Position of the Academy of Nutrition and Dietetics: Health Implications of Dietary Fiber. J Acad Nutr Diet. 2015;115:1861-1870. [PMID: 26514720 DOI: 10.1016/j.jand.2015.09.003]

Review of history and mechanisms of action of lactulose (4-O-β-D-Galactopyranosyl-β-D-fructofuranose): present and future applications in food

Lactulose is a synthetic disaccharide composed of galactose and fructose. Literature review of history, legal status and possible food applications of lactulose in functional foods, such as confectionery and beverages. In the colon, lactulose is fermented by the microbiota and acts as a selective modulator of bacterial growth, promoting the growth of Lactobacilli and Bifidobacteria. It generates organic acids, such as short-chain fatty acids and lactic acid, which lower the pH of the colon and act as an osmotic laxative. Lactulose was first used in 1957 as an ingredient in an infant formula. Later it was registered as a prescription drug and banned for food use in many countries. In 2012, lactulose received an EU (European union) health claim "contributes to acceleration of intestinal transit". It can be used in food and food supplements across all age groups, from infants to the elderly. Lactulose has favourable technological properties, such as sweetness of 48-62% sucrose without an aftertaste, high solubility, low cariogenic potential and stability. Lactulose gummy candy, without added sweeteners, has an overall likability comparable to classic sucrose/glucose-based candy. With more than 60 years of safe use in infant, child, adult and elderly population, lactulose is an ideal ingredient for prebiotic functional food. Its technological properties allow for development of functional candy and beverages almost indistinguishable from those made from sucrose.

Adherence to plant-based diet during pregnancy and risk of gestational diabetes: a prospective birth cohort study

BACKGROUND

Studies have shown that plant-based foods have a protective effect against gestational diabetes (GDM). We examined the association between plant-based dietary patterns and the risk of GDM in a sample of Iranian adults.

METHODS

We enrolled 635 pregnant women for the present study. Dietary intakes were evaluated by using a 90-item food frequency questionnaire during the first trimester of pregnancy. Three plant-based including plant-based (PDI), unhealthy (uPDI) and healthy (hPDI) were calculated. Cox proportional hazard model were fitted to estimate hazard ratio (HR) and 95% confidence interval (CI) of GDM across categories of the plan-based dietary indices, while controlling for age, educational level, physical activity, family income, prepregnancy body mass index, gestational weight gain, and total energy intake.

RESULTS

A total of 635 mothers were included, of whom 79 participants were diagnosed with GDM. Those in the third tertile of the PDI (HR: 0.55, 95% CI: 0.30, 0.98) and hPDI (HR: 0.43, 95% CI: 0.24, 0.78) had a lower risk of developing GDM during their current pregnancy as compared to the first tertile. There was no association between uPDI and risk of GDM.

CONCLUSIONS

We found that higher adherence to a plant-based diet during early pregnancy may be associated with a lower GDM risk among Iranian women. Confirmation of this finding is necessary in larger cohort studies, taking into account other pregnancy outcomes such as birth weight.

Intermittent fasting in the management of diabetes: a review of glycemic control and safety

Intermittent fasting (IF) regimens have emerged as a dietary tool to improve the glycemic profile, but a critical appraisal of clinical studies assessing the effects of IF regimens in patients with diabetes is needed. Thus, this review encompasses clinical studies examining the impact of different IF regimens on markers of glycemic control in patients with diabetes. Furthermore, clinical nuances relative to pharmacological treatment are also addressed, mainly insulin therapy, to discuss the risk of hypoglycemic events. Only a handful of clinical studies have investigated the effects of IF on patients with diabetes. Overall, IF regimens may elicit modest benefits on glycemic parameters in patients with diabetes, but their effects are not necessarily greater than those of control diets. Last, although IF regimens may be considered safe for patients receiving insulin therapy within interventional and observational research, markers of glycemic control must be constantly monitored in clinical practice to reduce the risk of hypoglycemia and its related complications.

Higher fibre and lower carbohydrate intake are associated with favourable CGM metrics in a cross-sectional cohort of 470 individuals with type 1 diabetes

AIMS/HYPOTHESIS

The aim of this work was to investigate the association between macronutrient intakes and continuous glucose monitoring (CGM) metrics in individuals with type 1 diabetes.

METHODS

In 470 individuals with type 1 diabetes of the GUTDM1 cohort (65% female, median age 40 [IQR 28-53] years, median diabetes duration 15 [IQR 6-29] years), we used logistic regression to establish associations between macronutrient intakes and the CGM metrics time in range (TIR, time spent between 3.9-10.0 mmol/l blood glucose, optimally set at ≥70%) and time below range (TBR, <3.9 mmol/l blood glucose, optimally set at <4%). ORs were expressed per 1 SD intake of nutrient and were adjusted for other macronutrient intakes, age, sex, socioeconomic status, BMI, duration of type 1 diabetes, pump use, insulin dose and alcohol intake.

RESULTS

The median (IQR) TIR was 67 (51-80)% and TBR was 2 (1-4)%; the mean ± SD energy intake was 6879±2001 kJ, fat intake 75±31 g, carbohydrate intake 162±63 g, fibre intake 20±9 g and protein intake 70±24 g. A higher fibre intake and a lower carbohydrate intake were associated with higher odds of having a TIR≥70% (OR [95% CI] 1.64 [1.22, 2.24] and 0.67 [0.51, 0.87], respectively), whereas solely a higher carbohydrate intake was associated with TBR<4% (OR 1.34 [95% CI 1.02, 1.78]).

CONCLUSIONS/INTERPRETATION

A higher fibre intake is independently associated with a higher TIR. A higher carbohydrate intake is associated with less time spent in hypoglycaemia, a lower TIR and a higher time above range. These findings warrant confirmatory (interventional) investigations and may impact current nutritional guidelines for type 1 diabetes.

Cookies Fortified with Clitoria ternatea Butterfly Pea Flower Petals: Antioxidant Capacity, Nutritional Composition, and Sensory Profile

This study aimed to fortify cookies to be functional food by adding Clitoria ternatea flower (CT) at concentrations ranging from 0 to 8%. Sensory profiling identified 6% CT as optimal for organoleptic attributes. The addition of CT did not significantly impact protein, lipid, and ash content but decreased energy value and increased insoluble and soluble fibre levels. The inclusion of 6% CT had a significant effect on the overall total phenolic content (TPC), which increased compared to the control sample. Antioxidative activity analyses showed enhanced antioxidative activity in ABTS, DPPH, ORACFL, and PCL assays. The addition of 6% CT inhibited hydroperoxide production in cookies. However, over a period of 6 weeks, a significant rise in peroxide value was observed during the 4th and 6th weeks of storing fortified cookies. All assessed products met the high microbiological quality standards. The sensory evaluation scores showed that CT can create cookies with health benefits and a good overall acceptance score. The texture of the cookies gradually became softer, but no significant changes in visual appearance were observed. CT can be extensively used in baked cookies as a rich source of polyphenols with strong antioxidant properties and high fibre content, as well as a fortification source for the development of functional foods.

Impact of Dietary Patterns on Metabolic Syndrome in Young Adults: A Cross-Sectional Study

Metabolic syndrome has become a significant public health concern. This study aims to investigate the impact of dietary patterns on metabolic syndrome in young adults and how physical activity modulates this effect. A cross-sectional study was conducted at a health management center in Tianjin, China, from September 2022 to March 2023. Participants aged 18-35 years were recruited using convenience sampling. Dietary intake was assessed using a validated food frequency questionnaire. Logistic regression models evaluated associations between these patterns and metabolic syndrome, adjusting for potential confounders. Among 442 participants, four dietary patterns were identified: Legume-Nut, Alcohol-Meat, Sugar-Processed, and Egg-Vegetable. The Legume-Nut dietary pattern was associated with a higher risk of metabolic syndrome (OR = 2.63, 95% CI: 1.08-6.37), while the Egg-Vegetable dietary pattern was associated with a lower risk (OR = 0.26, 95% CI: 0.10-0.70). No significant associations were found for the Sugar-Processed and Alcohol-Meat patterns. Subgroup analysis revealed that the Legume-Nut pattern increased the risk of metabolic syndrome among those with irregular physical activity, whereas the Egg-Vegetable pattern decreased the risk. These findings highlight the significant influence of dietary patterns on the risk of metabolic syndrome in young adults and the modifying effect of regular physical activity, underscoring the need for targeted dietary and lifestyle interventions to prevent metabolic syndrome in this population.

