Quantitative evaluation method for personalized glucose metabolism sensitivity and personalized dietary carbon water recommended intake system

Abstract

The invention discloses a quantitative evaluation method for personalized glucose metabolism sensitivity and a personalized dietary carbon water recommended intake system. According to the invention, on the basis of repeated measurement of a continuous blood glucose monitor on blood glucose fluctuation after various different standard meals, a new quantitative index is created to characterize differentiated glucose metabolism levels of different individuals. On the basis, the invention also creates a personalized diet library which can provide customized maximum carbon-water intake upper limit of each meal for different individuals for the same food. According to the tool, residents can better know the own glucose metabolism level and the upper limit of the optimal carbon-water intake of each kind of food, so that accurate management of glucose metabolism is realized.

Description

Technical Field

[0001] The present invention belongs to the field of precision nutrition, and relates to a quantitative assessment method for personalized glucose metabolism sensitivity and a personalized dietary carbohydrate intake recommendation system. The present invention aims to improve blood glucose homeostasis, and provides a method and use for assessing the sensitivity of blood glucose response fluctuations after carbohydrate intake in different individuals. Background Art

[0002] In the past decade, the field of precision nutrition has been undergoing a paradigm shift, with growing evidence showing that there are wide individual differences in biological responses to diet. This field aims to develop targeted dietary guidelines that not only enhance individual health, but also take into account the complex interactions between diet and genetic, metabolic, microbial and lifestyle, socioeconomic and other factors.

[0003] The evolution of precision nutrition can be traced back to major advances in nutritional genetics, nutritional genomics, and projects such as Food4Me, the Israel Personalized Nutrition Study, and the PREDICT-1 study, all of which emphasize the individualized nature of dietary responses. However, the field of N-of-1 clinical trials represents a new frontier in nutrition research. These trials, which have been successful in psychology and pharmacology, are now being applied to the field of nutrition, aiming to provide personalized dietary recommendations and dietary guidance for different individuals based on detailed individual data.

[0004] As a key phenotype, postprandial hyperglycemic response is considered an important risk factor for chronic diseases such as obesity, type 2 diabetes, and cardiovascular disease. Therefore, understanding and managing the impact of diet on blood glucose levels is crucial to improving people's health. Although the glycemic index (GI) is widely used in general dietary recommendations, it has limited effectiveness in addressing individual differences in blood glucose response to the same meal. These differences have prompted us to rethink the "one-size-fits-all" approach used in traditional dietary guidelines.

[0005] To investigate participants’ individual responses to meals with varying GI, we conducted a study using an n-of-1 design, which revealed significant variability in postprandial blood glucose responses, highlighting the need for personalized dietary advice. One of the key outcomes of the study was the development of a personalized glycemic sensitivity index (PGS), which quantifies an individual’s response to glycemic load. Combined with traditional GI indicators, PGS enables us to provide personalized carbohydrate intake guidance for each person. PGS is not only a new index, but may also more accurately reflect individual glucose metabolism sensitivity characteristics.

[0006] This technology uses novel PGS metrics to provide a revolutionary perspective for nutrition research and paves the way for future studies that personalize dietary recommendations to suit individual metabolic characteristics. This personalized approach is expected to optimize blood sugar management and may change the landscape of dietary guidelines and health outcomes. Although putting these personalized dietary guidelines into practice may require major changes in patient education, medical systems, infrastructure, etc., in the long run, they may have a profound impact on public health strategies and medical personalization, bringing huge health significance and public health benefits. Summary of the invention

[0007] The purpose of the present invention is to provide a quantitative assessment method for personalized glucose metabolism sensitivity and a personalized dietary carbohydrate recommendation intake system for the existing "one-size-fits-all" dietary recommendation model of traditional nutrition. It is a method for quantitatively assessing the glucose metabolism sensitivity of different individuals based on a continuous glucose monitoring chip (Continuous glucose monitoring system, CGM) and postprandial blood glucose response of various carbohydrate foods. This assessment method is not affected by the postprandial dietary response level of others, can more truly and accurately reflect the individual specificity, and has strong extrapolability and universality. In order to guide individuals to adjust their dietary patterns and promote the implementation and development of precision nutrition.

