A prospective study of whole-grain intake and risk of type 2 diabetes mellitus in US women

Effect of quinoa (Chenopodium quinoa W.) flour supplementation in breads on the lipid profile and glycemic index: an in vivo study

Quinoa is a gluten-free pseudocereal, with an excellent nutrient profile containing considerable amounts of fiber and minerals and rich in antioxidants such as polyphenols. The purpose of this research was to investigate the effects of quinoa bread on physical, chemical, bioactive components, glycaemic index (GI), and biochemical parameters. Human subjects aged between 20 and 50 years with the absence of morbid factors were fed daily with quinoa bread for 3 months in order to study its pre-and post-treatment effects on blood glucose, glycosylated haemoglobin, and lipid profile. The effort was made to incorporate the maximum amount of quinoa into the bread without compromising the acceptability of the bread. Of the 14 formulations, TQ13, containing 20% quinoa flour with 3% wheat bran, was selected for further analysis. The GI study revealed that quinoa bread peaked at 45 min with a gradual increase after ingestion of the bread and a steady decline thereafter. The observed value for blood glucose levels, before and after supplementation with quinoa-incorporated bread, was 86.96 ± 15.32 mg/dL and 84.25 ± 18.26 mg/dL, respectively. There was a statistically significant (p ≤ 0.05) decrease in levels of triglycerides, total cholesterol, low-density lipoprotein (LDL), and very-LDL (VLDL) level before and after supplementation. However, non-significant changes were observed for high-density lipoprotein levels from the pre- and post-treatment with the quinoa-incorporated bread. Quinoa-incorporated bread possessed low GI (42.00 ± 0.83) compared to control (69.20 ± 1.84) and long-term consumption proved to contain functional efficacies in terms of hypolipidemic effect.

Cardioprotective role of a magnolol and honokiol complex in the prevention of doxorubicin-mediated cardiotoxicity in adult rats

Doxorubicin (DOXO) induces marked cardiotoxicity, though increased oxidative stress while there are some documents related with cardioprotective effects of some antioxidants against organ-toxicity during cancer treatment. Although magnolia bark has some antioxidant-like effects, its action in DOXO-induced heart dysfunction has not be shown clearly. Therefore, here, we aimed to investigate the cardioprotective action of a magnolia bark extract with active component magnolol and honokiol complex (MAHOC; 100 mg/kg) in DOXO-treated rat hearts. One group of adult male Wistar rats was injected with DOXO (DOXO-group; a cumulative dose of 15 mg/kg in 2-week) or saline (CON-group). One group of DOXO-treated rats was administered with MAHOC before DOXO (Pre-MAHOC group; 2-week) while another group was administered with MAHOC following the 2-week DOXO (Post-MAHOC group). MAHOC administration, before or after DOXO, provided full survival of animals during 12-14 weeks, and significant recoveries in the systemic parameters of animals such as plasma levels of manganese and zinc, total oxidant and antioxidant statuses, and also systolic and diastolic blood pressures. This treatment also significantly improved heart function including recoveries in end-diastolic volume, left ventricular end-systolic volume, heart rate, cardiac output, and prolonged P-wave duration. Furthermore, the MAHOC administrations improved the structure of left ventricles such as recoveries in loss of myofibrils, degenerative nuclear changes, fragmentation of cardiomyocytes, and interstitial edema. Biochemical analysis in the heart tissues provided the important cardioprotective effect of MAHOC on the redox regulation of the heart, such as improvements in activities of glutathione peroxidase and glutathione reductase, and oxygen radical-absorbing capacity of the heart together with recoveries in other systemic parameters of animals, while all of these benefits were observed in the Pre-MAHOC treatment group, more prominently. Overall, one can point out the beneficial antioxidant effects of MAHOC in chronic heart diseases as a supporting and complementing agent to the conventional therapies.

Association of Whole Grain Consumption and Cognitive Decline: An Investigation From a Community-Based Biracial Cohort of Older Adults

BACKGROUND AND OBJECTIVES

To examine the association of whole grain consumption and longitudinal change in global cognition, perceptual speed, and episodic memory by different race/ethnicity.

METHODS

We included 3,326 participants from the Chicago Health and Aging Project who responded to a Food Frequency Questionnaire (FFQ), with 2 or more cognitive assessments. Global cognition was assessed using a composite score of episodic memory, perceptual speed, and the Mini Mental State Examination (MMSE). Diet was assessed by a 144-item FFQ. Linear mixed-effects models were used to estimate the association of intakes of whole grains and cognitive decline.

RESULTS

This study involved 3,326 participants (60.1% African American [AA], 63.7% female) with a mean age of 75 years at baseline and a mean follow-up of 6.1 years. Higher consumption of whole grains was associated with a slower rate of global cognitive decline. Among AA participants, those in the highest quintile of whole grain consumption had a slower rate of decline in global cognition (β = 0.024, 95% CI [0.008-0.039], p = 0.004), perceptual speed (β = 0.023, 95% CI [0.007-0.040], p = 0.005), and episodic memory (β = 0.028, 95% CI [0.005-0.050], p = 0.01) compared with those on the lowest quintile. Regarding the amount consumed, in AA participants, those who consumed >3 servings/d vs those who consumed <1 serving/d had a slower rate of decline in global cognition (β = 0.021, 95% CI [0.005-0.036], p = 0.0093). In White participants, with >3 servings/d, we found a suggestive association of whole grains with global cognitive decline when compared with those who consumed <1 serving/d (β = 0.025, 95% CI [-0.003 to 0.053], p = 0.08).

DISCUSSION

Among AA participants, individuals with higher consumption of whole grains and more frequent consumption of whole grain had slower decline in global cognition, perceptual speed, and episodic memory. We did not see a similar trend in White adults.

FODMAPs-Unknowns for Consumers: First Survey in Serbia

According to unofficial data, every fifth person in Serbia suffers from some form of irritable bowel syndrome (IBS). Compounds classified as FODMAPs (Fermentable Oligo-, Di-, and Monosaccharides and Polyols) are newly found potential triggers of IBS and a number of associated gastrointestinal disorders. Cereals, predominantly in their wholegrain form, represent the key contributors to the high contents of FODMAPs in wholegrain (high-fiber) bakery products. The current work was structured in a way to systematically evaluate the consumer's knowledge and preferences toward wholegrain and low-FODMAP bakery products. The questionnaire was filled out by 725 respondents, aged from 18 to 86 years. They were informed about the aim of the research and management of anonymous data. The present study is the first detailed survey in this region of Europe, aiming to improve the familiarity with and attitude toward FODMAPs and a low-FODMAP diet by analyzing the different dietary habits regarding wholegrain-cereal-based products among consumers of various ages, genders, places of residence, and education. The results suggest that the respondents are, to some degree, aware of the health benefits of consuming foods with high fiber content while indicating a low level of knowledge about FODMAP compounds and connected topics. Education about contemporary scientific findings and the potentially harmful effects of consuming FODMAP compounds for a population with gastrointestinal disorders and diseases will be imperative in the future.

