What were the remarkable results of a crossover study randomizing hundreds of people with diabetes to one and a third cup of millet every day?
The Benefits of Millet for Diabetes
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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
How does millet come to the help of diabetics? A substantial portion of the starch in millet is resistant starch––meaning resistant to digestion in our small intestine, so, providing a bounty for the good bugs in our colon. Here’s how the various millets do––all way more than more common grains like rice or wheat, but proso and kodo millet lead the pack.
What’s going on? The protein matrix in millet not only acts as a physical barrier, but actually also partially sequesters your starch-munching enzyme, and the millet polyphenols also can act as starch blockers in and of themselves.
Millet also has markedly slower stomach-emptying times than other starchy foods. If you eat white rice, boiled potatoes, or pasta, your stomach takes about an hour to digest it before starting to slowly dump it into your intestines, and two or three hours to empty about halfway. Whereas, you eat sorghum or millet, and stomach emptying doesn’t even start until two or three hours, and may take five hours to empty even halfway. Note this was for both a thick millet porridge and for just millet couscous. Since the non-viscous millet couscous meal was also equally slow in emptying, this suggests that there may just be something about millet itself that helps slow stomach emptying, which should blunt the blood sugar spike. But you don’t know, until you put it to the test.
And indeed, millet caused about a 20 percent lower surge in blood sugar than the same amount of carbs in the form of rice. Remember how excited I was to show you how it only took the body like half the insulin to handle sorghum, compared to a grain like corn? Well, millet did even better.
Give a group of prediabetics only about three-quarters of a cup of millet a day, and within six weeks, their insulin resistance dropped so much their prediabetic fasting blood sugars turned into non-prediabetic blood sugars. This so-called “self-controlled” clinical trial, the same subjects before and after, is just a sneaky way of saying an uncontrolled trial. There was no control group that didn’t add the millet or added something else. And we know just being in a study under scrutiny can cause people to eat better in other ways. So, we don’t know what role, if any, the millet itself played. What we need is a randomized, controlled crossover trial where the same people eat both a millet-containing and non-millet containing diet and see which works better.
And, here we go! A randomized, crossover study having hundreds of patients both do an American Diabetes Association-type diet, with and without about one and one-third cup of millet every day, and…the millet-based diet lowered hemoglobin A1C levels––meaning an improvement in long-term blood sugar control, along with some side benefits, like lowering cholesterol.
The target for good blood sugar control recommended by the American Diabetes Association is an A1C less than 7. They started out at 8.37, but after a few months on millet, dropped it to an average of 6.77. Is it just because they lost weight or something? No, suggesting that it was an effect specific to the millet. But they didn’t just give millet. They mixed the millet with split black lentils and spices, and we know from dozens of randomized, controlled experimental trials in people with and without diabetes that the consumption of pulses (meaning beans, split peas, chickpeas, or lentils) can improve long-term measures of blood sugar control, like A1C levels. So, while the researchers conclude that millets have the potential for a protective role in the management of diabetes, a more accurate conclusion might be a mix of millet and lentils can be protective––though, hey, maybe the spices helped too. They didn’t say which ones they used, and I couldn’t get a hold of the authors, but a similar study done by one of the same researchers included about a tablespoon a day of a mixture of fenugreek, coriander, cumin, and black pepper, with a fifth spice, perhaps cinnamon or turmeric.
Please consider volunteering to help out on the site.
- Kam J, Puranik S, Yadav R, et al. Dietary Interventions for Type 2 Diabetes: How Millet Comes to Help. Front Plant Sci. 2016;7:1454.
- Annor GA, Marcone M, Bertoft E, Seetharaman K. In vitro starch digestibility and expected glycemic index of kodo millet (Paspalum scrobiculatum) as affected by starch–protein–lipid interactions. Cereal Chem. 2013;90(3):211-7.
- Annor GA, Tyl C, Marcone M, Ragaee S, Marti A. Why do millets have slower starch and protein digestibility than other cereals? Trends Food Sci Technol. 2017;66:73-83.