Dichotomous effect of dietary fiber in pediatrics: a narrative review of the health benefits and tolerance of fiber

Dietary fibers are associated with favorable gastrointestinal, immune, and metabolic health outcomes when consumed at sufficient levels. Despite the well-described benefits of dietary fibers, children and adolescents continue to fall short of daily recommended levels. This gap in fiber intake (i.e., "fiber gap") might increase the risk of developing early-onset pediatric obesity and obesity-related comorbidities such as type 2 diabetes mellitus into adulthood. The structure-dependent physicochemical properties of dietary fiber are diverse. Differences in solubility, viscosity, water-holding capacity, binding capability, bulking effect, and fermentability influence the physiological effects of dietary fibers that aid in regulating appetite, glycemic and lipidemic responses, and inflammation. Of growing interest is the fermentation of fibers by the gut microbiota, which yields both beneficial and less favorable end-products such as short-chain fatty acids (e.g., acetate, propionate, and butyrate) that impart metabolic and immunomodulatory properties, and gases (e.g., hydrogen, carbon dioxide, and methane) that cause gastrointestinal symptoms, respectively. This narrative review summarizes (1) the implications of fibers on the gut microbiota and the pathophysiology of pediatric obesity, (2) some factors that potentially contribute to the fiber gap with an emphasis on undesirable gastrointestinal symptoms, (3) some methods to alleviate fiber-induced symptoms, and (4) the therapeutic potential of whole foods and commonly marketed fiber supplements for improved health in pediatric obesity.

An Isofibrous Diet with Fiber Konjac Glucomannan Ameliorates Salmonella typhimurium-Induced Colonic Injury by Regulating TLR2-NF-κB Signaling and Intestinal Microbiota in Mice

This study aimed to investigate the hypothesis that dietary konjac glucomannan (KGM) could alleviate Salmonella typhimurium-induced colitis by modulating intestinal microbiota. Mice were fed an isocaloric and isofibrous diet supplemented with either 7% KGM or cellulose and were treated with 5 × 108 CFU of S. typhimurium. The results showed that KGM had an average molecular weight of 936 kDa and predominantly consisted of mannose and glucose at a molar ratio of 1:1.22. In vivo studies demonstrated that dietary KGM effectively mitigated colonic lesions, oxidative stress, disruption of tight junction protein 2 and occludin, and the inflammatory response induced by S. typhimurium. Moreover, KGM administration alleviated the dramatic upregulation of toll-like receptor 2 (TLR2) and phosphonuclear factor κB (NF-κB) protein abundance, induced by Salmonella treatment. Notably, dietary KGM restored the reduced Muribaculaceae and Lactobacillus abundance and increased the abundance of Blautia and Salmonella in S. typhimurium-infected mice. Spearman correlation analysis revealed that the gut microbiota improved by KGM contribute to inhibit inflammation and oxidative stress. These results demonstrated the protective effects of dietary KGM against colitis by modulating the gut microbiota and the TLR2-NF-κB signaling pathway in response to Salmonella infection.

Structural characteristics of wheat bran insoluble dietary fiber with various particle size distributions and their influences on the kinetics of gastrointestinal emptying in mice

Wheat bran is an abundant yet underutilized agricultural byproduct. Herein, the insoluble dietary fiber from wheat bran (WBIDF) was ultra-milled to investigate its impact on physicochemical properties and gastrointestinal emptying. SEM and CLSM showed that the laminar structure of WBIDF was disrupted as the particle size was significantly reduced. In the similar characteristic peaks appearing at 3410, 2925, 1635, 1041, and 895 cm-1 in the FT-IR spectra and at 2940, 1593, 1080, and 526 cm-1 in the Raman spectra, the peak intensity was increased as the particle size decreased. It may be that the hydrogen bonding between cellulose, hemicellulose, or other macromolecules was enhanced. X-ray diffraction showed cellulose type I results for all five samples. Correspondingly, the water-holding, swelling, and oil-holding capacities increased by 75.33 %, 52.62 %, and 75.00 %, respectively, in WBIDF-CW1.8 compared with WBIDF-CWy. Additionally, smaller particle sizes had lower viscosity, thereby enhancing intestinal propulsion and gastric emptying rates. Enhanced contact of the cecal tissue growth factor with the intestinal mucosa delayed ghrelin secretion and stimulated the secretion of motilin, gastrin, and cholecystokinin. In conclusion, the particle sizes of WBIDF were reduced through ultramicro-grinding, leading to altered structure, enhanced hydration and oil-holding capacities, decreased viscosity, and improved gastrointestinal emptying capacity.

Eating away cancer: the potential of diet and the microbiome for shaping immunotherapy outcome

The gut microbiome (GMB) plays a substantial role in human health and disease. From affecting gut barrier integrity to promoting immune cell differentiation, the GMB is capable of shaping host immunity and thus oncogenesis and anti-cancer therapeutic response, particularly with immunotherapy. Dietary patterns and components are key determinants of GMB composition, supporting the investigation of the diet-microbiome-immunity axis as a potential avenue to enhance immunotherapy response in cancer patients. As such, this review will discuss the role of the GMB and diet on anti-cancer immunity. We demonstrate that diet affects anti-cancer immunity through both GMB-independent and GMB-mediated mechanisms, and that different diet patterns mold the GMB's functional and taxonomic composition in distinctive ways. Dietary modulation therefore shows promise as an intervention for improving cancer outcome; however, further and more extensive research in human cancer populations is needed.

Effect of special types of bread with select herbal components on postprandial glucose levels in diabetic patients

BACKGROUND

Nutrition recommendations in patients with type 2 diabetes mellitus (T2DM) are to consume rye or integral bread instead of white bread. A positive effect on glucoregulation has been achieved by enriching food with various biologically active substances of herbal origin, so we formulated an herbal mixture that can be used as a supplement for a special type of bread (STB) to achieve better effects on postprandial glucose and insulin levels in patients with T2DM.

AIM

To compare organoleptic characteristics and effects of two types of bread on postprandial glucose and insulin levels in T2DM patients.

METHODS

This trial included 97 patients with T2DM. A parallel group of 16 healthy subjects was also investigated. All participants were given 50 g of rye bread and the same amount of a STB with an herbal mixture on 2 consecutive days. Postprandial blood glucose and insulin levels were compared at the 30th, 60th, 90th and 120th min. A questionnaire was used for subjective estimation of the organoleptic and satiety features of the two types of bread.

RESULTS

Compared to patients who consumed rye bread, significantly lower postprandial blood glucose and insulin concentrations were found in T2DM patients who consumed STB. No relevant differences were found among the healthy subjects. Subjectively estimated organoleptic and satiety characteristics are better for STB than for rye bread.

CONCLUSION

STB have better effects than rye bread on postprandial glucoregulation in T2DM patients. Subjectively estimated organoleptic and satiety characteristics are better for STB than for rye bread. Therefore, STB can be recommended for nutrition in T2DM patients.

Analysis of 1999-2017 NHANES Data: Minimal Increase and Racial Disparities in U.S. Fiber Consumption Over 18 Years

Low dietary fiber consumption is associated with an increased risk of colorectal cancer, a leading cause of cancer-related mortality in the United States. The average daily fiber intake has declined over recent decades. Notably, Black Americans exhibit lower fiber consumption than other racial/ethnic groups, possibly influencing their elevated colorectal cancer rates. We hypothesize that there has been a significant increase in dietary fiber consumption in the United States from 1999 to 2017. The study encompassed 59,204 adult NHANES participants and observed variations in caloric intake over survey years. Although there was a slight overall increase in dietary fiber intake compared to 1999, the most substantial increment occurred among individuals classified as Hispanic (AD: +2.86 g, P < 0.001), followed by non-Hispanic Black (AD: +1.64 g, P < 0.001), and finally non-Hispanic White showed a decrease in fiber intake (AD: -0.86 g, P < 0.001). The findings suggest a modest rise in fiber consumption from 1999 to 2017, but disparities persist, particularly with non-Hispanic Black individuals consuming the least fiber. This emphasizes the need for interventions to promote fiber intake and address racial/ethnic inequalities in dietary habits.

Dietary fiber (oligosaccharide and non-starch polysaccharide) in preventing and treating functional gastrointestinal disorders - Challenges and controversies: A review

Functional gastrointestinal disorders (FGIDs) are a group of chronic or recurrent gastrointestinal functional diseases, including functional dyspepsia, irritable bowel syndrome, and functional constipation. A lack of safe and reliable treatments for abdominal pain-related FGIDs has prompted interest in new therapies. Evidence has shown that supplementation with dietary fiber may help treat FGIDs. Dietary fibers (DFs) have been demonstrated to have regulatory effects on the gut microbiota, microbiota metabolites, and gastrointestinal movement and have important implications for preventing and treating FGIDs. However, the adverse effects of some DFs, such as fermentable oligosaccharides, on FGIDs are unclear. This review provides an overview of the DFs physiological properties and functional characteristics that influence their use in management of FGIDs, with emphasis on structural modification technology to improve their therapeutic activities. The review highlights that the use of appropriate or novel fibers is a potential therapeutic approach for FGIDs.

