Table 1 - uploaded by Jennie C Brand-Miller
Content may be subject to copyright.
Nutrient content (per 100 g) and glycaemic/insulin index testing portion of four German-type breads
Source publication
Background/objectives:
German-style breads are recommended as a lower glycaemic index (GI) alternative, yet little data is available. Our aim was to test the GI and insulin index (II) of four breads and rolls commonly consumed in Germany.
Subjects/methods:
Four German bread products were tested for their GI and II in 12 healthy subjects accordin...
Contexts in source publication
Context 1
... types of breads and rolls, representing typical breads consumed in Germany, were chosen: wholemeal rye bread with intact grains and sunflower seeds (Kraftkerni; Lieken Urkorn, Dortmund, Germany), organic wholemeal spelt wheat bread (Dinkelvollkornbrot, backdat; local bakery), rye wheat sourdough bread (Paderborner; Lieken Urkorn) and soft pretzels (Brezel; Ditsch, Mainz, Germany). The nutrient content is shown in Table 1. The breads from Germany were freshly purchased, frozen and then placed in foam boxes and transported from Germany to Sydney, Australia via express delivery for testing. ...
Context 2
... the Sydney University Glycaemic Index Research Service (SUGiRS), the breads were kept frozen until the start of the testing procedure. One day before testing, the required portion sizes (see Table 1) were weighed out and stored in the refrigerator to defrost overnight. Each bread product was tested once by each participant, whereas the glucose solution (reference food) was tested on three separate occasions 22 in accordance with the International Standard Organization (ISO) methodology. ...
Citations
... Food items with a published GI [18] were given preference to allow for a valid estimation of the meal GI particularly of the intervention meal. Hence, pretzels were used, i.e. the only tested German bread with a value GI > 70 [19]. If more than one published GI value was available, the mean of these values was assigned. ...
Purpose
Glycemic response to the same meal depends on daytime and alignment of consumption with the inner clock, which has not been examined by individual chronotype yet. This study examined whether the 2-h postprandial and 24-h glycemic response to a meal with high glycemic index (GI) differ when consumed early or late in the day among students with early or late chronotype.
Methods
From a screening of 327 students aged 18–25 years, those with early (n = 22) or late (n = 23) chronotype participated in a 7-day randomized controlled cross-over intervention study. After a 3-day observational phase, standardized meals were provided on run-in/washout (days 4 and 6) and intervention (days 5 and 7), on which participants received a high GI meal (GI = 72) in the morning (7 a.m.) or in the evening (8 p.m.). All other meals had a medium GI. Continuous glucose monitoring was used to measure 2-h postprandial and 24-h glycemic responses and their variability.
Results
Among students with early chronotype 2-h postprandial glucose responses to the high GI meal were higher in the evening than in the morning (iAUC: 234 (± 92) vs. 195 (± 91) (mmol/L) × min, p = 0.042). Likewise, mean and lowest 2-h postprandial glucose values were higher when the high GI meal was consumed in the evening (p < 0.001; p = 0.017). 24-h glycemic responses were similar irrespective of meal time. Participants with late chronotype consuming a high GI meal in the morning or evening showed similar 2-h postprandial (iAUC: 211 (± 110) vs. 207 (± 95) (mmol/L) × min, p = 0.9) and 24-h glycemic responses at both daytimes.
Conclusions
Diurnal differences in response to a high GI meal are confined to those young adults with early chronotype, whilst those with a late chronotype seem vulnerable to both very early and late high GI meals. Registered at clinicaltrials.gov (NCT04298645; 22/01/2020).
... In Europe, it provides up to 30% of the daily carbohydrate consumption in women and up to 37% in men [1]. In Germany, around~58 kg bread is consumed per person annually, whereas bread consumption is significantly lower in countries with a typically Mediterranean diet [2]. ...
... In addition to providing carbohydrates, bread is also an important source of fibre, proteins, minerals, vitamins and other bioactive compounds [6]. Bread baked from milled whole grain or refined wheat flour is characterised not only by high glycaemic but also high insulin indices [2], which are known to inhibit lipolysis [7]. High-carbohydrate diets and hyperinsulinaemia [8][9][10] are associated with being overweight and obese, type 2 diabetes and cardiovascular diseases [11][12][13][14]. ...
