High-glycemic index foods, hunger, and obesity: is there a connection?

Consumption of underground storage organs is associated with improved energetic status in a graminivorous primate

Early hominin species likely had access to open, grassy habitats where periodic reliance on underground storage organs (USOs) is hypothesized to have played a crucial dietary role. As the only living graminivorous primate today, geladas (Theropithecus gelada) provide a unique perspective for understanding the energetic consequences of seasonal consumption of USOs. Geladas rely heavily on above-ground grasses throughout the year, but when grass is seasonally less available, they feed more on USOs. To assess whether USOs fit the definition of fallback foods (i.e., foods that are difficult to access, less preferred, or both), we examined how foraging effort (measured via time spent feeding and moving) and energetic status (measured via urinary C-peptide) fluctuated during seasonal dietary changes in a population of wild geladas in the Simien Mountains National Park, Ethiopia. If, indeed, USOs are fallback foods, we predicted an increase in foraging effort and a decline in energetic status during the dry season, when geladas rely more heavily on USOs. We collected behavioral and physiological data from 13 adult gelada males across a 13-month period. As expected, we found that male geladas spent more time moving during drier months. However, counter to the hypothesis that USOs are fallback foods in geladas, urinary C-peptide concentrations were significantly higher during the dry season. We suggest that USOs may represent an energy-rich food item for geladas, but it remains unclear why USOs are not consumed year-round. Future work is needed to better understand seasonal variation in the availability, nutrient content, and digestibility of USOs. However, results indicate that exploiting USOs seasonally could have been a valuable dietary strategy for the evolutionary success of early hominins.

Glycemic index, glycemic load, dietary insulin index, and dietary insulin load in relation to cardiometabolic risk factors among participants with atherosclerosis: a cross-sectional study

BACKGROUND

We examined the cross-sectional associations of dietary Glycemic Index (GI), Glycemic Load (GL), Dietary Insulin Index (DII), and Dietary Insulin Load (DIL) with cardiovascular disease (CVD) factors in subjects with atherosclerosis.

METHODS

The present cross-sectional study was conducted on subjects with atherosclerosis. Regular dietary intake was assessed using a 168-item semi-quantitative food frequency questionnaire (FFQ) and GI, GL, DIL, and DII were also calculated. Odds Ratio (OR) and 95% Confidence Intervals (CIs) were estimated for general and central obesity according to the GI, GL, DII, and DIL.

RESULTS

According to the continuous score of GL, there was a significant positive association between GL and central obesity for women in all models. Regarding the association between DIL score and biochemical variables, there was a significant positive association between Na and Aspartate transaminase (AST) with DII. Moreover, there was a significant positive association between LDL-c(p = 0.03) and AST (p = 0.04)with DIL score in all 3 models.

CONCLUSION

In this study, GL was associated with greater odds of central obesity in women, but not in men. Neither dietary DII nor DIL was associated with BMI and central obesity. GI, GL, DII, and DIL were significantly associated with some CVD risk biomarkers in subjects with atherosclerosis.

Randomized controlled trial of a novel lifestyle intervention used with or without meal replacements in work sites

OBJECTIVE

Lifestyle interventions have had limited effectiveness in work sites when evaluated in randomized trials. This study assessed the effectiveness of a novel lifestyle intervention for weight loss (Healthy Weight for Living [HWL]) implemented with or without meal replacements (MR) in work sites. HWL used a new behavioral approach emphasizing reducing hunger and building healthy food preferences, and, unlike traditional lifestyle interventions, it did not require calorie counting.

METHODS

Twelve work sites were randomized to an 18-month intervention (n = 8; randomization within work sites to HWL, HWL + MR) or 6-month wait-listed control (n = 4). Participants were employees with overweight or obesity (N = 335; age = 48 [SD 10] years; BMI = 33 [6] kg/m2 ; 83% female). HWL was group-delivered in person or by videoconference. The primary outcome was 6-month weight change; secondary outcomes included weight and cardiometabolic risk factors measured at 6, 12, and 18 months in intervention groups.

RESULTS

Mean 6-month weight change was -8.8% (95% CI: -11.2% to -6.4%) for enrollees in HWL and -8.0% (-10.4% to -5.5%) for HWL + MR (p < 0.001 for both groups vs. controls), with no difference between interventions (p = 0.40). Clinically meaningful weight loss (≥5%) was maintained at 18 months in both groups (p < 0.001).

CONCLUSIONS

A new lifestyle intervention approach, deliverable by videoconference with or without MR, supported clinically impactful weight loss in employees.

Dietary glycemic index and glycemic load mediate the effect of CARTPT rs2239670 gene polymorphism on metabolic syndrome and metabolic risk factors among adults with obesity

INTRODUCTION

The importance of genetic and dietary factors in occurrence and progression of chronic diseases such as metabolic syndrome (MetS) has been established. However, complex interrelationships, including direct and indirect effects of these variables are yet to be clarified. So, our aim was to investigate the mediating role of glycemic indices in the relationship between CARTPT rs2239670 polymorphism, socio-demographic and psychological factors and metabolic risk factors and the presence of MetS in adults with obesity.

METHODS

In a cross-sectional study of 288 apparently healthy adults with obesity aged 20-50 years, dietary glycemic index (GI) and glycemic load (GL) were measured using a validated semi-quantitative food frequency questionnaire (FFQ). Biochemical parameters, blood pressure and anthropometric indicators were assayed by standard methods. Genotyping was carried out by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Structural equation modeling (SEM) was used in the statistical analysis.

RESULTS

CARTPT rs2239670 had a positive direct effect on MetS (B = 0.037 ± 0.022; P = 0.043) and, on the other hand, this variant was found to be indirectly associated with MetS presence through mediation of GI (B = 0.039 ± 0.017; P = 0.009). CARTPT was a significant predictor of both dietary GI and GL (B = 1.647 ± 0.080 and B = 3.339 ± 0.242, respectively). Additionally, glycemic indicators appeared to mediate the association of age and gender with LDL-C (B = 0.917 ± 0.332; P = 0.006) and HDL (B = 1.047 ± 0.484; P = 0.031), respectively. GI showed a positive relationship with LDL-C (P = 0.024) in men and similar relationships were found between GL and LDL-C (P = 0.050) and cholesterol (P = 0.022) levels in women.

CONCLUSION

The SEM findings suggest a hypothesis of the mediating effect of glycemic indices in the relationship between genetic susceptibility to obesity and MetS presence. Our findings need to be confirmed with large prospective studies.

Fast-Food Consumption, Dietary Quality, and Dietary Intake of Adolescents in Saudi Arabia

High fast-food consumption is a common public-health concern among adolescents, due to its link to a number of non-communicable diseases. Frequent consumption of fast food may also affect diets of individuals; however, research addressing this issue is lacking in Saudi Arabia. We aimed to investigate the association between fast-food consumption, dietary quality, and dietary intake of adolescents in Saudi Arabia. This is a cross-sectional study of 617 healthy adolescents aged 11-18 years, who were recruited randomly from 16 middle- and high-schools located in Jeddah and Madinah, Saudi Arabia. Sociodemographic data were collected from parents. Dietary data, including the frequency of fast-food consumption, dietary quality (assessed using the short-form food frequency questionnaire), and dietary intake (assessed using multiple 24 h diet recalls from a subsample), were collected from the adolescents. Approximately one-third of adolescents (28.5%) reported frequent fast-food consumption (>two times a week). Results showed that a higher proportion of male adolescents frequently consumed fast-food, compared with female adolescents (32.8% vs. 24.8%, p = 0.039). Adolescents with the highest monthly family-income (≥SAR 21,000 ) reported a significantly higher frequency of fast-food consumption compared with families with a lower monthly income (p = 0.009). Frequency of fast-food consumption predicted lower dietary-quality in adolescents (Beta (B) = -0.27 [95% confidence interval (CI): -0.35 to -0.18]) and higher carbohydrate and free-sugar intake (B = 6.93 [95% CI: 0.78 to 13.1], and B = 3.93 [95% CI: 1.48 to 6.38], respectively). In conclusion, nutrition-intervention programs aiming to limit fast-food consumption and enhance the dietary quality of adolescents in Saudi Arabia, are warranted.