Effect of Fiber-Rich Diet and Rope Skipping on Memory, Executive Function, and Gut Microbiota in Young Adults: A Randomized Controlled Trial

SCOPE

To investigate the effects of fiber-rich diets (FDs), rope skipping (RS), and the combination of these two interventions (fiber-rich diet with rope skipping [FD-RS]) on memory, executive function in young adults, and to explore their relationship with gut microbiota.

MATERIALS AND RESULTS

The study is a 12-week parallel-design randomized controlled trial in which 120 undergraduates (19 ± 1 years) are randomized to FD (fiber ≥ 20 g day-1 ), RS (3 × 2000 times per week), FD-RS or control group (n = 30 per group). Memory and executive function are assessed by scales, and stool samples are collected at baseline and after the intervention. FD group and FD-RS group show fewer prospective and retrospective subjective memory impairments than the control group, but there is no significant difference between FD-RS and the intervention alone (FD or RS). No obvious change in executive function is observed throughout the trial. In terms of the gut microbiota, the α-diversity does not increase, but the microbial community evenness improves after the RS and FD intervention. Additionally, the relative abundance of phylum Firmicutes and genera Faecalibacterium, Eubacterium_coprostanoligenes_group in the RS group and NK4A214_group in the FD group significantly increase. In the RS group, a correlation is found between the increase in microbial evenness and the improvement in retrospective memory.

CONCLUSION

The FD and FD-RS have beneficial effects on memory in young adults. Meanwhile, FD and RS can improve the microbial evenness and increase several beneficial genera of phylum Firmicutes.

Vegetables, fruits, and berries - a scoping review for Nordic Nutrition Recommendations 2023

Vegetables, fruits, and berries comprise a large variety of foods and are recognised to play an important role in preventing chronic diseases. Many observational studies have been published during the last decade, and the aim of this scoping review is to describe the overall evidence for the role of vegetables, fruits, and berries for health-related outcomes as a basis for setting and updating food-based dietary guidelines. A scoping review was conducted according to the protocol developed within the Nordic Nutrition Recommendations 2023 project. Current available evidence strengthens the role of consuming vegetables, fruits, and berries in preventing chronic diseases. The most robust evidence is found for cancer in the gastric system and lung cancer, cardiovascular disease, and all-cause mortality. Steeper risk reductions are generally seen at the lower intake ranges, but further reductions have been seen for higher intakes for cardiovascular disease. Weaker associations are seen for type 2 diabetes. There is evidence that suggests a beneficial role also for outcomes such as osteoporosis, depression, cognitive disorders, and frailty in the elderly. The observed associations are supported by several mechanisms, indicting causal effects. Some subgroups of vegetables, fruits, and berries may have greater benefits than other subgroups, supporting a recommendation to consume a variety of these foods.

Physiological and nutrition-related challenges as perceived by spinal cord-injured endurance hand cyclists

This study explored the perceptions of spinal cord-injured (SCI) endurance hand cyclists regarding their physiological and nutrition-related challenges and the perceived impact of these challenges on nutritional intake and exercise capacity. This was an interpretive qualitative descriptive study in which semi-structured interviews were conducted with 12 adult South African national-level SCI endurance hand cyclists. Thematic analysis was used to explore perceptions regarding physiological and nutrition-related challenges and the impact thereof on nutritional practices and exercise capacity. Four themes emerged from the interviews: (i) physiological challenges experienced, (ii) nutrition-related challenges experienced, (iii) changes in nutritional practices, and (iv) compromised exercise capacity. The SCI endurance hand cyclists reported a number of physiological and nutrition-related challenges. Bowel and bladder challenges, limited hand function, muscle spasms, thermoregulatory challenges, pressure sores, menstrual periods, and low iron levels/anaemia were perceived to predominantly impact food and fluid intake (restrict intake) and compromise exercise capacity. This information can assist to devise tailored guidelines aimed to optimise fluid intake, overcome bladder challenges and ensure adequate nutritional intake in light of limited hand function.

Gut microbial features and dietary fiber intake predict gut microbiota response to resistant starch supplementation

Resistant starch (RS) consumption can have beneficial effects on metabolic health, but the response, in terms of effects on the gut microbiota and host physiology, varies between individuals. Factors predicting the response to RS are not yet established and would be useful for developing precision nutrition approaches that maximize the benefits of dietary fiber intake. We sought to identify predictors of gut microbiota response to RS supplementation. We enrolled 76 healthy adults into a 7-week crossover study with 59 individuals completing the study. Participants consumed RS type 2 (RS2), RS type 4 (RS4), and digestible starch, for 10 d each with 5-d washout periods in between. We collected fecal and saliva samples and food records during each treatment period. We performed 16S rRNA gene sequencing and measured fecal short-chain fatty acids (SCFAs), salivary amylase (AMY1) gene copy number, and salivary amylase activity (SAA). Dietary fiber intake was predictive of the relative abundance of several amplicon sequence variants (ASVs) at the end of both RS treatments. AMY1-related metrics were not predictive of response to RS. SAA was only predictive of the relative abundance of one ASV after digestible starch supplementation. Interestingly, SCFA concentrations increased the most during digestible starch supplementation. Treatment order (the order of consumption of RS2 and RS4), alpha diversity, and a subset of ASVs were predictive of SCFA changes after RS supplementation. Based on our findings, dietary fiber intake and gut microbiome composition would be informative if assessed prior to recommending RS supplementation because these data can be used to predict changes in specific ASVs and fecal SCFA concentrations. These findings lay a foundation to support the premise that using a precision nutrition approach to optimize the benefits of dietary fibers such as RS could be an effective strategy to compensate for the low consumption of dietary fiber nationwide.

Dietary fiber intake and all-cause and cause-specific mortality: An updated systematic review and meta-analysis of prospective cohort studies

BACKGROUND

Accumulating evidence supports the effects of dietary fiber on the risk of non-communicable diseases (NCDs). However, there is no updated systematic review and meta-analysis that compares and pools the effect of different types of fiber on mortality.

METHODS

In this systematic review and meta-analysis, all prospective cohort studies that evaluated the relationship between dietary fiber intake and all-cause or cause-specific mortality were included. The PubMed, SCOPUS, and Web of Science databases were searched up to October 2022. Data extraction and quality assessment were performed by two researchers independently. Heterogeneity between studies was assessed using Chi-square based test. Random/fixed effect meta-analysis was used to pool the hazard ratios (HR) or relative risks (RR) and 95 % confidence intervals (CI) for the association between different types of fiber and mortality.

RESULTS

This systematic review included 64 eligible studies, with a total sample size of 3512828 subjects, that investigated the association between dietary fiber intake and mortality from all-cause, cardiovascular disease (CVD), and cancer. Random-effect meta-analysis shows that higher consumption of total dietary fiber, significantly decreased the risk of all-cause mortality, CVD-related mortality, and cancer-related mortality by 23, 26 and 22 % (HR:0.77; 95%CI (0.73,0.82), HR:0.74; 95%CI (0.71,0.77) and HR:0.78; 95%CI (0.68,0.87)), respectively. The consumption of insoluble fiber tended to be more effective than soluble fiber intake in reducing the risk of total mortality and mortality due to CVD and cancer. Additionally, dietary fiber from whole grains, cereals, and vegetables was associated with a reduced risk of all-cause mortality, while dietary fiber from nuts and seeds reduced the risk of CVD-related death by 43 % (HR:0.57; 95 % CI (0.38,0.77)).

CONCLUSION

This comprehensive meta-analysis provides additional evidence supporting the protective association between fiber intake and all-cause and cause-specific mortality rates.

Vegetarian Nutrition in Chronic Kidney Disease

There is rising interest globally with respect to the health implications of vegetarian or plant-based diets. A growing body of evidence has demonstrated that higher consumption of plant-based foods and the nutrients found in vegetarian and plant-based diets are associated with numerous health benefits, including improved blood pressure, glycemic control, lipid levels, body mass index, and acid-base parameters. Furthermore, there has been increasing recognition that vegetarian and plant-based diets may have potential salutary benefits in preventing the development and progression of chronic kidney disease (CKD). While increasing evidence shows that vegetarian and plant-based diets have nephroprotective effects, there remains some degree of uncertainty about their nutritional adequacy and safety in CKD (with respect to protein-energy wasting, hyperkalemia, etc.). In this review, we focus on the potential roles of and existing data on the efficacy/effectiveness and safety of various vegetarian and plant-based diets in CKD, as well as their practical application in CKD management.