New Advances in Metabolic Syndrome, from Prevention to Treatment: The Role of Diet and Food

The definition of metabolic syndrome (MetS) has undergone several changes over the years due to the difficulty in establishing universal criteria for it. Underlying the disorders related to MetS is almost invariably a pro-inflammatory state related to altered glucose metabolism, which could lead to elevated cardiovascular risk. Indeed, the complications closely related to MetS are cardiovascular diseases (CVDs) and type 2 diabetes (T2D). It has been observed that the predisposition to metabolic syndrome is modulated by complex interactions between human microbiota, genetic factors, and diet. This review provides a summary of the last decade of literature related to three principal aspects of MetS: (i) the syndrome's definition and classification, pathophysiology, and treatment approaches; (ii) prediction and diagnosis underlying the biomarkers identified by means of advanced methodologies (NMR, LC/GC-MS, and LC, LC-MS); and (iii) the role of foods and food components in prevention and/or treatment of MetS, demonstrating a possible role of specific foods intake in the development of MetS.

Association between whole-grain intake and myopia in chinese children: a cross-sectional epidemiological study

BACKGROUND

Nutritional status influences the growth and development of the eyes. However, there are few studies on the association between diet, especially whole grains (WG) consumption, and myopia. The study aimed to evaluate the association between WG intake and myopia prevalence among primary school-age children in China.

METHODS

This cross-sectional epidemiological study conducted between November 2019 and December 2019 included 586 children, aged 6-12 years, attending primary school in Binhai district, Tianjin, China. Ophthalmologic examinations and optometric cycloplegic refraction measurements were conducted. Information was collected on known risks and protective factors for myopia and the consumption of WGs, vegetables, and fruits. This association between the probability of myopia and the proportion of WG consumption (WG proportion was calculated as the mean intake from WG sources divided by total grain intake), adjusted for protective and risk factors, was analysed using crude and multivariable logistic regression.

RESULTS

Among the study participants, 226/586 (38.57%) children had myopia in at least one eye. WG intake was inversely correlated with the prevalence of myopia. Furthermore, in the multivariate analysis, WG intake of > 50% was identified as a protective factor against myopia after subsequent adjustment for children's age, sex, parental myopia, near-work activity, screen time, reading and writing habits, visual fatigue, outdoor time, and classroom light environment (all P < 0.05).

CONCLUSION

WG intake (> 50%) was an independent protective factor against myopia. Modifying the form of grains consumed (whole versus refined) could be one of the targets of future public health measures.

Parkinson's Disease and Sugar Intake-Reasons for and Consequences of a Still Unclear Craving

Lately, studies have shown that patients with Parkinson’s disease (PD) report a strong craving for sweets and consume significantly more fast-acting carbohydrates than healthy controls. Consuming food with a high-sugar content is assumed to lead to an increase in insulin concentration, which could positively influence dopamine concentration in the brain and unconsciously be used by patients as kind of “self-medication” to compensate for a lack of dopamine in PD. On the other hand, high-sugar intake could also lead to insulin resistance and diabetes, which is discussed as a causative factor for progressive neurodegeneration in PD. In this critical appraisal, we discuss the role of sugar intake and insulin on dopamine metabolism in patients with PD and how this could influence the potential neurodegeneration mediated by insulin resistance.

Phytochemical Components and Human Health Effects of Old versus Modern Italian Wheat Varieties: The Case of Durum Wheat Senatore Cappelli

The Mediterranean diet has significant beneficial health effects and wheat is a major component of the Mediterranean diet, mainly in the form of bread and pasta. Modern wheat generally refers to varieties that were developed after the introduction of dwarfing genes in the 1950s, while old varieties are considered those developed before that time. Research findings on Italian wheat varieties showed that the total polyphenol content in both old and modern durum and soft wheat varieties are similar; but the old varieties have a higher number of polyphenols and of isomer forms. In particular, the durum wheat Senatore Cappelli genotype shows a very high variety of polyphenolic components. Recent studies have demonstrated healthy cardiovascular effects (favorable changes of atherosclerosis markers such as lipid parameters and hemorheological variables) as well as a marked reduction in gastrointestinal and extra-intestinal symptoms in non-celiac gluten sensitivity subjects with the consumption of pasta obtained by old durum wheat Senatore Cappelli variety, even though this type of wheat contains high amounts of gluten. In conclusion, old wheat Italian varieties, and in particular the Senatore Cappelli genotype, are characterized by multiple nutraceutical specificities that could suggest their use for health-promoting purposes. Additional research is needed to confirm these findings, focusing attention also on the effect of different environments and years.

Oxidative stress in the pathophysiology of type 2 diabetes and related complications: Current therapeutics strategies and future perspectives

Type 2 diabetes (T2DM) is a persistent metabolic disorder rising rapidly worldwide. It is characterized by pancreatic insulin resistance and β-cell dysfunction. Hyperglycemia induced reactive oxygen species (ROS) production and oxidative stress are correlated with the pathogenesis and progression of this metabolic disease. To counteract the harmful effects of ROS, endogenous antioxidants of the body or exogenous antioxidants neutralise it and maintain bodily homeostasis. Under hyperglycemic conditions, the imbalance between the cellular antioxidant system and ROS production results in oxidative stress, which subsequently results in the development of diabetes. These ROS are produced in the endoplasmic reticulum, phagocytic cells and peroxisomes, with the mitochondrial electron transport chain (ETC) playing a pivotal role. The exacerbated ROS production can directly cause structural and functional modifications in proteins, lipids and nucleic acids. It also modulates several intracellular signaling pathways that lead to insulin resistance and impairment of β-cell function. In addition, the hyperglycemia-induced ROS production contributes to micro- and macro-vascular diabetic complications. Various in-vivo and in-vitro studies have demonstrated the anti-oxidative effects of natural products and their derived bioactive compounds. However, there is conflicting clinical evidence on the beneficial effects of these antioxidant therapies in diabetes prevention. This review article focused on the multifaceted role of oxidative stress caused by ROS overproduction in diabetes and related complications and possible antioxidative therapeutic strategies targeting ROS in this disease.

Overview of the Composition of Whole Grains’ Phenolic Acids and Dietary Fibre and Their Effect on Chronic Non-Communicable Diseases

Chronic non-communicable diseases are the major cause of death globally. Whole grains are recommended in dietary guidelines worldwide due to increasing evidence that their consumption can improve health beyond just providing energy and nutrients. Epidemiological studies have suggested that the incorporation of whole grains, as part of a healthy diet, plays a key role in reducing one’s risk for cardiovascular diseases (CVDs), obesity, type 2 diabetes (T2D) and cancer. Phenolic acids and dietary fibre are important components found in whole grains that are largely responsible for these health advantages. Both phenolic acids and dietary fibre, which are predominantly present in the bran layer, are abundant in whole-grain cereals and pseudo-cereals. Several studies indicate that whole grain dietary fibre and phenolic acids are linked to health regulation. The main focus of this study is two-fold. First, we provide an overview of phenolic acids and dietary fibres found in whole grains (wheat, barley, oats, rice and buckwheat). Second, we review existing literature on the linkages between the consumption of whole grains and the development of the following chronic non-communicable diseases: CVDs, obesity, T2D and cancer. Altogether, scientific evidence that the intake of whole grains reduces the risk of certain chronic non-communicable disease is encouraging but not convincing. Based on previous studies, the current review encourages further research to cover the gap between the emerging science of whole grains and human health.