Vitamin B6 Inhibits High Glucose-Induced Islet β Cell Apoptosis by Upregulating Autophagy

Vitamin B6 may alleviate diabetes by regulating insulin secretion and increasing insulin sensitivity, but its mechanism remains to be explored. In this study, vitamin B6-mediated autophagy and high glucose-induced apoptosis were tested to investigate the mechanism by which vitamin B6 regulates insulin release. The results showed that 20 mM glucose increased the apoptosis rate from 10.39% to 22.44%. Vitamin B6 reduced the apoptosis rate of RIN-m5F cells from 22.44% to 11.31%. Our data also showed that the vitamin B6 content in processed eggs was decreased and that the hydrothermal process did not affect the bioactivity of vitamin B6. Vitamin B6 increased the number of autophagosomes and the ratio of autophagosome marker protein microtubule associated protein 1 light chain 3 beta to microtubule associated protein 1 light chain 3 alpha (LC3-II/LC3-I). It also decreased the amount of sequetosome 1 (SQSTM1/p62) and inhibited the phosphorylation of p70 ribosomal protein S6 kinase (p70S6K) under normal and high glucose stress. Another study showed that vitamin B6 inhibited the apoptosis rate, whereas the autophagy inhibitor 3-methyladenine (3-MA) blocked the protective effect of vitamin B6 against apoptosis induced by high glucose. The hydrothermal process decreased the vitamin B6 content in eggs but had no effect on the cytoprotective function of vitamin B6 in RIN-m5f cells. In conclusion, we demonstrated that vitamin B6-mediated autophagy protected RIN-m5f cells from high glucose-induced apoptosis might via the mTOR-dependent pathway. Our data also suggest that low temperatures and short-term hydrothermal processes are beneficial for dietary eggs.

Postprandial Glucose and Gastrointestinal Hormone Responses of Healthy Subjects to Wheat Biscuits Enriched with L-Arginine or Branched-Chain Amino Acids of Plant Origin

The study investigates the effects of wheat biscuits supplemented with plant flours originating from legumes/seeds enriched either in L-arginine (L-arg) or branched-chain amino acids (BCAAs) on postprandial glucose response of healthy subjects. Gastrointestinal hormone and amino acid responses as well as subjective appetite sensations are also evaluated. Subjects consumed wheat-based biscuits, enriched either in L-arg (ArgB) or BCAAs (BCAAsB) or a conventional wheat biscuit (CB) or a glucose solution (GS) in an acute randomized crossover design. Responses of glucose, insulin, ghrelin, glucagon-like peptide-1 (GLP-1), peptide YY (PYY) and glicentin, as well as those of L-arginine, L-leucine, L-isoleucine and L-valine, were evaluated over 180 min. Consumption of ArgB and BCAAsB elicited lower glucose iAUC compared to GS (p < 0.05). A lower iAUC for insulin was observed after consumption of BCAAsB (p < 0.05 compared to CB and ArgB), while ArgB elicited higher iAUC for GLP-1 accompanied by higher glicentin response (p < 0.05 compared to CB). BCAAsB and ArgB increased postprandial amino acid concentrations and caused stronger satiety effects compared to CB. Increasing protein content of wheat biscuits with supplementation of plant flours originating from legumes/seeds decreases postprandial glycemia and provides with healthier snack alternatives which can easily be incorporated into diet.

The association between dietary glycemic index and cardio-metabolic risk factors in obese individuals

Background:

The dietary glycemic index (GI) has been introduced as a novel index to elucidate the potential of foods to increase postprandial glucose. According to the limited available data about the association of GI with cardio-metabolic risk factors such as lipid profile, blood glucose markers, and blood pressure in developing countries, the current study was conducted to investigate this association in apparently obese individuals.

Method and material:

Three hundred forty-seven obese adults were recruited in the present cross-sectional study. A validated 147-food item semi-quantitative food frequency questionnaire (FFQ) was used to evaluate the usual dietary intake of study participants. Dietary GI was calculated using the international GI database. Fatty acid desaturase (FADs)2 gene variants were determined according to polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). ANOVA was used to compare study variables across different tertile of GI.

Results:

We found significant differences in terms of anthropometric parameters [weight (P = 0.038), waist circumference (WC) (P = 0.023), weight to hip ratio (WHR) (P = 0.007), and fat-free mass (FFM) (P < 0.001)] between different tertiles of GI. Similarly, energy and macronutrient intakes had a significant difference across dietary GI, and subjects with a higher dietary intake of energy and macronutrients (carbohydrate, protein, and total fat) were assigned to the third tertile of dietary GI (P < 0.001). While there was no significant difference in terms of cardio-metabolic risk factors in different dietary GI tertiles. Moreover, the total GI score was non-significantly higher in the TT genotype of FADS2 gene polymorphism compared with other genotypes. While no significant difference was observed between FADS2 genotype frequencies in different GI tertiles.

Conclusion:

Calculated dietary GI was associated with several cardio-metabolic risk factors in obese individuals. However, further prospective studies and clinical trials are needed to confirm our findings.

Is there any putative mediatory role of inflammatory markers on the association between ultra-processed foods and resting metabolic rate?

The resting metabolic rate (RMR) represents the largest component of total daily energy expenditure. The sale of ultra-processed foods (UPF) is increasing globally; however, UPF can have many adverse effects, including increasing inflammatory markers and altering RMRs. This cross-sectional study included 285 healthy overweight and obese women. Anthropometric measurements were evaluated using a bioelectrical impedance analyzer InBody 770 scanner. High-sensitivity C-reactive protein (hs-CRP), plasminogen activator-1 (PAI-1), monocyte chemoattractant protein (MCP-1), and interleukin-1 beta (IL-1β) blood levels were measured after a 12-h fasting. Indirect calorimetry was used to evaluate the RMR by using the Weir equation, and RMR deviation (RMR estimated - RMR actual), RMR per body mass index (BMI), and free fat mass (FFM) were estimated. A validated food frequency questionnaire (FFQ) was used, and seven groups of UPFs were extracted based on the NOVA method. A negative association between the RMR [β = -0.159, 95% confidence interval (CI): -0.471, -0.052, P = 0.044], RMR per BMI (β = -0.014, 95% CI: -0.025, -0.006, P = 0.036), and RMR per FFM (β = -0.241, 95% CI: -0.006, -0.000, P = 0.041) using the NOVA score was observed after adjusting for confounders. This association disappeared after inclusion of each inflammatory marker. All the markers may inversely mediate the relationship between the mentioned variables and the NOVA score. hs-CRP and MCP-1 also had a negative effect on the relationship between the NOVA score and RMR deviation. Finally, UPF intake is likely related with the RMR, mediated through changes in the production of hs-CRP, PAI-1, MCP-1, and IL-1β.

Psychosocial stress accompanied by an unhealthy eating behavior is associated with abdominal obesity in Korean adults: A community-based prospective cohort study

Psychosocial stress is recognized as a potential modulator of eating behavior. Psychosocial stress also constitutes an independent risk factor for the development of non-communicable diseases. This study examined the gender-stratified associations between perceived stress, eating behavior, and abdominal obesity in 4,411 adults aged 40–69 years during a 10-year follow-up of the Korean Genome and Epidemiology Study (KoGES). Psychosocial stress was evaluated using the Psychosocial Wellbeing Index Short Form (PWI-SF), and eating behavior was analyzed with a focus on the dietary variety score (DVS). The Cox's proportional hazard model was used to examine the risk of abdominal obesity according to stress levels. Higher stress levels were associated with lower DVS in women. Lower DVS scores were positively associated with the consumption of grains and refined grains but was negatively associated with the consumption of fruits. The DVS was not significantly associated with stress levels among men. Prospectively, the highest tertile of grains and refined grains consumption showed an increased risk of abdominal obesity compared to the lowest tertile in women (HR: 1.36, 95% CI: 1.04–1.78, p < 0.05; HR: 1.28, 95% CI: 1.03–1.59, p < 0.05, respectively). By contrast, in all participants, the highest tertile of fruits consumption decreased the risk of abdominal obesity compared to the lowest tertile (men, HR: 0.56, 95% CI: 0.45–0.70, p < 0.01; women, HR: 0.51, 95% CI: 0.40–0.65, p < 0.01). Furthermore, high stress levels showed a borderline significant association with the risk of abdominal obesity only in women (HR: 1.27, 95% CI: 1.00–1.59, p < 0.05). These findings suggested that psychosocial stress might contribute to abdominal obesity by interacting with eating behavior represented by a low DVS. The approach to consume a diet with a high DVS might help decrease the risk of abdominal obesity among people in stressful environments.

