Thesis (Ph. D.)--Ohio State University, 2003. / Title from first page of PDF file. Document formatted into pages; contains xi, 137 p.: ill. Includes abstract and vita. Advisor: M. Rosita Schiller, Dept. of Human Nutrition and Food Management. Includes bibliographical references (p. 126-137).

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Fractions from white and tannin sorghums were processed into extrudates, thick porridges, and breads. The effects of sorghum type and fraction on the in vitro starch availability of the products were evaluated, and the estimated glycemic indexes (EGI) of the products were obtained. Sorghum extrudates were significantly more slowly digested than corn meal extrudates for all preparation methods (whole, cracked and decorticated kernels). Furthermore, tannin extrudates were less digestible than white sorghum extrudates. The soft endosperm nature of the tannin sorghum limited friction formation inside the extruder, reducing starch gelatinization. On the other hand, condensed tannins also interfered with the starch availability for digestion. White sorghum was more 'suitable' for extrusion, giving extrudates with higher starch degradation and expansion than the tannin sorghums. However, tannin sorghums also gave acceptable products offering the benefit of lower EGI values. Sorghum porridges were more slowly digested than a corn flour porridge when using whole and decorticated flours. In addition, tannin sorghum porridges had a lower starch digestibility compared to all the samples. Tannin sorghum flours produced soft porridges with enhanced initial starch digestibility. However, condensed tannins seemed to offset the starch digestion by limiting starch availability. All sorghum porridges had significantly lower EGI values than the corn porridge. Extrudates and porridges had reduced starch digestibilities and EGI values when using whole grains compared to using the decorticated fractions. This was observed in both the white and the tannin sorghum. Therefore, whole-grain products from sorghum have health benefits attributed to whole grain foods and slower digesting starches; for instance, prevention and treatment of diseases such as diabetes, insulin resistance, obesity, cardiovascular disease, and some types of cancer. When 12% of tannin bran was added to a wheat bread formulation, a slower rate of starch digestion was observed compared to a wheat bread. The high concentration of non-starch components of the bran (i.e. dietary fiber, condensed tannins) affected starch digestion. The addition of tannin sorghum bran significantly reduced the EGI value of wheat bread, besides being a natural source of brown color, and an excellent source of antioxidants and dietary fiber.

Ecological studies and results from our low-fat, high-carbohydrate dietary intervention trial suggest that different carbohydrates are associated with breast cancer risk in different ways. We examined the association of diet glycemic index (GI), a ranking of carbohydrate containing foods based on their blood glucose raising potential, with breast cancer risk and phenotype. GI was calculated from multiple food records from subjects in our intervention trial using a nested case-control design (220 cases, 440 controls). GI was not associated with risk of total or estrogen receptor positive breast cancer, tumor size or nodal status. GI was strongly positively associated with hormone negative breast cancer. This finding is potentially important as little is known about the etiology of hormone negative breast cancer, which has a worse prognosis than hormone positive breast cancer. However, this finding is based on a small number of cases and should be replicated in a larger sample.

Ecological studies and results from our low-fat, high-carbohydrate dietary intervention trial suggest that different carbohydrates are associated with breast cancer risk in different ways. We examined the association of diet glycemic index (GI), a ranking of carbohydrate containing foods based on their blood glucose raising potential, with breast cancer risk and phenotype. GI was calculated from multiple food records from subjects in our intervention trial using a nested case-control design (220 cases, 440 controls). GI was not associated with risk of total or estrogen receptor positive breast cancer, tumor size or nodal status. GI was strongly positively associated with hormone negative breast cancer. This finding is potentially important as little is known about the etiology of hormone negative breast cancer, which has a worse prognosis than hormone positive breast cancer. However, this finding is based on a small number of cases and should be replicated in a larger sample.