... Bread is a typical component of the average diet in Germany [1,2] which is reflected by a mean of 3.5 slices of bread consumed daily by the participants prior to the trial. This translates to about 100-200 g of bread per day, which perfectly fits to the estimated consumption of about 58 kg bread per person a year in Germany [32]. ...
The impact on body weight development is usually analysed by comparing different diet types. Our approach was to change only one component, namely bread, common to most diets. In a single-centre triple-blind randomised controlled trial the effects of two different breads on body weight were analyzed without further lifestyle modification. Overweight adult volunteers (n = 80) were randomised 1:1 to exchange previously consumed breads for either a rye bread from milled whole grain (control) or a medium-carbohydrate, low-insulin-stimulating bread (intervention). Pre-tests demonstrated that the two bread types strongly differed in the glucose and insulin response elicited, but had similar energy content, texture and taste. The primary endpoint was the estimated treatment difference (ETD) in change of body weight after 3 months of treatment. Whereas body weight remained unchanged in the control group (−0.1 ± 2.0 kg), significant weight reduction was observed in the intervention group (−1.8 ± 2.9 kg), with an ETD of −1.7 ± 0.2 kg (p = 0.007), that was more pronounced in participants ≥ 55 years (−2.6 ± 3.3 kg), paralleled by significant reductions in body mass index and hip circumference. Moreover, in the intervention group, the percentage of participants with significant weight loss (≥1 kg) was twice as high as in the control group (p < 0.001). No other statistically significant changes in clinical or lifestyle parameters were noted. Simply exchanging a common insulinogenic bread for a low-insulin-stimulating bread demonstrates potential to induce weight loss in overweight persons, especially those at older age.
... Postprandial glucose response was measured in 28 articles and was lower in 14 of them after consumption of sourdough bread (Bo et al., 2017;Borczak et al., 2011;De Angelis et al., 2009;De Angelis et al., 2007;Hefni et al., 2021;Lappi et al., 2010;Maioli et al., 2008;Mofidi et al., 2012;Najjar et al., 2009;Novotni et al., 2011;Ramel et al., 2012;Rizzello et al., 2019;Scazzina et al., 2009;Tucker et al., 2014), compared to a control. In contrast, 13 found no significant effect after ingestion of sourdough bread (Bondia-Pons et al., 2011;Dall'Asta et al., 2022;Darzi et al., 2012;Goletzke et al., 2016;Korem et al., 2017;Lappi et al., 2014;Lioger et al., 2009;MacKay et al., 2012;Mikusova et al.;Nordlund et al., 2016;Polese et al., 2018;Shah et al., 2020;Zamaratskaia et al., 2017), croissant (Polese et al., 2018) or pasta (Shah et al., 2020) and one found a higher glucose response after consumption of sourdough pizza (Cavagnuolo et al., 2019). Insulin response was lower in seven studies after sourdough bread consumption (Bo et al., 2017;Bondia-Pons et al., 2011;Lioger et al., 2009;Maioli et al., 2008;Mofidi et al., 2012;Nordlund et al., 2016;Ramel et al., 2012), while eleven found no difference after sourdough bread (Dall'Asta et al., 2022;Darzi et al., 2012;Goletzke et al., 2016;Lappi et al., 2014;Lappi et al., 2010;MacKay et al., 2012;Mikusova et al.;Najjar et al., 2009;Shah et al., 2020;Tucker et al., 2014;Zamaratskaia et al., 2017) or pasta (Shah et al., 2020). ...
... In contrast, 13 found no significant effect after ingestion of sourdough bread (Bondia-Pons et al., 2011;Dall'Asta et al., 2022;Darzi et al., 2012;Goletzke et al., 2016;Korem et al., 2017;Lappi et al., 2014;Lioger et al., 2009;MacKay et al., 2012;Mikusova et al.;Nordlund et al., 2016;Polese et al., 2018;Shah et al., 2020;Zamaratskaia et al., 2017), croissant (Polese et al., 2018) or pasta (Shah et al., 2020) and one found a higher glucose response after consumption of sourdough pizza (Cavagnuolo et al., 2019). Insulin response was lower in seven studies after sourdough bread consumption (Bo et al., 2017;Bondia-Pons et al., 2011;Lioger et al., 2009;Maioli et al., 2008;Mofidi et al., 2012;Nordlund et al., 2016;Ramel et al., 2012), while eleven found no difference after sourdough bread (Dall'Asta et al., 2022;Darzi et al., 2012;Goletzke et al., 2016;Lappi et al., 2014;Lappi et al., 2010;MacKay et al., 2012;Mikusova et al.;Najjar et al., 2009;Shah et al., 2020;Tucker et al., 2014;Zamaratskaia et al., 2017) or pasta (Shah et al., 2020). Furthermore, three studies reported a faster gastric emptying rate after consumption of sourdough croissants (Polese et al., 2018), sourdough bread (Rizzello et al., 2019) or sourdough pasta (Shah et al., 2020) while two studies found no impact of sourdough bread consumption on the gastric emptying rate (Bondia-Pons et al., 2011;Najjar et al., 2009). ...
