ABSTRACT
Knowledge about the glycaemic load of a food is very
important in minimizing the prevalence of diabetes and other Non-Communicable
Diseases. This study seeks to determine the glycaemic load of varieties of fufu
that are often eaten in Ghana. The study was a crossover experimental study
which used 10 healthy participants, who were given 50 g of pure glucose and
subsequently served with a measured amount of test foods; cassava – plantain
fufu, cassava – cocoyam fufu and cassava – yam fufu, containing 50 g of
carbohydrate. Fasting blood glucose was taken and after ingestion of test
foods, capillary blood was also taken within a 2-hour period and assayed for postprandial
glucose concentration. The glycaemic loads were determined using the GI values
taking into account the typical portion size of fufu. Sensory evaluation was
carried out to identify the most preferred variety. A proximate analysis was
also carried out on all three varieties to assess their nutritional components.
Findings from proximate analysis indicated that, cassava – plantain combination
had the least amount of carbohydrate of 34.87%, followed by the cassava –
cocoyam with an amount of 36.10% and the cassava – yam with an amount of
43.00%. All three varieties had low glycaemic index, however, they had high GL.
Cassava- plantain fufu had GL of 40%, cassava – yam fufu had 22% and cassava -
cocoyam fufu had 29%. This was attributed to the large portion sizes of fufu
eaten. Results from sensory evaluation revealed that cassava – plantain fufu
variety was much preferred among the three varieties. Culture was identified as
the main reason why panelists preferred a particular fufu variety to the others.
Consumers must take smaller portion sizes of any of the fufu variety in order
to minimize the effect on their blood sugar level.
CHAPTER ONE
INTRODUCTION
Background to the Study
The key purpose of eating food is to satisfy hunger. More
importantly, the intake of food is very necessary for providing the body with
energy, maintaining tissues as well as promoting growth and also for the
protection of the body against diseases. To ensure all these, the need for a
balanced consumption of food is very vital as this guarantees a healthy living.
In Ghana, there are varieties of local foods which contain essential nutrients
that are needed for a healthy living, however one may prefer a particular food
to the other due to factors such as, cost, personal likes, and dislikes,
religion, culture, food availability among others, with or without knowledge
about the nutritional value of the food (Tull, 1996).
Fufu is one of the local foods mostly eaten in Ghana and other
West African countries. In Ghana, it is commonly eaten among the Akans and it
is made from cassava and/or plantain, cocoyam or yam. Even though most people
prefer the cassava and plantain combination, the cassava and yam or the cassava
and cocoyam combination become an option for people especially during seasons
when plantain becomes scarce and expensive in the country. There are equally
other people who prefer the other combination to the cassava and plantain
combination.
The main nutrient found in fufu is carbohydrate. This means
that there are other nutrients that can be found in fufu. Carbohydrates are
broken down into sugar when they are eaten and absorbed into the
bloodstream. According to Davis (2009), as blood sugar levels rise, the
pancreas produces insulin, a hormone that prompts cells to absorb blood sugar
for energy or storage. Carbohydrate is the main nutrient that will raise blood
glucose (Davis, 2009). Blood glucose is the amount of glucose in an
individual’s blood at a given time. Other factors that could cause a rise in
blood glucose include stress, medication, sickness and genetic factors
(American Diabetes Association; ADA, 2015).
Carbohydrate can be classified as simple or complex
carbohydrate. However, grouping carbohydrates into simple and complex does not
account for the impact they have on blood sugar and the chronic diseases
associated with them (FAO/WHO, 1998). To describe the direct effect different
kinds of carbohydrate-rich foods have on blood sugar, the glycaemic index was
developed and is considered a better way of classifying carbohydrates,
especially starchy foods (The nutrition source, 2016). Glycaemic index is the
measure of the relative ranking of how fast or slow a carbohydrate-rich food
raises blood sugar level after the food has been ingested (Jenkins, Wolever,
Kalmusky, Giudici, Giordano & Wong, 1985). Eating high glycaemic index foods
can lead to powerful spikes in blood sugar. The outcome of this may lead to an
increased risk of Type 2 diabetes (de Munter, Hu, Spiegelman, Franz & van
Dam, 2007), heart diseases (Beulens, de Bruijne, Stolk, Peeters, Bots, Grobbee,
& van der Schouw, 2007) and even overweight (Ebbeling, Leidig, Feldman,
Lovesky & Ludwig, 2007).
