Metabolic health and microbiome modulation at the core of diabetes prevention

22 Aug 2024 --- Dietary choices to maintain metabolic health, regulate blood glucose and optimize the gut microbiome are central to the modern diabetes prevention approach. We catch up with Beneo, Ingredion, Cargill and PharmaLinea for an in-depth perspective on why these approaches are vital.

“The good news is that in many cases, nutrition can be key in delaying or preventing type 2 diabetes and its complications. In fact, within a consensus statement, leading scientists agreed that there is convincing evidence that low glycemic diets reduce the risk of type 2 diabetes and coronary heart disease, help to control blood glucose for people with diabetes and can also help to manage weight,” Dr. Stephan Theis, head of nutrition science and communication at Beneo, tells Nutrition Insight.

The company supports the concept of all-day options made of low-glycemic ingredients, including breakfast, in-between snacks, lunch and dinner.

“Making the right ingredient choice is paramount. We have the products, the knowledge, the ingredients that are backed up by sound science and we’re ready to help our food industry partners and our customers to take a low-glycemic response approach to their final products — along with the associated on-pack health claim — and target both sugar reduction and the blood glucose response,” Theis explains.

Codifying metabolic health

Ingredion offers a type 2 diabetes-resistant starch product called Hi-Maize 260 and another dietary fiber product, Tic Pretested gum acacia, for blood glucose management. The company has a series of stevia products such as leaf extract, bio-converted and fermented and allulose to reduce or replace sugar. Their soluble fibers also build back the functionalities of sugar.

“Given that lifestyle factors such as dietary intake and physical activity significantly contribute to the development of type 2 diabetes, a metabolic disorder, it is crucial for individuals to be mindful of their dietary choices to maintain metabolic health,” says Jing Zhou, senior manager, Global Scientific and Regulatory Affairs Nutrition, Healthful Solutions at Ingredion.Nutrition formulations that provide all-day low glycemic snacking options are the cornerstone of managing diabetes.

“Ingredion strategically focuses its Healthful Solutions business on supporting various aspects of consumer health, including metabolic health. We define metabolic health as achieving optimal levels of body weight, waist circumference, blood glucose, blood lipid profile and blood pressure. This definition aligns with scientific consensus and guides our future R&D efforts.” 

Gut microbiome and glycemic response

According to Beneo, gut microbiota has been identified as a significant predictor of individual glycemic response and following a low glycemic diet. Minor dietary adjustments can support blood glucose management. 

“For example, this has been shown in a two-week citizen science study that adopted a real-life conditions approach,” says Theis. “That means that participants kept to their usual diet and eating habits. The only difference was that they consumed Beneo’s ingredients: a drink with a functional carbohydrate (isomaltulose) and prebiotic chicory root fibers.” 

The results showed that both functional ingredients, independently of each other, supported blood glucose management, promoting improved metabolic health and that prebiotic chicory root fibers also beneficially modulate gut microbiota. 

Theis notes: “The demonstration of the synergetic effect of the two ingredients related to the decrease in glycemic variability over time confirmed that microbiota composition and blood sugar management are closely interrelated.”

Microbiome modulation

Maja Orešnik, science and research director at PharmaLinea, says several microbiome-related approaches are connected to diabetes prevention. 

“On one hand, we can see the benefits in the usage of fibers, such as slowing down the digestion of the carbohydrates, feeding the beneficial bacteria and changing the GI of the product,” Orešnik explains. “On the other hand, there’s a growing body of research on probiotics and their role in metabolic health and prediabetes, such as lowering the peaks of blood sugar after a meal.”

She highlights that PharmaLinea’s Your Prediabetiq Line supports balanced blood glucose levels with an immediate, measurable effect. The products are developed to improve glycemic response by reducing post-meal blood glucose levels on the one hand and enhancing insulin efficacy and sensitivity on the other. 

“Adding chromium to the formulation can be helpful when we wish to improve insulin sensitivity. The role of chromium in the human body is connected to insulin function, and its long-term supplementation has been proven to improve insulin-related parameters,” Orešnik adds.

Alyssa Leyva, sweeteners lead for Cargill Food Solutions North America, asserts that the human gut microbiome plays a critical role in human health and can be affected by overall diet and food ingredients.Low glycemic ingredients give people with diabetes more options for snacking during the day. 

