Postprandial glycemic response in a non-diabetic adult population: the effect of nutrients is different between men and women

Background: There is a growing interest in the pathopysiological consequences of postprandial hyperglycemia. It is well known that in diabetic patients 2h plasma glucose is a better risk predictor for coronary heart disease than fasting plasma glucose. Data on the glycemic response in healthy people are scarce. Objective: To evaluate the effect of macronutrients (carbohydrates, fats, and proteins) and fiber on postprandial glycemic response in an observational study of a non-diabetic adult population. Design: Cross-sectional study. 150 non-diabetic adults performed continuous glucose monitoring for 6days. During this period they recorded food and beverage intake. The participants were instructed not to make changes in their usual diet and physical exercise. Variables analyzed included clinical parameters (age, sex, body weight, height, body mass index, blood pressure, and waist measurement), meal composition (calories, carbohydrates, fats, proteins, and fiber) and glycemic postprandial responses separated by sexes. The study period was defined from the start of dinner to 6h later. Results: A total of 148 (51% women) subjects completed all study procedures. Dinner intake was higher in males than in females (824 vs 531kcal). Macronutrient distribution was similar in both sexes. No significant differences were found in fiber intake between men and women (5.5g vs 4.5g). In both sexes, the higher intake of carbohydrates corresponded to a significantly higher glycemic response (p=0.0001 in women, p=0.022 in men). Moreover, in women, as fat intake was higher, a flattening of the postprandial glycemic curve was observed (p=0.003). With respect to fiber, a significantly lower glycemic response was observed in the group of women whose fiber intake at dinner was higher (p=0.034). Conclusions: Continuous glucose monitoring provides important information about glucose levels after meals. In this study, the postprandial glycemic response in women was different from that of men, and carbohydrates were the main determinant of elevated postprandial glucose levels.