Article Efficacy of Isomaltulose Compared to Sucrose in Modulating Endothelial Function in Overweight Adults Eric de Groot 1,2, *, Lisa Schweitzer 3 and Stephan Theis 3 1 Imagelabonline & Cardiovascular, 4117 GV Erichem, The Netherlands 2 Amsterdam UMC—Location Academic Medical Centre, Departments of Clinical Epidemiology, Biostatistics and Bioinformatics, and Gastroenterology 1105 AZ Amsterdam, The Netherlands 3 BENEO ‐ Institute, c/o BENEO GmbH, Wormser Straße 11, 67283 Obrigheim, Pfalz, Germany; lisa.schweitzer@beneo.com (L.S.); stephan.theis@beneo.com (S.T.) * Correspondence: ericdg@xs4all.nl; Tel.: +31 ‐ 6 ‐ 2006 ‐ 2662 Received: 11 October 2019; Accepted: 31 December 2019; Published: 3 January 2020 Abstract: Hyperglycemia is linked to impaired arterial endothelial function (EF), an early sign of cardiovascular disease. We compared the efficacy of low ‐ glycemic index isomaltulose (Palatinose™) with that of sucrose in modulating EF, as assessed by flow ‐ mediated dilation (FMD). In this double ‐ blinded cross ‐ over study, 80 overweight mildly hypertensive subjects were randomized to receive 50 g of either isomaltulose or sucrose. On two non ‐ consecutive days, brachial artery ultrasound FMD scans were obtained prior to and hourly (T0–T3) after carbohydrate load. Blood was drawn immediately after scanning. Glucose and insulin levels were analyzed. Overall, the FMD decrease was attenuated by isomaltulose compared to sucrose ( Δ FMD = − 0.003% and − 0.151%; p > 0.05 for the interaction treatment x period). At T2, FMD was significantly higher after isomaltulose administration compared to that after sucrose administration (FMD = 5.9 ± 2.9% and 5.4 ± 2.6%, p = 0.047). Pearson correlations between FMD and blood glucose showed a trend for a negative association at T0 and T2 independently of the carbohydrate (r ‐ range = − 0.20 to − 0.23, p < 0.1). Sub ‐ analysis suggested a lower FMD in insulin ‐ resistant (IR) compared to insulin ‐ sensitive subjects. Isomaltulose attenuated the postprandial decline of FMD, particularly in IR persons. These data support the potential of isomaltulose to preserve the endothelial function postprandially and consequently play a favorable role in cardiovascular health. Keywords: isomaltulose; endothelial function; glycemic index; carbohydrates; insulin resistance; cardiovascular health 1. Introduction Endothelial function (EF) plays a pivotal role in cardiovascular health. Impaired EF is a prominent health concern, as it typically contributes to cardiovascular disease (CVD), i.e., hypertension, atherosclerosis, or myocardial infarction [1,2]. In an aging population, the high prevalence, still increasing incidence, and alarming number of deaths due to CVD every year worldwide [3–5] demonstrate the importance of counterbalancing CVD with the development of innovative preventive strategies integrated in everyday life. EF can be assessed by brachial artery ultrasound imaging. With this completely non ‐ invasive, subject ‐ friendly technique, the shear stress ‐ induced flow ‐ mediated endothelium ‐ dependent vasodilation (FMD) of the brachial artery can be measured [6]. A high FMD (e.g., 10% and above) corresponds to a vital endothelium; a low or no FMD (e.g., 5 to 0%) indicates impaired EF or endothelial dysfunction (ED). Brachial ultrasound FMD measurements are well reproducible and are considered a validated early marker of CVD risk [7]. Although the underlying mechanism of ED is
Nutrients 2020 , 12 , 141; doi:10.3390/nu12010141
www.mdpi.com/journal/nutrients
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