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The Influence of the Subjects' Training State on the Glycemic Index

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The Influence of the Subjects' Training State on the Glycemic Index European Journal of Clinical Nutrition (2007) 61, 19–24 & 2007 Nature Publishing Group All rights reserved 0954-3007/07 $30.00 www.nature.com/ejcn ORIGINAL ARTICLE The influence of the subjects’ training state on the glycemic index S Mettler, F Lamprecht-Rusca, N Stoffel-Kurt, C Wenk and PC Colombani Department of Agricultural and Food Sciences, ETH Zurich, Zurich, Switzerland Objective: To determine the glycemic index (GI) dependence on the training state of healthy adult males. Subjects and design: Young, adult males of normal body mass index and normal glucose tolerance were tested twice with a 50 g reference glucose solution and twice with a breakfast cereal containing 50 g of available carbohydrates in a randomized order. Ten subjects were sedentary (SE), 12 were moderately trained (MT) and 12 were endurance trained (ET). Blood glucose, insulin and glucagon were measured. Results: The GI differed significantly between SE and ET subjects (P ¼ 0.02, mean difference: 23 GI units, 95% CI ¼ 3–42 GI units). The GI of the MT subjects was intermediary, but did not differ significantly from the SE or ET subjects. The insulin index did not differ significantly between the groups (P ¼ 0.65). Conclusion: The GI of the commercially available breakfast cereal depended on the training state of the healthy males. The training state is the first reported factor influencing the GI that is subject specific rather than food specific. European Journal of Clinical Nutrition (2007) 61, 19–24. doi:10.1038/sj.ejcn.1602480; published online 12 July 2006 Keywords: carbohydrates; glucose; exercise; glycemic index; insulin; insulinemic index Introduction or absolute glycemic response (Wolever et al., 2003). An important subject specific factor, a subject’s training state or The concept of the glycemic index (GI) was introduced by fitness, however, has not been investigated since the GI’s Jenkins et al. 25 years ago (Jenkins et al., 1981). Since then introduction 25 years ago. Thus, we recently have explored the GI concept has become widely used and even the Food whether the GI might differ according to the training state of and Agriculture Organization/World Health Organisation healthy people, and were surprised to find a substantial recommends the use of the GI (FAO/WHO, 1998). A food’s (25 GI units) variation in a commercially available breakfast GI is a percentage representing the area under the blood cereal’s GI when comparing endurance trained (ET) to glucose response curve (over 2 h and measured at defined sedentary (SE) subjects (Mettler et al., 2006). To our knowl- intervals) relative to the blood glucose response curve of a edge, this was the first report of a subject-specific factor reference food (glucose or white bread) (FAO/WHO, 1998). impacting the GI. As this result would challenge the actual One of the GI’s characteristics is that it describes a specific prescription of the GI determination, and to some extent the food and does not seem to be related to subject-specific existing GI values, it was mandatory to validate the results factors such as age, gender, body mass index (BMI), ethnicity obtained in our recent study. Therefore, this study’s main aim was to repeat the GI determination of a breakfast cereal with SE and ET subjects. Secondary aims were to identify Correspondence: S Mettler, Department of Agricultural and Food Sciences, possible reasons for the GI’s dependence on the training state ETH Zurich, Universita¨tsstrasse 2, ETH Zentrum – LFH A2, Zurich CH-8092, Switzerland. and to include a group of moderately trained(MT) subjects in E-mail: [email protected] order to detect a potential dose–response relation between Study data have not been previously published and are not currently training state and GI. submitted for publication. Guarantor: PC Colombani. Contributors: SM was responsible for and coordinated the execution of the study and laboratory analysis, performed the statistical analysis and drafted Materials and methods the manuscript. SM, CW and PCC obtained the funding, planned and designed the study. SM, FLR and NSK executed the study. PCC edited the Study design manuscript and FLR, NSK and CW commented on the manuscript. Received 6 January 2006; revised 24 May 2006; accepted 8 June 2006; The study was carried out in a random crossover order and published online 12 July 2006 consisted of a duplicate assessment of the reference food Glycemic index and training state S Mettler et al 20 (glucose) and of a commercially available breakfast cereal. At GmbH, Bitz, Germany). The subjects were asked not to have least 7 days before the first of these four trials, which were any large meal within 4 h of the test and not to have any separated by 3–7 days, each subject performed a VO2max small snack within 