Correlation Coefficient (r) | ||
Total Cholesterol | 0.529 ** | <0.01 |
Triglycerides | 0.314 ** | <0.01 |
LDL | 0.599 ** | <0.01 |
Fasting Insulin | 0.237 * | <0.05 |
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Pavithran, N.; Kumar, H.; Menon, A.S.; Pillai, G.K.; Sundaram, K.R.; Ojo, O. South Indian Cuisine with Low Glycemic Index Ingredients Reduces Cardiovascular Risk Factors in Subjects with Type 2 Diabetes. Int. J. Environ. Res. Public Health 2020, 17, 6232. https://doi.org/10.3390/ijerph17176232
Pavithran N, Kumar H, Menon AS, Pillai GK, Sundaram KR, Ojo O. South Indian Cuisine with Low Glycemic Index Ingredients Reduces Cardiovascular Risk Factors in Subjects with Type 2 Diabetes. International Journal of Environmental Research and Public Health. 2020; 17(17):6232. https://doi.org/10.3390/ijerph17176232
Chicago/Turabian StylePavithran, Nivedita, Harish Kumar, Arun Somasekharan Menon, Gopala Krishna Pillai, Karimassery Ramaiyer Sundaram, and Omorogieva Ojo. 2020. "South Indian Cuisine with Low Glycemic Index Ingredients Reduces Cardiovascular Risk Factors in Subjects with Type 2 Diabetes" International Journal of Environmental Research and Public Health 17, no. 17: 6232. https://doi.org/10.3390/ijerph17176232