Effect of Meal Dilution on the Postprandial Glycemic Response: Implications for glycemic testing

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Abstract
OBJECTIVE To investigate the effect of varying the volume of sugar meals on the postprandial glycemic response (PGR). RESEARCH DESIGN AND METHODS On six separate occasions, after an overnight fast, blood glucose concentrations were measured in eight healthy subjects (34 ± 4 years of age, BMI 22.9 ± 0.9 kg/m2) after the consumption of 25 g glucose, sucrose, or fructose dissolved in either 200 or 600 ml of water. Blood was obtained at fasting and then at times 15, 30, 45, 60, and 90 min after the start of the test meal. RESULTS PGR was found to be influenced by carbohydrate type (P < 0.001). Mean response areas (min · mmol · l−1) to the three sugars were statistically different (P P < 0.01). By tripling meal volume from 200 to 600 ml, PGR areas were significantly increased for all three sugars, glucose (79.3 ± 10.3 vs. 100.8 ± 12.0, P = 0.035), sucrose (52.6 ± 5.5 vs. 70 ± 7.4, P = 0.0094), and fructose (11.0 ± 3.8 vs. 18.4 ± 3.9, P = 0.012). Where the effects of time (P < 0.05) and dose (P < 0.05) were determined to be independent (interaction nonsignificant) for all three sugars, this increase in volume also significantly increased glycemic concentrations at 15 min, for glucose (P = 0.033) and sucrose (P = 0.026), suggesting that changes in gastric emptying time may be a mechanism of action. CONCLUSIONS Varying the volume of liquid sugar meals alters PGR.Understanding this concept may help to reduce variability both in the glycemic testing of foods and oral glucose tolerance testing.