Standardization and quality profile of sattu mix

Wheat (T1) and maize (T2) based sattu were formulated using chick pea, barley and other food adjuncts. Results revealed that, no significant difference was observed in the protein and ash content between control (chickpea basede sattu mix) and T1. However, significant difference was observed between the control and T2 sample between moisture, fat, insoluble and total fiber, with the exception of protein, soluble fiber and ash. In case of T1 and T2, significant difference was observed in fat and total fiber content. Coming on to the mineral composition, significant difference was observed between the mineral content in control and T1, with respect to calcium, potassium, sodium, magnesium, iron, manganese and copper. In case of control and T2, significant difference was observed with respect to calcium, potassium, sodium, magnesium, iron and copper, with the exception of manganese. Coming on to the mineral content of both the formulations, significant difference was observed with respect to all the minerals estimated. Significant difference was observed in the total amylose content between control and formulated samples on 0, 30 and 60 days. Microstructural studies of raw and roasted sattu and its ingredients by observation under scanning electron microscope revealed that substantial structural changes occurred during processing. The raw grains were tightly packed and contained no air spaces. However, a large number of air spaces are formed in the cotyledon of the roasted grain sample. It was observed that, T1and T2 had medium GI value (56 and 58% respectively), Whereas for control it was 60%. The formulated samples were found to be shelf stable for 60 days at RT, with an increase in moisture content of 4-6%. All the samples were sensorial acceptable and there was no perceptible off odor or off taste.

Effects of dietary paddy rice on growth performance, carcass traits, bare skin color, and nutrient digestibility in geese

The aim of this study was to investigate the effects of dietary paddy rice on growth performance, carcass traits, bare skin color, and nutrient digestibility in geese. A total of 300 twenty-eight-day-old male goslings were randomly divided into 5 treatment groups with 6 pens containing 10 goslings each. The geese were raised for 42 d on feed with 0% (control), 13, 26, 39, or 52% dietary paddy rice inclusion. Body weight and feed intake per pen were recorded from the arrival of goslings to the end of the trial. On d 70, two goslings were selected from each pen, one of which was used to measure slaughter performance, meat quality, meat proximate composition, and bare skin color, and one was used to determine nutrient utilization. The results showed that goslings fed a diet containing 26, 39, and 52% paddy rice had a higher final body weight, average daily feed intake, and average daily gain than those in the control group (P < 0.05). The abdominal fat yield in dietary paddy rice groups was higher than that of the control group (P < 0.05). There were no effects on the moisture, protein, and fat contents of breast and thigh muscle among the five treatments (P > 0.05). Compared to the control group, the breast muscle of geese fed the paddy rice had a lower L* value and a higher a* value (P < 0.05). Dietary paddy rice decreased the bill score of geese (P < 0.05). Geese in the paddy rice groups exhibited higher total starch digestibility than geese in the control group (P < 0.05). The digestibility of energy, crude protein, crude fat, crude fiber, NDF, and ADF did not differ between groups (P > 0.05). In conclusion, paddy rice is an excellent energy source in geese diets and could improve the growth performance, breast muscle color, and utilization of total starch but increase the abdominal fat yield and decrease the bill color of geese.

Migraine, Brain Glucose Metabolism and the "Neuroenergetic" Hypothesis: A Scoping Review

Increasing evidence suggests that migraine may be the result of an impaired brain glucose metabolism. Several studies have reported brain mitochondrial dysfunction, impaired brain glucose metabolism and gray matter volume reduction in specific brain areas of migraineurs. Furthermore, peripheral insulin resistance, a condition demonstrated in several studies, may extend to the brain, leading to brain insulin resistance. This condition has been proven to downregulate insulin receptors, both in astrocytes and neurons, triggering a reduction in glucose uptake and glycogen synthesis, mainly during high metabolic demand. This scoping review examines the clinical, epidemiologic and pathophysiologic data supporting the hypothesis that abnormalities in brain glucose metabolism may generate a mismatch between the brain's energy reserve and metabolic expenditure, triggering migraine attacks. Moreover, alteration in glucose homeostasis could generate a chronic brain energy deficit promoting migraine chronification. Lastly, insulin resistance may link migraine with its comorbidities, like obesity, depression, cognitive impairment and cerebrovascular diseases. PERSPECTIVE: Although additional experimental studies are needed to support this novel "neuroenergetic" hypothesis, brain insulin resistance in migraineurs may unravel the pathophysiological mechanisms of the disease, explaining the migraine chronification and connecting migraine with comorbidities. Therefore, this hypothesis could elucidate novel potential approaches for migraine treatment.

Weight Loss Strategies

Lifestyle interventions for weight loss combine support for changing diet and physical activity with weight management education and are considered the first line treatment for obesity. A variety of diet-focused interventions including time-restricted eating are also increasingly being promoted for weight management. This chapter reviews different types of interventions for weight management, their underlying health behavior change models, and effectiveness to date in randomized trials. The results justify increasing efforts to improve program effectiveness generally, and to personalize interventions to support long-term adherence. The high prevalence of obesity worldwide, combined with the known increase in risk of non-communicable diseases with duration of excess weight, provides a compelling justification for routine delivery of effective weight management interventions in the community and in clinical care.

Hunger mediates the relationship between food insecurity and binge eating among bariatric surgery candidates

BACKGROUND

The food insecurity-obesity paradox suggests that people lacking access to adequately nutritious foods are more susceptible to disordered eating. However, the mechanisms underlying the relationship between food insecurity and binge eating are not well understood.

OBJECTIVES

This study sought to assess the role of eating behaviors (i.e., cognitive restraint, disinhibition, and hunger) as mediators between food insecurity and binge eating among a sample of preoperative bariatric candidates.

SETTING

University hospital in the Appalachian region of the United States.

METHODS

A total of 369 adults seeking bariatric surgery were included in this cross-sectional study. Patients completed validated measures of food insecurity and eating behaviors as part of a routine psychological evaluation prior to bariatric surgery.

RESULTS

Food insecurity was significantly related to binge eating symptoms (r[369] = .14, P < .01) and hunger (r[369] = .11, P < .05). Hunger mediated the relationship between food insecurity and binge eating (b = 1.23, standard error = .62, 95% confidence interval .08-2.54). Food insecurity was not associated with restraint (r[369] = .06, P = .27) or disinhibition (r[369] = .02, P = .69).

CONCLUSIONS

Food insecurity presents a unique pathway to binge eating that has several implications for intervention prior to bariatric surgery. Identification of food insecurity and the subsequent effects on eating behaviors is crucial to understanding the factors relevant to disordered eating prior to bariatric surgery.

Snacking on Almonds Lowers Glycaemia and Energy Intake Compared to a Popular High-Carbohydrate Snack Food: An Acute Randomised Crossover Study

Consuming nuts may have advantages over other snack foods for health and body-weight regulation. Suggested mechanisms include increased satiety and lower glycaemia. We used an acute randomised crossover trial to assess glycaemic and appetite responses to consuming two isocaloric snacks (providing 10% of participants’ total energy requirements or 1030 kJ (equivalent to 42.5 g almonds), whichever provided greater energy): raw almonds and sweet biscuits among 100 participants with available data (25 males and 75 females) following 106 being randomised. Two hours after consuming a standardised breakfast, participants consumed the snack food. Finger-prick blood samples measuring blood glucose and subjective appetite ratings using visual analogue scales were taken at baseline and at 15 or 30 min intervals after consumption. Two hours after snack consumption, an ad libitum lunch was offered to participants and consumption was recorded. Participants also recorded food intake for the remainder of the day. The mean area under the blood glucose response curve was statistically and practically significantly lower for almonds than biscuits (mean (95% CI) difference: 53 mmol/L.min (45, 61), p < 0.001). Only the composite appetite score at 90 min was higher in the almond treatment compared to the biscuit treatment (45.7 mm vs. 42.4 mm, p = 0.035 without adjustment for multiple comparisons). There was no evidence of differences between the snacks for all other appetite ratings or for energy intake at the ad libitum lunch. However, mean energy intakes following snack consumption were significantly lower, both statistically and in practical terms, for the almond treatment compared to the biscuit (mean (95% CI) diff: 638 kJ (44, 1233), p = 0.035). Replacing popular snacks with almonds may have advantages in terms of glycaemia and energy balance.

