High-Amylose Wheat Lowers the Postprandial Glycemic Response to Bread in Healthy Adults: A Randomized Controlled Crossover Trial

Abstract

ABSTRACTBackgroundConventional wheat-based foods contain high concentrations of readily digestible starch that commonly give these foods a high postprandial glycemic response and may contribute to the development of type 2 diabetes and cardiovascular disease.ObjectivesThe aim of this study was to determine if bread made from high-amylose wheat (HAW) and enriched in resistant starch dampens postprandial glycemia compared with bread made from conventional low-amylose wheat (LAW).MethodsThis single-center, randomized, double-blinded, crossover controlled study involved 7 consecutive weekly visits. On separate mornings, 20 healthy nondiabetic men and women (mean age 30 ± 3 y; body mass index 23 ± 0.7 kg/m2) consumed a glucose beverage or 4 different breads (each 121 g); LAW-R (refined), LAW-W (wholemeal), HAW-R, or HAW-W. The starch contents of the LAW and HAW breads were 24% and 74% amylose, respectively. Venous blood samples were collected at regular intervals before and for 3 h after the breakfast meal to measure plasma glucose, insulin, ghrelin, and incretin hormone concentrations, and the incremental area under the curve (AUC) was calculated (mmol/L × 3 h). Satiety and cravings were also measured at 30-min intervals during the postprandial period.ResultsHAW breads had a glycemic response (AUC) that was 39% less than that achieved with conventional wheat breads (HAW 39 ± 5 mmol/L × 3 h; LAW 64 ± 5 mmol/L × 3 h; P < 0.0001). Insulinemic and incretin responses were 24–30% less for HAW breads than for LAW breads (P < 0.05). Processing of the flour (wholemeal or refined) did not affect the glycemic, insulinemic, or incretin response. The HAW breads did not influence plasma ghrelin, or subjective measures of satiety or cravings during the postprandial period.ConclusionsReplacing LAW with HAW flour may be an effective strategy for lowering postprandial glycemic and insulinemic responses to bread in healthy men and women, but further research is warranted. This trial was registered at the Australian and New Zealand Clinical Trials Registry as ACTRN12616001289404.