Insights of Nutritional and Anti-nutritional Retention in Traditionally Processed Millets

Millets are nutritionally superior indigenous staple crops packed with high protein, vitamins, and minerals. However, anti-nutrients such as phytic acid, tannins, and polyphenols present in the millets tend to reduce the bio-accessibility of minerals (iron and zinc), due to which the millet diets are greatly compromised. Although most of the cereals, such as wheat flour, brown rice, and barley, contain phytic acid to a level far more than that of the millets, it is important to develop feasible household methods to reduce the level of phytic acid so as to enhance nutrient absorption. The present study was carried out to investigate the effect of traditional processing on nutrient and anti-nutrient retention of three majorly consumed millets, namely, sorghum, finger millet, and pearl millet. These millets were traditionally cooked and then fermented overnight with water and curd. The results show that this type of simple, traditional household-level process significantly reduced the phytic acid content by 62.9% in sorghum, 34.1% in finger millet, and 29.35% in pearl millet. There is a considerable decrease in phytic acid–zinc molar ratio by 71.38, 61.15, and 33.47% and in phytic acid–iron molar ratio by 73.52, 48.07, and 66.39% in sorghum, finger millet, and pearl millet, respectively. Among the macronutrients, the protein and ash contents were significantly increased. A high retention of water-soluble vitamins was observed in the processed millets. Overall, the traditionally cooked millet, fermented overnight and then added with curd, enhanced many essential macro- and micronutrients and concurrently reduced phytic acid, thus forming a sustainably simple household method for improving dietary nutrients.

Diabetic neuropathy: an insight on the transition from synthetic drugs to herbal therapies

The global pandemic of prediabetes and diabetes has led to a severe corresponding complication of these disorders. Neuropathy is one of the most prevalent complication of diabetes is, affecting blood supply of the peripheral nervous system that may eventually results into loss of sensations, injuries, diabetic foot and death. The utmost identified risk of diabetic neuropathy is uncontrolled high blood glucose levels. However, aging, body mass index (BMI), oxidative stress, inflammation, increased HbA1c levels and blood pressure are among the other key factors involved in the upsurge of this disease. The so far treatment to deal with diabetic neuropathy is controlling metabolic glucose levels. Apart from this, drugs like reactive oxygen species (ROS) inhibitors, aldose reductase inhibitors, PKC inhibitors, Serotonin-norepinephrine reuptake inhibitors (SNRIs), anticonvulsants, N-methyl-D-aspartate receptor (NMDAR) antagonists, are the other prescribed medications. However, the related side-effects (hallucinations, drowsiness, memory deficits), cost, poor pharmacokinetics and drug resistance brought the trust of patients down and thus herbal renaissance is occurring all over the word as the people have shifted their intentions from synthetic drugs to herbal remedies. Medicinal plants have widely been utilized as herbal remedies against number of ailments in Indian medicinal history. Their bioactive components are very much potent to handle different chronic disorders and complications with lesser-known side effects. Therefore, the current article mainly concludes the etiology and pathophysiology of diabetic neuropathy. Furthermore, it also highlights the important roles of medicinal plants and their naturally occurring bioactive compounds in addressing this disease.

The association between low-carbohydrate diet score and metabolic syndrome among Iranian adults

OBJECTIVE

Assessing the relationship between low-carbohydrate diet (LCD) score and metabolic syndrome (Mets) in Iranian adults.

DESIGN

Cross-sectional study.

SETTING

Yazd Health Study and Taghzieh Mardom-e-Yazd study.

PARTICIPANTS

Data of 2074 participants were used. Dietary intakes were assessed by a validated semi-quantitative FFQ. LCD score was calculated for each person by summing up the assigned scores to deciles of energy percentages from macronutrients. Mets was evaluated using National Cholesterol Education Program Adult Treatment Panel III. Eventually, association between LCD score and Mets was examined using logistic regression.

RESULTS

Total Mets prevalence was approximately 40·5 %. After adjustment for confounders, subjects in the higher quartile of LCD score had a significant lower chance of Mets than lower quartile among all participants (Q4 v. Q1: OR: 0·68, 95 % CI (0·50, 0·92)) and separately in men (Q4 v. Q1: OR: 0·54, 95 % CI (0·34, 0·86)) and women (Q2 v. Q1: OR: 0·53, 95 % CI (0·34, 0·82)). Furthermore, more LCD adherence in men reduced abdominal obesity by 47 % (Q3 v. Q1: OR: 0·53, 95 % CI (0·28, 0·99)). A significant inverse relation was also observed between low HDL cholesterol and LCD score in all participants (Q4 versus Q1 OR: 0·74, 95% CI: 0·56-0·99) and separately in men (Q4 versus Q1 OR: 0·63, 95% CI: 0·40-0·98).

CONCLUSIONS

More adherence to LCD might be related to lower chance of Mets and some of its components such as low HDL-cholesterol and abdominal obesity specially in men. Further studies are required to confirm the findings.

Effect of grinding and extraction conditions on the determination of antioxidant activity and phenolic acids in barley

In the present study, the objective was to evaluate the effects of barley kernel size, grind level, and extract solvent on the antioxidant activities associated with total phenolic content and phenolic acid compositions. Three barley varieties (Kindred, Azure, and Tradition), were used and the results showed that with the exception of superoxide anion radical scavenging activity, thin kernel size fraction (2.0 mm) showed much higher antioxidant activities and total phenolic content than those in the 2.4 mm and 2.8 mm fractions when averaged across barley cultivar, grind level, and extract solvent. A similar trend was found for individual phenolic acid compositions among kernel sizes. Simple correlation analysis revealed that total phenolic content showed strong correlation with DPPH· scavenging activity, ABTS + scavenging activity, and reducing power. Generally, fine grind and 80% acetone extract showed averaged highest values in antioxidant activities, total phenolic content, and individual phenolic acid compositions. Stepwise linear regression showed that extract solvent was the most important factor for DPPH· scavenging activity, ABTS + scavenging activity, reducing power, and iron chelating activity. The sum of syringic acid and caffeic acid exhibited a dominant role in explaining the major variation in antioxidant activities except for superoxide anion radical scavenging activity.

Oat Intake and Risk of Type 2 Diabetes, Cardiovascular Disease and All-Cause Mortality: A Systematic Review and Meta-Analysis

Cardiovascular disease (CVD) and type 2 diabetes (T2D) remain the top disease and mortality burdens worldwide. Oats have been shown to benefit cardiovascular health and improve insulin resistance. However, the evidence linking oat consumption with CVD, T2D and all-cause mortality remains inconclusive. We conducted a comprehensive systematic review and meta-analysis of prospective cohort studies to evaluate the associations between oat consumption and risks of T2D, CVD and all-cause mortality in the general population. Five electronic databases were searched until September, 2020. Study specific relative risks (RR) were meta-analyzed using random effect models. Of 4686 relevant references, we included 9 articles, based on 8 unique studies and 471,157 participants. Comparing oat consumers versus non-consumers, RRs were 0.86 (95% CI 0.72–1.03) for T2D incidence and 0.73 (95% CI 0.5–1.07) for combined CVD incidence. Comparing participants with highest versus lowest oat intake, RRs were 0.78 (95% CI 0.74–0.82) for T2D incidence, 0.81 (95% CI 0.61–1.08) for CHD incidence and 0.79 (95% CI 0.59–1.07) for stroke. For all-cause mortality one study based on three cohorts found RR for men and women were 0.76 (95% CI 0.69–0.85) and 0.78 (95% CI 0.70–0.87), respectively. Most studies (n = 6) were of fair to good quality. This meta-analysis suggests that consumption of oat could reduce the risk for T2D and all-cause mortality, while no significant association was found for CVD. Future studies should address a lack of standardized methods in assessing overall oat intake and type of oat products, and investigate a dose-dependent response of oat products on cardiometabolic outcomes in order to introduce oat as preventive and treatment options for the public.