Randomized trial of a novel lifestyle intervention compared with the Diabetes Prevention Program for weight loss in adult dependents of military service members

BACKGROUND

Lifestyle interventions are the first-line treatment for obesity, but participant weight loss is typically low.

OBJECTIVES

We evaluated the efficacy of an alternative lifestyle intervention [Healthy Weight for Living (HWL)] compared with a modified Diabetes Prevention Program (m-DPP). HWL was based on a revised health behavior change model emphasizing hunger management and the development of healthy food preferences. m-DPP was a standard Diabetes Prevention Program implemented with counselor time matched to HWL. Participants were adult dependents of military personnel and had overweight or obesity.

METHODS

Participants were randomly assigned to HWL (n = 121) or m-DPP (n = 117), delivered primarily by group videoconference with additional midweek emails. The primary outcome was 12-mo weight change. Secondary outcomes included 6-mo changes in cardiometabolic risk factors and diet. Intention-to-treat (ITT) and complete case (CC) analyses were performed using linear mixed models.

RESULTS

Retention did not differ between groups (72% and 66% for HWL and m-DPP at 12 mo, respectively; P = 0.30). Mean ± SE adjusted 12-mo weight loss in the ITT cohort was 7.46 ± 0.85 kg for HWL and 7.32 ± 0.87 kg for m-DPP (P = 0.91); in the CC cohort, it was 7.83 ± 0.82 kg for HWL and 6.86 ± 0.88 kg for m-DPP (P = 0.43). Thirty-eight percent of HWL and 30% of m-DPP completers achieved ≥10% weight loss (P = 0.32). Improvements in systolic blood pressure, LDL cholesterol, triglycerides, fasting glucose, general health, sleep, and mood were similar across groups; improvements in diastolic blood pressure were greater in m-DPP. Adjusted group mean reductions in energy intake were not significantly different between groups, but HWL participants were more adherent to their dietary prescription for lower glycemic index and high fiber and protein (P = 0.05 to <0.001 for ITT).

CONCLUSIONS

HWL and m-DPP showed equivalent and clinically impactful mean weight loss with cardiometabolic benefits. These results identify an alternative approach for behavioral treatment of overweight and obesity.This trial was registered at clinicaltrials.gov as NCT02348853.

The association between dietary patterns with severity of coronary artery stenosis, serum leptin-to-adiponectin ratio, and some related risk factors in patients with coronary artery disease

Background

This research aimed to investigate the association between dietary patterns with severity of coronary artery stenosis, serum leptin-to-adiponectin ratio, and some related risk factors in patients with coronary artery disease referred for coronary angiography.

Methods

This cross-sectional study was carried out on 191 men patients with known coronary disease aged 40-70 years whom were admitted to angiography ward of Ahvaz teaching hospital, Ahvaz, Iran. Dietary patterns were investigated using 161-item semi-quantitative food frequency questionnaire. Anthropometric indices; blood pressure; serum levels of adiponectin and leptin, blood levels of glucose, total cholesterol, HDL-C, LDL-C, and triglycerides were measured. Patients were categorized based on the severity of coronary artery disease [number of vessel involved-single (VD1), double (VD2), triple (VD3)].

Results

Three major dietary patterns were recognized using a factor analysis approach: western, healthy, and traditional patterns. Linear regression analysis demonstrated that there was a negative association between healthy dietary pattern with LDL-C, total cholesterol, and triglycerides. This dietary pattern was positively related to HDL-C. Both traditional and western dietary patterns were related to fasting blood glucose level and lipid profile. General obesity was positively associated with traditional and western dietary patterns. There was a positive relationship between central obesity with traditional and western dietary patterns, but a negative association was reported between the healthy dietary pattern and central obesity. Traditional and western dietary patterns demonstrated a significant positive relationship with serum leptin levels and ratio of L/A, and an inverse relationship with adiponectin. Healthy dietary pattern had a significant negative association with serum leptin levels and ratio of L/A. Healthy dietary pattern was negatively related to the severity of vessel stenosis. Patients in the third quartile of healthy dietary pattern were less likely to have vessel stenosis (OR = 43%, 95% CI: 0.07-0.87).

Conclusions

The findings show that adherence to a healthy dietary pattern was negatively associated with coronary artery stenosis and its related risk factors. However, adherence to western and traditional dietary patterns was positively related to coronary artery disease risk factors.

The association between major dietary patterns at dinner and obesity in adults living in Tehran: A population-based study

Introduction: Findings of studies on the association between evening meal and obesity are inconclusive. Thus, we sought to investigate the association between major dietary patterns at evening meal and obesity among apparently healthy adults in Tehran. Methods: This cross-sectional research was conducted using 833 adult men and women who lived in Tehran (age range: 20-59 years). Their dietary intake was evaluated by three, 24-h dietary recalls(24hDRs), and major patterns were identified using exploratory factor analysis. The association between major dietary patterns at dinner with general and central obesity was assessed using logistic regression analysis. Results: We identified 3 major dietary patterns at dinner including "prudent", "potatoes and eggs" and"Western" patterns. There was no significant relationship between prudent and general obesity (OR:0.76, 95% CI = 0.21, 1.15, P value = 0.20), and, a significant association was not observed between potatoes and eggs and general obesity (OR: 0.89, 95% CI = 0.60, 1.32, P value = 0.57) also, there was no significant relationship between Western dietary pattern and general obesity in this study (OR: 0.95,95% CI = 0.63, 1.43, P value = 0.82). Further analyses showed that there was no significant relationship between central obesity with any of the dietary patterns. Conclusion: The results of this study do not support a possible relationship between major dietary patterns at dinner with general and central obesity. However, the presented findings should be confirmed in prospective studies.

Associations of Dietary Glycemic Index, Glycemic Load and Carbohydrate with the Risk of Cervical Intraepithelial Neoplasia and Cervical Cancer: A Case-Control Study

BACKGROUND

The association of dietary glycemic index (GI) and glycemic load (GL) with the risk of cervical cancer has never been investigated. Thus, we aimed to find evidence of any association of GI and GL with the risk of cervical intraepithelial neoplasia (CIN) and cervical cancer.

METHODS

In this hospital-based case-control study, we included 1340 women (670 controls and 262, 187 and 221 patients with CIN1, CIN2/3, and cervical cancer, respectively) from the Korean human papillomavirus cohort study. Completed demographic questionnaires and semi-quantitative food-frequency questionnaires were collected. The association of dietary GI and GL with CIN and cervical cancer was estimated using a logistic regression model.

RESULTS

The multivariate odds ratios (OR) of the highest compared with the lowest quintile of GL for CIN1 were 2.8 (95% confidence interval (CI) = 1.33-5.88). Dietary GI and GL were not associated with CIN2/3 and cervical cancer. Stratified analyses by body mass index (BMI) indicated a positive association between GI and GL and CIN 1 risk among women with a BMI (in kg/m2) <23 (OR = 2.94; 95% CI = 1.32-6.53; p for trend = 0.031 for GI and OR = 3.15; 95% CI = 1.53-6.52; p for trend = 0.013 for GL), but not among those with a BMI of ≥23. A stratification analysis by menopausal status showed that the highest quintile of GI and GL was significantly associated with the risk of CIN1 (OR = 2.91; 95% CI = 1.43-5.96; p for trend = 0.005) (OR = 2.96; 95% CI = 1.53-5.69; p for trend = 0.023) among premenopausal women. Also, in HPV positive women, dietary GL showed significant CIN1 risk (OR = 2.61; 95% CI = 1.09-6.24; p for trend = 0.087).