... The risk of bias assessment is summarized in Fig. 3. For sourdough, four articles were identified as low risk (Bo et al., 2017;MacKay et al., 2012;Polese et al., 2018;Zamaratskaia et al., 2017), 23 as some concerns (Bondia-Pons et al., 2011;Borczak et al., 2011;Cavagnuolo et al., 2019;Dall'Asta et al., 2022;Darzi et al., 2012;De Angelis et al., 2009;De Angelis et al., 2007;Goletzke et al., 2016;Iversen et al., 2018;Korem et al., 2017;Lappi et al., 2010;Lioger et al., 2009;Maioli et al., 2008;Mikusova et al.;Mofidi et al., 2012;Najjar et al., 2009;Nordlund et al., 2016;Novotni et al., 2011;Ramel et al., 2012;Rizzello et al., 2019;Shah et al., 2020;Tucker et al., 2014;Tucker et al., 2010) and four as high risk (Hefni et al., 2021;Lappi et al., 2014;Raninen et al., 2017;Scazzina et al., 2009). For fermented soybean, seven articles were identified as low risk (Ahn et al., 2018;Araki et al., 2020;Byun et al., 2016;Cha et al., 2013;Kondo et al., 2019;Lee et al., 2017;Noer et al., 2021), six as some concerns (Cha et al., 2014;Fujita et al., 2001;Inoguchi et al., 2012;Jung et al., 2021;Papagianni et al., 2022;Shin et al., 2011) and seven as high risk (Back et al., 2011;Cavallini et al., 2016;Cha et al., 2012;Fatmah, 2017Fatmah, , 2020Lee et al., 2012;Taniguchi-Fukatsu et al., 2012). ...
... After removing the duplicated citations, 2979 were sorted by titles and abstracts and 121 studies were selected for full reading. Out of these, 19 (Bo et al. 2017;Bondia-Pons et al. 2011;Buczkowski and Derbyshire 2012;De Angelis et al. 2007Fredensborg et al. 2010;Goletzke et al. 2016;Lappi et al. 2010Lappi et al. , 2014MacKay et al. 2012;Maioli et al. 2008;Mikušová et al. 2013;Najjar et al. 2008;Novotni et al. 2012;Scazzina et al. 2009;Shah et al. 2020;Tucker et al. 2014;Zamaratskaia et al. 2017;Dall' Asta et al, 2022) matched the eligibility criteria and were included in this systematic review ( Figure 1). ...
... The amount of bread offered in the intervention and control was similar between the studies (50 to 100 g per day). From all the studies included, 12 (Goletzke et al. 2016, Zamaratskaia et al. 2017, Mikušová et al. 2013, Bondia-Pons et al. 2011, Lappi et l, 2014, Lappi et al. 2010, Maioli et al. 2008, Najjar et al. 2008 (Buczkowski and Derbyshire 2012, Novotni et al. 2012, Fredensborg et al. 2010, Scazzina et al. 2009, De Angelis et al. 2009, De Angelis et al. 2007Dall' Asta et al, 2022) evaluated capillary blood glucose. Altogether, 12 studies (Bondia-Pons et al. 2011;Fredensborg et al. 2010;Lappi et al. 2010;MacKay et al. 2012;Maioli et al. 2008;Mikušová et al. 2013;Najjar et al. 2008;Novotni et al. 2012;Shah et al. 2020;Tucker et al. 2014;Zamaratskaia et al. 2017) provided data on the effect of sourdough bread consumption on glycemic control. ...
... Of these 12 studies, five (Buczkowski and Derbyshire 2012;De Angelis et al. 2007Goletzke et al. 2016;Scazzina et al. 2009, Dall'Asta et al., 2022 had results for the variation in blood glucose for each group. When comparing the variations in final blood glucose in the intervention and control groups, it was observed that 60 minutes after sourdough bread intake, the blood glucose was lower in the intervention group than in the control one (MD = −0.42, ...
