Metabolic Responses to Isomaltulose by Malaysian Chinese Adults: - PowerPoint PPT Presentation

Metabolic Responses to Isomaltulose by Malaysian Chinese Adults: A Pilot Study Chan Chee Shan

Introduction - What is isomaltulose? Chan Chee Shan 2018 NSM Conference

Chan Chee Shan 2018 NSM Conference

Isomaltulose vs. sucrose* 3.0 Change in blood glucose (mmol/L) sucrose 2.5 2.0 1.5 isomaltulose 1.0 0.5 0.0 -0.5 0 30 60 90 120 Time (mins) Chan Chee Shan 2018 NSM Conference

Isomaltulose-containing products in Malaysia Muscle- Child growing- Oral building up nutritional supplement supplement formula Health Sports supplement supplement Chan Chee Shan 2018 NSM Conference

Isomaltulose-containing products in Malaysia Muscle-building Child growing- Oral supplement up nutritional Consumption of isomaltulose supplement formula is expected to increase in Malaysia in the future Health Sports supplement supplement Chan Chee Shan 2018 NSM Conference

Research questions I. What is the maximum bolus of isomaltulose that is well-tolerated by young healthy adults in Malaysia? II. Is the claimed difference between the blood glucose responses to isomaltulose and sucrose valid? III. Will isomaltulose induce a drop in faecal pH, suggestive of prebiotic activity? Chan Chee Shan 2018 NSM Conference

Study objectives I. To determine the degree of spill-over of different doses of isomaltulose into the colon among Malaysian healthy adults by means of a breath hydrogen test. II. To determine the dose-dependent increase in glycaemic response to bolus administration of isomaltulose, in comparison to sucrose. III. To examine the potential prebiotic activity of isomaltulose. Chan Chee Shan 2018 NSM Conference

Methodology Chan Chee Shan 2018 NSM Conference

Process  This study was approved by the IMU-Joint Committee for ethics approval.  Data collection was done at IMU, Bukit Jalil campus.  Subjects were recruited by group and targeted presentations to individuals (convenient sampling). Chan Chee Shan 2018 NSM Conference

Inclusion criteria i. Age: 18 – 40 years old ii. BMI: 15.0 – 26.9 kg/m 2 iii. Exclusive hydrogen producers Chan Chee Shan 2018 NSM Conference

Exclusion criteria Alcohol consumption within the previous 24 hours i. ii. Smoking a cigarette within 48 hours iii. Antibiotics taken within 1-month prior to the test iv. Pregnancy v. Active medical conditions involving major organs vi. Exclusive methane producers (non-hydrogen producers) Chan Chee Shan 2018 NSM Conference

Methodology - Study flow chart Chan Chee Shan 2018 NSM Conference

Chan Chee Shan 2018 NSM Conference

Determination of intolerance ≥ 20 ppm Gastro+ Gastrolyzer Gastrointestinal (Bedfont Scientific Ltd) symptoms Chan Chee Shan 2018 NSM Conference

Discussion ❑ Interaction? - Co-consumption of starch and isomaltulose indigestion ❑ Glycaemic response: - The involvement of incretin hormones? ❑ Suggested prebiotic activity Chan Chee Shan 2018 NSM Conference

1. Interaction - Co-consumption of starch & isomaltulose digestion  Amylose and amylopectin → maltose + isomaltose  Isomaltose and maltose are competitive inhibitors of isomaltulose.  The digestion of starch and isomaltulose need to be investigated. Sucrase Isomaltase Connecting segment (stalk) Transmembrane segment Chan Chee Shan 2018 NSM Conference

2. Glycaemic response: [The action of incretin hormones?]  No significant differences between iAUC of tolerant and intolerant subjects to isomaltulose.  Incretins effect? Chan Chee Shan 2018 NSM Conference

In isomaltulose- tolerant subjects… rapid insulin release GIP secretion high [glucose] Chan Chee Shan 2018 NSM Conference

3. Prebiotic activity  Production of SCFAs in the colon and faeces tends to reduce faecal pH.  Changes in pre- and post-test faecal pH:  Spill-over of isomaltulose into the colon followed by anaerobic fermentation.  Increase in acidification of faecal samples Chan Chee Shan 2018 NSM Conference

Selected references Lina BA, Jonker D, Kozianowski G: Isomaltulose (Palatinose): a review of 1. biological and toxicological studies. Food Chem. Toxicol. 2002;40:1375-1381. Ghoshal UC: How to interpret hydrogen breath tests. Journal of 2. Neurogastroenterology and Motility 2011;17:312-317. Holub I, Gostner A, Theis S, Nosek L, Kudlich T , Melcher R, Scheppach W: 3. Novel findings on the metabolic effects of the low glycaemic carbohydrate isomaltulose (Palatinose). British Journal of Nutrition 2010;103:1730-1737. Maeda A, Miyagawa J, Miuchi M, Nagai E, Konishi K, Matsuo T , et al. Effects of 4. the naturally‐occurring disaccharides, palatinose and sucrose, on incretin secretion in healthy non‐obese subjects. Journal of diabetes investigation 2013;4(3):281-286. Keyhani-Nejad F , Kemper M, Schueler R, Pivovarova O, Rudovich N, Pfeiffer 5. AF . Effects of palatinose and sucrose intake on glucose metabolism and incretin secretion in subjects with type 2 diabetes. Diabetes Care 2016 Mar;39(3):e38-9. Chan Chee Shan 2018 NSM Conference

Selected references Hira T , Muramatsu M, Okuno M, Hara H. GLP-1 secretion in response to oral and 6. luminal palatinose (isomaltulose) in rats. J Nutr Sci Vitaminol (Tokyo) 2011;57(1):30-35. Tonouchi H, Yamaji T , Uchida M, Koganei M, Sasayama A, Kaneko T , et al. Studies 7. on absorption and metabolism of palatinose (isomaltulose) in rats. Br J Nutr 2011;105(01):10-14. Roberfroid M, Gibson GR, Hoyles L, McCartney AL, Rastall R, Rowland I, et al. 8. Prebiotic effects: metabolic and health benefits. Br J Nutr 2010;104(S2):S1-S63. Rana SV , Malik A. Hydrogen breath tests in gastrointestinal diseases. Indian 9. Journal of Clinical Biochemistry 2014;29(4):398-405. 10. Food Standards Australia New Zealand. Application A578- Isomaltulose as a novel food. 2015; Available at: http://www.foodstandards.gov.au/code/applications/Pages/applicationa578isoma 3297.aspx. Accessed May 14th, 2017. Chan Chee Shan 2018 NSM Conference

Chan Chee Shan 2018 NSM Conference