A food’s glycaemic index is not the optimum way of
determining the effect of the carbohydrate on blood glucose. This is because it
does not take into account how much digestible carbohydrate; the total
carbohydrate excluding fibre, it delivers (The nutrition source, 2016). For
this reason, researchers established a related way to categorize foods that
take into account both the glycaemic index and the amount of carbohydrate in
the food and its impact on blood sugar levels. This is known as the glycaemic
load (Liu & Willet, 2002; Willet, Manson & Liu, 2002). A food’s
glycaemic load is determined by multiplying its glycaemic index by the amount
of carbohydrate present in the food. A glycaemic load of 20 or more is high, 11
to 19 is medium, and 10 or less is low (Venn, Wallace, Monro, Perry, Brown,
Frampton et al., 2006). A study conducted by Livesey, Taylor, Livesey, and Liu
(2013) concludes that people who eat lower-glycaemic load diets are at a lower
risk of developing type 2 diabetes than those who eat a diet of
higher-glycaemic load foods. A comparable analysis by Mirrahimi, de Souza,
Chiavaroli, Sievenpiper, Beyene, Hanley et al. (2012) have also shown that
higher-glycaemic load diets are associated with an increased risk of coronary
heart diseases.
Carbohydrate metabolism is vital in the development of Type 2
diabetes. This happens when the body cannot produce enough insulin or
cannot properly use the insulin it makes. Type 2 diabetes usually develops
progressively over years. It starts when muscles and other cells stop
responding to insulin, a condition, known as insulin resistance. This causes
blood sugar and insulin levels to remain high over long periods after eating.
With time, the hefty demands made on the insulin-producing cells wear them out,
and insulin production ultimately stops (The Nutrition Source, 2016). This can also lead to a long-term damage to the body and the
failure of various organs and tissues (Centre for Disease Control, 2014).
In 1997, an estimate of 124 million people worldwide had
diabetes, 91% of whom were non- insulin dependent Diabetes mellitus (Type 2
diabetes). By the year 2010, the total number of people with diabetes was
anticipated to reach 221 million. The regions with the highest potential
increase are Asia and Africa, where the rate could rise 2 or 3 times what is
experienced today (Zimmet & Amos, 1997). In a study, Acheampong, Eho, and
Boateng (1995) states that the diabetes prevalence rate in Ghana is estimated
to be 2.0% with a mortality rate of 13%. In urban Ghana today, Type 2 Diabetes
mellitus affects at least 6% of adults and is associated with age and obesity
(Amoah, Owusu, & Adjei, 2002). Even though there are other factors that can
contribute to diabetes, foods that have a high glycaemic indices, as well as
high glycaemic loads, are the leading causes of diabetes.
Statement of the Problem
Willet et al. (2002) report that the consumption of high
glycaemic indices and high glycaemic load diets for several years might result
in increased postprandial
blood glucose spikes
and excessive insulin
secretion. This could lead to the loss of insulin-secreting function of the
pancreatic β-cells, resulting in irreversible Type 2 Diabetes
mellitus. In addition to this assertion, Ludwig and Daniel (2002) in a
study state that, sustained spikes in blood sugar and insulin levels may lead
to increased diabetes risk.
Diabetes mellitus Type 2 is currently one of the most prevailing chronic
diseases in the world and the number of people with the disease is stated to be
increasing in every country.
International Diabetes Federation (IDF) has estimated that
415 million adults globally, are presently living with the condition.
Nonetheless, this is predicted that people having this condition would rise to
642 million by 2040. An estimated 14.2 million adults (aged 20-79) have
diabetes in Africa, representing 6.7% (IDF, 2016). This prevalence can be
minimized to a lower rate when people are made aware of the glycaemic indices
and glycaemic loads of the foods they consume, as these play major roles in the
development of this condition. When consumers are well informed on the rate at
which the glucose in our local foods is released into the bloodstream, they
will be very cautious about their choice of food and even the time they eat
these foods as well as the amount they consume.
A study by Wormenor (2015) revealed that the fufu made from
cassava and plantain has a low glycaemic index of 55, hence it has little
impact on blood glucose level when ingested and digested. However, people do
not only consume cassava-plantain variety of ‘fufu’ in Ghana. Some take the
cassava and yam and the cassava and cocoyam combinations. The research did not
focus on the glycaemic load of fufu. Little works appear to have been done on
these other fufu varieties and their impact on the blood glucose. This study
investigated all the possible varieties of fufu that is consumed in the country
and to analyze the extent to which each of variety affects the blood glucose
level.
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