The aim of this study was to carry out a systematic review of clinical trials followed by meta-analysis, to evaluate the effect of sourdough bread on glycemic control and appetite and satiety regulators such as leptin, ghrelin, GLP-1 (glucagon-like peptide-1), GLP-2 (glucagon-like peptide-2), NPY (neuropeptide Y), AgRP (agouti-related protein), PYY (peptide YY), and GIP (glucose-dependent insulinotropic polypeptide). Clinical trials compared the intake of sourdough bread to that of an industrially fermented one or control glucose solution in adults over 18 years of age. This systematic review included all randomized, parallel, or crossover trials published up to June 2021 in the EMBASE, MEDLINE, Scopus, and Web of Science databases. After the selection process, 18 studies were included. The analysis of the final average difference of the change in serum glucose after 60 minutes for the intervention indicated that the consumption of sourdough bread has a lower impact on blood glucose compared to that of industrial bread or glucose (MD = -0.29, IC 95% = [-0.46; -0.12]; I2 = 0%). The evaluation of blood glucose 120 minutes after the consumption of the intervention also indicated a lower increment in blood glucose when compared to the consumption of other types of bread or the same amount of glucose (MD = -0.21, IC 95% = [-0.32; -0.09]; I2 = 0%). The certainty of evidence varied from low to very low. The results showed that sourdough is effective in reducing the increment of postprandial glycemia, especially when prepared with whole wheat flour, although it does not reduce fasting serum insulin, nor does it change plasma PYY.
... A bread with 66% whole-grain wheat was chosen as the control bread instead of refined wheat bread to reflect dietary habits in Northern European countries. Since the quality of bread and the associated metabolic effects varies substantially, 27 use of a medium to low glycaemic index-bread rich in beta-glucan may substantially benefit metabolic health. While complex interventions have been found to substantially reduce progression to diabetes among persons with pre-diabetes, 28 many patients may not be prepared for such complex changes; thus, exchange of bread with a healthier alternative may be more feasible. ...
Introduction
In 2012, the estimated global prevalence of pre-diabetes was 280 million, and the prevalence is expected to rise to 400 million by 2030. Oat-based foods are a good source of beta-glucans, which have been shown to lower postprandial blood glucose. Studies to evaluate the effectiveness of the long-term intake of beta-glucan-enriched bread as part of a habitual diet among individuals with pre-diabetes are needed. Therefore, we designed a multicentre intervention study in adults with pre-diabetes to investigate the effects of consumption of an oat-derived beta-glucan-enriched bread as part of a normal diet on glycated haemoglobin (HbA1c) in comparison to consumption of whole-grain wheat bread.
Methods and analysis
The CarbHealth trial is a multicentre double-blind randomised controlled 16-week dietary intervention trial in participants 40–70 years of age with a body mass index of ≥27 kg/m ² and HbA1c of 35–50 mmol/mol. The study is conducted at four universities located in Norway, Sweden and Germany and uses intervention breads specifically designed for the trial by Nofima AS. The aim is to recruit 250 participants. The primary outcome is the difference in HbA1c between the intervention and the control groups. The main analysis will include intervention group, study centre and baseline HbA1c as independent variables in an analysis of covariance model.
Ethics and dissemination
The study protocol was approved by respective ethical authorities in participating countries. The results of the study will be communicated through publication in international scientific journals and presentations at (inter)national conferences.
Trial registration number
NCT04994327 .
... Venous or capillary blood was collected at regular intervals (every 7.5-30 min) from right before the breakfast was served and for the following 3-4.5 h. Three studies covered a shorter period of only 2 h (38)(39)(40), while two studies extended over 6 and 7.8 h and included a standardized lunch in addition to the breakfast meal (41,42). Most of the studies consisted of more than one rye product and/or more than one non-rye product (control), and thereby consisted of more than one pairwise comparison between a rye product and a control product. ...
... In a similar study, comparing two different loaf type wheat breads with different structure and fiber content, Eelderink et al. found similar, but less pronounced results (72). Goletzke et al. found that a whole meal spelt bread had similar effects as two rye based breads, compared to a low fiber soft wheat pretzel(38). Liljeberg et al. found lowering of insulin, without affecting glucose, when comparing barley kernel based breads and a rye kernel based bread with a wheat kernel based bread ...