Associations of Whole Grain and Refined Grain Consumption With Metabolic Syndrome. A Meta-Analysis of Observational Studies

Background: The associations of whole grain and refined grain consumption with metabolic syndrome (MetS) has been evaluated in several epidemiological studies with conflicting results. This meta-analysis was therefore employed to further investigate the above associations. Method: We searched the PubMed, Web of Science and Embase database until March 2021 (without restriction for inclusion time), for observational studies on the associations of whole grain and refined grain consumption with MetS. The pooled relative risk (RR) of MetS for the highest vs. lowest category of whole grain and refined grain consumption, as well as their corresponding 95% confidence interval (CI) were calculated. Results: A total of 14 observational studies, which involved seven cross-sectional and seven prospective cohort studies, were identified. Specifically, nine studies were related to whole grain consumption, and the overall multi-variable adjusted RR demonstrated that the whole grain consumption was inversely associated with MetS (RR = 0.80, 95%CI: 0.67-0.97; P = 0.021). With regard to refined grain consumption, 13 studies were included. The overall multi-variable adjusted RR indicated that refined grain consumption was positively associated with MetS (RR = 1.37, 95%CI: 1.02-1.84; P = 0.036). Conclusions: The existing evidence suggests that whole grain consumption is negatively associated with MetS, whereas refined grain consumption is positively associated with MetS. Our result might be helpful to better consider the diet effect on MetS. However, more well-designed prospective cohort studies are needed to elaborate the concerned issues further.

Dietary Fibre Intake in Type 2 and New-Onset Prediabetes/Diabetes after Acute Pancreatitis: A Nested Cross-Sectional Study

The association between intake of dietary fibre and glucose metabolism has been extensively investigated in numerous metabolic disorders. However, little is known about this association in individuals after an attack of acute pancreatitis (AP). The aim was to investigate the associations between intake of dietary fibre and markers of glucose metabolism in individuals with new-onset prediabetes or diabetes after acute pancreatitis (NODAP), pre-exiting type 2 prediabetes or diabetes, and normoglycaemia after acute pancreatitis. This cross-sectional study was nested within the parent prospective longitudinal cohort study. The studied markers of glucose metabolism were fasting plasma glucose and glycated haemoglobin. Habitual intake of dietary fibre was determined using the EPIC-Norfolk food frequency questionnaire. Multivariable linear regression analyses were conducted. The study included a total of 108 individuals after AP. In the NODAP group, increased intakes of total fibre (β = −0.154, p = 0.006), insoluble fibre (β = −0.133, p = 0.01), and soluble fibre (β = −0.13, p = 0.02) were significantly associated with a reduction in fasting plasma glucose. Increased intakes of vegetables (β = −0.069, p = 0.004) and nuts (β = −0.039, p = 0.038) were significantly associated with a reduction in fasting plasma glucose. Increased intake of nuts (β = −0.054, p = 0.001) was also significantly associated with a reduction in glycated haemoglobin. None of the above associations were significant in the other study groups. Habitual intake of dietary fibre was inversely associated with fasting plasma glucose in individuals with NODAP. Individuals after an attack of AP may benefit from increasing their intake of dietary fibre (specifically, vegetables and nuts) with a view to preventing NODAP.

Whole Grains, Refined Grains, and Cancer Risk: A Systematic Review of Meta-Analyses of Observational Studies

PubMed, Web of Science, and the Cochrane Database of Systematic Reviews were searched for meta-analyses that provided risk estimates (±95% confidence intervals) for associations between intakes of whole and refined grains and risk of total and site-specific cancer. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed. Only meta-analyses that included whole grains and refined grains as separate food groups, and not as part of dietary patterns, were included. A total of 17 publications were identified that met inclusion criteria. Within these, results from a total of 54 distinct meta-analyses were reported for whole grains and 5 meta-analyses for refined grains. For total cancer mortality, 7 meta-analyses of cohort studies indicated that whole grain intake was associated with 6% to 12% lower risk in comparison of highest vs. lowest intake groups, and 3% to 20% lower risk for doses ranging from 15 to 90 g/day. For site-specific cancers, meta-analyses indicated that whole grain intake was consistently associated with lower risks of colorectal, colon, gastric, pancreatic, and esophageal cancers. Limited data were available for refined grains, with only 4 publications providing risk estimates, and only 1 of the meta-analyses included more than 3 studies. High intake of refined grains was associated with increased risk of colon and gastric cancer. By contrast, in the only dose-response meta-analysis, each 90 g/day consumption of refined grains was associated with a 6% lower risk of total cancer. In addition to the limited number of published meta-analyses on refined grains, results were also weakened due to the fact that refined grains were frequently defined to include both staple grain foods and indulgent grain foods, and the majority of studies included in the meta-analyses provided no specific definition of refined grains. Overall, meta-analyses of cohort and case-control studies consistently demonstrate that whole grain intake is associated with lower risk of total and site-specific cancer, and support current dietary recommendations to increase whole grain consumption. By contrast, the relationship between refined grain intake and cancer risk is inconclusive.

Whole Grain Intake and Impaired Fasting Glucose in Adolescents, National Health and Nutrition Examination Survey, 2005-2014

INTRODUCTION

Large prospective cohort studies show a lower risk of developing type 2 diabetes among adults with higher whole grain consumption. Less is known about the relationship between whole grain consumption and precursors for diabetes risk in adolescents. We examined whether intake of whole grains was associated with impaired fasting glucose (IFG) in adolescents.

METHODS

We analyzed data on dietary intake from an average of two 24-hour diet recalls from fasting, nondiabetic adolescents aged 12-18 years (N = 2,286) across 5 cycles of the National Health and Nutrition Examination Survey (NHANES 2005-2014). We used logistic regression to calculate the odds of having IFG (100-125 mg/dL) with respect to servings of whole and refined grains, as well as percentage of whole grains, adjusting for sex, age, race/ethnicity, annual household income, obesity, total energy, and diet quality.

RESULTS

IFG was present in 17% of participants. After adjusting for covariates, number of servings per day of whole grains was significantly associated with lower odds of IFG, but there was no relationship between IFG and servings of refined grains or percentage of whole grains. Consuming at least 1 ounce-equivalent serving (16 g) of whole grains daily, compared with consuming no whole grains, was associated with a 40% reduction in the adjusted odds of having IFG (adjusted odds ratio = 0.60; 95% CI, 0.38-0.93).

CONCLUSION

Analysis of 10 years of national cross-sectional data suggests that US adolescents whose daily diets consist of a minimum threshold amount of whole grains may be less likely to have IFG, a finding that has implications for diabetes prevention in adolescents.

