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Pomegranate juice, but not an extract, confers a lower glycemic response on a high-glycemic index food: randomized, crossover, controlled trials in healthy subjects.
Am J Clin Nutr 2017; 106(6):1384-1393AJ

Abstract

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.

Authors+Show Affiliations

School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom; and.School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom; and.School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom; and.CEBAS-CSIC, Murcia, Spain.School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom; and g.williamson@leeds.ac.uk.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

29021286

Citation

Kerimi, Asimina, et al. "Pomegranate Juice, but Not an Extract, Confers a Lower Glycemic Response On a High-glycemic Index Food: Randomized, Crossover, Controlled Trials in Healthy Subjects." The American Journal of Clinical Nutrition, vol. 106, no. 6, 2017, pp. 1384-1393.
Kerimi A, Nyambe-Silavwe H, Gauer JS, et al. Pomegranate juice, but not an extract, confers a lower glycemic response on a high-glycemic index food: randomized, crossover, controlled trials in healthy subjects. Am J Clin Nutr. 2017;106(6):1384-1393.
Kerimi, A., Nyambe-Silavwe, H., Gauer, J. S., Tomás-Barberán, F. A., & Williamson, G. (2017). Pomegranate juice, but not an extract, confers a lower glycemic response on a high-glycemic index food: randomized, crossover, controlled trials in healthy subjects. The American Journal of Clinical Nutrition, 106(6), pp. 1384-1393. doi:10.3945/ajcn.117.161968.
Kerimi A, et al. Pomegranate Juice, but Not an Extract, Confers a Lower Glycemic Response On a High-glycemic Index Food: Randomized, Crossover, Controlled Trials in Healthy Subjects. Am J Clin Nutr. 2017;106(6):1384-1393. PubMed PMID: 29021286.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pomegranate juice, but not an extract, confers a lower glycemic response on a high-glycemic index food: randomized, crossover, controlled trials in healthy subjects. AU - Kerimi,Asimina, AU - Nyambe-Silavwe,Hilda, AU - Gauer,Julia S, AU - Tomás-Barberán,Francisco A, AU - Williamson,Gary, Y1 - 2017/10/11/ PY - 2017/06/07/received PY - 2017/09/15/accepted PY - 2017/10/13/pubmed PY - 2017/12/12/medline PY - 2017/10/13/entrez KW - carbohydrate digestion KW - glucose transport KW - glycemic index KW - polyphenol KW - starch SP - 1384 EP - 1393 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 106 IS - 6 N2 - 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. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/29021286/Pomegranate_juice_but_not_an_extract_confers_a_lower_glycemic_response_on_a_high_glycemic_index_food:_randomized_crossover_controlled_trials_in_healthy_subjects_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.117.161968 DB - PRIME DP - Unbound Medicine ER -