CONCLUSION

Our case-control study supports the hypothesized associations of dietary GI and GL with increased risk of CIN1. Thus, the consumption of low GI and GL foods plays a significant role in the prevention of cervical carcinogenesis.

Food is special by itself: Neither valence, arousal, food appeal, nor caloric content modulate the attentional bias induced by food images

When food cues appear in a visual context, such information is likely to influence eating behavior by enhancing attention for food cues. We investigated whether active but task-irrelevant information could modulate the attentional bias for food stimuli using a novel paradigm in which participants were purposely deceived by being enrolled in a memory experiment. A set of images were first held in working memory and then used as task-irrelevant distractors in a subsequent single target rapid serial visual presentation (RSVP) task, allowing us to investigate the attentional blink (AB) effect elicited by those images. In Experiment 1, the results revealed that food images elicited a larger AB effect than nonfood images. In three follow-up experiments, we investigated whether valence or arousal (Experiment 2), food preparation (Experiment 3), or food caloric content (Experiment 4) were factors related to the attentional bias for food. Overall, our results demonstrated that when held in working memory, food images can easily capture attention, even in circumstances in which the information retained in memory is irrelevant to solve the task, as indicated by the strong correlation found between items that were recognized in the RSVP task and the AB effect. Nonetheless, none of the food-related properties we examined were found to be associated with this attentional bias for food.

Comparison of structural, functional and in vitro digestion properties of bread incorporated with grapefruit peel soluble dietary fibers prepared by three microwave-assisted modifications

In our previous study, three kinds of grapefruit peel soluble dietary fibers (SDFs) were prepared by microwave-assisted modifications, including microwave-sodium hydroxide treatment SDF (MST-SDF), microwave-enzymatic treatment SDF (MET-SDF) and microwave-ultrasonic treatment SDF (MUT-SDF). The present study aimed to investigate the structural, functional and in vitro digestion properties of three kinds of bread incorporated with SDFs, named MST-SDF bread (SB), MET-SDF bread (EB), and MUT-SDF bread (UB). Scanning electron microscopy, X-ray diffraction, differential scanning calorimetry and texture profile analysis were used to determine the structural properties. In comparison with the SB and EB, the UB showed an ideal hardness and internal structure, and also significant improvement of the thermal stability. Meanwhile, the UB exhibited the highest overall acceptability in the sensory evaluation. In addition, the water holding capacity (WHC), cholesterol adsorption capacity (CAC) and nitrite ion adsorption capacity (NIAC) of UB were superior to those of the other two samples. Moreover, the in vitro digestive glucose release rates of breads were all significantly reduced by the addition of SDFs, especially that of UB. In summary, the present study showed that UB presented the best performance in terms of structural, functional and in vitro digestion properties, implying that MUT-SDF could be utilized in bread with high quality and low glucose release rate, and developed as a potential ingredient of functional food.

Knowledge, attitudes, and practices toward added sugar consumption among female undergraduate students in Madinah, Saudi Arabia: A cross-sectional study

OBJECTIVES

This study aimed to evaluate knowledge, attitudes, and practices toward added sugar intake and the associations with nutrient intakes and weight status.

METHODS

This cross-sectional study was conducted among 190 healthy female undergraduate students at Taibah University, Madinah, Saudi Arabia. Demographic, knowledge and attitudes toward added sugar, dietary intake, and anthropometric data (i.e., height, weight, and waist circumference) were collected during face-to-face interviews.

RESULTS

Approximately half of the students (n = 106; 55.8%) were aware of the health consequences of excessive intake of added sugar, but only 32.6% (n = 62) reported making an effort to reduce their added sugar intake. The data indicated that 8.42% of the students (n = 16) consumed carbonated soft drinks daily, 15.8% (n = 30) consumed fruit drinks daily, and 45.8% (n = 87) consumed sweets daily. Underweight students consumed higher quantities of added sugar (expressed as percent of total energy intake) compared with students in all other weight status groups. Results showed negative associations between percentage of added sugar intake and intakes of fiber, iron, zinc, vitamin D, body mass index, and waist circumference.

CONCLUSIONS

Our findings indicated that a large proportion of young women had limited knowledge on the health consequences of excessive added sugar intakes. The observed inverse relationships between added sugar and micronutrient intakes and the weight status highlight the urgent need for expanded efforts to improve added sugar-related knowledge and promote the reduction of added sugar intake among young women.

Animal and Clinical Studies Evaluating Blood Glucose Control With Palatinose-Based Alternative Sweeteners

Animal and clinical studies were performed to determine whether Palatinose-based alternative sweeteners with increased sweetness contributed to blood glucose elevations. In the animal study, male Sprague-Dawley rats (6 weeks old) received an oral load of 2 g of glucose or Palatinose-based alternative sweeteners per kilogram of body weight. Thirty minutes after the glucose load, the rat blood glucose levels in the Palatinose-based alternative sweetener groups were significantly lower than those in the glucose groups (p < 0.05). Palatinose-based alternative sweeteners significantly improved glucose tolerance in rats. However, significant differences in the blood glucose levels were not observed among the Palatinose-based alternative sweeteners. In the clinical study, 14 healthy volunteers (21.4 ± 1.3 years) consumed glucose or Palatinose-based alternative sweeteners (50 g). At 60 min, when Palatinose-based alternative sweeteners were ingested, blood glucose was significantly lower compared to when glucose was ingested (Palatinose-L, 123.1 mg/dL; Palatinose-IS, 125.9 mg/dL; Palatinose-FOS. 129.1 mg/dL vs. glucose, 154.8 mg/dL, p < 0.05). The glycaemic index of Palatinose-L, Palatinose-IS and Palatinose-FOS was 43.9, 58.1, and 49.2, respectively. Palatinose-based alternative sweeteners could help maintain health as the postprandial blood glucose levels are constantly maintained owing to slow hydrolysis.

Lentil sprouts: a nutraceutical alternative for the elaboration of bread

The pro-health action of germinated lentils could be useful to be added with wheat flour in the production of box bread. In this work, we spectroscopically evaluate the germinated and non-germinated lentils, and use them at the concentrations of 5 and 10% for the production of box bread. The chemical and physical tests of the bread and its determination of phenolic acids and flavonoids (by HPLC) were also performed. As well as the evaluation of the quality of flour and dough used to produce the bread and the acceptance of the germinated lentil bread with a population of 20 people with diabetes or with diabetic relatives It is shown that: (1) The amplitude of photoacoustic signal obtained by photoacoustic spectroscopy is modified as a function of the percentage of germinated lentil (GL) flour (0, 5 or 10%) add to the bread; being higher the photoacoustic amplitude to higher concentration of GL in the absorption band of 300-425 nm, which is related to higher content of phenols and flavonoids. (2) The contents of phenolic acids (Sinapinic, β- resorcylic, Chlorogenic and Ferulic) and flavonoids (Quercetin and Isorhamnetin) tended to increase in the germinated lentil bread with 10% concentration of germinated lentil flour with respect to the control bread (0% GL). (3) The addition of germinated lentils flour to 5 and 10% into wheat flour to produce bread with higher hardness and less cohesiveness than bread based on wheat flour only. The Falling number indicate that there is no significant difference between the control sample and the 5% GL flour, while in the 10% GL flour there was a reduction of 21 s, with respect to the control. The effect of the germinated lentil flour percentage on the pasting properties of the flours was significant between the control and 10% GL flour. In general, the quality of the dough and flour are modified due to the addition of germinates lentils, and this affectation increases with the increase in the concentration of GL. (4) The bread added with germinated lentil has sensory acceptance with a group of people with diabetes and/or diabetic relatives in their attributes in general. The obtained results thus support the production of wheat bread with mixed germinated lentils flour, as a nutraceutical option for human consumption.