Modulating a prebiotic food source influences inflammation and immune-regulating gut microbes and metabolites: insights from the BE GONE trial

BACKGROUND

Accessible prebiotic foods hold strong potential to jointly target gut health and metabolic health in high-risk patients. The BE GONE trial targeted the gut microbiota of obese surveillance patients with a history of colorectal neoplasia through a straightforward bean intervention.

METHODS

This low-risk, non-invasive dietary intervention trial was conducted at MD Anderson Cancer Center (Houston, TX, USA). Following a 4-week equilibration, patients were randomized to continue their usual diet without beans (control) or to add a daily cup of study beans to their usual diet (intervention) with immediate crossover at 8-weeks. Stool and fasting blood were collected every 4 weeks to assess the primary outcome of intra and inter-individual changes in the gut microbiome and in circulating markers and metabolites within 8 weeks. This study was registered on ClinicalTrials.gov as NCT02843425, recruitment is complete and long-term follow-up continues.

FINDINGS

Of the 55 patients randomized by intervention sequence, 87% completed the 16-week trial, demonstrating an increase on-intervention in diversity [n = 48; linear mixed effect and 95% CI for inverse Simpson index: 0.16 (0.02, 0.30); p = 0.02] and shifts in multiple bacteria indicative of prebiotic efficacy, including increased Faecalibacterium, Eubacterium and Bifidobacterium (all p < 0.05). The circulating metabolome showed parallel shifts in nutrient and microbiome-derived metabolites, including increased pipecolic acid and decreased indole (all p < 0.002) that regressed upon returning to the usual diet. No significant changes were observed in circulating lipoproteins within 8 weeks; however, proteomic biomarkers of intestinal and systemic inflammatory response, fibroblast-growth factor-19 increased, and interleukin-10 receptor-α decreased (p = 0.01).

INTERPRETATION

These findings underscore the prebiotic and potential therapeutic role of beans to enhance the gut microbiome and to regulate host markers associated with metabolic obesity and colorectal cancer, while further emphasizing the need for consistent and sustainable dietary adjustments in high-risk patients.

FUNDING

This study was funded by the American Cancer Society.

Undaria pinnatifida fucoidan contributes to anti-inflammation activity of Bacteroides in fiber-deficient mice via modulation of gut microbiota and protection of intestinal barrier integrity

Bacteroides as potential probiotics has several health benefits to the host, but its practical application faces many challenges due to its inherent properties. In this study, Bacteroides strains isolated from human feces alleviated colonic inflammation in mice, as evidenced by increased colon length and reduced tissue damage. Further study showed that anti-inflammation activity of Bacteroides strains was disturbed by dietary fiber deficiency (FD), which disrupted the balance between gut microbiota and colonic mucus layer, leading to a thinning of colonic mucus layer. A combination of Bacteroides strains and Undaria pinnatifida fucoidan (UPF) better alleviated colonic inflammation than either of them, including increases in the densities of goblet cells and glycoproteins and reduction in intestinal epithelial damage, pro-inflammatory cytokines and oxidative stress. The underlying mechanisms can be attributed to that UPF-induced alterations of mucosal microbiota cannot only directly benefit host health but also create an ecological condition that facilitates Bacteroides strains exert their healthy properties. In addition, both Bacteroides strains and UPF improved FD-induced lipid metabolism abnormality, mainly involving glycerophospholipid metabolism pathway. This study suggests that the application of Bacteroides has certain limitations, and UPF can be developed as a probiotic adjuvant for Bacteroides to enhance human health.

Recent Progress in Distiller's Grains: Chemical Compositions and Biological Activities

Distiller's grains (DGs) are solid mixtures that remain after the production of alcoholic beverages. A large amount of DGs is produced each year during the brewing process. Currently, they are mostly used as a feedstock or substrate in the feed industry. However, the lack of a comprehensive understanding of the chemical composition of DGs is a major constraint on their further development and application for high-value-added usages. Some studies were published on the bioactive constituents of DGs in several different types of journals. Data were therefore collated to provide a comprehensive overview of these natural products. DGs are rich in phenols, phytosterols, and fatty acids, in addition to general lipid and protein constituents. These compounds and their related extracts possess diverse biological activities, including antioxidant, anti-inflammatory, and anti-hyperglycaemic effects. We hope that this review will provide research incentives for the further development and utilisation of DGs to develop high-value-added products.

Association between plant-based or animal-based dietary pattern and plasma glucose during oral glucose tolerance test among Chinese women with gestational diabetes mellitus: a prospective cohort study

OBJECTIVE

This study explored whether plant-based and animal-based dietary patterns are associated with plasma glucose levels during oral glucose tolerance test in women with gestational diabetes mellitus (GDM).

DESIGN

A prospective cohort study was conducted using a Food Frequency Questionnaire to collect dietary data. Dietary patterns were derived using principal component analysis. Multivariate logistic regression analysis was performed to explore the association between dietary patterns and plasma glucose levels. Stratified analyses were conducted according to maternal age, prepregnancy body mass index (BMI) and other confounders.

SETTING AND PARTICIPANTS

The study, conducted in January 2022 in two hospitals in Fujian, China, involved 424 women diagnosed with GDM using a 75 g 2-hour oral glucose tolerance test at 24-28 gestational weeks.

RESULTS

Six maternal dietary patterns (plant based and animal based) were identified. Participants with plant-based pattern had lower 2-hour plasma glucose levels than those with animal-based pattern (β=-0.314; 95% CI (-0.596 to -0.032)). After adjusting the regression model covariates, this significant association remained (β=-0.288; 95% CI (-0.568 to -0.008)) and appeared more pronounced in women aged 30 years or above and those with prepregnancy BMI<24 kg/m2.

CONCLUSIONS

Plant-based pattern is associated with lower plasma glucose levels in women with GDM, which is valuable information for dietary counselling and intervention.

Anemia and frailty in the aging population: implications of dietary fiber intake (findings of the US NHANES from 2007-2018)

BACKGROUND

Frailty has long been seen as an indicator of reduced physical functions in the elderly, which may be caused by a variety of chronic illnesses or cancerous tumors. Dietary fiber was connected with anemia and frailty, whereas it was uncertain if dietary fiber consumption modifies the impact of anemia on frailty in elderly adults.

METHODS

We performed a secondary analysis using older adults aged 60 years and over from the National Health and Nutrition Examination Survey (NHANES) 2007-2018 cycles. Dietary fiber intake was estimated using two 24-h dietary recalls. Participants were dichotomized as frail or non-frail based on a modified Fried physical frailty phenotype from previous NHANES studies. The weighted logistic regression was used to estimate the odds ratio (OR) and confidence interval (CI) for the associations between hemoglobin levels and frailty at high- and low-dietary fiber intake levels.

RESULTS

A total of 9644 older adults were included in this study, and the weighted sample was 56,403,031, of whom 3,569,186 (6.3%) were deemed to be frail, and the remainder were deemed to be non-frail. Among the low dietary fiber intake group, higher hemoglobin was significantly associated with a lower risk of frailty (OR = 0.79, 95% CI: 0.71-0.87), and anemia was associated with an almost threefold elevated risk of frailty (OR = 3.24, 95% CI:1.98-5.29) in the fully adjusted model. However, this phenomenon was not observed in groups with high dietary fiber intake. In addition, L-shaped dose response relationship was found in the high dietary fiber intake group (P overall association < 0.001; P non-linear association = 0.076). Whereas the dose response relationship was not significant in the high dietary fiber intake group (P overall association 0.752; P non-linear association = 0.734).

CONCLUSIONS

Frailty was positively associated with the severity of anemia in older adults with low, but not high, dietary fiber intake. Adequate fiber intake may be an innovative dietary strategy to reduce frailty in older adults.

A phenotypic approach to obesity treatment

Obesity is a chronic disease that increases morbidity and mortality and adversely affects quality of life. The rapid rise of obesity has outpaced the development and deployment of effective therapeutic interventions, thereby creating a global health crisis. The presentation, complications, and response to obesity treatments vary, yet lifestyle modification, which is the foundational therapeutic intervention for obesity, is often "one size fits all." The concept of personalized medicine uses genetic and phenotypic information as a guide for disease prevention, diagnosis, and treatment and has been successfully applied in diseases such as cancer, but not in obesity. As we gain insight into the pathophysiologic mechanisms of obesity and its phenotypic expression, specific pathways can be targeted to yield a greater, more sustained therapeutic impact in an individual patient with obesity. A phenotype-based pharmacologic treatment approach utilizing objective measures to classify patients into predominant obesity mechanism groups resulted in greater weight loss (compared with a non-phenotype-based approach) in a recent study by Acosta and colleagues. In this review, we discuss the application of lifestyle modifications, behavior therapy and pharmacotherapy using the obesity phenotype-based approach as a framework.