[0008] The technical solution adopted by the present invention is as follows:

[0009] A quantitative assessment method for personalized glucose metabolism sensitivity, comprising:

[0010] a) Identify 3 or more standard meals and calculate the mixed carbohydrate load GL for each standard meal meal ;

[0011] b) Use standard meals to intervene in the individuals to be evaluated, and measure the blood glucose fluctuation values ​​within 2 hours after intervention with different standard meals, and then calculate the blood glucose response increment iAUC 0-2h ;

[0012] c) Linearly fitting the mixed carbohydrate load of the standard meal and the blood glucose response increment after the standard meal intervention, and using the slope of the obtained regression fitting line as the personalized glucose metabolism sensitivity index PGS to quantify the differences in personalized glucose metabolism responses between individuals;

[0013] d) In addition, the personalized carbohydrate intake upper limit iUL-CHO for each individual for different types of food or different food combinations per meal can be calculated based on the personalized glucose metabolism sensitivity index PGS, thereby constructing a personalized dietary carbohydrate intake recommendation system to achieve personalized guidance on residents' daily dietary choices and intake restrictions.

[0014] In the above technical solution, further, the standard meal is food or a combination thereof using carbohydrates as the main energy source.

[0015] Furthermore, after determining the standard meal, the glycemic index GI value of each food in the standard meal is weighted according to its carbohydrate content to obtain the glycemic index GI of the standard meal. meal , and then calculate the glycemic load GL of each standard meal meal That is, the mixed carbohydrate load, which is calculated as follows:

[0016]

[0017] GL meal =GI meal ×CHO total

[0018] GI i Indicates the glycemic index of the i-th food in the meal; CHO i is the carbohydrate weight (g) of the i-th food in the meal; CHO total It represents the total weight of carbohydrate intake in each meal; n is the number of food types in a standard meal.

[0019] Furthermore, the intervention specifically includes: the individual to be evaluated needs to consume a standard meal on an empty stomach, remain sedentary within 2 hours after consumption, avoid consuming other energy substances, avoid strenuous exercise and drinking large amounts of water, and at the same time, record the name of the food consumed, the estimated weight, and the time of the first bite of the meal, and monitor post-meal blood sugar fluctuation data.

[0020] Furthermore, during the intervention period, each standard meal was repeated 2 or more times on different days.

[0021] Furthermore, based on the blood glucose values ​​recorded by the continuous blood glucose monitor every 15 minutes, the trapezoidal area calculation method between two adjacent points was used to accumulate and subtract the baseline blood glucose area within 2 hours to obtain iAUC 0-2h Represents the increase in blood glucose response after a meal.

[0022] Furthermore, the method for constructing the personalized dietary carbohydrate intake recommendation system includes the following steps:

[0023] The fasting, 1-hour and 2-hour postprandial blood glucose values ​​of clinically diagnosed prediabetes were used as the upper limit of the ideal postprandial blood glucose range iAUC ref , by combining the individual's PGS and the GI of each meal meal Combined, the maximum carbohydrate intake of each food is calculated, thereby creating a personalized dietary library with a personalized upper carbohydrate intake limit iULs-CHO.

[0024] iUL-CHO=iAUC ref / (PGS×GI meal )

[0025] Among them, iUL-CHO represents the upper limit of total carbohydrate intake of a meal; iAUC ref GI: The area under the curve that represents the upper limit of the ideal postprandial blood glucose range; meal : It indicates the glycemic index (GI) of a meal after weighting according to the carbon water ratio of each food in the meal. If the meal contains multiple food categories, it is necessary to perform a weighted calculation based on the carbon water ratio of each food in the meal. If the meal is a single food, the GI of the food itself is the GI meal .

[0026] Furthermore, based on the personalized dietary carbohydrate intake recommendation system, it is only necessary to know the individual's PGS and the GI of a certain food or the weighted glycemic index GI of a certain meal. meal , you can get the maximum carbohydrate intake of this food or meal recommended for the individual, thereby achieving personalized dietary guidance for daily diet.

