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As years progress, we are found more often in a postprandial than a postabsorptive state. Chrononutrition is an integral part of metabolism, pancreatic function, and hormone secretion. Eating most calories and carbohydrates at lunch time and early afternoon, avoiding late evening dinner, and keeping consistent number of daily meals and relative times of eating occasions seem to play a pivotal role for postprandial glycemia and insulin sensitivity. Sequence of meals and nutrients also play a significant role, as foods of low density such as vegetables, salads, or soups consumed first, followed by protein and then by starchy foods lead to ameliorated glycemic and insulin responses. There are several dietary schemes available, such as intermittent fasting regimes, which may improve glycemic and insulin responses. Weight loss is important for the treatment of insulin resistance, and it can be achieved by many approaches, such as low-fat, low-carbohydrate, Mediterranean-style diets, etc. Lifestyle interventions with small weight loss (7–10%), 150 min of weekly moderate intensity exercise and behavioral therapy approach can be highly effective in preventing and treating type 2 diabetes. Similarly, decreasing carbohydrates in meals also improves significantly glycemic and insulin responses, but the extent of this reduction should be individualized, patient-centered, and monitored. Alternative foods or ingredients, such as vinegar, yogurt, whey protein, peanuts and tree nuts should also be considered in ameliorating postprandial hyperglycemia and insulin resistance. This review aims to describe the available evidence about the effects of diet, chrononutrition, alternative dietary interventions and exercise on postprandial glycemia and insulin resistance.

Anthropogenic climate change drives ocean acidification, which alters marine iodine cycling and increases bioaccumulation in marine ecosystems. This environmental shift may alter marine iodine cycling and, under certain conditions, lead to increased dietary and atmospheric iodine exposure, particularly in coastal populations, with potential risks for thyroid dysfunction and downstream cardiovascular complications. Experimental data suggest that acidification may enhance iodine uptake in marine organisms such as kelp and seafood, with possible implications for consumption by humans. Because chronic iodine excess has already been associated with thyroid disease and its related cardiovascular disorders, these connections are worthy of further examination. In this narrative review we provide a synthesis of the possible mechanistic pathways by which ocean acidification, iodine bioavailability, thyroid function, and cardiovascular health may be connected. We also highlight the need for ongoing investigation, environmental monitoring, and interdisciplinary collaboration to further explain and address these tentative associations.

The coronavirus (COVID-19) pandemic and the measures taken by most countries to curb virus transmission, such as social distancing, distance learning, population, home confinement and disruption of all organized activities, has affected children and adolescents worldwide. The aim of this review was to assess the role of diet and lifestyle changes due to COVID-19 measures on body weight/composition and cardiometabolic risk factors in children and adolescents. An electronic search was conducted in PUBMED, COCHRANE, Google Scholar and SCOPUS databases up to 31 October 2021. 15 eligible studies were identified. According to the studies included in the analysis, COVID-19 measures seem to have had a negative impact on the diets and lifestyles of children and adolescents, with a consequent increase in body weight and central fat accumulation. On the other hand, the parental presence and control resulted in better glycaemic control in children with diabetes mellitus (DM) Type 1, but the effect of the pandemic in the glycaemic control of children with DM2 2 is controversial. Finally, diet and lifestyle changes had a differential impact on children’s hypertension prevalence. These findings point to the need for public policy measures to prevent obesity and its complications, to and improve diet and lifestyle during the continuing and yet unresolved COVID-19 epidemic.