Fractions from white and tannin sorghums were processed into extrudates, thick porridges, and breads. The effects of sorghum type and fraction on the in vitro starch availability of the products were evaluated, and the estimated glycemic indexes (EGI) of the products were obtained. Sorghum extrudates were significantly more slowly digested than corn meal extrudates for all preparation methods (whole, cracked and decorticated kernels). Furthermore, tannin extrudates were less digestible than white sorghum extrudates. The soft endosperm nature of the tannin sorghum limited friction formation inside the extruder, reducing starch gelatinization. On the other hand, condensed tannins also interfered with the starch availability for digestion. White sorghum was more 'suitable' for extrusion, giving extrudates with higher starch degradation and expansion than the tannin sorghums. However, tannin sorghums also gave acceptable products offering the benefit of lower EGI values. Sorghum porridges were more slowly digested than a corn flour porridge when using whole and decorticated flours. In addition, tannin sorghum porridges had a lower starch digestibility compared to all the samples. Tannin sorghum flours produced soft porridges with enhanced initial starch digestibility. However, condensed tannins seemed to offset the starch digestion by limiting starch availability. All sorghum porridges had significantly lower EGI values than the corn porridge. Extrudates and porridges had reduced starch digestibilities and EGI values when using whole grains compared to using the decorticated fractions. This was observed in both the white and the tannin sorghum. Therefore, whole-grain products from sorghum have health benefits attributed to whole grain foods and slower digesting starches; for instance, prevention and treatment of diseases such as diabetes, insulin resistance, obesity, cardiovascular disease, and some types of cancer. When 12% of tannin bran was added to a wheat bread formulation, a slower rate of starch digestion was observed compared to a wheat bread. The high concentration of non-starch components of the bran (i.e. dietary fiber, condensed tannins) affected starch digestion. The addition of tannin sorghum bran significantly reduced the EGI value of wheat bread, besides being a natural source of brown color, and an excellent source of antioxidants and dietary fiber.

Two tannin sorghums, (high-tannin, black with tannin), high anthocyanin sorghum (black), and non-tannin sorghum (white) were used to investigate the effects of sorghum phenolic compounds on in vitro starch digestibility, estimated glycemic indices (EGI) and resistant starch contents (RS) of porridges. Sorghum varieties were chosen to have a wide range of total phenols (3-23 mg/g gallic acid) and tannin contents (0-34 mg catechin eq./g). Normal corn starch, enzyme resistant high amylose corn starch, and whole sorghum grains were cooked with the aqueous fraction of sorghum bran extracts obtained with 70% aqueous acetone. Endosperms of soft and hard sorghum varieties were mixed with sorghum brans and cooked into porridges with distilled water. Hi-tannin, black and black with tannin sorghum bran extracts significantly (p<0.05) decreased starch digestibility and estimated glycemic index (EGI) while they increased resistant starch (RS) contents of normal corn starch, enzyme resistant high amylose corn starch, and whole sorghum grain porridges. The highest reduction in starch digestibility of the porridges occurred with hi-tannin sorghum bran extracts, followed by black with tannin and black sorghum bran extracts. Double cooked corn starch porridges, which were cooked with these bran extracts had EGI values of 49-67 and RS contents of 9.1-57.7%. These RS values are higher than foods such as legumes, whole pasta and whole grain cereals which are considered health foods with low EGI (36-71) and high RS contents (2.9-6.8). Only brans of condensed tannin-containing sorghum varieties (tannin, black with tannin sorghums) significantly (p<0.05) decreased starch digestibility, and EGI, and increased RS contents of the endosperm porridges. When tannin sorghum bran extracts were cooked with zein added to corn starch porridges, starch digestibility of the porridges significantly (p<0.05) increased, while RS significantly (p<0.05) decreased because the zein reacted preferentially with the tannins. The cooking trials indicated that sorghums with tannins significantly reduced the activity of digestive enzymes, reduced EGI, and increased RS contents of porridges. Thus, specialty sorghum varieties have a potential to lower EGI and increase RS contents of starchy foods. Their aqueous bran extracts have potential use to reduce risk factors for type II diabetes and obesity.