Substantial and Sustained Improvements in Blood Pressure, Weight and Lipid Profiles from a Carbohydrate Restricted Diet: An Observational Study of Insulin Resistant Patients in Primary Care

Hypertension is the second biggest known global risk factor for disease after poor diet; perhaps lifestyle interventions are underutilized? In a previous small pilot study, it was found that a low carbohydrate diet was associated with significant improvements in blood pressure, weight, 'deprescribing' of medications and lipid profiles. We were interested to investigate if these results would be replicated in a larger study based in 'real world' GP practice. 154 patients with type 2 diabetes or impaired glucose tolerance were recruited into an observational cohort study in primary care. The effects of a low carbohydrate diet sustained for an average of two years (interquartile range 10-32 months) on cardiovascular risk factors were examined. Results demonstrate significant and substantial reductions in blood pressure (mean reduction of systolic BP 10.9 mmHg (interquartile range 0-22 mmHg) (p < 0.0001), mean reduction in diastolic BP 6.3 mmHg (interquartile range 0-12.8 mmHg) (p < 0.0001) and mean weight reduction of 9.5 Kg (interquartile range 5-13 Kg) (p < 0.0001) together with marked improvement in lipid profiles. This occurred despite a 20% reduction in anti-hypertensive medications. This novel and potentially highly effective dietary modification, done very cheaply alongside routine care, offers hope that should be tested in a large prospective trial.

Food Groups and Risk of Overweight, Obesity, and Weight Gain: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies

This meta-analysis summarizes the evidence of a prospective association between the intake of foods [whole grains, refined grains, vegetables, fruit, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages (SSBs)] and risk of general overweight/obesity, abdominal obesity, and weight gain. PubMed and Web of Science were searched for prospective observational studies until August 2018. Summary RRs and 95% CIs were estimated from 43 reports for the highest compared with the lowest intake categories, as well as for linear and nonlinear relations focusing on each outcome separately: overweight/obesity, abdominal obesity, and weight gain. The quality of evidence was evaluated with use of the NutriGrade tool. In the dose-response meta-analysis, inverse associations were found for whole-grain (RRoverweight/obesity: 0.93; 95% CI: 0.89, 0.96), fruit (RRoverweight/obesity: 0.93; 95% CI: 0.86, 1.00; RRweight gain: 0.91; 95% CI: 0.86, 0.97), nut (RRabdominal obesity: 0.42; 95% CI: 0.31, 0.57), legume (RRoverweight/obesity: 0.88; 95% CI: 0.84, 0.93), and fish (RRabdominal obesity: 0.83; 95% CI: 0.71, 0.97) consumption and positive associations were found for refined grains (RRoverweight/obesity: 1.05; 95% CI: 1.00, 1.10), red meat (RRabdominal obesity: 1.10; 95% CI: 1.04, 1.16; RRweight gain: 1.14; 95% CI: 1.03, 1.26), and SSBs (RRoverweight/obesity: 1.05; 95% CI: 1.00, 1.11; RRabdominal obesity: 1.12; 95% CI: 1.04, 1.20). The dose-response meta-analytical findings provided very low to low quality of evidence that certain food groups have an impact on different measurements of adiposity risk. To improve the quality of evidence, better-designed observational studies, inclusion of intervention trials, and use of novel statistical methods (e.g., substitution analyses or network meta-analyses) are needed.

High Pancreatic Amylase Expression Promotes Adiposity in Obesity-Prone Carbohydrate-Sensitive Rats

BACKGROUND

We have reported large differences in adiposity (fat mass/body weight) gain between rats fed a low-fat, high-starch diet, leading to their classification into carbohydrate "sensitive" and "resistant" rats. In sensitive animals, fat accumulates in visceral adipose tissues, leading to the suggestion that this form of obesity could be responsible for rapid development of metabolic syndrome.

OBJECTIVE

We investigated whether increased amylase secretion by the pancreas and accelerated starch degradation in the intestine could be responsible for this phenotype.

METHOD

Thirty-two male Wistar rats (7-wk-old) were fed a purified low-fat (10%), high-carbohydrate diet for 6 wk, in which most of the carbohydrate (64% by energy) was provided as corn starch. Meal tolerance tests of the Starch diet were performed to measure glucose and insulin responses to meal ingestion. Indirect calorimetry combined with use of 13C-labelled dietary starch was used to assess meal-induced changes in whole body and starch-derived glucose oxidation. Real-time polymerase chain reaction was used to assess mRNA expression in pancreas, liver, white and brown adipose tissues, and intestine. Amylase activity was measured in the duodenum, jejunum, and ileum contents. ANOVA and regression analyses were used for statistical comparisons.

RESULTS

"Resistant" and "sensitive" rats were separated according to adiposity gain during the study (1.73% ± 0.20% compared with 4.35% ± 0.36%). Breath recovery of 13CO2 from 13C-labelled dietary starch was higher in "sensitive" rats, indicating a larger increase in whole body glucose oxidation and, conversely, a larger decrease in lipid oxidation. Amylase mRNA expression in pancreas, and amylase activity in jejunum, were also higher in sensitive rats.

CONCLUSION

Differences in digestion of starch can promote visceral fat accumulation in rats when fed a low-fat, high-starch diet. This mechanism may have important implications in human obesity.

Dietary glycemic index and glycemic load in relation to general obesity and central adiposity among adults

BACKGROUND & AIMS

Although the association between dietary Glycemic Index (GI), Glycemic Load (GL) and general/abdominal obesity has extensively been examined, limited data are available in this regard in developing countries. The aim of this study was to examine the association between dietary GI and GL with general and abdominal obesity.

METHODS

This cross-sectional study was conducted among adults in Isfahan, Iran. Dietary GI and GL were assessed using a validated dish-based 106-item semi-quantitative food frequency questionnaire (DS-FFQ). Data regarding height, weight and waist circumference were collected using a self-reported questionnaire. Overweight or obesity was defined as body mass index ≥25 kg/m², and abdominal obesity was defined as waist circumference ≥80 cm for women and ≥94 cm for men.

RESULTS

There was no significant association between dietary GI and GL and general obesity. After adjustment for potential confounders, participants in the highest quintile of dietary GI had a higher chance for abdominal obesity (OR: 1.29; 95% CI: 1.01-1.64), compared with those in the lowest quintile. No significant association was observed between dietary GL and abdominal obesity. After adjustment for potential confounders, women in the top quintile of dietary GI had higher chance for abdominal obesity compared with those in the bottom quintile (OR: 1.48, 95% CI: 1.02-2.15). No significant association was found between dietary GI and abdominal obesity among men. We failed to find any significant association between dietary GI and general obesity in either gender [Comparing top vs. bottom quintiles, for men: OR: 0.97; 95% CI: 0.74-1.29 and for women: OR: 1.01; 95% CI: 0.75-1.40]. No significant association was found between dietary GL and general [for men: OR: 1.13; 95% CI: 0.85-1.49 and for women: OR: 1.01; 95% CI: 0.76-1.35], as well as abdominal obesity [for men: OR: 1.21; 95% CI: 0.88-1.67 and for women: OR: 1.25; 95% CI: 0.88-1.77].

CONCLUSIONS

We found a significant positive association between dietary GI and abdominal obesity. When we conducted analyses stratified by gender, we also observed such association in women, but not in men. No other significant associations were observed between dietary GI and GL with general or abdominal obesity.

A Synergistic Formulation of Plant Extracts Decreases Postprandial Glucose and Insulin Peaks: Results from Two Randomized, Controlled, Cross-Over Studies Using Real-World Meals

This study investigated the efficacy of a plant-derived dietary supplement with respect to decreasing postprandial glucose and insulin peaks after the intake of real-world meals. Two randomized, double-blind, placebo-controlled, cross-over experiments were conducted on healthy subjects who received a supplement containing extracts of white mulberry, white bean, and green coffee or one containing the three extracts with added fibre before consuming high-GI/GL (glycaemic index/glycaemic load) meals. In study one, 32 subjects received an investigational product/placebo before a standardized meal at two visits. In study two, 150 subjects received an investigational product/placebo before five different standardized meals. Postprandial glucose and insulin concentrations were lower 20–35 min after meal intake among subjects taking the investigational product, and fewer episodes of postprandial reactive hypoglycaemia were noted. For example, after consuming breakfast cereal with milk, lower glucose peaks were observed for the investigational product (vs. placebo) after 20 min (100.2 ± 1.97 vs. 112.5 ± 3.12 mg/dL, respectively; p < 0.01); lower insulin peaks were noted at the same time point (45.9 ± 4.02 IU/mL vs. 68.2 ± 5.53 IU/mL, respectively, p < 0.01). The combined formulation decreases the adverse consequences of high-GI/GL meal consumption. It can be an effective dietary supplement for the management of metabolic syndrome and type 2 diabetes mellitus.