- Jin Z, Bai F, Chen Y, Bai B. Interactions between protein, lipid and starch in foxtail millet flour affect the in vitro digestion of starch. CYTA J Food. 2019;17(1):640-7.
- Cisse F, Erickson DP, Hayes AMR, Opekun AR, Nichols BL, Hamaker BR. Traditional Malian Solid Foods Made from Sorghum and Millet Have Markedly Slower Gastric Emptying than Rice, Potato, or Pasta. Nutrients. 2018;10(2):124.
- Narayanan J, Sanjeevi V, Rohini U, Trueman P, Viswanathan V. Postprandial glycaemic response of foxtail millet dosa in comparison to a rice dosa in patients with type 2 diabetes. Indian J Med Res. 2016;144(5):712-7.
- Abdelgadir M, Abbas M, Järvi A, Elbagir M, Eltom M, Berne C. Glycaemic and insulin responses of six traditional Sudanese carbohydrate-rich meals in subjects with Type 2 diabetes mellitus. Diabet Med. 2005;22(2):213-7.
- Jali MV, Kamatar MY, Jali SM, Hiremath MB, Naik RK. Efficacy of value added foxtail millet therapeutic food in the management of diabetes and dyslipidamea in type 2 diabetic patients. Recent Res Sci Technol. 2012 4(7):3-4.
- Ren X, Yin R, Hou D, et al. The Glucose-Lowering Effect of Foxtail Millet in Subjects with Impaired Glucose Tolerance: A Self-Controlled Clinical Trial. Nutrients. 2018;10(10):1509.
- Sievenpiper JL, Kendall CW, Esfahani A, et al. Effect of non-oil-seed pulses on glycaemic control: a systematic review and meta-analysis of randomised controlled experimental trials in people with and without diabetes. Diabetologia. 2009;52(8):1479-95.
- Itagi S, Naik R, Bharati P, Sharma P. Readymade foxtail millet mix for diabetics. Int J Sci Nat. 2012;3(1):47-50.
Video production by Glass Entertainment
Motion graphics by Avocado Video
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
How does millet come to the help of diabetics? A substantial portion of the starch in millet is resistant starch––meaning resistant to digestion in our small intestine, so, providing a bounty for the good bugs in our colon. Here’s how the various millets do––all way more than more common grains like rice or wheat, but proso and kodo millet lead the pack.
What’s going on? The protein matrix in millet not only acts as a physical barrier, but actually also partially sequesters your starch-munching enzyme, and the millet polyphenols also can act as starch blockers in and of themselves.
Millet also has markedly slower stomach-emptying times than other starchy foods. If you eat white rice, boiled potatoes, or pasta, your stomach takes about an hour to digest it before starting to slowly dump it into your intestines, and two or three hours to empty about halfway. Whereas, you eat sorghum or millet, and stomach emptying doesn’t even start until two or three hours, and may take five hours to empty even halfway. Note this was for both a thick millet porridge and for just millet couscous. Since the non-viscous millet couscous meal was also equally slow in emptying, this suggests that there may just be something about millet itself that helps slow stomach emptying, which should blunt the blood sugar spike. But you don’t know, until you put it to the test.
And indeed, millet caused about a 20 percent lower surge in blood sugar than the same amount of carbs in the form of rice. Remember how excited I was to show you how it only took the body like half the insulin to handle sorghum, compared to a grain like corn? Well, millet did even better.
Give a group of prediabetics only about three-quarters of a cup of millet a day, and within six weeks, their insulin resistance dropped so much their prediabetic fasting blood sugars turned into non-prediabetic blood sugars. This so-called “self-controlled” clinical trial, the same subjects before and after, is just a sneaky way of saying an uncontrolled trial. There was no control group that didn’t add the millet or added something else. And we know just being in a study under scrutiny can cause people to eat better in other ways. So, we don’t know what role, if any, the millet itself played. What we need is a randomized, controlled crossover trial where the same people eat both a millet-containing and non-millet containing diet and see which works better.
And, here we go! A randomized, crossover study having hundreds of patients both do an American Diabetes Association-type diet, with and without about one and one-third cup of millet every day, and…the millet-based diet lowered hemoglobin A1C levels––meaning an improvement in long-term blood sugar control, along with some side benefits, like lowering cholesterol.
