Effect of prior meal macronutrient composition on postprandial glycemic responses and glycemic index and glycemic load value determinations
Open accessAbstract
The potential impact of prior meal composition on the postprandial glycemic response and glycemic index (GI) and glycemic load (GL) value determinations remains unclear. We determined the effect of meals that varied in macronutrient composition on the glycemic response and determination of GI and GL values of a subsequent standard test food. Twenty healthy participants underwent 6 test sessions within 12 wk. The subjects received each of 3 isocaloric breakfast meals (i.e., high carbohydrate, high fat, or high protein) on separate days in a random order, which was followed by a standard set of challenges (i.e., white bread and a glucose drink) that were tested on separate days in a random order 4 h thereafter. Each challenge provided 50 g available carbohydrate. Arterialized venous blood was sampled throughout the 2-h postchallenge period. GI, GL, and insulin index (II) values were calculated with the use of the incremental area under the curve (AUCi) method, and serum lipids were determined with the use of standard assays. The consumption of the high-protein breakfast before the white-bread challenge attenuated the rise in the postprandial serum glucose response (P < 0.0001) and resulted in lower glucose AUCi (P < 0.0001), GI (P = 0.0096), and GL (P = 0.0101) values than did the high-carbohydrate and high-fat breakfasts. The high-protein breakfast resulted in a lower insulin AUCi (P = 0.0146) for white bread than did the high-fat breakfast and a lower II value (P = 0.0285) than did the high-carbohydrate breakfast. The 3 breakfasts resulted in similar serum lipid responses to the white-bread challenge. These data indicate that the macronutrient composition of the prior meal influences the glycemic response and the determination of GI and GL values for white bread. Future studies are needed to determine whether the background food macronutrient composition influences mean dietary GI and GL values that are calculated for eating patterns, which may alter the interpretation of the associations between these values and chronic disease risk. This trial was registered at clinicaltrials.gov as NCT01023646.
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Carbohydrate appearance can be influenced by the composition of the preceding meal and by within-day factors.
“Because carbohydrate appearance can also be influenced by the composition of the preceding meal and by within-day factors, consistent monitoring remains essential [6,29].”
From Does Resistant Starch Formed by Cooling Pasta Decrease the Postprandial Glycemic Response in Type 1 Diabetes? A Randomized Single-Blind Crossover Study (2026) · cites this paper as [29]
The Results report that breakfast macronutrient composition changed the subsequent glucose response to white bread, and the Introduction discusses eating at different times of day. But the paper measures blood-glucose responses, not carbohydrate appearance, and does not independently test within-day factors. (LLM, conf=0.82)
Experimental — accuracy not yet measuredIn experimental studies, appetite effects of resistant starch have been inconsistent and may depend on RS type, dose, and fermentation-related mechanisms rather than on the modest RS increase achieved by a single cooling cycle.
“In experimental studies, appetite effects of resistant starch have been inconsistent and may depend on RS type, dose, and fermentation-related mechanisms rather than on the modest RS increase achieved by a single cooling cycle [16,29].”
From Does Resistant Starch Formed by Cooling Pasta Decrease the Postprandial Glycemic Response in Type 1 Diabetes? A Randomized Single-Blind Crossover Study (2026) · cites this paper as [29]
The Introduction and Study design and interventions sections describe how prior-meal composition affects subsequent glycemic responses, not appetite effects of resistant starch. Searches for resistant-starch appetite effects, RS type and dose, fermentation, and a cooling cycle found no passage addressing the claim; a References entry mentions fermentation only in relation to the second-meal glycemic effect. Page numbers were not available in our copy. (LLM, conf=0.78)
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- Authors
- Meng, H., Matthan, N. R., Ausman, L. M., & Lichtenstein, A. H.
- Affiliations
- Tufts University (US)
- Corresponding author
- Lichtenstein, Alice H
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2017-11
- Volume
- 106
- Issue
- 5
- Pages
- 1246-1256
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC5657290
- OpenAlex
- W2756090556
- Cited by
- 74
- References
- 69
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 9 · 2023: 10 · 2022: 13 · 2021: 9 · 2020: 12 · 2019: 5 · 2018: 6
- FWCI
- 5.23
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion, other-oa)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Agriculture (58‐1950‐4‐401)
- National Institutes of Health (58-1950-4-401)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK 0733221)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- postprandial glycemic response, glycemic index, glycemic load, insulin index, white bread, high-fat breakfast, serum lipids, incremental area under the curve
- MeSH terms
- Glycemic Load, Aged, Aged, 80 and over, Blood Glucose, Bread, Diet, Dietary Proteins, Fatty Acids, Nonesterified, Female, Humans, Insulin, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Triglycerides, Exercise, Body Mass Index, Cross-Over Studies, Postprandial Period, Glycemic Index, Breakfast
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