Do Refined Grains Have a Place in a Healthy Dietary Pattern: Perspectives from an Expert Panel Consensus Meeting

Although dietary guidance recommends increasing consumption of whole grains and concurrently limiting consumption of refined and/or enriched grain foods, emerging research suggests that certain refined grains may be part of a healthy dietary pattern. A scientific expert panel was convened to review published data since the release of 2015 dietary guidance in defined areas of grain research, which included nutrient intakes, diet quality, enrichment/fortification, and associations with weight-related outcomes. Based on a 1-d roundtable discussion, the expert panel reached consensus that 1) whole grains and refined grains can make meaningful nutrient contributions to dietary patterns, 2) whole and refined grain foods contribute nutrient density, 3) fortification and enrichment of grains remain vital in delivering nutrient adequacy in the American diet, 4) there is inconclusive scientific evidence that refined grain foods are linked to overweight and obesity, and 5) gaps exist in the scientific literature with regard to grain foods and health.

Is frequency of potato and white rice consumption associated with cardiometabolic risk factors in children and adolescents: the CASPIAN-V study

Background

This study evaluated the association of frequency of potato and rice consumption with cardiometabolic risk factors in children and adolescents.

Methods

This nationwide cross-sectional survey was conducted on 14,400 children and adolescents. Fasting blood was obtained from a sub-sample of 4200 randomly selected students. Physical examination and laboratory tests were conducted under standard protocols. Metabolic Syndrome (Mets) was defined based on the Adult Treatment Panel III criteria modified for the pediatric age group. The self-reported frequency consumption of white rice and potato was reported on a daily or non-daily basis.

Results

The participation rate for the whole study and for blood sampling were 99 and 91.5%, respectively. Overall, 49.4% of the participants were girls while 50.6% were boys. The frequency of daily consumption of white rice and potato was 84.4 and 21.3%, respectively. In the multivariable linear regression model, daily consumption of potato increased body mass index (β: 0.05, SE: 0.20, p = 0.010), waist (β: 0.63, SE: 0.24, p = 0.008), and hip circumferences (β: 0.62, SE: 0.26, p = 0.019). Moreover, in the multivariable logistic regression, daily consumption of potato was significantly associated with an increased risk of overweight (OR: 1.21, 95% CI: 1.04–1.39, P = 0.012). The potato and rice consumption had no statistically significant association with other cardiometabolic risk factors.

Conclusions

Daily consumption of potato was significantly associated with higher anthropometric measures, whereas rice consumption had no statistically significant association with cardiometabolic risk factors. Future research to examine the possible obesogenic effects of intake of potato on children and adolescents is recommended.

Assessment of a medication management program targeting hypertension and diabetes patients: Impact on medication adherence

BACKGROUND

The National Health Insurance Service in South Korea has conducted a telephone outreach program to improve medication adherence for hypertension and diabetes patients since 2014.

OBJECTIVES

To evaluate the direct outcomes of the program.

METHODS

Patients were identified among those who visited an outpatient clinic at least twice or used an inpatient service at least once for hypertension or diabetes during 6-month intervals and who were nonadherent based on the proportion of days covered (PDC) calculated. As a preliminary intervention, participants were mailed an information leaflet on their own medication adherence and other tips for effective self-management of chronic diseases. For the intervention, two phone calls and three phone messages were made to patients by 24 participating regional offices. Ultimately, 2,428 hypertension patients and 884 diabetes patients received the intervention. Propensity matching was used based on age, sex, and the Charlson Comorbidity Index to select 12,140 hypertension and 4,420 diabetes patients as controls in the non-participating regions. The outcome was PDC. Multivariate ordinary least squares or logistic regression analysis were used with difference-in-difference specification.

RESULTS

The adjusted quarterly PDC increased by 1.96%p for hypertension (p = 0.023) and by 7.79%p for diabetes patients (p < 0.001). Approximately 40.6% and 51.7% of hypertension and diabetes patients in the treatment arm (p = 0.0069) became adherent after the intervention, whereas the corresponding proportions were 37.7% and 41.4% (p < 0.001) in the control group. Both treatment groups showed a higher likelihood of good medication adherence (hypertension: odds ratio = 1.157, 95% CI [1.058, 1.265]; diabetes: odds ratio = 1.532, 95% CI [1.323, 1.774]). The control group, who received only a print intervention with a mailed leaflet, also showed a dramatic increase in medication adherence.

CONCLUSIONS

An insurer-coordinated telephone-administered program resulted in improvement of medication adherence among patients with hypertension and diabetes.

Association of magnesium intake with type 2 diabetes and total stroke: an updated systematic review and meta-analysis

OBJECTIVE

The detailed associations between type 2 diabetes (T2D) and total stroke and magnesium intake as well as the dose-response trend should be updated in a timely manner.

DESIGN

Systematic review and meta-analyses.

DATA SOURCES

PubMed, Embase, Cochrane Library, Web of Science and ClinicalTrials.gov were rigorously searched from inception to 15 March 2019.

ELIGIBILITY CRITERIA

Prospective cohort studies investigating these two diseases were included.

DATA SYNTHESIS

Relative risk (RR) and 95% CI in random effects models as well as absolute risk (AR) were pooled to calculate the risk of T2D and stroke. Methodological quality was assessed by the Newcastle-Ottawa Scale.

RESULTS

Forty-one studies involving 53 cohorts were included. The magnitude of the risk was significantly reduced by 22% for T2D (RR 0.78 (95% CI 0.75 to 0.81); p<0.001; AR reduction 0.120%), 11% for total stroke (RR 0.89 (95% CI 0.83 to 0.94); p<0.001; AR reduction 0.281%) and 12% for ischaemic stroke (RR 0.88 (95% CI 0.81 to 0.95); p=0.001; AR reduction 0.246%) when comparing the highest magnesium intake to the lowest. The inverse association still existed when studies on T2D were adjusted for cereal fibre (RR 0.79; p<0.001) and those on total stroke were adjusted for calcium (RR 0.89; p=0.040). Subgroup analyses suggested that the risk for total and ischaemic stroke was significantly decreased in females, participants with ≥25 mg/m² body mass index and those with ≥12-year follow-up; the reduced risk in Asians was not as notable as that in North American and European populations.

CONCLUSIONS

Magnesium intake has significantly inverse associations with T2D and total stroke in a dose-dependent manner. Feasible magnesium-rich dietary patterns may be highly beneficial for specific populations and could be highlighted in the primary T2D and total stroke prevention strategies disseminated to the public.

PROSPERO REGISTRATION NUMBER

CRD42018092690.

Grain Subtype and the Combination of Grains Consumed Are Associated with the Risk of Metabolic Syndrome: Analysis of a Community-Based Prospective Cohort

BACKGROUND

Evidence on the prospective association between grain consumption and metabolic syndrome (MetS) is lacking.

OBJECTIVE

This study explored the association between grain intake by subtype or various combinations of grain intake and the risk of developing MetS in South Korean adults using data from a community-based prospective cohort study.

METHODS

A total of 5717 participants (2984 men and 2733 women) aged 40-69 y without MetS were followed up for 10 y (2001-2012). Grain consumption was assessed using a semiquantitative FFQ at baseline (2001-2002) and a follow-up examination (2005-2006). A multivariate Cox proportional hazards model was used to examine the risk of incident MetS and its components according to grain consumption (<1, 1 to <3, or ≥3 servings/d) by sex.

