Effects of <i>Cephalaria Syriaca</i>-Added Bread on Glucose Metabolism and Appetite Regulating Hormones in Healthy Individuals, Patients with Obesity and Patients with Diabetes: A Pilot Study

Background: Improving nutritional quality of widely consumed foods such as bread with natural additives is a rational approach for community nutrition and management of non-communicable diseases (e.g., diabetes, obesity). Pelemir (Cephalaria syriaca L.), an annual weed growing in wheat fields, improves the quality of bread when added to wheat flour and is expected to reduce the glycemic index due to its high protein, fiber and polyphenol contents. We aimed to investigate the effects of pelemir-added bread on glucose metabolism and appetite-regulating hormones. Materials and Methods: Study population consisted of three groups (healthy control, obesity, and diabetes; each n=20). The participants ingested two test meals (bread with and without pelemir) with one-week interval. Blood samples for glucose, insulin, C-peptide, GLP-1, leptin, ghrelin, and PYY were obtained at 0, 30, 60, 90, 120 minutes. The effect on appetite was evaluated subjectively by visual analog scales. Results: Area under curve (AUC)-Insulin and AUC-C-peptide were higher with pelemir-added bread in total group (p=0.044). In healthy group, AUC-GLP-1 was higher with pelemir-added bread (p=0.021). Additionally, pelemir-added bread resulted in an increased trend in AUC-C-peptide and AUC-PYY in healthy group; AUC-Insulin, AUC-C-peptide and AUC-Ghrelin in diabetes group; and a decreased trend in AUC-Leptin and AUC-PYY in obesity group. AUC for progressive food consumption was lower with pelemir bread in obesity group (p=0.006). Conclusion: The preliminary findings of this pilot study suggested that pelemir may possess beneficial effects on regulating glucose metabolism and hormonal responses. However, long-term, large-scale studies are needed to further clarify these effects.