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Today's show topic is "Diabetes Risk, Insulin Sensitivity, and the Benefits of Barley Beta Glucan." Our guest today is Dr. Joy Frestedt, a PhD in laboratory medicine and pathology from the University of Minnesota Medical School, a certified clinical trial investigator, and is currently the president and CEO of Frestedt, Incorporated, which provides services in regulatory, clinical and quality affairs. Dr. Frestedt also co-authored a paper entitled "Reduced Viscosity Barley Beta Glucan Versus Placebo. A Randomized Controlled Trial of the Effects on Insulin Sensitivity for Individuals At Risk For Diabetes Mellitus" in the journal Nutrition and Metabolism in August 2011.
Welcome, Dr. Frestedt. Thank you so much for being on the show today.
DR. JOY L. FRESTEDT: Hello Kirk.
KIRK HAMILTON: So you did a paper, and see if I can read it right here, "Reduced Viscosity Barley Beta Glucan Versus Placebo. A Randomized Controlled Trial of The Effects on Insulin Sensitivity for Individuals at Risk for Diabetes Mellitus." And this was in Nutrition and Metabolism. Why did you happen to even choose to do this study? What got you - perked your interest?
DR. JOY L. FRESTEDT: Well for me personally I've always been interested in clinical trials for foods and food ingredients and how they might impact people as they try to manage various different health conditions. And this particular product, this beta glucan, is an interesting extract from plants and it has a fair amount of research behind it. So there was a lot of information about cholesterol and lipid effects. And I got intrigued about the possibility of having - this product having an effect on glucose levels. And so we really wanted to study the impact of these beta glucans on glycemic control. And we had a product that could be put into water. So we had a flavored water beverage that we could use to evaluate as people benefitted from having that water. And we were checking their blood glucose levels after they consumed the water.
KIRK HAMILTON: So describe to the audience and maybe keep it in layman's terms what beta glucan is and what foods it comes from.
DR. JOY L. FRESTEDT: Sure. Beta glucan is a soluble fiber that's extracted from plants. So for example, in the product that we used it was taking whole grain barley flour and using enzymes to extract the beta glucan. This fiber, this beta glucan, is typically from the plant cell wall and these types of fibers are not fully digested from - by humans because of the special way that the glucose molecules are linked together they're called beta linkages. And these glucose sugar molecules in this beta linkage form - create long polymers, long strings of glucose that is a fiber. And those difficult to digest beta linkages allow functionality for the product because it can alter the degree of nutrient absorption or among other characteristics they slow uptake of glucose or lipids or cholesterol into the blood after meals.
KIRK HAMILTON: So does, aside from slowing glucose and maybe keeping lipids lower, are there are any other potential functions of beta glucan? I think I've heard about it as immune function - as an immune function potentiating agent.
DR. JOY L. FRESTEDT: There's some studies that have looked at the biologic response modifier types of ways that this product might activate the immune system. There are a lot of different end points to measure in immune testing, so there's a lot of research being done and still needing to be done to really fully understand the impact of the product. Immune cells as individual cells and then the whole body and how your body uses this immune system. For example to fight off colds and things. It's really - there have been other benefits including things like the sensation of feeling full longer so this process of having a slowly digestible type of fiber might contribute to those kinds of benefits as well.
KIRK HAMILTON: So you use 3 and 6 grams of this beta glucan in your study. And I was just trying - I'm always trying to put that as a visual. I think of oatmeal when I think of you know -
DR. JOY L. FRESTEDT: Yep.
KIRK HAMILTON: - the beta glucan, so can you put it into some kind of visual context of how much 3 and 6 grams is? It seems like a lot.
DR. JOY L. FRESTEDT: Yeah, it's really not that much because if you think about the plant, the cell wall of the plant, that's the large part of the plant. And so for example if you take oats, like you were thinking about oatmeal, one cup of oatmeal in an unprocessed type of oatmeal contains about 3 to 4 grams of oat beta glucan.
KIRK HAMILTON: So that wouldn't take too much. And so you could do your study with one and two cups of oatmeal a day.
DR. JOY L. FRESTEDT: Correct.
KIRK HAMILTON: It reminds me of the work of Dr. James Anderson from the University of Kentucky. He's an endocrinologist who 30 years ago was using his HCF diet and one of his biggest components was oat bran fiber for treating diabetics and that's what kind of rung my bell here.
DR. JOY L. FRESTEDT: Right. He's the senior officer on some of this work that we're talking about today.
KIRK HAMILTON: Yeah. He's been around a long time doing stuff with fiber and diabetes. So tell me about - you got it into water.
DR. JOY L. FRESTEDT: Yeah.
KIRK HAMILTON: That sounds like I'm gonna see it out in you know the next mini mart here that we're gonna be able to control blood sugar and lower our cholesterol with drinking water. Is that where we're heading?
DR. JOY L. FRESTEDT: Wouldn't that be kind of cool? This was a product that was specifically formulated to have that lower viscosity so that it could go into water. And that was the purpose of the test was to see if that was actually beneficial to glucose levels. So there's actually an FDA-approved health claim about beta glucan and cardiovascular health. We don't have the same type of claim available for glucose yet but we're certainly working on that.
KIRK HAMILTON: So tell us a little about what you know you're studying and just what you found out.
DR. JOY L. FRESTEDT: Well the study was designed to really look at this flavored water beverage and see - and measure glucose and insulin levels after consumption. So we had patients consuming the product over time and then we were measuring their glucose and insulin levels to see if they had any benefits. And we were able to show an improvement in glucose as well as insulin when measured over time.