Breakfast quality and cardiometabolic risk profiles in an upper middle-aged German population

Background/Objectives:

Little is known about relation of overall breakfast quality with cardiometabolic risk factors. Therefore, this study aimed to explore sex-specific associations between breakfast quality and cardiometabolic risk profiles in a sample of an upper middle-aged German population.

Subjects/Methods:

Cardiometabolic profiles of 339 men and 329 women were cross-sectionally assessed using an overall biomarker score (BScore), glycated hemoglobin (HbA1_c), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), blood pressure, body mass index (BMI) and waist circumference (WC). Overall breakfast quality was assessed by using (i) an a-priori defined breakfast quality score (BQS) and (ii) data-driven breakfast patterns based on principal component analysis (PCA). Multiple linear regression models for association of breakfast quality with all outcomes were adjusted for all potential confounders including overall diet quality.

Results:

After adjustment for all potential confounders the BQS was inversely associated with the BScore (regression beta with 95% Confidence Interval: −0.29 (052−0.06)) and HbA1c (−0.12 (−0.21, −0.04)) in men; whereas no such associations were observed in women. Four breakfast (B) patterns were identified: B-processed-food pattern, B-cereal pattern, B-high fat pattern and B-dairy & cereal pattern. The B-processed-food pattern was positively associated with HbA1c (0.09(0.01, 0.18)), BMI (0.16 (0.06, 0.26)), and WC (0.17 (0.8, 0.26)) in men, and BMI (0.13 (0.1, 0.25)) and WC (0.11(0.01.0.22)) in women. The B-cereal pattern was inversely associated with BScore (−0.23 (−0.45, −0.01)) and BMI (-0.11 (−0.20, −0.01)) in men and WC(−0.16 (−0.27, −0.05)) in women. The B-dairy & cereal pattern was also inversely associated with BScore (−0.26 (−0.48, −0.04)) in men but not in women.

Conclusions:

The overall breakfast quality was cross-sectionally associated with a healthier cardiometabolic profile, especially in upper-middle age men, independent of overall dietary quality. Such analyses should be supplemented by studies investigating the circadian sequence of food intake and metabolic consequences including hard disease endpoints.

Short-Term Effect of Convenience Meal Intake on Glycemic Response and Satiety among Healthy College Students in South Korea

This study examined the effect of convenience meals purchased at convenience stores on glycemic response and satiety in healthy college students. A total of 9 non-obese volunteers (4 males and 5 females) aged 20 to 24 years participated in this study. On 3 separate days, participants consumed a standard diet (cooked rice and side dishes), type 1 convenience meal (kimbap and instant ramen), and type 2 convenience meal (sweet bread and flavored milk). Capillary blood-glucose response and satiety were measured every 30 minutes for 2 hours after consuming the 3 different test meals. Although mean fasting glucose levels were not different, glucose levels at 30 minutes and 120 minutes after the type 1 convenience meal intake were significantly higher than those in the standard meal (p < 0.05, p < 0.01). Total glucose response was higher after consumption of the type 1 convenience meal, followed by the type 2 convenience meal and standard meal (p < 0.05). Though the type 2 convenience meal contained higher calorie than the other meals, satiety of the type 2 convenience meal was lowest at 30 minutes and 60 minutes after consumption (p < 0.01, p < 0.05). This pilot study suggests that convenience meals may increase glycemic response or induce higher calorie intake with low satiety compared with nutritionally balanced Korean style meal.

Short-term effects of a low glycemic index carob-containing snack on energy intake, satiety, and glycemic response in normal-weight, healthy adults: Results from two randomized trials

OBJECTIVES

The potential positive health effects of carob-containing snacks are largely unknown. Therefore, the aims of these studies were to determine the glycemic index (GI) of a carob snack compared with chocolate cookie containing equal amounts of available carbohydrates and to compare the effects of a carob versus chocolate cookie preload consumed as snack before a meal on (a) short-term satiety response measured by subsequent ad libitum meal intake, (b) subjective satiety as assessed by visual analog scales and (c) postprandial glycemic response.

METHODS

Ten healthy, normal-weight volunteers participated in GI investigation. Then, 50 healthy, normal-weight individuals consumed, crossover, in random order, the preloads as snack, with 1-wk washout period. Ad libitum meal (lunch and dessert) was offered. Capillary blood glucose samples were collected at baseline, 2 h after breakfast, just before preload consumption, 2 h after preload, 3 h after preload, just before meal (lunch and dessert), 1 h after meal, and 2 h after meal consumption.

RESULTS

The carob snack was a low GI food, whereas the chocolate cookie was a high GI food (40 versus 78, respectively, on glucose scale). Consumption of the carob preload decreased the glycemic response to a following meal and to the individual's feelings of hunger, desire to eat, preoccupation with food, and thirst between snack and meal, as assessed with the use of visual analog scales. Subsequently, participants consumed less amounts of food (g) and had lower total energy intake at mealtimes.

CONCLUSIONS

The carob snack led to increased satiety, lower energy intake at meal, and decreased postmeal glycemic response possibly due to its low GI value. Identifying foods that promote satiety and decrease glycemic response without increasing the overall energy intake may offer advantages to body weight and glycemic control.

A Low Glycaemic Index Diet Incorporating Isomaltulose Is Associated with Lower Glycaemic Response and Variability, and Promotes Fat Oxidation in Asians

Low glycaemic index (GI) foods minimize large blood glucose fluctuations and have been advocated to enhance fat oxidation and may contribute to weight management. We determined whether the inclusion of isomaltulose compared to sucrose in a low/high GI meal sequence can modulate the glycaemic response and substrate oxidation in an Asian population. Twenty Chinese men (body mass index (BMI): 17–28 kg/m²) followed a 24 h low GI (isomaltulose, Palatinose^TM) or high GI (sucrose) diet in a randomized double-blind, controlled cross-over design. Treatment meals included dinner (day 1), breakfast, lunch, and snack (day 2). Continuous glucose monitoring provided incremental area under the curve (iAUC) and mean amplitude of glycaemic excursion (MAGE) and 10 h indirect calorimetry (whole body calorimeter) (day 2) provided energy expenditure and substrate oxidation. Our results demonstrated that the low GI diet resulted in lower 24 h glucose iAUC (502.5 ± 231.4 vs. 872.6 ± 493.1 mmol/L; p = 0.002) and lower 24 h glycaemic variability (MAGE: 1.67 ± 0.53 vs. 2.68 ± 1.13 mmol/L; p < 0.001). Simultaneously, 10 h respiratory quotient increased more during high GI (p = 0.014) and fat oxidation was higher after low GI breakfast (p = 0.026), lunch (p < 0.001) and snack (p = 0.013). This indicates that lower GI mixed meals incorporating isomaltulose are able to acutely reduce the glycaemic response and variability and promote fat oxidation.