Chia (Salvia hispanica L.) flour modulates the intestinal microbiota in Wistar rats fed a high-fat and high-fructose diet

A diet rich in sugar and fat can promote metabolic disorders development, especially in the intestine. Chia flour (Salvia hispanica. L) is a source of dietary fiber, alpha-linolenic fatty acid (ALA), bioactive peptides, and phenolics, promoting health benefits. This study aimed to analyze chia flour's effect on gut microbiota modulation and intestinal health in adult male Wistar rats fed a high-fat and high-fructose (HFHF) diet. Male Wistar rats (n = 10/group) were fed the diets standard (AIN-93M) or HFHF (31% saturated fat and 20% fructose) in the first phase to induce metabolic disorders. In the second phase, the rats were fed AIN-93M, HFHF, or HFHF plus 14.7% chia flour (HFHF + CF) for 10 weeks. The consumption of chia flour increased the ALA (3.24 ± 0.24) intake and significantly improved immunoglobulin A (IgA) levels (1126.00 ± 145.90), goblet cells number (24.57 ± 2.76), crypt thickness (34.37 ± 5.86), crypt depth (215.30 ± 23.19), the longitudinal muscle layer (48.11 ± 5.04), cecum weight (4.39 ± 0.71), Shannon index (p < 0.05), and significantly increased the production of acetic (20.56 ± 4.10) and butyric acids (5.96 ± 1.50), Monoglobus sp., Lachnospiraceae sp., and Prevotellaceae sp. abundance. Furthermore, chia significantly reduced the cecal pH content (7.54 ± 1.17), body mass index (0.62 ± 0.03) and weight (411.00 ± 28.58), and Simpson index (p < 0.05). Therefore, chia intake improved intestinal health parameters and functionality in rats with metabolic disorders, which demonstrates to be an effective strategy for gut microbiota modulation.

Associations of healthful and unhealthful plant-based diets with plasma markers of cardiometabolic risk

PURPOSE

Plant-based diets, particularly when rich in healthy plant foods, have been associated with a lower risk of type 2 diabetes and cardiovascular disease. However, the impact of plant-based diets that distinguish between healthy and unhealthy plant foods on cardiometabolic biomarkers remains unclear.

METHODS

Dietary information was collected by two 24-h recalls among 34,785 adults from a nationwide cross-sectional study. Plasma levels of insulin, C-peptide, glucose, C-reactive protein (CRP), white blood cell (WBC) count, triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) were measured. Linear regression was used to evaluate the percentage difference in plasma marker concentrations by three plant-based diet indices, namely the overall plant-based diet index (PDI), the healthful PDI (hPDI), and the unhealthful PDI (uPDI).

RESULTS

Greater hPDI-adherence scores (comparing extreme quartiles) were associated with lower levels of insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), TG/HDL-C ratio, CRP, WBC count, and TG, and higher levels of HDL-C, with the percentage differences of  - 14.55,  - 15.72,  - 11.57,  - 14.95,  - 5.26,  - 7.10, and 5.01, respectively (all Ptrend ≤ 0.001). Conversely, uPDI was associated with higher levels of insulin, C-peptide, HOMA-IR, TG/HDL-C ratio, CRP, WBC count, and TG, but lower HDL-C, with the percentage differences of 13.71, 14.00, 14.10, 10.43, 3.32, 8.00, and  - 4.98 (all Ptrend ≤ 0.001), respectively. Overall PDI was only associated with lower levels of CRP and WBC count (all Ptrend ≤ 0.001).

CONCLUSION

Our findings suggest that hPDI may have positive, whereas uPDI may have negative impacts on multiple cardiometabolic risk markers, and underscore the need to consider the quality of plant foods in future PDI studies.

Gut microbiota and fecal short chain fatty acids differ with adiposity and country of origin: the METS-microbiome study

The relationship between microbiota, short chain fatty acids (SCFAs), and obesity remains enigmatic. We employ amplicon sequencing and targeted metabolomics in a large (n = 1904) African origin cohort from Ghana, South Africa, Jamaica, Seychelles, and the US. Microbiota diversity and fecal SCFAs are greatest in Ghanaians, and lowest in Americans, representing each end of the urbanization spectrum. Obesity is significantly associated with a reduction in SCFA concentration, microbial diversity, and SCFA synthesizing bacteria, with country of origin being the strongest explanatory factor. Diabetes, glucose state, hypertension, obesity, and sex can be accurately predicted from the global microbiota, but when analyzed at the level of country, predictive accuracy is only universally maintained for sex. Diabetes, glucose, and hypertension are only predictive in certain low-income countries. Our findings suggest that adiposity-related microbiota differences differ between low-to-middle-income compared to high-income countries. Further investigation is needed to determine the factors driving this association.

Relationship between Oat Consumption, Gut Microbiota Modulation, and Short-Chain Fatty Acid Synthesis: An Integrative Review

The gut microbiota consists of a set of microorganisms that colonizes the intestine and ferment fibers, among other nutrients, from the host's diet. A healthy gut microbiota, colonized mainly by beneficial microorganisms, has a positive effect on digestion and plays a role in disease prevention. However, dysregulation of the gut microbiota can contribute to various diseases. The nutrition of the host plays an important role in determining the composition of the gut microbiota. A healthy diet, rich in fiber, can beneficially modulate the gut microbiota. In this sense, oats are a source of both soluble and insoluble fiber. Oats are considered a functional ingredient with prebiotic potential and contain plant proteins, unsaturated fats, and antioxidant compounds. The impact of oat consumption on the gut microbiota is still emerging. Associations between oat consumption and the abundance of Akkermansia muciniphila, Roseburia, Lactobacillus, Bifidobacterium, and Faecalibacterium prausnitzii have already been observed. Therefore, this integrative review summarizes the findings from studies on the relationship between oat consumption, the gut microbiota, and the metabolites, mainly short-chain fatty acids, it produces.

Possibilities of valorization of Gnetum spp leaves in modern gastronomy: Production and characterization of new vegetable tarts and salads

Gnetum spp is a green creeper plant abundantly found in the Central African forests. Their leaves are eaten as vegetable by inhabitants. In order to valorize this vegetable in modern gastronomy, a survey was carried out in three towns of Cameroon to evaluate its importance in the feeding habits. The leaves were also sliced in two different forms, precooked, spin-dried and used for Gnetum tarts and salads production. 50, 100 and 150 g of thin sliced precooked leaves were used to prepare three salads and three tarts, keeping the other ingredients constant. Three additional tarts were prepared similarly using thinnest sliced precooked leaves. The final products were analyzed in terms of physiochemical, nutritional and sensorial properties. More than 96.9% of people investigated eat Gnetum leafy vegetables at least once per month. The survey study indicates that the transformation of Gnetum is mostly done by people within the age of 20 to 40 years old. Results of the physicochemical analyses showed that the total protein, lipid and carbohydrate contents increased in general with the increasing of the Gnetum leaf quantities used for preparation. The crude fiber contents of salads and tarts ranged from 52.00 ± 0.68 to 62.66 ± 1.26 and 29.33 ± 0.67 to 33.66 ± 0.47 g/100 g DW respectively. They were positively correlated with the quantity of Gnetum leaves used. The total phenolic contents, also increased significantly (p < 0.05) with the quantity of Gnetum leaves, from 182.45 ± 1.69 to 493.52 ± 2.10 mg/100 g DW for the salad and from 86.69 ± 4.08 to 283.21 ± 6.79 mg/100 g DW for the tart. The calculated energy density of tarts and salads permitted to classify these food products as low and high energy density foods respectively. The nutritional densities of produced tarts oscillated from 0.27 to 0.3 and that of salads from 0.58 to 0.71. With their nutritional values and the significant amount of fibers, Gnetum tarts and salads could be good new recipes to valorize the Gnetum leafy vegetables.

Valorisation of Buckwheat By-Product as a Health-Promoting Ingredient Rich in Fibre for the Formulation of Gluten-Free Bread

Bread is a widely consumed food that has often been used as a vehicle for functional ingredients such as dietary fibre. Fibre-rich breads have beneficial physiological effects on health, helping to combat chronic pathologies such as cardiovascular disease, diabetes, and certain types of colon cancer. The aim of this study is to evaluate the technological and nutritional effects of the inclusion of buckwheat hull particles (BH) at two addition levels (3 and 6%) and two particle sizes (fine, D₅₀: 62.7 μm; coarse, D₅₀: 307 μm) in a gluten-free (GF) bread formulation. A significant (p < 0.05) increase in the dough elastic modulus (G') was observed for all doughs containing BH, from 712 Pa for a rice-based dough to 1027-3738 Pa for those containing BH. Compared to rice-based breads, those containing BH showed a significant (p < 0.05) increase in total dietary fibre content (from three to five times) and in antioxidant capacity (from 78 to 290 mg TE/100 g dw. in the ORAC test). Breads containing fine BH at a level of 3% had similar sensory properties to the rice-based bread, demonstrating that it is possible to improve the TDF content while maintaining the sensory quality of the GF bread.