2 h of the test. The physically active test. The study’s design was approved by the ethical subjects were asked not to compete the week before the test committee of the ETH Zurich. All participants of the study and not to train vigorously in the 2 days before the test. The gave their written, informed consent. protocol consisted of a 5 min warm-up at 50 W, a start power of 80 and a 15 W increment every 30 s (Buchfuhrer et al., 1983; Zhang et al., 1991). The pedal frequency was not Subjects standardized during the warm-up, but it was set at or above All subjects were young (inclusion criteria: age 18–40 years), 70 (73) r.p.m. throughout the test. Oxygen uptake was non-smoking, normoglycemic (glycosylated hemoglobin measured breath by breath with the Quark b2 System (HbA1c): 4.8–5.9%; fasting blood glucose o5.6 mmol lÀ1) (COSMED, Rome, Italy). The highest oxygen uptake reached, À2 males of normal BMI (19–25 kg m ). None of the subjects’ averaged over 20 s, was designated as the VO2max. All nearest relatives had diabetes. Forty-one subjects who subjects reached a VCO2/VO2 above 1.1 and a subjective fulfilled all inclusion criteria were divided into three groups rating of at least 18 on the BORG scale. according to their reported training volume. Seven subjects dropped out before completing all trials because of illness, unexpected change in their workplace or other personal Study meals reasons, such as not feeling comfortable with the arm vein The reference food for the GI determination was glucose catheter or inaccurate adherence to the standardization (50 g dissolved in 200 ml water) and the commercially procedure. The remaining subjects consisted of 10 SE males available breakfast cereal was Kellogg’s Special K (Kellogg who were neither involved in any exercise-like activity in AG, Zug, Switzerland). The subjects were served 57.6 g of the their leisure time nor engaged in any physically intense cereal with 150 ml of partially skim milk (2.8% fat), so that occupational activity, 12 MT males who exercised two to the test meal provided a total of 50 g available carbohydrates, three times per week and 12 ET males who trained at least 14 g protein, 4.6 g fat and 1.7 g fiber. An additional 200 ml four times per week, and some of them being competitive tap water was served with both meals. The amount of athletes (Table 1). The subjects’ physical activity level had to available carbohydrates was calculated according to nutri- be constant for at least 6 months before the start of and tional information provided by the manufacturer and throughout the study. additionally verified by analysis of the digestible (available) starch and carbohydrate as well as indigestible fibers with Anthropometry. Body mass was measured in the fasted state the AOAC/AACC method (McCleary et al., 1997, 2002) with light clothing (underwear and t-shirt) on a scale (Multi using enzymatic kits of Megazyme International (Wicklow, Range, Sauter GmbH, Albstadt 1-Ebingen, Germany). Height Ireland). was measured in the morning and body fat was measured with a skinfold caliper (Harpenden Skinfold Caliper, British Indicators, West Sussex, UK) at three skinfolds (chest, Experimental procedures abdominal, femoral). Body density and body fat were In addition to maintaining their habitual physical activity calculated according to Jackson et al. (1980) and Siri (1993). level throughout the entire experimental period, each subject’s physical activity level was standardized for 2 days VO2max. The maximal oxygen uptake (VO2max) was before each trial according to the subject’s habitual lifestyle determined on a cycle ergometer (Ergoline 800S, Ergoline and activity pattern. Thus, the SE subjects refrained from Table 1 Characteristics of the subjects (mean7s.d.) SE (n ¼ 10) MT (n ¼ 12) ET (n ¼ 12) Age (year) 24.374.1 25.073 22.871.9 BMI (kg mÀ2) 21.671.4 22.871.9 22.971.9 Body fat (%) 11.974.7 13.077.0 8.472.9 À1 À1 A A B VO2max (ml min kg ) 42.676.7 47.178.0 55.776.6 Training (sessions weekÀ1)070A 2.570.5B 7.671.7C Total training volume (min weekÀ1)070A 163755B 6597192C Endurance volume (min weekÀ1)070A 82734B 4957187C Fasting capillary glucose (mmol lÀ1) 4.9670.31 4.9370.32 4.8570.32 Glycosylated hemoglobin HbA1c (%) 5.370.3 5.570.4 5.270.2 BMI, Body mass index; ET, endurance trained; MT, moderately trained; SE, sedentary. A,B,CDifferent letters denote a significant difference between the subject groups (Po0.05). European Journal of Clinical Nutrition Glycemic index and training state S Mettler et al 21 physical activity above their normal level during the 2 days Calculations and statistical methods preceding each trial. In contrast, the MT subjects were not The incremental area under the curve (IAUC) values for allowed to exercise the day before each trial, and the ET glucose and insulin were calculated geometrically, ignoring subjects were not allowed to perform any vigorous exercise areas below the fasting value (Brouns et al., 2005).
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