Dietary Strategies for Improving Post-Prandial Glucose, Lipids, Inflammation, and Cardiovascular Health
James H. OKeefe, MD*,
Neil M. Gheewala, MS and
Joan O. OKeefe, RD
Mid America Heart Institute and University of Missouri–Kansas City, Kansas City, Missouri.

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Figure 1 Post-Challenge Glucose and Coronary Atherosclerosis Progression
Patients with normal glucose tolerance who had a post-prandial glucose level of <87 mg/dl had coronary regression. The remaining patients had coronary progression in proportion to the increase in post-prandial glucose. Data from Mellen et al. (10).
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Figure 2 Glucose Excursion Directly Related to Oxidant Stress
Linear correlation between post-prandial glucose excursions and urinary excretion of 8-iso prostaglandin F2 (PGF2 ), a measure of oxidant stress. Reprinted with permission (17).
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Figure 3 Post-Prandial Stress
The immediate deleterious effects of a beverage containing 75 g glucose mixed with 700 kcal/m2 of whipping cream. Within 2 to 4 h glucose and triglyceride levels double, causing immediate oxidant stress (nitrotyrosine), inflammation (C-reactive protein [CRP]), resulting in deterioration in endothelial function. FMD % = percent flow-mediated dilation. Data from Ceriello et al. (41).
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Figure 4 Almonds Reduce Post-Prandial Glucose
The post-prandial increase in the area under the curve for glucose was reduced by 58% when 90 g of almonds were added to a high glycemic index meal (p = 0.009). Data from Josse et al. (28).
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Figure 5 Vinegar Reduces Post-Prandial Glucose
The addition of 2 tablespoons of vinegar to 2 slices of white bread significantly reduced the post-prandial glucose increase. Data from Östman et al. (32).
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Figure 6 Whey Protein Reduces Post-Prandial Glucose
Increases in blood glucose after either a glucose drink or the same glucose drink mixed with whey protein. Whey protein reduced the area under the curve for blood glucose by 56% (p < 0.05). Data from Nilsson et al. (33).
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Figure 7 Alcohol Reduces Post-Prandial Glucose
In this group of healthy individuals, 20 g alcohol (approximately 1.5 drinks) in various beverages reduced postmeal glucose by up to 38%. Data from Brand-Miller et al. (37).
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Figure 8 Daily Activity Reduces Post-Prandial Glucose
Cumulative daily light-intensity physical activity was inversely associated with post-prandial glucose levels. Data from Healy et al. (39).
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