KIRK HAMILTON: Now these weren't diabetic patients just at risk patients.
DR. JOY L. FRESTEDT: That's correct. They were at risk, so they had some evidence that their glucose levels were borderline high.
KIRK HAMILTON: So like somewhere around - would they be defined as prediabetic, because those are those the people you know technically above 100 are prediabetic?
DR. JOY L. FRESTEDT: Right. So we were very careful not to test this as a disease treatment, though you know many of us are in that metabolic syndrome type of label or prediabetic type of label, yes.
KIRK HAMILTON: This drink. Can you take it any time during the day or did you have to take it with meals to block some of the absorption, or how was it divided out during the day?
DR. JOY L. FRESTEDT: Yeah. We elected to set up the protocol for the clinical trial to have this product taken with meals three times a day, so breakfast, lunch and dinner you would have a bottle of this flavored water with your meal.
KIRK HAMILTON: And were there any side effects?
DR. JOY L. FRESTEDT: There were no side effects that differed between the treatment group and the control group. So we had water that didn't have this product in it. And then there were also just typical things that you see when people that haven't been consuming a lot of fiber, if they start to consume a lot of fiber. And this isn't a lot in terms of 3 to 6 grams per day but it may be more than a person normally consumes. Those types of people sometimes have a little GI upset. And so that was seen in the study but it was not considered serious or in any way unique to the product that had the beta glucan compared to those just drinking water on its own. People have the same kinds of reaction.
KIRK HAMILTON: So in this study, did you document lipids being lowered?
DR. JOY L. FRESTEDT: That wasn't the purpose of our study. We were really looking at glucose and insulin.
KIRK HAMILTON: And insulin dropped significantly or ?
DR. JOY L. FRESTEDT: There were significant reductions in both glucose and insulin for different time points in the trial. So the 3 gram per day dose had some reductions and so did the 6 gram per day dose.
KIRK HAMILTON: So where is this going to lead you? What are you going to do next? Are you an encourager of marketing this product or what's your role next?
DR. JOY L. FRESTEDT: My role is to continue investigating the effects of the product to make sure that the effects are robust and able to withstand the kind of health claim that we were talking about earlier. So this was a small study. There were not hundreds of patients in this study. It was very suggestive but we need additional research to try and bolster the findings so that we can eventually get to that point where we're very confident exactly how much beta glucan do you need and exactly what format do you deliver it in order to consistently get the exact same results every time.
KIRK HAMILTON: So tell me a little bit about Frestedt, Incorporated. You're the president and CEO of that. What your company does, and then I actually should have done this forward, but I'm doing it backward to forward, tell me a little bit about your background.
DR. JOY L. FRESTEDT: Sure. So Frestedt, Incorporated is a virtual CRO, a contract research organization if you will. And we help companies when they're trying to do clinical trials. We help them from every point of on the way from the very concept to the end results of actually publishing and talking about the results as scientists. My background, I have a PhD in laboratory medicine and pathology from the University of Minnesota Medical School. Most of my background has been studying chemicals and treatments in oncology. After grad school I kind of moved into the business sector and that where my business work stems across many different types of clinical trials. We also do regulatory submissions where we discuss data with Food and Drug Administration here in the U.S. or other regulatory groups overseas. And that kind of draws us into the quality system development that we work on to try as we were just talking about to get consistent high quality results across multiple types of tests.
KIRK HAMILTON: Looking back here, I'm always fascinated with the food part here and I'm looking at our little chart. So when this - the fiber content doesn't tell you whether it's a soluble fiber which is what the beta glucan is correct?
DR. JOY L. FRESTEDT: Correct. So you have to read that graph that I provided to you with some discretion because not all of these are plants that have a high percentage of beta glucan. For example, barley has a high percentage or a high, relatively high content of beta glucan. So this was fiber. So for barley for example the fiber amount is mostly beta glucan.
KIRK HAMILTON: Wow, one cup of barley's a lot. That more than twice your upper dose range, correct?
DR. JOY L. FRESTEDT: Right. Not very many people eat just raw barley. And a cup at a time.
KIRK HAMILTON: So how about the berries now? I want to look at - so the blueberries, the blackberries, are they 50/50 split soluble/insoluble, or are they -
DR. JOY L. FRESTEDT: No, this is really a fiber - this was just to give us an understanding of fiber. Again the ones that are high in beta glucan are barley and oat.
KIRK HAMILTON: Barley and oat.
DR. JOY L. FRESTEDT: The other plants are not nearly as high, so rye has a little bit of beta glucan. To a much lesser degree, to a much smaller degree than oat or barley.
KIRK HAMILTON: Yeah. Oat would be - oatmeal would probably be my best shot to get this dietary-wise because that's simple enough to do.
DR. JOY L. FRESTEDT: It's good. It's a good provider of beta glucan.
KIRK HAMILTON: Well, is there anything else you'd like to say? I think you did a great job of summarizing that kind of technical long name. Anything else?
DR. JOY L. FRESTEDT: Thank you very much for having me on the show. I appreciate it.
KIRK HAMILTON: Well thank you very much for taking the time out. You also did one in print. I appreciate that too. So I want to thank Dr. Frestedt. She is the present CEO of Frestedt, Incorporated, and that's in Minneapolis, Minnesota. And they can go - if somebody wanted to look at your website, it's Frestedt.com. Frestedt.com. So thanks Dr. Frestedt.
DR. JOY L. FRESTEDT: Thank you. Have a great day.
KIRK HAMILTON: And I want to thank you, the audience, for listening to this edition of Staying Healthy Today Radio. And until next time, Stay and Be Well.
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