The target for good blood sugar control recommended by the American Diabetes Association is an A1C less than 7. They started out at 8.37, but after a few months on millet, dropped it to an average of 6.77. Is it just because they lost weight or something? No, suggesting that it was an effect specific to the millet. But they didn’t just give millet. They mixed the millet with split black lentils and spices, and we know from dozens of randomized, controlled experimental trials in people with and without diabetes that the consumption of pulses (meaning beans, split peas, chickpeas, or lentils) can improve long-term measures of blood sugar control, like A1C levels. So, while the researchers conclude that millets have the potential for a protective role in the management of diabetes, a more accurate conclusion might be a mix of millet and lentils can be protective––though, hey, maybe the spices helped too. They didn’t say which ones they used, and I couldn’t get a hold of the authors, but a similar study done by one of the same researchers included about a tablespoon a day of a mixture of fenugreek, coriander, cumin, and black pepper, with a fifth spice, perhaps cinnamon or turmeric.
Please consider volunteering to help out on the site.
- Kam J, Puranik S, Yadav R, et al. Dietary Interventions for Type 2 Diabetes: How Millet Comes to Help. Front Plant Sci. 2016;7:1454.
- Annor GA, Marcone M, Bertoft E, Seetharaman K. In vitro starch digestibility and expected glycemic index of kodo millet (Paspalum scrobiculatum) as affected by starch–protein–lipid interactions. Cereal Chem. 2013;90(3):211-7.
- Annor GA, Tyl C, Marcone M, Ragaee S, Marti A. Why do millets have slower starch and protein digestibility than other cereals? Trends Food Sci Technol. 2017;66:73-83.
- Jin Z, Bai F, Chen Y, Bai B. Interactions between protein, lipid and starch in foxtail millet flour affect the in vitro digestion of starch. CYTA J Food. 2019;17(1):640-7.
- Cisse F, Erickson DP, Hayes AMR, Opekun AR, Nichols BL, Hamaker BR. Traditional Malian Solid Foods Made from Sorghum and Millet Have Markedly Slower Gastric Emptying than Rice, Potato, or Pasta. Nutrients. 2018;10(2):124.
- Narayanan J, Sanjeevi V, Rohini U, Trueman P, Viswanathan V. Postprandial glycaemic response of foxtail millet dosa in comparison to a rice dosa in patients with type 2 diabetes. Indian J Med Res. 2016;144(5):712-7.
- Abdelgadir M, Abbas M, Järvi A, Elbagir M, Eltom M, Berne C. Glycaemic and insulin responses of six traditional Sudanese carbohydrate-rich meals in subjects with Type 2 diabetes mellitus. Diabet Med. 2005;22(2):213-7.
- Jali MV, Kamatar MY, Jali SM, Hiremath MB, Naik RK. Efficacy of value added foxtail millet therapeutic food in the management of diabetes and dyslipidamea in type 2 diabetic patients. Recent Res Sci Technol. 2012 4(7):3-4.
- Ren X, Yin R, Hou D, et al. The Glucose-Lowering Effect of Foxtail Millet in Subjects with Impaired Glucose Tolerance: A Self-Controlled Clinical Trial. Nutrients. 2018;10(10):1509.
- Sievenpiper JL, Kendall CW, Esfahani A, et al. Effect of non-oil-seed pulses on glycaemic control: a systematic review and meta-analysis of randomised controlled experimental trials in people with and without diabetes. Diabetologia. 2009;52(8):1479-95.
- Itagi S, Naik R, Bharati P, Sharma P. Readymade foxtail millet mix for diabetics. Int J Sci Nat. 2012;3(1):47-50.
Video production by Glass Entertainment
Motion graphics by Avocado Video
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Title
The Benefits of Millet for Diabetes
LicenseCreative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Content URLDoctor's Note
If you missed my previous video, check out Studies on Millet Nutrition: Is It a Healthy Grain?
Here’s the sorghum video I talked about: Is Sorghum a Healthy Grain?
For more on what lentils can do for diabetics, see Diabetics Should Take Their Pulses.
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