Quantitative assessment method for personalized glucose metabolism sensitivity and personalized dietary carbohydrate intake recommendation system

Abstract

The present invention discloses a quantitative assessment method for personalized glucose metabolism sensitivity and a personalized dietary carbohydrate intake recommendation system. Based on the repeated measurement of blood glucose fluctuations after a variety of standard meals by a continuous blood glucose monitor, the present invention creates a new quantitative index to characterize the differentiated glucose metabolism levels of different individuals. On this basis, the present invention also creates a personalized diet library, which can provide different individuals with customized maximum carbohydrate intake limits for each meal for the same food. Residents can use this tool to better understand their own glucose metabolism levels and the optimal carbohydrate intake limit for each food, thereby achieving precise management of glucose metabolism.

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. It aims to improve blood glucose homeostasis and provides a method and use for assessing the sensitivity of different individuals to blood glucose response fluctuations after carbohydrate intake. Background Art

[0002] Over the past decade, the field of precision nutrition has been undergoing a paradigm shift, driven by growing evidence demonstrating widespread individual variability in biological responses to diet. The field aims to develop targeted dietary guidelines that not only enhance individual health but also consider the complex interactions between diet and genetic, metabolic, microbial, lifestyle, and socioeconomic factors.

[0003] The evolution of precision nutrition can be traced back to significant advances in nutrigenetics, nutrigenomics, and projects like 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, previously successful in psychology and pharmacology, are now being applied to nutrition, aiming to provide personalized dietary recommendations and guidance based on detailed individual data.

[0004] Postprandial hyperglycemic response, as a key phenotype, 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 caused by 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 GIs, 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 findings 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, the PGS enables us to provide personalized carbohydrate intake guidance for each person. The PGS is not only a new index but also has the potential to 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 personalized medicine, 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 traditional nutrition "one-size-fits-all" dietary recommendation model. 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 food intakes. This assessment method is not affected by the postprandial dietary response level of others, can more truly and accurately reflect the specificity of the individual, and has strong extrapolation 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 in 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) of each standard meal meal ;

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

[0012] c) Perform a linear fit between the mixed carbohydrate load of the standard meal and the incremental blood glucose response after the standard meal intervention. The slope of the resulting regression line is used as the personalized glucose metabolism sensitivity index (PGS), which is used to quantify individual differences in personalized glucose metabolism responses.

[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 provide personalized guidance for residents' daily dietary choices and intake restrictions.

[0014] In the above technical solution, further, the standard meal is food or a combination thereof that uses 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 This 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. 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 every 15 minutes by the continuous blood glucose monitor, the trapezoidal area between two adjacent points was accumulated and the baseline blood glucose area within 2 hours was subtracted to obtain iAUC 0-2h Indicates 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:

[0023] The upper limit of the ideal postprandial blood glucose range (iAUC) is the fasting, 1-hour and 2-hour postprandial blood glucose values ​​for clinical diagnosis of prediabetes. 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 : Indicates the glycemic index (GI) of a meal weighted by the carbohydrate content of each food in the meal. If the meal contains multiple food categories, it is necessary to perform a weighted calculation based on the carbohydrate content of each food in the meal. If the meal consists of 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 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.

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

[0028] The present invention starts from the perspective of precision nutrition, 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. In particular, 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 page 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 with reference to specific embodiments.

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

[0031] The present invention linearly fits the carbohydrate load (GL) of various standard meals and the incremental blood glucose response after the standard meal intervention. The slope of the resulting regression line is the personalized glycemic sensitivity index (PGS). This index can be used to quantify individual differences in personalized glucose metabolism responses. A larger value indicates a greater increment in the area under the postprandial glucose response curve for the same food and the same carbohydrate intake, i.e., a greater sensitivity to the carbohydrate intake of that food. The latest clinical guidelines emphasize the significance of increased daily blood glucose fluctuations in the risk of developing diabetes. Previous studies have also found that PGS is positively correlated with daily blood glucose fluctuations, i.e., the larger the PGS value, the more severe the blood glucose fluctuations. Most importantly, the PGS's ability to reflect daily blood glucose fluctuations is superior to the single-point measurement results obtained from the classic OGTT test. This also means that PGS, as a new glucose metabolism response evaluation index, has the unique ability to reflect individual glucose metabolism characteristics independently of the 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 by its carbohydrate content according to equations (1) and (2). meal ), and then we can get the glycemic load of each standard meal (Glycemic load of meal, GL meal The GI values ​​of various foods are from the Chinese Food Composition Table (Standard Edition) (Issue 6, 2018). The second step is to accumulate the blood glucose values ​​recorded every 15 minutes by the continuous blood glucose monitor using 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 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] Among them, the standard meal included 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 calculation of the previous data, only when the number of standard meals included in the calculation of PGS reaches 5 or more, 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 : Indicates the glycemic index (GI) of a meal weighted by the carbohydrate content of each food in the meal. If the meal contains multiple food categories, it is necessary to perform a weighted calculation based on the carbohydrate content of each food in the meal; if the meal consists of a single food, the GI of the food itself is 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) Within 14 days after wearing CGM, volunteers need to consume carbohydrate-containing foods, i.e., standard meals, on an empty stomach. 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 a baseline oral glucose tolerance test (OGTT). Within 2 hours after intake, keep still, avoid consuming 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 glucose 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, and the blood glucose fluctuation values ​​2 hours after each meal were extracted to calculate the postprandial blood glucose increment iAUC and each meal GL meal , used to construct the computational PGS.