RESULTS

In total, 2218 participants (38.8%) developed MetS. Frequent consumers of whole grains (≥3 servings/d) had a lower risk of incident MetS (men-HR: 0.51; 95% CI: 0.41, 0.63; P  = 0.0001; women-HR: 0.73; 95% CI: 0.60, 0.90; P = 0.0029), whereas frequent consumers of refined grains had a higher risk of incident MetS (men-HR: 1.63; 95% CI: 1.31, 2.03; P < 0.0001; women-HR: 2.25; 95% CI: 1.82, 2.78; P < 0.0001) compared with rare consumers (<1 serving/d). The combination of low whole grains (<2 servings/d) and high refined grains (≥2 servings/d) was associated with a higher risk of MetS than the combination of high whole grains and low refined grains (men-HR: 1.21; 95% CI: 1.04, 1.41; P = 0.012; women-HR: 1.43; 95% CI: 1.23, 1.66; P < 0.0001).

CONCLUSIONS

Higher consumption of whole grains was associated with lower risk of incident MetS, whereas higher refined-grain consumption was associated with a higher risk in a middle-aged and older Korean population.

Rice Intake and Emerging Concerns on Arsenic in Rice: a Review of the Human Evidence and Methodologic Challenges

PURPOSE OF REVIEW

Rice is a major staple food worldwide and a dietary source of arsenic. We therefore summarized the state of the epidemiologic evidence on whether rice consumption relates to health outcomes associated with arsenic exposure.

RECENT FINDINGS

While epidemiologic studies have reported that higher rice consumption may increase the risk of certain chronic conditions, i.e., type 2 diabetes, most did not consider specific constituents of rice or other sources of arsenic exposure. Studies that examined rice intake stratified by water concentrations of arsenic found evidence of increasing trends in cardiovascular disease risk, skin lesions, and squamous cell skin cancers and bladder cancer associated with higher rice consumption. Further studies are needed to understand the health impacts of arsenic exposure from rice consumption taking into account all sources of rice intake and potential confounding by other dietary constituents or contaminants and arsenic exposure from sources such as water.

Multiple health and environmental impacts of foods

Dietary choices are a leading global cause of mortality and environmental degradation and threaten the attainability of the UN’s Sustainable Development Goals and the Paris Climate Agreement. To inform decision making and to better identify the multifaceted health and environmental impacts of dietary choices, we describe how consuming 15 different food groups is associated with 5 health outcomes and 5 aspects of environmental degradation. We find that foods associated with improved adult health also often have low environmental impacts, indicating that the same dietary transitions that would lower incidences of noncommunicable diseases would also help meet environmental sustainability targets.

Food choices are shifting globally in ways that are negatively affecting both human health and the environment. Here we consider how consuming an additional serving per day of each of 15 foods is associated with 5 health outcomes in adults and 5 aspects of agriculturally driven environmental degradation. We find that while there is substantial variation in the health outcomes of different foods, foods associated with a larger reduction in disease risk for one health outcome are often associated with larger reductions in disease risk for other health outcomes. Likewise, foods with lower impacts on one metric of environmental harm tend to have lower impacts on others. Additionally, of the foods associated with improved health (whole grain cereals, fruits, vegetables, legumes, nuts, olive oil, and fish), all except fish have among the lowest environmental impacts, and fish has markedly lower impacts than red meats and processed meats. Foods associated with the largest negative environmental impacts—unprocessed and processed red meat—are consistently associated with the largest increases in disease risk. Thus, dietary transitions toward greater consumption of healthier foods would generally improve environmental sustainability, although processed foods high in sugars harm health but can have relatively low environmental impacts. These findings could help consumers, policy makers, and food companies to better understand the multiple health and environmental implications of food choices.

Perspective: Refined Grains and Health: Genuine Risk, or Guilt by Association?

Refined grain intake is widely assumed to be associated with adverse health outcomes, including increased risk for cardiovascular disease (CVD), type 2 diabetes (T2D), and obesity. The 2015 Dietary Guidelines Advisory Committee recommended that to improve dietary quality, the US population should replace most refined grains with whole grains. This recommendation was based largely on results from studies that examined dietary patterns, not separate food groups. A Western dietary pattern typically includes red and processed meat, sugar-sweetened foods and beverages, French fries, and high-fat dairy products, as well as refined grains, and has been linked to increased risk of many chronic diseases. However, when evaluated as a distinct food category, 11 meta-analyses of prospective cohort studies, which included a total of 32 publications with data from 24 distinct cohorts, demonstrated that refined grain intake was not associated with all-cause mortality, T2D, CVD, coronary heart disease (CHD), stroke, hypertension, or cancer. By contrast, consumption of red and processed meat was consistently associated with increased risk of these same health outcomes. Refined grain consumption up to 6-7 servings/d (1 serving = 30 g) was not associated with higher risk of CHD, T2D, hypertension, or all-cause mortality. Moreover, total grain intake was not associated with risk of CVD, CHD, stroke, or cancer, but was associated with lower risk of all-cause mortality. Consequently, the recommendation to reduce refined grain intake based on results from studies linking a Western dietary pattern to numerous adverse health outcomes is contrary to a substantial body of published scientific evidence. Future research needs to better define refined grain intake to distinguish between staple grain foods and indulgent grain foods, and to better design randomized controlled trials to resolve discrepancies between results from observational studies and such trials with regard to determining the benefits of whole grains compared with refined grains.

Dietary intake and lifestyle behaviour in different phenotypes of polycystic ovarian syndrome: a case-control study

BACKGROUND

The present study aimed to compare dietary intake and lifestyle behaviour in women with polycystic ovarian syndrome (PCOS) and healthy women.

METHODS

One hundred and sixty healthy women (partner with male infertility) were recruited to a control group; 168 women with PCOS (diagnosed on ultrasound) were recruited to a case study group for this cross-sectional comparative study. The case group was classified into three phenotypes based on the presence or absence of menstrual disorder (M), hyperandrogenism (HA) and polycystic ovary according to sonography (PCO): HA+PCO (n = 53), PCO+M (n = 57) and M+HA+PCO (n = 66). Dietary intake and lifestyle behaviour were measured using a food frequency questionnaire and a lifestyle questionnaire.

RESULTS

The mean energy (P < 0.001) and fat (P < 0.001) intakes were greater in PCOS groups compared to the control group. The average energy and fat intakes were greater in HA+M+PCO group after age and body mass index (BMI) adjustment compared to the other phenotypes (P < 0.001). In comparison with the control group, lifestyle scores were lower in the PCOS group in the fields of physical activity, weight and nutrition control after age and BMI adjustment (P < 0.001). The average score of lifestyle in the fields of physical activity, weight and nutrition control, and psychological health was lower in the phenotype HA+M+PCO compared to the other phenotypes (P < 0.001).

CONCLUSIONS

A limited energy and fat intake is strongly recommended in Iranian women with PCOS, especially for phenotype HA+M+PCO. Consultation with respect to improvement of psychological health and the importance of weight and nutrition control, as well as appropriate physical activity, is advocated, especially in patients with phenotype HA+M+PCO.

Identification of risk factors affecting impaired glucose metabolism among the adult population of district Srinagar

BACKGROUND

The World has seen an emerging trend of diabetes among adolescents and moderately aged people over the last decade. The aim of the study was to identify the risk factors associated with impaired glucose metabolism and the prevalence of impaired glucose metabolism among the adult population of district Srinagar.