Consumption of whole grain has been associated with lower incidence of type-2 diabetes, cardiovascular disease and their risk factors including improved glycemic control. In comparison with other whole grain products, rye bread has been shown to induce lower insulin response in the postprandial phase, without affecting the glucose response. This phenomenon has been referred to as the “rye factor” and is being explored in this review where we summarize the findings from meal and extended meal studies including rye-based foods. Overall, results from intervention studies showed that rye-based foods vs. (wheat) control foods had positive effect on both insulin and glucose responses in the postprandial phase, rather than on insulin alone. Mechanistic studies have shown that the rye factor phenomenon might be due to slowing of the glucose uptake in the intestine. However, this has also been shown for wheat-based bread and is likely an effect of structural properties of the investigated foods rather than the rye per se. More carefully controlled studies where standardized structural properties of different cereals are linked to the postprandial response are needed to further elucidate the underlying mechanisms and determinants for the effect of specific cereals and product traits on postprandial glycemic control.
... Selbst das Vollkornbrot resultierte in vergleichbaren Erhöhungen der Glukosespiegel ähnlich der anderen Brotsorten wie Roggenmisch-oder Weißbrot. Diese Erkenntnisse wurden auch durch andere Wissenschaftler bereits entdeckt [7]. Auch wenn sich nur leichte Unterschiede in den Gruppenmittelwerten zwischen den Brotsorten in der gegenwärtigen Untersuchung andeuten, waren die individuellen Veränderungen der Teilnehmer nach Nahrungsmittelaufnahme z. T. sehr unterschiedlich. ...
Zusammenfassung
Einleitung Mit der Low-Insulin-Methode konnten wir kürzlich ein neuartiges Gewichtsabnehmprogramm etablieren, das einen Gewichtsverlust im Mittel um 10 kg nach einem Jahr ermöglichte. In der gegenwärtigen Untersuchung haben wir alltägliche Lebensmittel auf deren Glukose- sowie Insulinauswirkung unter „real-life“-Bedingungen getestet. Das kontinuierliche Glukosemonitoring diente dabei als Motivationstool für die Teilnehmer. Die genutzten Produkte wurden so gewählt, dass sie zu einer Insulinsekretion führen, die bekanntlich die Lipolyse blockiert.
Methoden Unterschiedliche Produkte des Alltags (Getränke, Brote und Müsli, Süßigkeiten) wurden von gesunden Personen (n = 12; BMI = 20,5–32,0 kg/m²; Alter = 18–60 Jahre) nüchtern morgens konsumiert. Glukosespiegel wurden mittels Flash-Glukose-Systeme gemessen. Zusätzlich wurde aus venösem Blut der Insulinspiegel bestimmt. Zur statistischen Bewertung des Einflusses der Testprodukte auf die Glukose- sowie Insulinspiegel wurde die incremental-area-under-the-curve (iAUC) nach 120 min berechnet.
Ergebnisse Die Getränke Apfelsaft und Limonade zeigten im Vergleich keinen statistischen Unterschied in ihrer postprandialen Glukosewirkung (iAUCGlukose: rd. 1000 mg * 15 min/ dl) nach 120 min. Bei den Broten und Müsli hatte insbesondere das spezielle Eiweißbrot keinen relevanten Einfluss auf den Glukosespiegel. Bei den Süßigkeiten zeigten die Bioriegel einen signifikant niedrigeren postprandialen Glukoseanstieg im Vergleich zum handelsüblichen Schokoriegel (P < 0,01). Die postprandialen iAUC-Werte von Insulin- und Glukose korrelierten signifikant positiv (r = 0,354; P = 0,016).
Diskussion Alltägliche Lebensmittel zeigten einen sehr unterschiedlichen Einfluss auf den Glukose- und Insulinspiegel. Die Praktikabilität der kontinuierlichen Glukosemessung deutet auf ein mögliches Motivationstool für Patienten zur Reduktion von Insulinspiegeln hin.
... International Standard-ISO 26642 asserts a minimum of ten participants is enough to determine the GI value (19); accordingly, 16 participants were considered (19,22,(25)(26)(27)(28). Then IAUC and GI values were calculated using Microsoft Excel ® 2010, the results were expressed as means with standard error of the mean (SEM). ...
Background:
The glycemic index (GI) values of staple foods are not available in a standardized method in Iran.