“High-intensity sweeteners are known to reach the gut, but research on their effects on the human gut microbiome is limited. Cargill has completed a study on stevia to fill in this knowledge gap,” Leyva explains.

Cargill’s recent study published in the Journal of Nutrition found that a high dose of stevia consumed daily for four weeks has no significant effect on the human gut microbiome profile or function, adding to the considerable body of research supporting its use in food and beverages.

“The study found that a high dose in the daily consumption of a stevia-sweetened beverage was well tolerated by study participants, had no significant effects on the relative abundance of gut microflora and had no significant effects on microbial production of short-chain fatty acids, which have notable beneficial biological functions,” says Leyva.

 “It also found that it had no significant effect on fasting blood glucose and insulin levels and it produced a modest improvement in body mass index compared to sugar.”

Low glycemic diet

Ingredion’s Hi-Maize ingredient has an approved FDA-qualified health claim regarding its benefits in reducing the risk of type 2 diabetes. It also has an approved EFSA health claim about supporting glycemic health. In addition to Hi-Maize, the FDA has recognized resistant starch type 4 ingredients as a dietary fiber due to their physiological benefits in supporting glycemic health. 

“A study was published earlier this year in the journal Nature Metabolism that demonstrated how resistant starch can have a beneficial effect in the areas of maintaining a healthy weight and optimizing postprandial blood glucose and insulin levels, which the researchers attributed to a shift in the microbiome. The specific resistant starch used in this study was Hi-Maize 260 resistant starch,” Zhou explains.

 Ingredion’s sugar reduction solutions — stevia, allulose and some polyols (polyhydric alcohols) — can easily be included to support a glycemic diet in conjunction with other low-glycemic food items.

Leyva underscores that people with diabetes must maintain blood sugar levels, also known as glycemia, to a range with no peaks and valleys because sugar intake can increase these levels to unhealthy proportions.   

“Yet when formulating products designed to support blood sugar management, food and beverage manufacturers face a myriad of challenges. They’re trying to reduce sugars to maintain the sweetness and texture consumers love — all while still creating a final product that tastes great,” Leyva explains.

Choosing the right carbohydrate

This underscores that carbohydrates are important in the diet to establish balanced nutrition. Many evidence-based reports suggest that the preferred choice of carbohydrate should be slowly available and low glycemic. 

“This is to enable a lower blood glucose profile to be maintained throughout the day, allowing a lower insulin level to be achieved. When it comes to blood sugar management, Beneo has a range of ingredients that can help to lower the blood glucose and insulin response and all have approved health claims in the EU related to this effect,” says Theis.  

Beneo’s Orafti inulin and oligofructose contribute to a low-glycemic diet by replacing available carbohydrates and enriching the food with dietary fiber, supporting effective blood sugar management.Healthy snacks help manage blood glucose and insulin levels. 

The company’s Palatinose (isomaltulose) is a slow-release sugar made from sucrose, which is naturally sourced from sugar beets. It delivers a lower rise in blood glucose while delivering full carbohydrate energy (4 kcal/g), making it an ideal ingredient to help support blood sugar management. 

Their sugar replacer isomalt supports a low glycemic diet by making sugar-free confectionery that provides half the calories of sugar while having an almost neglectable effect on blood sugar and insulin levels. Beneo’s Orafti β-Fit is a clean label wholegrain barley flour with 20% beta-glucans that improves heart health and blood sugar management.

Growing portfolio of sweeteners

Cargill has a growing portfolio of ingredients that do not impact glycemia, such as Truvia and ViaTech stevia leaf extracts and EverSweet stevia sweetener, which are produced via fermentation. The company’s Zerose erythritol sweetener is a bulking agent that boosts stevia’s sweetness.

“A combination of stevia and erythritol provides the same sweetness and properties as sugars in foods and beverages but are not metabolized the same as sugars and do not raise blood glucose or insulin levels. Stevia and erythritol have little effect on blood glucose levels and thus can help support healthy blood glucose levels,” says Leyva. 

Cargill nutrition scientists have partnered with researchers to conduct a clinical study to understand how stevia influences appetite, energy intake and blood glucose levels. The study found that a zero-calorie stevia beverage given before a meal provided the enjoyment of a sweet taste without raising blood glucose levels and did not negatively affect appetite. 

“The results indicate that stevia may be useful in managing appetite and food intake without raising blood glucose. For people with diabetes and individuals with impaired glucose management, proper blood sugar management is critical,” says Leyva. 

By Inga de Jong