METHODS

Multi-stage cluster random sampling design was used and from each household, participants were selected using a Kish grid method. Socio-demographic and clinical data were collected. The participants were then subjected to fasting venous blood glucose estimation.

RESULTS

Age, waist circumference, hip circumference, weight, and body mass index were all statistically significant between normoglycemic participants and those with impaired glucose metabolism (p < 0.018). On logistic regression, subjects who had a higher BMI were more likely to develop Impaired glucose metabolism (OR = 3.52, OR 95% CI = 1.25-9.87); Moreover, consumption of carbonated drinks, (3-6 times/week OR = 4.40, OR 95% CI = 2.06-9.40; >6 times/week OR = 11.04, OR 95% CI = 0.86-140.66) was found to be a potential risk factor. Participants with a family history of diabetes were more susceptible to develop impaired glucose metabolism (OR = 6.41, OR 95% CI = 3.22-12.78). The risk effect of these factors was even stronger before adjusting for age, sex, family history of diabetes, and BMI in participants.

CONCLUSION

Risk factors for impaired glucose metabolism include increasing age, obesity, and higher consumption of carbonated drinks, hypertension, smoking behavior, high-calorie diet intake and positive family history of diabetes.

Adiposity mediates the association between whole grain consumption, glucose homeostasis and insulin resistance: findings from the US NHANES

Background

Growing evidence suggests an inverse association between whole grain (WG) consumption and insulin resistance (IR) or inflammation. However, it is still unclear whether adiposity plays a role in this relationship.

We investigated whether the associations between WG intake with IR, glucose homeostasis and inflammation are mediated by adiposity in US adults.

Methods

The 2005–2010 National Health and Nutrition Examination Surveys participants were included. WG intake was assessed and markers of IR and glucose homeostasis, inflammation, general and central adiposity. Analysis of co-variance and mediation analysis were applied, while accounting for survey design.

Results

Overall 16,621 participants were included in this analysis (mean age = 47.1 years, 48.3% men). After adjustment for age, gender, and race, mean C-reactive protein (CRP), apolipoprotein B (apo-B), fasting blood glucose (FBG), insulin, homeostatic model assessment of IR (HOMA-IR) and β cell function (HOMA-β), hemoglobin A_1c (HbA_1c), and 2 h glucose after an oral glucose tolerance test decreased with increasing quarters of WG (all p < 0.001). Body mass index (BMI) had significant mediation effects on the associations between WG intake and CRP, apo-B, fasting glucose, insulin, HOMA-IR, HOMA-B, HbA_1c, triglyceride to high density lipoprotein-cholesterol (TG:HDL-C) ratio and triglyceride-glucose (TyG) index (all p < 0.05) after adjustment for age, gender, race/ethnicity, educational status, smoking and level of physical activity. Both waist circumference (WC) and anthropometrically predicted visceral adipose tissue (apVAT) mediated the association between WG intakes with CRP, FBG, HbA_1c, TG:HDL-C ratio and TyG index, i.e. WC and apVAT had indirect effect (all p < 0.05).

Conclusion

Our findings provide insights into the favourable impact of WG consumption on IR and inflammation, which may be affected by both central and visceral adiposity, i.e. the link between WG with IR and inflammation is more mediated in overweight/obese compared with lean individuals.

Wholegrain Intake and Risk of Type 2 Diabetes: Evidence from Epidemiological and Intervention Studies

Type 2 diabetes mellitus (T2DM) is one of the most common metabolic diseases and represents a leading cause of morbidity and mortality because of its related complications. The alarming rise in T2DM prevalence worldwide poses enormous challenges in relation to its social, economic, and a clinical burden requiring appropriate preventive strategies. Currently, lifestyle modifications—including approaches to promote a moderate body weight reduction and to increase regular physical exercise—are the first crucial intervention for T2DM prevention. In the light of the difficulty in reducing body weight and in long-term maintenance of weight loss, quality changes in dietary patterns—in terms of macro and micronutrient composition—can also strongly affect the development of T2DM. This may provide a more practical and suitable preventative approach than simply implementing caloric restriction. Along this line, there is increasing evidence that wholegrain consumption in substitution of refined grains is associated with a reduction of the incidence of several non-communicable chronic diseases. The aim of the present review is to summarize the current evidence from observational and randomized controlled clinical trials on the benefits of wholegrain on T2DM prevention and treatment. Plausible mechanisms by which wholegrain could act on glucose homeostasis and T2DM prevention are also evaluated. Altogether, the totality of the available evidence supports present dietary recommendations promoting wholegrain foods for the prevention and treatment of T2DM.

Feeding in adults with type II diabetes mellitus in three public hospitals in Cundinamarca, Colombia

Introduction: Type II diabetes mellitus (DMII) is one of the main causes of morbidity and mortality both worldwide and in Colombia. It mainly affects men and women over 45 years of age. Inadequate control of this disease can generate greater health complications making it one of the most costly diseases in the country. Treatment includes activities other than glycemic control and requires constant monitoring by medical personnel and educational processes directed at the patient and his or her family. Objective: To characterize the feeding of patients with DMII in three public hospitals of Cundinamarca. Materials and methods: We conducted a cross-sectional descriptive study of 212 patients that analyzed sociodemographic characteristics, frequency of consumption and feeding practices. Results: Most of the population was over 45 years old and had a low educational level. In total, 52% had a dietary plan, but only 8.9% received nutritional guidance from a nutritionist. The consumption of carbohydrates predominated, with low consumption of proteins, vitamins, minerals, and fiber. The consumption of sugars was lower in patients with a dietary plan (p <0.05). Conclusions: Most of the patients did not have an adequate nutrition; moreover, there was low adherence to dietary treatment, weakness in nutritional counseling and barriers to food access. These results can contribute to improving policies for the prevention and control of DMII and strategies based on the sociocultural context of the patients.

Bioactivities of Phenolics by Focusing on Suppression of Chronic Diseases: A Review

Phenolics, which are secondary metabolites of plants, exhibit remarkable bioactivities. In this contribution, we have focused on their protective effect against chronic diseases rather than their antioxidant activities, which have been widely discussed in the literature. A large body of epidemiological studies has proven the bioactivities of phenolics in both standard compounds and natural extracts: namely, anticancer, anti-inflammatory, and antibacterial activities as well as reducing diabetes, cardiovascular disease, and neurodegenerative disease. Phenolics also display anti-analgesic, anti-allergic, and anti-Alzheimer’s properties. Thus, this review provides crucial information for better understanding the bioactivities of phenolics in foods and fills a gap in the existing collective and overall knowledge in the field.