Os carboidratos presentes nos alimentos são responsáveis por mais da metade do valor energético da alimentação do homem. Além do aporte energético, esse nutriente tem importante função na manutenção da glicose sanguínea e na integridade e funcionamento do trato gastrintestinal. Os produtos finais da digestão de carboidratos consistem, quase que exclusivamente, em glicose, frutose e galactose. Os carboidratos digeridos e absorvidos no intestino delgado provocam alterações na resposta glicêmica; essa elevação, ao longo do tempo, depende de fatores que interferem na velocidade de digestão e de difusão dos produtos de hidrólise no intestino delgado. Os carboidratos podem ser classificados de acordo com a glicemia pós prandial produzida. O índice glicêmico (IG) expressa de forma indireta, como cada alimento se comporta em termos de velocidade de digestão e absorção de seus carboidratos. A partir dos valores de IG dos alimentos pode-se calcular a carga glicêmica (CG), a qual inclui tanto a quantidade como a qualidade dos carboidratos ingeridos. O presente estudo teve como objetivo avaliar o IG e a CG de cinco frutos nacionais em indivíduos saudáveis. Em cada ensaio foram elaboradas as curvas glicêmicas produzidas após a ingestão de porções contento exatamente 25g ou 50g de carboidrato disponível dos seguintes frutos: abacaxi pérola (Ananas comosus); amora silvestre (Rubus rosaefoluis); morango oso grande (Fragaria ananassa Duch) e bananas (Musa spp.) mysore e nanica. A partir da relação entre a área abaixo da curva glicêmica dos alimentos teste e a área do pão (controle) foi calculado o IG. A CG foi calculada para cada fruto de acordo com o seu IG e a quantidade de alimento consumida habitualmente pela população. Tanto o cerne quanto a polpa de abacaxi apresentaram alto IG. A banana nanica apresentou IG médio e os demais frutos, banana mysore, morango e amora, apresentaram baixo IG. Em relação à carga glicêmica, a banana nanica apresentou CG média, enquanto os demais frutos apresentaram baixa CG. Nos frutos estudados, a CG demonstrou ser a melhor ferramenta para escolha destes alimentos no plano alimentar, pois expressa não somente a quantidade como a qualidade dos carboidratos. / The carbohydrates are responsible for more than half of the energy value in people\'s nourishment. Besides energy, this nutrient plays an important role in the maintenance of blood glucose levels and in the integrity and functioning of the gastrointestinal tract. The final products of the carbohydrates digestion are, almost exclusively, glucose, fructose and galactose. The carbohydrates digested and absorbed in the small intestine cause an increase in the glycemic response, which depends on factors that interfere in the speed of both digestion and diffusion of hydrolysis products in the small intestine. The carbohydrates can be classified according to the post prandial glycemia. The glycemic index (GI) predicts, indirectly, how each food behaves in terms of digestion and absorption speed of its carbohydrates. From the GI values of foods, it is possible to calculate the glycemic load (GL), which includes both quantity and quality of the ingested carbohydrates. This study aimed to evaluate the GI and GL of five Brazilian fruits in healthy subjects. The glycemic curves were elaborated in each essay. These curves were produced after the intake of portions containing exactly 25g or 50g of \"available\" carbohydrate in the fruits: pineapple (Ananas comosus); blackberry (Rubus rosaefoluis); strawberry (Fragaria ananassa Duch) and bananas (Musa spp.) mysore and nanica. The GI was calculated from the relation between the area below the glycemic curve of the test foods and the area of bread (standard food). The GL was calculated for each fruit according to its GI and the amount of food usually consumed by the population. Both core and pulp of pineapple presented high GI. Banana nanica presented medium GI and the other fruits, banana mysore, strawberry and blackberry, presented a low GI. The banana nanica showed medium GL, while the other fruits showed low GL. In the studied fruits, the GL proved to be the best tool in order to choose these foods in the food planning, once it expresses not only quality but also quantity of the carbohydrates