[0027] The beneficial effects of the present invention are:

[0028] Starting from the perspective of precision nutrition, the present invention is based on the differences in individual glucose metabolism responses and proposes a new quantitative evaluation index for glucose metabolism sensitivity, which provides a new reference model for precision nutrition in clinical and community glucose management. Especially with the popularization of CGM in clinical diabetes management, this also provides the necessary conditions for the implementation of the present invention. The processing process of the present invention has realized code automation and interactive web design, which makes it more convenient for users to obtain individual glucose metabolism sensitivity index by uploading data by themselves (https: / / gisquare.shinyapps.io / keapp / ). DETAILED DESCRIPTION

[0029] The technical solution of the present invention is further described in detail below in conjunction with specific embodiments.

[0030] 1. A quantitative index for evaluating individual glucose metabolism characteristics

[0031] The present invention linearly fits the carbohydrate load (GL) of a variety of standard meals and the increment of blood glucose response after standard meal intervention, and the slope of the obtained regression fitting line is the personalized glycemic sensitivity index (PGS). This index can be used to quantify the difference in personalized glucose metabolism response between individuals. If the value is larger, it indicates that the area increment under the postprandial blood glucose response curve caused by the same food and the same carbon water intake is larger, that is, the more sensitive to the carbon water intake of the food. The latest clinical guidelines emphasize the risk significance of the increase in the amplitude of daily blood glucose fluctuations for the onset of diabetes. In previous studies, it was also found that PGS is positively correlated with daily blood glucose fluctuations, that is, the larger the PGS value, the more severe the blood glucose fluctuations. And most importantly, the ability of PGS to reflect the daily blood glucose fluctuations is better than the single-point measurement results obtained by the classic OGTT test. This also means that PGS, as a new glucose metabolism response evaluation index, has a unique ability to reflect individual glucose metabolism characteristics independent of OGTT.

[0032] 2.PGS calculation process

[0033] In general, the first step is to obtain the glycemic index of meal (GI) by weighting the GI value of each food according to its carbohydrate content according to equations (1) and (2). meal ), and then the glycemic load of each standard meal (Glycemic load of meal, GL meal ). The GI values ​​of various foods come from the Chinese Food Composition Table (Standard Edition) (Issue 6, 2018). The second step is to accumulate the blood glucose values ​​recorded by the continuous blood glucose monitor every 15 minutes by the trapezoidal area calculation method between two adjacent points, and subtract the baseline blood glucose area within 2 hours to obtain iAUC 0-2h The third step is to establish multiple standard meal GL in a person. meal And the corresponding iAUC 0-2h The linear regression mathematical model of the fitting model is shown in equation (3). The β coefficient of the fitting model is the personalized glucose metabolism response index, PGS.

[0034] The included standard meal needs to be able to calculate the weighted GI meal And the weighted GL between different standard meals meal During the effective period of CGM monitoring, it is recommended that each meal be repeated more than 2 times on different days to correct the measurement error. According to the previous data calculation, only when the number of standard meals included in the calculation of PGS reaches 5 or more times and the GL in the standard meal is mealIf the span (the difference between the maximum and minimum values) is greater than or equal to 60, the obtained PGS can reach a consistency of more than 0.75 in the internal consistency test (ICC), indicating that the obtained index is relatively stable and reliable.

[0035] The detailed calculation process of PGS is as follows:

[0036]

[0037] GL meal = GI meal ×CHO total (2)

[0038] E(iAUC 0-2h ) = PGS × GL meal (3)

[0039] GI i : Indicates the glycemic index of a specific food in a meal.

[0040] GI meal : It indicates the glycemic index (GI) of a meal after weighting according to the carbon water ratio of each food in the meal. If the meal contains multiple food categories, it is necessary to perform a weighted calculation based on the carbon water ratio of each food in the meal; if the meal is a single food, the GI of the food itself i GI meal .

[0041] CHO total : Indicates the total weight (grams) of carbohydrate intake in a meal.