Effect of Sugar versus Mixed Breakfast on Metabolic and Neurofunctional Responses in Healthy Individuals

We investigated the effects of glucose and diverse breakfasts on glucose increment and ghrelin suppression and cognitive processing of sensory information assessed by frontal P300 evoked potentials. In a randomized crossover design, 12 healthy individuals (6M/6F; BMI 22.2 ± 0.4 kg/m²; 27 ± 1.3 years, mean ± SEM) underwent 50 g OGTT (A) and 3 breakfasts (B1: milk and cereals; B2: milk, apple, and chocolate cream-filled sponge cake; B3: milk, apple, bread, and hazelnut chocolate cream) to assess plasma glucose-, insulin-, and ghrelin excursions. An electroencephalography was performed before and 100 min after consumption of each load to measure the latency of frontal P300 evoked potentials as index of cognitive performance. Breakfasts B1 and B2 exhibited significantly lower glycemic and insulinemic responses as compared to A. Breakfast B3 exhibited significantly lower glycemic, but not insulinemic response, as compared to A. Final plasma ghrelin inhibition was more pronounced, albeit not significantly, in all breakfasts with respect to A. P300 latency tended to decrease following each of the three breakfasts, but B3 was the only breakfast capable to elicit a statistically significant reduction in P300 latency with respect to A (p < 0.01), suggesting ameliorated cognitive performance. Such amelioration was correlated with the 2-hour final inhibition of plasma ghrelin concentration (r = 0.61, p = 0.01).

Postprandial glycaemic response of foxtail millet dosa in comparison to a rice dosa in patients with type 2 diabetes

BACKGROUND & OBJECTIVES

Millets are rich source of dietary fibre and non-starchy polysaccharides with low glycaemic index (GI), hence can be used as a therapeutic diet. This study was conducted to estimate the effects of a millet-based dosa (foxtail dosa) compared to a rice dosa for breakfast on postprandial glucose levels in patients with type 2 diabetes mellitus (T2DM).

METHODS

The GI of rice dosa and foxtail millet dosa was estimated. A total of 105 T2DM participants were randomly selected for the study. The participants were on oral hypoglycaemic agents (OHA) and not on insulin. In this study, each individual served as their own control and experimental group. The postprandial increase in blood glucose was compared after a breakfast of rice dosa and millet dosa. Single and paired t test was used to note the change in blood glucose levels and the level of the significance.

RESULTS

The GI of foxtail millet dosa was 59.25 and rice dosa was 77.96. There was a significant reduction (P<0.001) in the postprandial glucose level of patients who consumed a millet-based dosa when compared to those who consumed a rice-based dosa. No significant reduction was observed in the fasting glucose levels.

INTERPRETATION & CONCLUSIONS

The results suggested that replacing a rice-based breakfast item with a millet-based breakfast item lowers the postprandial blood glucose levels in T2DM patients. Thus, millets may have a protective role in the management of hyperglycaemia. Further studies need to be done in a systematic manner to confirm these findings.

Associations of daily sleep duration and dietary macronutrient consumption with obesity and dyslipidemia in Koreans: A cross-sectional study

Daily sleep duration is known to be associated with obesity and dyslipidemia.This study was performed to examine the interactions between daily sleep duration and the risks of obesity and dyslipidemia according to dietary macronutrient consumption in 14,680 Korean adults using the 5th Korean National Health and Nutrition Examination Survey.Sleep duration was inversely associated with body mass index (P < 0.001), waist circumference (P < 0.001), total cholesterol (P < 0.001), and low-density lipoprotein -cholesterol (P = 0.001). Participants with short sleep durations consumed less dietary protein (P < 0.001) and fat (P < 0.001), and consumed more dietary carbohydrates (P < 0.001). Among participants with the shortest sleep duration (≤5 hours a day), the odds ratio of obesity was found to increase in the high fat consumption group (1.393, 95% confidence interval 1.083-1.790) and decrease in the high carbohydrate consumption group (0.770, 95% confidence interval 0.604-0.983). High fat and low carbohydrate consumption were confirmed to be associated with the risk of obesity in the shortest sleep duration group (≤5 hours a day).These findings indicate that sleep duration was negatively associated with obesity and dyslipidemia-related indices in Korean adults. Additionally, the association of short sleep duration with the risk of obesity was potentially changed by dietary fat and carbohydrate consumption.

Greater Healthful Dietary Variety Is Associated with Greater 2-Year Changes in Weight and Adiposity in the Preventing Overweight Using Novel Dietary Strategies (POUNDS Lost) Trial

BACKGROUND

Greater healthful dietary variety has been inversely associated with body adiposity cross-sectionally; however, it remains unknown whether it can improve long-term weight loss.

OBJECTIVE

This study prospectively examined associations between healthful dietary variety and short-term (6 mo) and long-term (2 y) changes in adiposity in the Preventing Overweight Using Novel Dietary Strategies (POUNDS Lost) weight-loss trial completed in 2007.

METHODS

Healthful dietary variety was assessed from 24-h recalls with the use of the US Healthy Food Diversity index among participants aged 30-70 y with overweight/obesity (n = 367). Changes in the index between baseline and 6 mo were divided into tertiles representing reduced (T1), stable (T2), or increased variety (T3). Body weight and waist circumference (WC) were measured every 6 mo, and the percentage of body fat and trunk fat were measured at 6 mo and 2 y. Associations between changes in variety and short-term and long-term changes in adiposity were analyzed by use of multivariable-adjusted generalized linear models and repeated-measures ANOVA.

RESULTS

Regardless of dietary arm, T3 compared with T2 was associated with greater reduction in weight (-8.6 compared with -6.7 kg), WC (-9.1 compared with -6.1 cm), and body fat at 6 mo (β = -4.61 kg, P < 0.05). At 2 y, individuals in T3 compared with those in T2 or T1 maintained greater weight loss [-4.0 (T3) compared with -1.8 kg (T2 and T1), P = 0.02] and WC reduction [-5.4 (T3) compared with -3.0 (T2) and -2.9 cm (T1), P = 0.01]. Total body fat and trunk fat reductions were similarly greater in T3 than in T2.

CONCLUSIONS

Increasing healthful food variety in energy-restricted diets may improve sustained reductions in weight and adiposity among adults with overweight or obesity on weight-loss regimens. This trial is registered at clinicaltrials.gov as NCT00072995.

The concept of low glycemic index and glycemic load foods as panacea for type 2 diabetes mellitus; prospects, challenges and solutions

BACKGROUND

This article examines the concepts of low glycemic indices (GIs) and glycemic load (GL) foods as key drivers in the dietary management of type 2 diabetes as well as their shortcomings. The controversies arising from the analysis of glycemic index (GI) and GL of foods such as their reproducibility as well as their relevance to the dietary management of type 2 diabetes are also discussed.

METHODS

Search was conducted in relevant electronic databases such as: Pubmed, Google Scholar, HINARI, the Cochrane library, Popline, LILACS, CINAHL, EMBASE, etc to identify the current status of knowledge regarding the controversies surrounding management of diabetes with low GI and GL foods.

CONCLUSION

This article suggests that in view of discrepancies that surround the results of GI versus GL of foods, any assay on the GI and GL of a food with the aim of recommending the food for the dietary management of type 2 diabetes, could be balanced with glycated hemoglobin assays before they are adopted as useful antidiabetic foods.

The association between BMI development among young children and (un)healthy food choices in response to food advertisements: a longitudinal study

Background

Previous studies have focused on the acute effects of food advertisements on the caloric intake of children; however, the long-term effects of this food cue reactivity on weight gain have not been examined. The main aim of this study was to explore if reactivity to food cues in an advertisement was associated with weight status two years later.

Methods

Children wo had previously taken part in an experiment investigating the impact of advergames on food intake had their height and weight re-measured two years later, for assessment of body mass index (BMI). A within-subject design was used to test the associations between food choices and BMI over time. In the previous experiment, children played an advergame that promoted energy-dense snacks, fruit, or nonfood products, or did not play an advergame (control condition). After playing the game, the free intake of energy-dense snacks and fruits was measured.

Results

Children who ate more apple after playing an advergame promoting energy-dense snacks had a lower BMI two years later. Consumption of energy-dense snacks after playing an advergame promoting energy-dense snacks was not associated with BMI two years later. In other condition, no association was found between food intake and BMI after two years .

Conclusions

The findings suggest that coping with environmental cues that trigger unhealthy eating behavior is associated with the body mass index of young children two years later. This might imply that learning to respond to food cues by choosing healthy options might prevent children from excessive weight gain.

This trial was registered at as ISRCTN17013832.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-016-0340-7) contains supplementary material, which is available to authorized users.