Introduction
cognitive impairments, cognitive effect [Cognitive function, T2DM
SECONDARY, TYPE 2 DIABETES
Given that glucose is the main fuel for the brain, it is perhaps not surprising that conditions that are associated with abnormalities in glucose regulation, such as type 2 diabetes (T2DM), are associated with cognitive impairments [Interestingly, dietary intervention studies that have investigated the link between glycemic response and cognitive performance in T2DM have used a single meal paradigm, typically focusing on breakfast. However, humans consume multiple meals throughout the day, spending most of any day in a postprandial state. Therefore, it is more representative of everyday dietary habits if a multiple meal protocol is used to determine the effects of dietary manipulations to improve glycemic control on postprandial cognitive function. The second meal effect demonstrates that the glycemic response to a previous meal can influence the glycemic response to the next meal. This mechanism has also been demonstrated for cognition whereby the nature of the evening meal can impact cognition the next day following an overnight fast, even after a standardized breakfast; a process known as the second meal cognitive effect [Cognitive function is also impacted by mood state, and in some cases, the mechanism for cognitive benefits can be via changes to mood states such as improved self-reported alertness and higher levels of contentment. Although the primary outcome measure here is cognitive function, mood state is also assessed as a secondary outcome measure. Indeed, there is some evidence that a low GI (LGI) diet and LGI foods are beneficial for mood outcomes relative to high GI (HGI) [