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Cocoa Increases Postprandial GLP‐1 Response in Adults with Impaired Glucose Tolerance
Author(s) -
Strat Karen,
Davy Brenda M,
Hulver Matthew W,
Davy Kevin P,
Neilson Andrew Peter
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.428.5
Subject(s) - postprandial , impaired glucose tolerance , medicine , incretin , prediabetes , endocrinology , type 2 diabetes , crossover study , placebo , meal , insulin , diabetes mellitus , impaired fasting glucose , glucose homeostasis , insulin resistance , alternative medicine , pathology
Prediabetes (elevated fasting glucose or impaired glucose tolerance) is an intermediate state in the development of type‐2 diabetes. Strategies are needed to prevent progression from this “at‐risk” state to fully developed disease. Cocoa flavanols offer a unique potential solution to improve glucose homeostasis by inhibiting digestive enzymes and stimulating an incretin hormone response. The purpose of this study was to determine the effects of acute cocoa consumption on postprandial blood glucose, insulin, and incretin hormone levels following a mixed meal in adults. Sixteen adults at risk for developing type‐2 diabetes were enrolled: n =11 had normal glucose tolerance (NGT, blood glucose < 140 mg/dl 2 h after 75 g OGTT) and n =5 had impaired glucose tolerance (IGT, 140–199 mg/dl 2 h after OGTT). Subjects completed two meal challenges consisting of a meal replacement shake blended with a cocoa beverage powder (10 g cocoa) or placebo beverage powder (0 g cocoa) in a randomized crossover design. Intravenous blood samples were taken at baseline and over 4 h post‐meal. For all subjects pooled together, cocoa significantly increased postprandial C‐peptide excursion from baseline compared to placebo (p = 0.0463). When data were split by phenotype (NGT vs. IGT subjects), the IGT cohort had slightly (but not significantly) lower fasting GLP‐1 levels and postprandial GLP‐1 response compared to the NGT cohort. Furthermore, the IGT cohort had significantly increased maximum postprandial GLP‐1 levels (p = 0.0452) with cocoa vs. placebo. In IGT subjects, GLP‐1 area under the curve and excursion from baseline approached significance with cocoa vs. placebo (p = 0.0759 and p = 0.0642, respectively). There were no differences in GLP‐1 response between treatments for the NGT group. There were no effects of cocoa on glucose, insulin, GIP, or adiponectin for either cohort or pooled subjects. Our data suggest that natural cocoa may rescue an impaired GLP‐1 response seen in adults with impaired glucose tolerance; NGT individuals may not experience these improvements, as their incretin and glycemic responses are not impaired. In conclusion, natural cocoa may be helpful in maintaining glucose homeostasis by enhancing the incretin response in a subset of adults at risk of developing type‐2 diabetes. Support or Funding Information Funding was provided by The Hershey Co., Hershey, PA.