Objectives:
The aim of this study was to measure the GI values of the major carbohydrate sources in a typical Iranian diet.
Methods:
Using the international standard method, the GI values were determined for four wheat flatbreads, barley and rye bread, white and brown rice, as well as white and brown rice mixed with lentils. Twelve healthy adults were given 50 g anhydrous glucose three times (as the reference carbohydrate) and the test foods once each throughout the study. Using finger-prick blood samples, capillary blood glucose was measured using a reliable glucometer. The GI was calculated using the trapezoidal method.
Results:
The GI values of the following types of bread were: Barley 66, Lavash 72, Taftoon 79, Sangak 82, rye 84, and Barbari 99. The GI values for brown and white rice were 65 and 71, respectively. The mixture of brown rice with lentils had a GI value of 55, and the mixture of white rice with lentils had a GI of 79.
Conclusions:
The most common types of bread and white rice consumed in Iran have high GI values. There is potential to reduce the overall GI values in the Iranian diet by encouraging the consumption of barley bread and brown rice.
... Both bread prototypes tested for in vivo GI were categorised as medium-GI bread, but they had a low GL value (6.8). These findings are in agreement with reported data on medium-GI breads (GI ¼ 61-62) from whole-meal wheat or rye flour baked with up to 40% sourdough (Gonzalez-Anton et al. 2015;Goletzke et al. 2016). However, others have shown that sourdough bread after enrichment with dietary fibre has lower GI values (<55) (De Angelis et al. 2007;De Angelis et al. 2009). ...
The concept of glycaemic index (GI) has led to efforts to develop low-GI foods. Bread contributes around one-quarter of carbohydrate intake in the Swedish diet. In this study, we sought to develop low-GI bread prototypes and examined the effects of bread making on content of total dietary fibre (TDF) and resistant starch (RS). Five bread prototypes were made in a commercial bakery, using sourdough fermentation and intact cereal and legume kernels. Predicted (p-GI) and in vivo GI values were determined, and TDF and RS were quantified. The p-GI value of the five prototypes was between 56 and 68. The confirmed in vivo GI value was 65 and 67 for two of the breads. The TDF content (≥17%) was not affected by bread making, but RS content was increased by three-fold. All breads were categorised as medium-GI, but with low glycaemic load (GL).
... As a consequence, bread's GI values can vary a lot and bread can fall in the category of either low, medium or high GI (6) . Lowering the GI of bread is of scientific interest especially for populations who consume large amounts of bread, such as the Nordic European countries (7) . Attenuation of GI can be achieved by different approaches, including the addition of intact structures not accessible to human amylases, viscous and non-viscous fibre (8) , legume flours, fruitbased ingredients and enrichment with specific micronutrients (9) . ...
... In addition, sourdough fermented endosperm rye bread was also shown to induce lower postprandial insulin response compared with white wheat bread without improving blood glucose profile in healthy subjects in the study by Bondia-Pons et al. (20) . In another study, a rye wheat sourdough bread was found to have medium GI (GI = 62) and caused lower postprandial insulin response compared with a soft pretzel (7) . ...
... Sourdough fermentation of either white or whole meal breads has consistently been shown to attenuate the GI (7,13,15,(32)(33) . Postprandial glucose response following the consumption of breads leavened with sourdough lactobacilli also results in lower iAUC values, compared with reference foods (14,16,(21)(22)(23) . ...
Lowering postprandial glucose and insulin responses may have significant beneficial implications for prevention and treatment of metabolic disorders. Bread is a staple food consumed worldwide in a daily basis, and the use of different baking technologies may modify the glucose and insulin response. The aim of this review was to critically record the human studies examining the application of different bread making processes on postprandial glucose and insulin response to bread. Literature is rich of results which show that the use of sourdough fermentation instead of leavening with Saccharomyces cerevisiae is able to modulate glucose response to bread, whereas evidence regarding its efficacy on lowering postprandial insulin response is less clear. The presence of organic acids is possibly involved, but the exact mechanism of action is still to be confirmed. The reviewed data also revealed that the alteration of other processing conditions (method of cooking, proofing period, partial baking freezing technology) can effectively decrease postprandial glucose response to bread, by influencing physical structure and retrogradation of starch. The development of healthier bread products that benefit postprandial metabolic responses is crucial and suggested baking conditions can be used by the bread industry for the promotion of public health.