Os carboidratos presentes nos alimentos são responsáveis por mais da metade do valor energético da alimentação do homem. Além do aporte energético, esse nutriente tem importante função na manutenção da glicose sanguínea e na integridade e funcionamento do trato gastrintestinal. Os produtos finais da digestão de carboidratos consistem, quase que exclusivamente, em glicose, frutose e galactose. Os carboidratos digeridos e absorvidos no intestino delgado provocam alterações na resposta glicêmica; essa elevação, ao longo do tempo, depende de fatores que interferem na velocidade de digestão e de difusão dos produtos de hidrólise no intestino delgado. Os carboidratos podem ser classificados de acordo com a glicemia pós prandial produzida. O índice glicêmico (IG) expressa de forma indireta, como cada alimento se comporta em termos de velocidade de digestão e absorção de seus carboidratos. A partir dos valores de IG dos alimentos pode-se calcular a carga glicêmica (CG), a qual inclui tanto a quantidade como a qualidade dos carboidratos ingeridos. O presente estudo teve como objetivo avaliar o IG e a CG de cinco frutos nacionais em indivíduos saudáveis. Em cada ensaio foram elaboradas as curvas glicêmicas produzidas após a ingestão de porções contento exatamente 25g ou 50g de carboidrato disponível dos seguintes frutos: abacaxi pérola (Ananas comosus); amora silvestre (Rubus rosaefoluis); morango oso grande (Fragaria ananassa Duch) e bananas (Musa spp.) mysore e nanica. A partir da relação entre a área abaixo da curva glicêmica dos alimentos teste e a área do pão (controle) foi calculado o IG. A CG foi calculada para cada fruto de acordo com o seu IG e a quantidade de alimento consumida habitualmente pela população. Tanto o cerne quanto a polpa de abacaxi apresentaram alto IG. A banana nanica apresentou IG médio e os demais frutos, banana mysore, morango e amora, apresentaram baixo IG. Em relação à carga glicêmica, a banana nanica apresentou CG média, enquanto os demais frutos apresentaram baixa CG. Nos frutos estudados, a CG demonstrou ser a melhor ferramenta para escolha destes alimentos no plano alimentar, pois expressa não somente a quantidade como a qualidade dos carboidratos. / The carbohydrates are responsible for more than half of the energy value in people\'s nourishment. Besides energy, this nutrient plays an important role in the maintenance of blood glucose levels and in the integrity and functioning of the gastrointestinal tract. The final products of the carbohydrates digestion are, almost exclusively, glucose, fructose and galactose. The carbohydrates digested and absorbed in the small intestine cause an increase in the glycemic response, which depends on factors that interfere in the speed of both digestion and diffusion of hydrolysis products in the small intestine. The carbohydrates can be classified according to the post prandial glycemia. The glycemic index (GI) predicts, indirectly, how each food behaves in terms of digestion and absorption speed of its carbohydrates. From the GI values of foods, it is possible to calculate the glycemic load (GL), which includes both quantity and quality of the ingested carbohydrates. This study aimed to evaluate the GI and GL of five Brazilian fruits in healthy subjects. The glycemic curves were elaborated in each essay. These curves were produced after the intake of portions containing exactly 25g or 50g of \"available\" carbohydrate in the fruits: pineapple (Ananas comosus); blackberry (Rubus rosaefoluis); strawberry (Fragaria ananassa Duch) and bananas (Musa spp.) mysore and nanica. The GI was calculated from the relation between the area below the glycemic curve of the test foods and the area of bread (standard food). The GL was calculated for each fruit according to its GI and the amount of food usually consumed by the population. Both core and pulp of pineapple presented high GI. Banana nanica presented medium GI and the other fruits, banana mysore, strawberry and blackberry, presented a low GI. The banana nanica showed medium GL, while the other fruits showed low GL. In the studied fruits, the GL proved to be the best tool in order to choose these foods in the food planning, once it expresses not only quality but also quantity of the carbohydrates

The focus of this research study is glycemic control in the presence of multiple morbidities and polypharmacy in homebound individuals with Type 2 diabetes aged 65 years and older. The research method is a quantitative retrospective cohort study of discharged patients of a nonprofit community-based home health agency from January 1, 2010, to December 31, 2011, using OASIS data. Glycemic control is assessed using the hA1C laboratory test following the recommendation of the American Diabetes Association. The study documents a moderate significant association between glycemic control, polypharmacy and comorbid conditions, indicating that homebound individuals with Type 2 diabetes aged 65 years and older are less likely to have optimal glycemic control in the presence of multiple morbidities and polypharmacy. There continues to be a need for scientific research in this population cohort; and the dose-response association between antidiabetic therapy interventions designed to lower blood glucose levels in the presence of chronic disease and polypharmacy.