The effects of spirulina consumption added in foods were investigated in two crossover clinical trials (n = 13 different healthy adults). In Trial-1 adults consumed cookies with-and-without spirulina (3.12 g per 100 g final product; 2.5 g spirulina per 50 g available carbohydrates) according to glycemic index (GI) methodology. In Trial-2, adults consumed 4 g, 6 g, and 8 g spirulina as beverage diluted in 50 g D-glucose vs. 50 g plain D-glucose. Capillary blood glucose samples were collected at 0, 15, 30, 45, 60, 90, and 120 min and blood pressure (BP) was measured at beginning and end of each visit in both trials. Trial-1: both cookies with and without spirulina provided medium GI values (59 and 60, respectively, on glucose-scale), but no significant differences were found for BP. Trial-2: both 4 g and 8 g spirulina lowered postprandial glucose at 120 min (95% CI: −1.64 to −16.12 and −1.23 to −15.87, respectively). The results explained 29% of variation. Only 8 g spirulina decreased significantly 90–120 min area under the curve (AUC) for glucose and systolic BP (−4%). No differences were found for fasting glucose. Adding spirulina to cookies did not affect glucose responses and BP. Only 8 g provided significantly lower 90–120 min-AUC for glucose and BP compared to 4 g, 6 g-and-D-glucose, indicating advantages to glycemic control and hypertension.

This study aimed to determine the glycemic index (GI) of a commercial mixed fruit juice (apple, orange, grape, and pomegranate; FJ) fortified with vitamin D3 or n-3 polyunsaturated fatty acids (PUFA) or probiotics, and their combination, and their effects on glycemic responses and salivary insulin concentrations. In a randomized controlled, double-blind, crossover study, 11 healthy participants (25 ± 2 years; five women; body mass index = 23 ± 1 kg/m2) were randomly assigned to receive five types of FJs [vitD (with vitamin D3); n-3 (with n-3 PUFA); probiotics (with Lacticaseibacillus casei Shirota and Lacticaseibacillus rhamnosus GG); vitD-n-3-probiotics FJ (combination of vitD3-n-3-probiotics), control (regular FJ)], all containing 50 g available carbohydrate, and glucose as reference drink. All FJs provided low GI values (control: 54; vitD3: 52; n-3: 51; probiotics: 50; and vitD-n-3-probiotics combination: 52, on glucose scale). Compared to the FJ control, the enriched FJs produced different postprandial glycemic and insulinemic responses and affected satiety scores. All FJ types, regardless of the added biofunctional ingredients, attenuated postprandial glycemic responses, which may offer advantages to glycemic control.

High sugar intake has been associated with adverse effects on health, with some types of breakfast being highly linked to overweight and obesity. The aim was to compare the effects of four sugar-free breakfast items, apricot jam with white bread (JWB), white bread (WB), cocoa with fat-free milk (CM), and dried cranberry cereal bar (CB), compared to d-glucose on the glycaemic responses. Using a cross-over design, twelve healthy individuals (25 ± 4 years; BMI 22 ± 2 kg/m2) received isoglucidic test meals (25 g of available carbohydrate) and 25 g glucose reference, in random order. Glycaemic index/load (GI/GL) were calculated, and capillary blood glucose samples were collected at 0–120 min after meal consumption. Subjective appetite was assessed with visual analogue scales. Sugar-free apricot jam and cocoa powder contained traces of available carbohydrates and were consumed along with bread and fat-free milk, respectively. JWB and WB were classified as medium GI, low-to-medium GL; CM as medium GI, low GL; and CB as high GI, low-to-medium GL. Subjective hunger was lower after JWB, fullness was higher after CM and pleasure was higher after CB (P for all < 0⋅05). In conclusion, sugar-free apricot jam with and without WB and cocoa powder with fat-free milk are suitable healthy breakfast options leading to improved glycaemic and subjective appetite responses.

Dietary fiber (DF) consumption has been associated with improved glycemic control in epidemiological and long-term interventional studies. However, its acute effects are not yet clear. This systematic review aims to elucidate the postprandial effects of DF in starchy products on glycemia and insulinemia. An electronic search of databases was conducted, and forty-one records met the inclusion criteria and underwent a risk-of-bias assessment. It was shown that soluble DF does not clearly affect glycemia in individuals with normal weight, while resistant starch may be more effective in flattening glycemic responses. Concerning insulinemia, both soluble DF and resistant starch have mixed results, with either favorable or no effects. Data on insoluble DF and glucose metabolism are scarce. The same mixed results for glycemia can be seen in healthy volunteers with overweight/obesity, while resistant starch seems to improve insulinemic responses. Finally, more studies need to examine the acute effects of DF in starchy foods on glucose metabolism and insulin secretion in individuals facing glucose abnormalities. Additionally, more studies are needed to prove whether ingesting high-fiber carbohydrate-containing products per se can result in blunted glycemic and insulinemic responses and which DF type and amount are more effective.