Therapeutic Applications and Effects of Lupinus angustifolius (Blue Lupin) and Its Components: A Systematic Review and Meta-Analysis

Lupinus angustifolius has a unique nutrient profile among legumes and may have beneficial health effects when included in the diet. The aim of this study was to investigate the biological properties of blue lupin (Lupinus angustifolius), its chemical components, and their relevance for monitoring biological and anthropometric health markers, including triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), BMI, weight, and glycemia, compared with control groups with other kinds of diets. PubMed, Web of Science, and Scopus databases, updated to December 2023, were searched. Out of the 194 studies identified, a total of 7 randomized controlled trials (RCTs) comprising 302 participants met the eligibility criteria. The results of our study indicated that the blue lupin diet has a direct relationship with parameters such as blood glucose, weight, and LDL-C but not with TGs or BMI. In conclusion, the research described in this review clearly indicates that L. angustifolius may play an important role in the dietary prevention of hyperlipidemia and hypertension. Therefore, it would be highly advisable to increase its consumption in diets. However, further studies, ideally in humans, are required to truly establish L. angustifolius's health-promoting properties.

Examining Physical Wellness as the Fundamental Element for Achieving Holistic Well-Being in Older Persons: Review of Literature and Practical Application in Daily Life

This review examines the impact of physical activity, nutrition, and sleep evaluations on the physical wellness (PW) and overall well-being of older individuals. A comprehensive search was conducted in databases like PubMed, Google Scholar, and EBSCO Information Services. The search spanned from January 2000 to December 2022, resulting in 19,400 articles, out of which 98 review articles met the inclusion criteria. Through the analysis of these articles, key characteristics of the literature were summarized, and opportunities to enhance the practical application of physical activity (PA), nutrition, and sleep evaluations in the daily lives of older persons were identified. Regular physical activity is crucial for older persons to maintain their physical, mental, and emotional well-being and prevent age-related health issues. Older persons have specific nutritional needs, including increased protein, vitamin D, calcium, and vitamin B12 intake. Poor sleep quality in older persons is associated with negative health outcomes such as cognitive decline, physical disability, and mortality. This review emphasizes the significance of considering physical wellness as a fundamental element for achieving holistic well-being in older persons and highlights the importance of physical activity, nutrition, and sleep evaluations in improving their overall health and well-being. By understanding and implementing these findings, we can enhance the quality of life and promote healthy aging in older persons.

Novel flours from leguminosae (Neltuma ruscifolia) pods for technological improvement and nutritional enrichment of wheat bread

Wheat bread is widely consumed in many Western cultures (>70 kg/per capita/year) despite the fact that the flour milling process reduces the content of dietary fibre, vitamins and minerals resulting in baked goods nutritionally poor. Vinal (Neltuma or Prosopis ruscifolia) fruit is an American carob that can be grinded to obtain different fractions such as endocarp, seeds, residue and the whole pod flours. The objective of the work was to analyse the chemical compositions, colour and physical, functional and hydration properties of grinding fractions from vinal (Neltuma ruscifolia); and also, study their application in wheat bread and their effect on rheological, textural and organoleptic characteristics. The obtained flours showed to be a good source of proteins (>30% seed flour) and dietary fibre (>38% endocarp flour), with good physical and functional properties, denoting its suitability as promising novel ingredients for the design and formulation of nutritionally enriched wheat breads. The addition of vinal flours (5%) in replacement of wheat flour in a traditional bread significantly affected the rheology, giving as results less extensive doughs. The bread loaf showed a lower specific volume, and firmer and darker colour with brown tone crumbs. Sensory analysis revealed a good degree of acceptance for the enriched breads (with the best values for residue flour) suggesting that these novel flours would be suitable as ingredients for bakery products with good nutritional profile.

Use of Dietary Fibers in Reducing the Risk of Several Cancer Types: An Umbrella Review

(1) Background: Numerous meta-analyses have shown that a high intake of dietary fiber plays a protective role in preventing the development of various types of cancer. However, previous studies have been limited by focusing on a single type of dietary fiber and variations in outcome measures, which may not be effectively applied to provide dietary guidance for the general population. (2) Object: We summarized the meta-analysis of dietary fiber and cancer, and provided references for residents to prevent cancer. (3) Methods: Systematic search of relevant meta-analyses on the association between dietary fiber and cancer occurrence in PubMed, Web of Science and other databases was conducted from the time of database construction to February 2023. The method logical and evidence quality assessments were performed by applying the criteria in the "A Measurement Tool to Assess Systematic Reviews-2" (AMSTAR2) scale and the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Expert Report, respectively. (4) Results: Our analysis included 11 meta-analyses, and the AMSTAR 2 assessment revealed that the overall methodological quality was suboptimal, with two key items lacking sufficient information. Nonetheless, our findings indicate that a high intake of dietary fiber is associated with a reduced risk of several types of cancer, including esophageal, gastric, colon, rectal, colorectal adenoma, breast, endometrial, ovarian, renal cell, prostate, and pancreatic cancers. The majority of these associations were supported by a "probable" level of evidence. (5) Conclusions: Dietary fiber intake has different protective effects on different cancers.

Microbial inulinase promotes fructan hydrolysis under simulated gastric conditions

Fermentable oligo-, di-, monosaccharides and polyols (FODMAPs) have emerged as key contributors to digestive discomfort and intolerance to certain vegetables, fruits, and plant-based foods. Although strategies exist to minimize FODMAP consumption and exposure, exogenous enzyme supplementation targeting the fructan-type FODMAPs has been underexploited. The objective of this study was to test the hydrolytic efficacy of a food-grade, non-genetically engineered microbial inulinase preparation toward inulin-type fructans in the INFOGEST in vitro static simulation of gastrointestinal (GI) digestion. Purified inulin was shown to undergo acid-mediated hydrolysis at high gastric acidity as well as predominantly inulinase-mediated hydrolysis at lower gastric acidity. Inulinase dose-response simulations of inulin, garlic, and high-fructan meal digestion in the gastric phase suggest that as little as 50 inulinase units (INU) and up to 800 INU per serving promote fructan hydrolysis better than the control simulations without inulinase. Liquid chromatography-mass spectrometry (LC-MS) profiling of fructo-oligosaccharides (FOS) in the gastric digestas following inulinase treatment confirms the fructolytic activity of inulinase under simulated digestive conditions. Altogether, these in vitro digestion data support the use of microbial inulinase as an exogenous enzyme supplement for reducing dietary fructan-type FODMAP exposure.

Acute Effects of Dietary Fiber in Starchy Foods on Glycemic and Insulinemic Responses: A Systematic Review of Randomized Controlled Crossover Trials

Dietary fiber (DF) consumption has been associated with improved glycemic control in epidemiological and long-term interventional studies. However, its acute effects are not yet clear. This systematic review aims to elucidate the postprandial effects of DF in starchy products on glycemia and insulinemia. An electronic search of databases was conducted, and forty-one records met the inclusion criteria and underwent a risk-of-bias assessment. It was shown that soluble DF does not clearly affect glycemia in individuals with normal weight, while resistant starch may be more effective in flattening glycemic responses. Concerning insulinemia, both soluble DF and resistant starch have mixed results, with either favorable or no effects. Data on insoluble DF and glucose metabolism are scarce. The same mixed results for glycemia can be seen in healthy volunteers with overweight/obesity, while resistant starch seems to improve insulinemic responses. Finally, more studies need to examine the acute effects of DF in starchy foods on glucose metabolism and insulin secretion in individuals facing glucose abnormalities. Additionally, more studies are needed to prove whether ingesting high-fiber carbohydrate-containing products per se can result in blunted glycemic and insulinemic responses and which DF type and amount are more effective.