The protective effect of muesli consumption on diabetes risk: Results from 12 years of follow-up in the Australian Longitudinal Study on Women's Health

Diabetes affects 9.8% of Australian women. Breakfast cereal consumption is potentially protective against diabetes. This study investigated the effects of breakfast cereal consumption on the 12-year risk of developing diabetes among mid-aged participants of the Australian Longitudinal Study of Women's Health (ALSWH). It was hypothesized that any breakfast cereal and higher-fiber breakfast cereals would be protective against the risk of developing diabetes. Data from Survey 3 (S3) to Survey 7 (S7) inclusive, from the 1946-51 ALSWH cohort were analyzed. Dietary data were obtained at S3 and the outcome was incident diabetes between S4-S7. Women were excluded if: they reported existing diabetes or impaired glucose tolerance at S3; dietary data were incomplete; or daily energy intake was <4,500 or >20,000 kJ. Logistic regression with discrete time survival analyses investigated the association between breakfast cereal intake and incident diabetes. Models were adjusted for income, BMI, smoking, physical activity, education, and dietary intakes and included a measure of time. There were 637 incident cases of diabetes. Breakfast cereal intake per se was not associated with incident diabetes (OR: 1.00; P = .98). Muesli consumption on its own (OR: 0.74; P = .00) or as a part of oats-based cereal (OR: 0.84; P = .047) was significantly associated with a decrease in the odds of developing diabetes. No other breakfast cereals were significantly associated with diabetes risk. Among mid-aged Australian women, muesli consumption was associated with a reduction in diabetes risk. This effect may be due to a particular profile of muesli eaters, but the relationship warrants further investigation.

Synthetic approaches to access acortatarins, shensongines and pollenopyrroside; potent antioxidative spiro-alkaloids with a naturally rare morpholine moiety

Pyrrole spiroketal alkaloids (PSAs) are a class of novel natural products that have been recently disclosed. Acortatarin A and acortatarin B, two potent antioxidative spiroalkaloids with a naturally rare morpholine moiety, are important members of this class. These spiroalkaloids are isolated from Acorus tatarinowii, Brassica campestris, Capparis spinose, bread crust, Xylaria nigripes and medicine Shensong Yangxin and could inhibit significantly the reactive oxygen species (ROS) production in high-glucose-induced mesangial cells in a time- and dose-dependent manner. Hence, these natural products are promising starting points for the formation of new therapeutics to medicate cardiovascular diseases, cancer, diabetic complications, and other diseases in which ROS are implicated. The impressive structure combined with an interesting pharmacological activity prompted synthetic chemists to construct an asymmetric synthetic strategy that could be used to access structural derivatives in addition to the larger quantities of natural products required for further biological investigations. This review summarizes the current state of the literature regarding with the synthesis of acortatarin A and B and its other family members viz. shensongine A, B and C, and pollenopyrroside A. The present review discusses the pros and cons of synthetic methodologies, which would be beneficial for further developments in the synthetic methodologies. Hopefully, this struggle pushes the reader's mind to consider new perspectives, think differently and forge new connections.

Prospective associations of dietary carbohydrate, fat, and protein intake with β-cell function in the CODAM study

PURPOSE

Type 2 diabetes mellitus (T2DM) is characterized by both impaired pancreatic β-cell function (BCF) and insulin resistance. In the etiology of T2DM, BCF basically determines whether a person with a certain degree of insulin resistance develops T2DM, as β-cells are able to compensatorily increase insulin secretion. The effects of dietary intake on BCF are largely unknown. Our study aim was to investigate whether dietary macronutrient intake predicts BCF.

METHODS

Prospective data (median follow-up 7 years) of 303 individuals recruited from the CODAM study population (aged 40-70 years, 39% women) were analyzed. BCF was measured by C-peptide deconvolution and physiological modeling of data from a 5-point, 75-g, 2-h oral glucose tolerance test. Macronutrient intake was estimated by a 178-item Food Frequency Questionnaire.

RESULTS

Associations adjusted for relevant covariates of baseline macronutrient intake with model-derived parameters describing BCF (glucose sensitivity, rate sensitivity or potentiation) or C-peptidogenic index were detected for trans fat [standardized regression coefficient (95%-CI) glucose sensitivity - 0.14 (- 0.26, - 0.01)] per g, cholesterol [potentiation 0.20 (0.02, 0.37)] per 100 mg, dietary fiber [glucose sensitivity 0.21 (0.08, 0.33)] per 10 g, MUFA glucose sensitivity 0.16 (0.02, 0.31) per 10 g, and polysaccharide [potentiation - 0.24 (- 0.43, - 0.05), C-peptidogenic index - 0.16 (- 0.29 - 0.03); odds ratio lowest versus highest tertile (95%-CI) rate sensitivity 1.51 (1.06, 2.15)) per 50 g.

CONCLUSIONS

In this population at high risk for developing T2DM, polysaccharide and trans fat intake were associated with worse BCF, whereas increased intake of MUFA, dietary cholesterol, and fiber were associated with better BCF.

The impact of raw materials and baking conditions on Maillard reaction products, thiamine, folate, phytic acid and minerals in white bread

The aim of this study was to develop a white bread with improved nutrient contents and reduced levels of potentially harmful Maillard reaction products such as N(ε)-carboxymethyllysine (CML) and 5-hydroxymethylfurfural (HMF). Assays were carried out through a full factorial experimental design allowing the simultaneous analysis of four factors at two levels: (1) wheat flour extraction rates (ash content: 0.60%-0.72%), (2) leavening agents (bakers' yeast - bakers' yeast and sourdough), (3) prebaking and (4) baking conditions (different sets of time and temperature). The baking conditions affected HMF and CML as well as certain mineral contents. A reduced baking temperature along with a prolonged heat treatment was found to be favourable for reducing both the CML (up to 20%) and HMF concentrations (up to 96%). The presence of sourdough decreased the formation of CML (up to 28%), and increased the apparent amounts of calcium (up to 8%) and manganese (up to 17.5%) probably through acidification of the dough. The extraction rate of flours as well as interactions between multiple factors also affected certain mineral content. However, compounds like folate, thiamine, copper, zinc, iron and phytic acid were not affected by any of the factors studied.

Plasma Alkylresorcinol Metabolite, a Biomarker of Whole-Grain Wheat and Rye Intake, and Risk of Type 2 Diabetes and Impaired Glucose Regulation in a Chinese Population

OBJECTIVE

To examine the association of plasma alkylresorcinol metabolite 3-(3,5-dihydroxyphenyl)-1-propanoic acid (DHPPA), a biomarker of whole-grain wheat and rye intake, with type 2 diabetes (T2D) and impaired glucose regulation (IGR) in a Chinese population.

RESEARCH DESIGN AND METHODS

A total of 1,060 newly diagnosed T2D patients, 736 newly diagnosed IGR patients, and 1,443 control subjects with normal glucose tolerance were recruited in the case-control study. Plasma DHPPA concentrations were determined by high-performance liquid chromatography-tandem mass spectroscopy. Multivariate logistic regression analysis was used to evaluate the independent association of plasma DHPPA concentrations with the likelihood of T2D and IGR.

RESULTS

After adjustment for age, sex, BMI, and family history of diabetes, the odds ratios (95% CI) of T2D and IGR were 0.57 (0.45, 0.73) and 0.66 (0.50, 0.85), respectively, comparing the lowest with the highest quartile of plasma DHPPA concentrations. Further adjustment for current smoking status, current alcohol consumption, physical activity, history of hypertension, and educational level did not change the observed association materially. Similar results were also obtained in T2D and IGR groups combined. The inverse association of plasma DHPPA with T2D persisted in stratified analyses according to age, sex, BMI, current smoking status, current alcohol consumption, physical activity, family history of diabetes, and history of hypertension.

CONCLUSIONS

These findings suggested that higher plasma DHPPA concentrations were associated with lower odds of T2D and IGR. Further studies are warranted to confirm these findings in prospective cohorts.