Background and Aims. Vinegar has been shown to have a glucose-lowering effect in patients with glucose abnormalities. However, the mechanisms of this effect are still obscure. The aim of this randomised, crossover study was to investigate the effect of vinegar on glucose metabolism in muscle which is the most important tissue for insulin-stimulated glucose disposal. Materials and Methods. Eleven subjects with DM2 consumed vinegar or placebo (at random order on two separate days, a week apart), before a mixed meal. Plasma glucose, insulin, triglycerides, nonesterified fatty acids (NEFA), and glycerol were measured preprandially and at 30–60 min for 300 min postprandially from the radial artery and from a forearm vein. Muscle blood flow was measured with strain-gauge plethysmography. Glucose uptake was calculated as the arteriovenous difference of glucose multiplied by blood flow. Results. Vinegar compared to placebo (1) increased forearm glucose uptake (p=0.0357), (2) decreased plasma glucose (p=0.0279), insulin (p=0.0457), and triglycerides (p=0.0439), and (3) did not change NEFA and glycerol. Conclusions. In DM2 vinegar reduces postprandial hyperglycaemia, hyperinsulinaemia, and hypertriglyceridaemia without affecting lipolysis. Vinegar’s effect on carbohydrate metabolism may be partly accounted for by an increase in glucose uptake, demonstrating an improvement in insulin action in skeletal muscle. This trial is registered with Clinicaltrials.gov NCT02309424.

Background/objectivesThis randomized, double blind, cross-over study investigated the glycemic response to six Greek honey grades differing in floral source and carbohydrate composition.Subjects/methodsEleven clinically and metabolically healthy, fasting individuals (27 ± 7 years; nine women; BMI 24 ± 4 kg/m2) received isoglucidic test meals (50 g available carbohydrate) and 50 g glucose reference, in random order. GI was calculated using the FAO/WHO method. Capillary blood glucose samples were collected at 0, 15, 30, 45, 60, 90, and 120 min. Salivary insulin samples were collected at 0, 60, and 120 min. Subjective appetite ratings (hunger, fullness and desire to eat) were assessed by visual analogue scales (VAS, 100 mm) at baseline and 120 min.ResultsFir and chestnut honeys provided medium GI values (59 and 66, respectively, on glucose scale). Citrus, heather, pine and thyme honeys provided high GI (>70 on glucose scale). Sucrose to oligosaccharides ratio, sucrose content and fructose to glucose ratio were inversely associated with GI (p < 0.05). No differences were observed between honey varieties for fasting glucose, fasting and post-test-meal insulin concentrations and subjective appetite.ConclusionsHoney varieties produced different glycemic responses, although having similar botanical origin and characterization, partly explained by their sucrose to oligosaccharide ratio (by 30%). Fir and chestnut honeys attenuated postprandial glycemic response, which may offer advantages to glycemic control.

Time-restricted feeding (TRF) and Ramadan fasting (RF) have been recently associated with several health outcomes. However, it is not yet clear if they are superior to existing treatments in terms of glucose metabolism, insulin action, and weight loss. This review aims to summarize the current data on the effects of these regimes on body weight, body composition, and glycemia. An electronic search was conducted in PUBMED and SCOPUS databases up to August 2022. Twenty-four records met the inclusion criteria and underwent a risk-of-bias assessment. The main outcomes were: (a) TRF may result in moderate weight loss in individuals with overweight/obesity; when TRF is combined with caloric restriction, weight loss is >5% of the initial body weight, (b) 14 h of fasting may be as effective as 16 h in terms of weight loss, and (c) TRF may lead to improved insulin sensitivity and glycemic responses/variability throughout the day in individuals with overweight/obesity. Concerning RF, only two studies were available and thus, conclusions were not drawn. TRF may be an effective nutritional approach for weight loss, and the amelioration of glycemic control and insulin sensitivity in individuals with overweight/obesity. However, more long-term, well-designed studies are needed.