[0042] iAUC 0-2h : Indicates the incremental area of ​​blood sugar fluctuation within 2 hours after a meal.

[0043] According to a specific embodiment of the present invention, a specific quantitative evaluation method may include the following:

[0044] (1) Volunteers need to consume carbohydrate foods, i.e. standard meals, on an empty stomach within 14 days after wearing CGM. Standard meals refer to foods that use carbohydrates as the main energy source, and the proportion of ingredients is relatively controllable and repeatable. These include four standardized meals, namely refined grain breakfast (RG), whole grain breakfast (WG), light fasting toast, and baseline oral glucose tolerance test (OGTT). Keep seated within 2 hours after intake, avoid intake of other energy sources, avoid strenuous exercise, etc., and drink a small amount of water. At the same time, volunteers need to cooperate in recording the name of the food consumed, the estimated weight, and the time of the first bite of the meal, so as to identify and match the postprandial blood sugar fluctuation data corresponding to each meal.

[0045] (2) After completing the standard meal intervention, the CGM monitoring data and the corresponding meal record information were collected, the blood glucose fluctuation values ​​2 hours after each meal were extracted, and the postprandial blood glucose increment iAUC and each meal GL were calculated. meal , used to construct the computational PGS.

[0046] (3) Based on the paired data of the individual's 14-day dynamic blood glucose monitoring, a linear equation of GL and iAUC was fitted (the formula is as follows). Among them, the β coefficient obtained by fitting is defined as the individual's PGS value, which reflects the individual's sensitivity to blood glucose fluctuations after different carbohydrate intake. Under the intervention of the same GL meal, the individual with a higher PGS is more likely to have a risk of postprandial hyperglycemia response.

[0047] E(iAUC 0-2h )=PGS×GL meal

[0048] (4) In order to better apply the results to clinical and resident dietary guidance, the present invention also proposes a personalized dietary library for personalized guidance of residents' dietary carbohydrate intake based on the PGS framework. The fasting, 1-hour and 2-hour postprandial blood glucose values ​​for clinical diagnosis of prediabetes (in clinical practice, the following standard is used to diagnose prediabetes: pre-meal blood glucose level is 6.9mmol / L, 1-hour and 2-hour post-meal blood glucose levels are 11mmol / L and 7.8mmol / L respectively) are used as the ideal postprandial blood glucose range, and the incremental area under the curve (iAUC ref), as the upper limit of the increase in the postprandial blood glucose fluctuation area. By combining the individual's PGS and dietary GI, the maximum carbohydrate intake of each food is calculated, and a personalized dietary library with a personalized carbohydrate intake upper limit (iULs-CHO) is created (the formula is as follows). Calculating the iULs-CHO of a certain food in a meal is not limited by whether the food has been tested for postprandial blood glucose response in advance. It only requires understanding the individual's PGS and food GI. This makes us realize that dietary recommendations under the PGS framework have the potential to provide personalized dietary guidance.

[0049] iUL-CHO=iAUC ref / (PGS×GI meal )

[0050] iUL-CHO: indicates the upper limit of carbohydrate intake in a meal.

[0051] iAUC ref : The increase in area under the curve representing the upper limit of the ideal postprandial blood glucose range.

[0052] Based on the quantitative assessment method and personalized diet library of the present invention, it can provide tailored maximum carbon water intake limits for each meal for different individuals for the same food or meal. Residents can use this tool to better understand their own sugar metabolism level and the optimal carbon water intake limit for each food, thereby achieving accurate management of sugar metabolism.

[0053] The above-described embodiments are only some of the preferred solutions of the present invention, but they are not intended to limit the present invention. A person skilled in the relevant technical field may make various changes and modifications without departing from the spirit and scope of the present invention. Therefore, any technical solution obtained by equivalent replacement or equivalent transformation falls within the protection scope of the present invention.