Understanding health disparities affecting people of West Central African descent in the United States: An evolutionary perspective

Human populations adapting to diverse aspects of their environment such as climate and pathogens leave signatures of genetic variation. This principle may apply to people of West Central African descent in the United States, who are at increased risk of certain chronic conditions and diseases compared to their European counterparts. Less well known is that they are also at reduced risk of other diseases. While discriminatory practices in the United States continue to affect access to and the quality of healthcare, the health disparities affecting African Americans may also be due in part to evolutionary adaptations to the original environment of sub-Saharan Africa, which involved continuous exposure to the vectors of potentially lethal endemic tropical diseases. Evidence is presented that these organisms selectively absorb vitamin A from the host, and its use in parasite reproduction contributes to the signs and symptoms of the respective diseases. These evolutionary adaptations included (1) sequestering vitamin A away from the liver to other organs, to reduce accessibility to the invaders; and (2) reducing the metabolism and catabolism of vitamin A (vA), causing it to accumulate to subtoxic concentrations and weaken the organisms, thereby reducing the risk of severe disease. However, in the environment of North America, lacking vA-absorbing parasites and with a mainly dairy-based diet that is high in vA, this combination of factors is hypothesized to lead to the accumulation of vA and to increased sensitivity to vA as a toxin, which contribute to the health disparities affecting African Americans. vA toxicity is linked to numerous acute and chronic conditions via mitochondrial dysfunction and apoptosis. Subject to testing, the hypothesis suggests that the adoption of traditional or modified West Central African-style diets that are low in vA and high in vA-absorbing fiber hold promise for disease prevention and treatment, and as a population-based strategy for health maintenance and longevity.

Longitudinal Trajectories of Dietary Fibre Intake and Its Determinants in Early Childhood: Results from the Melbourne InFANT Program

BACKGROUND

Optimal nutrition during early childhood, including dietary fibre intake, is important for children's health and development. Knowledge of fibre intake and its determinants in early childhood is limited. We aimed to describe fibre intake and sources and to identify trajectories of fibre intake at age 9, 18, 42, and 60 months and its child and maternal determinants. Associations between fibre trajectory groups and BMI z-scores and child overweight status were also assessed.

METHODS

This is a secondary analysis of longitudinal data from the Melbourne InFANT Program, trial registration: Current Controlled Trials (ISRCTN81847050). Group-based trajectory modelling was used to identify trajectories of fibre intake from ages 9 to 60 months (n = 503). Multivariable logistic or linear regression was used to assess the determinants of fibre intake trajectories and the association between fibre intake trajectories and obesity outcomes.

RESULTS

Four fibre intake trajectory groups were identified, with three groups following stable, rising trajectories of "Low" (52.3%), "Moderate" (32.2%), and "High" (13.3%), respectively. The remaining followed an "unstable" trajectory (2.2%). Girls versus boys were more likely to follow the "Low" fibre intake trajectory, whereas children who were breastfed for ≥6 months and whose mother had a university education were less likely to follow the "Low" fibre trajectory. No association was found between fibre trajectory groups and obesity outcomes.

CONCLUSION

Most children followed a stable, rising trajectory of low fibre intake in early childhood. Child sex, breastfeeding duration and maternal education were significant determinants of low fibre intake trajectory.

Resistant starch improves cardiometabolic disease outcomes: A narrative review of randomized trials

Healthy dietary patterns with adequate fiber improve cardiometabolic (CM) outcomes and attenuate disease progression. Resistant starch (RS) is a fermentable fiber that affects CM outcomes; however, studies are heterogeneous and inconsistent. Thus, the purpose of this narrative review is to assess the impact of RS intake by type and amount on CM outcomes while considering subject characteristics and trial duration. Randomized crossover or parallel studies (n = 31) were selected and compared according to acute (1 day; n = 12), medium (>1-30 days; n = 8), or long (>30 days; n = 11) duration. Most acute trials in healthy adults showed improvements in postprandial glycemic outcomes irrespective of RS type or amount. However, a more pronounced reduction occurred when test meals did not match for available carbohydrate. Daily RS intake had a minimal effect on CM outcomes in medium duration trials, but insulin resistant adults had better glycemic control at 4 weeks. Several longer duration trials (8-12 weeks) showed favorable CM outcomes with daily RS intake in adults with type 2 diabetes (T2D), but not in those at risk for T2D. Furthermore, some studies reported improved lipids, inflammatory biomarkers, and heart rate. Future studies should consider matching for available carbohydrates between the RS and control groups to understand the gut microbiome's role. Furthermore, energy and fiber should be considered. Overall, the acute intake of RS improves glycemic outcomes, and consuming RS at for least 4 and up to 8 to 12 weeks in adults with prediabetes and T2D, respectively, appears to improve CM outcomes.

Enhancing Capacity for Food and Nutrient Intake Assessment in Population Sciences Research

Nutrition influences health throughout the life course. Good nutrition increases the probability of good pregnancy outcomes, proper childhood development, and healthy aging, and it lowers the probability of developing common diet-related chronic diseases, including obesity, cardiovascular disease, cancer, and type 2 diabetes. Despite the importance of diet and health, studying these exposures is among the most challenging in population sciences research. US and global food supplies are complex; eating patterns have shifted such that half of meals are eaten away from home, and there are thousands of food ingredients with myriad combinations. These complexities make dietary assessment and links to health challenging both for population sciences research and for public health policy and practice. Furthermore, most studies evaluating nutrition and health usually rely on self-report instruments prone to random and systematic measurement error. Scientific advances involve developing nutritional biomarkers and then applying these biomarkers as stand-alone nutritional exposures or for calibrating self-reports using specialized statistics.

Basic constituents, bioactive compounds and health-promoting benefits of wine skin pomace: A comprehensive review

Wine pomace (WP) is a major byproduct generated during winemaking, and skin pomace (SKP) comprises one of the most valuable components of WP. Since SKP differs in composition and properties from seed pomace (SDP), precise knowledge of SKP will aid the wine industry in the development of novel, high-value products. The current review summarizes recent advances in research relating to SKP presents a comprehensive description of the generation, composition, and bioactive components, primarily focusing on the biological activities of SKP, including antioxidant, gastrointestinal health promotion, antibacterial, anti-inflammatory, anticancer, and metabolic disease alleviation properties. Currently, the separation and recovery of skins and seeds is an important trend in the wine industry for the disposal of winemaking byproducts. In comparison to SDP, SKP is rich in polyphenols including anthocyanins, flavonols, phenolic acids, stilbenes, and some proanthocyanidins, as well as dietary fiber (DF). These distinctive benefits afford SKP the opportunity for further development and application. Accordingly, the health-promoting mechanism and appropriate application of SKP will be further elucidated in terms of physiological activity, with the progress of biochemical technology and the deepening of related research.

Gut microbiota and fecal short chain fatty acids differ with adiposity and country of origin: The METS-Microbiome Study

The relationship between the gut microbiota, short chain fatty acid (SCFA) metabolism, and obesity remains unclear due to conflicting reports from studies with limited statistical power. Additionally, this association has rarely been explored in large scale diverse populations. Here, we investigated associations between fecal microbial composition, predicted metabolic potential, SCFA concentrations, and obesity in a large ( N = 1,934) adult cohort of African-origin spanning the epidemiologic transition, from Ghana, South Africa, Jamaica, Seychelles, and the United States (US). The greatest gut microbiota diversity and total fecal SCFA concentration was found in the Ghanaian population, while the lowest levels were found in the US population, respectively representing the lowest and the highest end of the epidemiologic transition spectrum. Country-specific bacterial taxa and predicted-functional pathways were observed, including an increased prevalence of Prevotella , Butyrivibrio , Weisella and Romboutsia in Ghana and South Africa, while Bacteroides and Parabacteroides were enriched in Jamaican and the US populations. Importantly, 'VANISH' taxa, including Butyricicoccus and Succinivibrio , were significantly enriched in the Ghanaian cohort, reflecting the participants' traditional lifestyles. Obesity was significantly associated with lower SCFA concentrations, a decrease in microbial richness, and dissimilarities in community composition, and reduction in the proportion of SCFA synthesizing bacteria including Oscillospira , Christensenella , Eubacterium , Alistipes , Clostridium and Odoribacter . Further, the predicted proportions of genes in the lipopolysaccharide (LPS) synthesis pathway were enriched in obese individuals, while genes associated with butyrate synthesis via the dominant pyruvate pathway were significantly reduced in obese individuals. Using machine learning, we identified features predictive of metabolic state and country of origin. Country of origin could accurately be predicted by the fecal microbiota (AUC = 0.97), whereas obesity could not be predicted as accurately (AUC = 0.65). Participant sex (AUC = 0.75), diabetes status (AUC = 0.63), hypertensive status (AUC = 0.65), and glucose status (AUC = 0.66) could all be predicted with different success. Interestingly, within country, the predictive accuracy of the microbiota for obesity was inversely correlated to the epidemiological transition, being greatest in Ghana (AUC = 0.57). Collectively, our findings reveal profound variation in the gut microbiota, inferred functional pathways, and SCFA synthesis as a function of country of origin. While obesity could be predicted accurately from the microbiota, the variation in accuracy in parallel with the epidemiological transition suggests that differences in the microbiota between obesity and non-obesity may be larger in low-to-middle countries compared to high-income countries. Further examination of independent study populations using multi-omic approaches will be necessary to determine the factors that drive this association.