[0046] (3) Based on the paired data of individual 14-day dynamic blood glucose monitoring, a linear equation was fitted for GL and iAUC (the formula is as follows). 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 intakes. Under the intervention of the same GL meal, individuals with higher PGS are 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 resident 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 standards are 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) is calculated. ref), as the upper limit of the increase in the area of ​​postprandial blood glucose fluctuation. 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 upper limit of carbohydrate intake (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 this invention's quantitative assessment method and personalized dietary library, it can provide tailored maximum carbohydrate intake limits per meal for each food or meal for different individuals. This tool can help residents better understand their own glucose metabolism levels and the optimal carbohydrate intake limits for each food, thereby achieving precise management of glucose metabolism.

[0053] The embodiments described above are merely some preferred embodiments of the present invention and are not intended to limit the present invention. Persons skilled in the art may make various changes and modifications without departing from the spirit and scope of the present invention. Therefore, any technical solution obtained by equivalent substitution or equivalent transformation falls within the scope of protection 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 a standard meal to intervene in the individual to be evaluated, and measure the blood glucose fluctuation values ​​within 2 hours after the intervention of different standard meals, and then calculate the blood glucose response increment iAUC 0-2h ; c) Perform a linear fit between the mixed carbohydrate load of the standard meal and the incremental blood glucose response after the standard meal intervention. The slope of the resulting regression line is used as the personalized glucose metabolism sensitivity index (PGS), which is used to quantify individual differences in personalized glucose metabolism responses. d) Based on the personalized glucose metabolism sensitivity index PGS, each individual's personalized upper limit of carbohydrate intake (iUL-CHO) for different types of food or different food combinations per meal is calculated, thereby constructing a personalized dietary carbohydrate intake recommendation system to provide personalized guidance on residents' daily dietary choices and intake restrictions.

2. The method for quantitatively assessing personalized glucose metabolism sensitivity according to claim 1, characterized in that: The standard meal is 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, wherein: 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 This is the mixed carbohydrate load, which is calculated as follows: ， GI i represents 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 assessing personalized glucose metabolism sensitivity according to claim 1, wherein: 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. 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.

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

6. The method for quantitatively assessing personalized glucose metabolism sensitivity according to claim 1, wherein: Based on the blood glucose values ​​recorded every 15 minutes by the continuous blood glucose monitor, 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 Indicates the increase in blood glucose response after a meal.

7. The method for quantitatively assessing personalized glucose metabolism sensitivity according to claim 1, wherein: The method for constructing the personalized dietary carbohydrate intake recommendation system includes the following steps: The upper limit of the ideal postprandial blood glucose range (iAUC) is the fasting, 1-hour and 2-hour postprandial blood glucose values ​​for clinical diagnosis of prediabetes. 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 carbohydrate intake upper limit iULs-CHO: ， Among them, iUL-CHO represents the upper limit of total carbohydrate intake of a meal; iAUC ref The incremental area under the curve representing the upper limit of the ideal postprandial blood glucose range; GI meal It represents the glycemic index (GI) of a meal weighted by the carbohydrate content of each food in the meal. If the meal contains multiple food categories, it needs to be weighted based on the carbohydrate content of each food in the meal. If the meal consists of a single food, the GI of the food itself is the GI. meal .

8. The method for quantitatively assessing personalized glucose metabolism sensitivity according to claim 7, wherein: 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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