Claims

1. A quantitative assessment method for personalized glucose metabolism sensitivity, characterized in that: include: a) Identify 3 or more standard meals and calculate the mixed carbohydrate load GL for each standard meal meal ; b) Use standard meals to intervene in the individuals to be evaluated, and measure the blood glucose fluctuation values ​​within 2 hours after intervention with different standard meals, and then calculate the blood glucose response increment iAUC 0-2h ; c) Linearly fitting the mixed carbohydrate load of the standard meal and the blood glucose response increment after the standard meal intervention, and using the slope of the obtained regression fitting line as the personalized glucose metabolism sensitivity index PGS to quantify the differences in personalized glucose metabolism responses between individuals; d) In addition, the personalized carbohydrate intake upper limit iUL-CHO for each individual for different types of food or different food combinations per meal can be calculated based on the personalized glucose metabolism sensitivity index PGS, thereby constructing a personalized dietary carbohydrate intake recommendation system to achieve personalized guidance on residents' daily dietary choices and intake restrictions.

2. The method for quantitatively evaluating personalized glucose metabolism sensitivity according to claim 1, characterized in that: The standard meal is a food or a combination thereof that uses carbohydrates as the main energy source.

3. The method for quantitatively evaluating personalized glucose metabolism sensitivity according to claim 1, characterized in that: After determining the standard meal, the glycemic index GI value of each food in the standard meal is weighted according to its carbohydrate content to obtain the glycemic index GI of the standard meal. meal , and then calculate the glycemic load GL of each standard meal meal That is, the mixed carbohydrate load, which is calculated as follows: GL meal =GIVE meal ×CHO total GI i Indicates the glycemic index of the i-th food in the meal; CHO i is the carbohydrate weight (g) of the i-th food in the meal; CHO total It represents the total weight of carbohydrate intake in each meal; n is the number of food types in a standard meal.

4. The method for quantitatively evaluating personalized glucose metabolism sensitivity according to claim 1, characterized in that: The intervention specifically includes: the individual to be evaluated needs to consume a standard meal on an empty stomach, remain sedentary within 2 hours after consumption, avoid intake of other energy substances, avoid strenuous exercise and drinking large amounts of water, and at the same time, record the name of the food consumed, estimated weight, and time of the first bite of the meal, and monitor post-meal blood sugar fluctuation data.

5. The method for quantitatively evaluating personalized glucose metabolism sensitivity according to claim 4, characterized in that: During the intervention period, each standard meal was repeated 2 or more times on different days.

6. The method for quantitatively evaluating personalized glucose metabolism sensitivity according to claim 1, characterized in that: Based on the blood glucose values ​​recorded by the continuous blood glucose monitor every 15 minutes, the iAUC is obtained by adding the values ​​between two adjacent points using the trapezoidal area calculation method and subtracting the baseline blood glucose area within 2 hours. 0-2h Represents the increase in blood glucose response after a meal.

7. The method according to claim 1 is characterized in that the method for constructing the personalized dietary carbohydrate intake recommendation system comprises the following steps: The fasting, 1-hour and 2-hour postprandial blood glucose values ​​of clinically diagnosed prediabetes were used as the upper limit of the ideal postprandial blood glucose range iAUC ref , by combining the individual's PGS and the GI meal Combined, the maximum carbohydrate intake of each food is calculated, thereby creating a personalized dietary library with a personalized upper carbohydrate intake limit iULs-CHO. iUL-CHO=iAUC ref / (PGS×GI meal ) in, iUL-CHO represents the upper limit of total carbohydrate intake for a meal; iAUC ref GI: The area under the curve that represents the upper limit of the ideal postprandial blood glucose range; meal : It indicates the glycemic index (GI) of a meal after weighting according to the carbon water ratio of each food in the meal. If the meal contains multiple food categories, it is necessary to perform a weighted calculation based on the carbon water ratio of each food in the meal. If the meal is a single food, the GI of the food itself is the GI meal .

8. The method for quantitatively evaluating personalized glucose metabolism sensitivity according to claim 7, characterized in that: Based on the personalized dietary carbohydrate intake recommendation system, it is only necessary to understand the individual's PGS and the GI of a certain food or the weighted glycemic index GI of a certain meal. meal , you can get the maximum carbohydrate intake of this food or meal recommended for the individual, thereby achieving personalized dietary guidance for daily diet.

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