A bibliometric analysis of studies on gut microbiota in attention-deficit and hyperactivity disorder from 2012 to 2021

Background

An increasing number of studies have focused on the role of gut microbiota in the treatment of ADHD, but its related molecular mechanisms are not yet clear, and there is still room for development of studies targeting this area. This study analyzes publications from 2012 to 2021 in a comprehensive and multi-faceted visualization, with the aim of grasping the existing research profile and guiding scholars to make more in-depth studies.

Methods

The 1,677 articles and 298 review articles on gut microbiota in ADHD were retrieved from the Web of Science Core Collection. CiteSpace, VOSviewer, Microsoft Excel 2019, Scimago Graphica, Bibliometrix and Pajek metrics software were used for visualization and analysis of the included literature.

Results

On August 3, 2022, a total of 1975 English-language articles on gut microbiota in ADHD were retrieved from Web of Science Core Collection (WoSCC) from January 2012 to December 2021, with a steady upward trend in the number of articles published in this field over the decade. The top three countries in terms of the number of articles published are the United States, China, and Spain. Meanwhile, CONSEJO SUPERIOR DE INVESTIGACIONES CIENTIFICAS CSIC, UNIV OF CALIFORNIA SYSTEM, and UDICE FRENCH RESEARCH UNIV have made significant contributions in this field. In the analysis of the published journals, PLoS One was not only the first in terms of number of articles published but also the most cited. Wang J was the most prolific author and CAPORASO JG ranked first in terms of co-cited authors. In addition, “Diet rapidly and reproducibly alters the human gut microbiome,” published by David LA et al., has the highest citation frequency in this field. The most frequently occurring keyword was “gut microbiota.”

Conclusion

The results of this paper clarify the current status of research on gut microbiota in ADHD. Based on the research on the mechanism of gut microbiota in other diseases, there is reason to believe that the exploration of gut microbiota in ADHD must be increasingly mature. And the study speculates that future research may focus on “nutrition supplements,” “lipid metabolism,” and “gut brain axis.” It is imperative to promote a closer international cooperation among scholars in this field.

Development of a Novel Low-Calorie Lime Juice-Based Prebiotic Beverage Using a Combined Design Optimization Methodology

A novel lime-juice based low-calorie functional beverage was developed by using D-optimal combined design optimization. For the preparation of the beverage, the following functional ingredients were used: lime juice, lime peel essential oil (LEO) as a flavoring agent and bioactive component, sucralose as a low-calorie sweetener, an inulin/polydextrose (I/P) mixture as prebiotic fibers, pectin as a thickening agent and soluble dietary fiber, lutein as a carotenoid colorant and antioxidant, and peppermint extract (ME) as a flavoring agent and bioactive component. A combined design consisting of one mixture factor (LEO/ME ratio), one numeric factor (lutein concentration), and one categoric factor (presence or absence of prebiotics) was used for optimizing the functional beverage based on the sensory quality. Regression models were adequately fitted to the data of sensory acceptance with a determination coefficient >90%. The sample containing a mixture of prebiotics, 2:3 (v/v) ratio of LEO: ME, and 3 mg/100 mL lutein was selected as the best formulation among the six optimal beverages which was suggested by Design-Expert software. This final optimum sample showed the highest total phenolic (44.22 mg gallic acid equivalents/L) and flavonoid (25.49 mg quercetin equivalents/L) contents, and its antioxidant activity (as 2,2-diphenyl-1-picrylhydrazyl radical (DPPH^•) scavenging) was 38.30%. The newly designed beverage has the potential to promote health benefits and in therapeutic applications.

Recommending ultra-processed oral nutrition supplements for unintentional weight loss: Are there risks?

Oral nutrition supplements (ONS) are widely recommended for the management of unintentional weight loss in patient populations, long-term care residents, and community-dwelling older adults. Most marketed ONS are ultra-processed, with precision nutrition and aseptic composition, as well as convenience and availability, driving their selection. However, therapeutic effectiveness is mixed and the potential health risks of consuming ultra-processed ONS long-term in lieu of less-processed foods have received little attention. A diverse and balanced microbiota supporting immunity and wellness is maintained by a diet rich in plant-sourced foods. The implications of ultra-processed ONS displacing plant-sourced foods, and specifically the potential for undesirable impacts on the gut microbiota, require consideration. Most ONS are either devoid of fiber or are supplemented with isolated or purified fibers that may contribute to adverse gastrointestinal symptoms and appetite suppression. In contrast, the diversity of microbial-available, nondigestible carbohydrates, together with the array of phytochemicals found in plant-sourced foods, support microbial diversity and its resiliency. This review outlines the clinical dilemma of recommending commercial ultra-processed ONS vs nutritionally adequate (eg, high-energy/high-protein) foods and beverages that contribute to diet quality, maintenance of a diverse and stable gut microbiota composition, and support nutrition status and health. Ultra-processed ONS may fall short of expected health benefits, and overreliance may potentially contribute to the risk for patient and older adult populations because of the displacement of a variety of healthful foods.

Ready-to-eat cereal is an affordable breakfast option associated with better nutrient intake and diet quality in the US population

Background

Results from observational studies have reported ready-to-eat cereal (RTEC) consumers have higher dietary quality and nutrient intake compared to consumers of non-RTEC breakfasts or those who do not eat breakfast. Yet, there have been few investigations on the relationship of RTEC to meal costs at breakfast and across the day, which may be one reason some consumers choose to not consume breakfast.

Objective

The objective of this study is to evaluate the contribution of RTEC consumed at breakfast to nutrient intake and adequacy, diet quality and meal costs in a nationally representative sample of children and adults in the US.

Methods

Dietary data from 2,259 children (2-18 years) and 4,776 adults (≥19 years) in the National Health and Nutrition Examination Survey (NHANES) 2017-2018 were evaluated to compare nutrient intake, adequacy, dietary quality, and food costs in RTEC breakfast consumers, non-RTEC breakfast consumers and those who did not consume breakfast.

Results

RTEC breakfast consumers made up 28% of children and 12% of adults. Children and adults consuming RTEC for breakfast had higher intakes of carbohydrate, dietary fiber, calcium, magnesium, iron, zinc, phosphorus, potassium, B vitamins, vitamins A and D, whole grains, and total dairy compared to consumers of non-RTEC breakfast or no breakfast. There were no differences by breakfast status for sodium, saturated fat, or added sugar, except adults consuming RTEC had lower added sugar intake compared to those who did not consume breakfast. RTEC breakfast consumers were also more likely to meet estimated average requirements (EAR) for intake of several nutrients and had overall higher dietary quality. For children, breakfast meal costs were less for RTEC breakfast compared to non-RTEC breakfast, but total daily meal costs were similar for consumers of RTEC and non-RTEC breakfasts.

Conclusion

RTEC breakfasts may contribute to greater nutrient intake and diet quality in children and adults in the US without increasing total daily meal costs.

Diabetes Prevention and Measures to Ensuring a Healthy Lifestyle during COVID-19 Pandemic and after

The incidence of diabetes mellitus (DM) is increasing exponentially globally, with 90% of the confirmed cases being type 2 DM. The global incidence of DM is expected to increase by 48% during 2017-2045. The coronavirus disease 2019 (COVID-19) pandemic continues to have a massive impact on human health, causing sudden lifestyle changes through quarantine measures, such as lockdown, social distancing, various curfews, and isolation at home. This in turn might increase the risk of developing numerous chronic diseases, such as DM, obesity, and cardiovascular diseases, which increase the severity of COVID-19. To this end, we performed a comprehensive review to determine viable measures for the prevention of DM and its subsequent upsurge globally. Additionally, we have determined strategies that should be adopted globally to ensure a healthy lifestyle during the COVID-19 pandemic and later.

[Nutrition for diabetic patients (Update 2023)]

All patients with diabetes require individual and personalized nutritional consultation with professionals. The patient's needs should be the primary focus of the dietary therapy, taking their lifestyle and the type of diabetes into consideration. With the recommendations to the patient's diet, there need to be specific metabolic goals to reduce the disease's progression and to avoid long term health effects. Therefore, practical guidelines such as portion size and meal planning tips should be the main focus.According to the latest national and international standards, patients suffering from diabetes should have access to nutrition consulting and nutritional training. During consultation they can be supported on- how to manage their health condition and choosing food and beverage to improve their health.These practical recommendations sum up the latest literature on nutritional aspects of diabetes treatment.