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11-02-2019 | Diabetes | News | Article

Personalized approach improves postprandial glycemic response prediction

medwireNews: Predicting an individual’s glycemic response to food can be improved by taking their physiological and clinical features into account alongside the standard nutritional content of the food consumed, researchers report.

Heidi Nelson (Mayo Clinic, Rochester, Minnesota, USA) and colleagues say that “[p]roviding individuals with tools to manage their glycemic responses to food based on personalized predictions of their PPGRs [postprandial glycemic responses] may allow them to maintain their blood glucose levels within limits associated with good health.”

The findings are based on data for 327 US individuals (mean age 45 years, 78% women) without diabetes who logged their food intake and activity levels for 6 days while having their blood glucose measured every 5 minutes using a continuous glucose monitor. With the exception of four standardized meals, participants maintained their normal eating habits throughout the study.

Using the standardized meals showed that although each individual responded fairly consistently to the same food (a bagel with cream cheese), there was substantial interindividual variability, with glycemic excursions ranging from 6 to 94 mg/dL.

“Therefore, it is important to take an individual’s characteristics into consideration when determining and recommending the best dietary approach for managing glycemic levels,” Nelson et al remark.

To confirm this, the researchers retrained a predictive model for PPGRs that had previously been applied to an Israeli population using information such as BMI, waist-to-hip ratio, glycated hemoglobin level, cholesterol level, and details on the composition of each participant’s fecal microbiome, in addition to the features of the foods consumed.

This model correctly predicted PPGR on 62% of occasions, which was substantially higher than when the predicted value was calculated using current standard-of-care approaches, namely calorie or carbohydrate content alone, which correctly predicted PPGR on 34% and 40% of occasions, respectively.

Writing in JAMA Network Open, Nelson and co-authors say that “[f]ollow-up studies should assess the long-term beneficial health consequences of the personalized dietary approach while considering adherence and overall effectiveness.”

They conclude: “Nonetheless, results presented herein point toward the potentially significant contribution of measurement-based personalized approaches across different populations in harnessing nutrition as a means of improving PPGRs, with subsequent reduction of the consequences of prolonged and repetitive exposure to hyperglycemia.”

By Laura Cowen

medwireNews is an independent medical news service provided by Springer Healthcare. © 2019 Springer Healthcare part of the Springer Nature group

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