Dietary Fiber Intake and Metabolic Syndrome Risk Factors among Young South African Adults

Sex difference in the association of dietary fiber intake with visceral fat volume in Japanese adults

PURPOSE

Dietary fiber is a possible nutritional component which aids in the prevention of visceral fat accumulation. We examined the association between dietary fiber intake and visceral fat volume (VFV) by sex, and further analysed the association by major food sources of dietary fiber.

METHODS

In this cross-sectional study, we measured VFV in 2779 Japanese (1564 men and 1215 women) aged 40-89 who underwent positron emission tomography/computed tomography for cancer screening between 2004 and 2005. Dietary fiber intake was calculated based on a validated semi-quantitative food frequency questionnaire. The association between dietary fiber intake and VFV was investigated using multivariate linear regression models after adjustment for potential confounders.

RESULTS

Total, soluble, and insoluble fiber intakes were inversely associated with VFV in men (Q1: 3740 cm3, Q4: 3517 cm3, Ptrend: 0.0006 for total fiber), but not in women (Q1: 2207 cm3, Q4: 2193 cm3,Ptrend: 0.88 for total fiber). Statistically significant sex difference was observed (Pinteraction = 0.001 for total fiber). Subgroup analyses by major food sources revealed that dietary fiber intakes from beans, vegetables and fruits showed an inverse association with VFV in men, while cereal fiber intake showed a tendency toward a positive association in both sexes (Q1: 3520 cm3, Q4: 3671 cm3, Ptrend: 0.05 in men, Q1: 2147 cm3, Q4: 2227 cm3, Ptrend: 0.10 in women).

CONCLUSION

We observed a sex-specific association between dietary fiber intake and VFV in Japanese adults. This study suggests that efforts against visceral fat accumulation should take account of the source of dietary fiber.

Plant-based meat alternatives in South Africa: An analysis of products on supermarket shelves

All over the world, the development of products that resemble meat but contain predominantly plant-sourced ingredients is a prime focus. Meat obtained by rearing animals is associated with a range of important issues related to the sustainability of the planet. Locally, the topic is trending and the cause of various debates among industry role players. This study aimed to explore and analyze plant-based meat alternative (PBMA) products in the South African retail market as well as review internal (nutritional content and ingredients) and external (country of origin, cost/kg, and label claims) factors of the products. This study also compared the nutritional content of PBMA and comparative meat products. Seventy-eight PBMA products were included: plant-based sausages (n = 23), burgers (n = 31), chicken-style (n = 11), mince (n = 8), and an "other" (n = 5) category providing for a variety of product lines. Information from product packaging (total fat, saturated fat, fiber, protein, sugar, sodium, carbohydrates, and energy density) was extracted for all PBMA (n = 78) and comparative meat product lines (n = 28). Meat products tended to be comparatively higher in saturated fat, while PBMAs were higher in carbohydrate, sugar, and dietary fiber content. Sodium content of plant-based mince was approximately five times higher than beef mince. On-pack claims for PBMAs included vegetarian/vegan/plant based (80% of products), high in/source of protein (48%), containing no genetically modified organisms (GMOs; 16%), and gluten free (26%). The plant protein trend has prompted innovation in PBMAs, however, wide nutrient ranges and higher sodium levels highlight the importance of nutrition guidelines for their development to ensure healthier product offerings to consumers. The findings of this study may assist in exploration of consumers' preferences/attitudes or engagement with PBMA products, which could, in turn, guide new product development within the category. However, information about possible barriers, drivers, consumer expectations, and attitudes toward these products is also required.

Association between Macronutrient and Fatty Acid Consumption and Metabolic Syndrome: A South African Taxi Driver Survey

We aimed to examine the association between macronutrient and fatty acid intake and metabolic syndrome (MetS) and its components in South African male mini-bus taxi drivers. One hundred and eighty-five (n = 185) male taxi drivers, aged 20 years and older, who operate in the Cape Town metropole, South Africa, were included. The International Diabetes Federation (IDF) algorithm was used to define MetS. The association between macronutrient and fatty acid intake (assessed using 24 h recall) and MetS were analyzed using multivariable nutrient density substitution models. Overall, protein consumption significantly increased the likelihood of high blood pressure (HBP) and significantly lowered the likelihood of having low levels of high-density lipoprotein cholesterol (HDL-C). In an isoenergetic state, the intake of protein instead of carbohydrates (CHOs) and total fat, reduced the likelihood of elevated triglycerides by 6.7% and 6.6%, respectively. The intake of CHOs instead of protein and total fat, reduced the likelihood of HBP by 2.2% and 2.8%, respectively. In the same isoenergetic state, the intake of saturated fatty acids (SFAs) instead of mono-unsaturated fatty acids (MUFAs) increased the likelihood of HBP by 9.8%, whereas the intake of polyunsaturated fatty acids (PUFAs) instead of SFAs decreased the likelihood of HBP by 9.4%. The current study showed that when total food energy intake is kept constant, a diet that is high in protein, CHOs and PUFAs reduces triglycerides and BP, whereas the intake of total fat and SFAs had the opposite effect. It should, however, be noted that these outcomes were produced using mathematical models, as such we recommend further prospective studies in real life that will reveal the actual associations between the consumption of macronutrients and fatty acids and MetS and its components.

The association of Carbohydrate Quality Index with cardiovascular disease risk factors among women with overweight and obesity: A cross-sectional study

Purpose

Diet is one of the most important factors influencing cardiovascular disease (CVD). The negative relationship between carbohydrate intake with lipid profiles and body weight has been previously investigated. However, this is the first study seeking to assess the association of carbohydrate quality index (CQI) with CVD risk factors.

Methods

This cross-sectional study was conducted on 291 Iranian overweight and obese women, with a body mass index (BMI) ranging between 25 and 40 kg/m², and aged 18–48 years. CQI scores were calculated by using a validated 168-item semi-quantitative food frequency questionnaire (FFQ). Biochemical and anthropometric measures were assessed using standard methods, and bioelectrical impedance was used to measure body composition.

Results

We observed that fruits (P < 0.001), vegetables (P < 0.001), and protein (P = 0.002) intake were higher in participants with a higher score of the CQI. When we adjusted for potential confounders, we observed that the CQI was negatively related to systolic blood pressure (SBP) (β = −6.10; 95% CI = −10.11, −2.10; P = 0.003) and DBP (β = −3.11; 95% CI = −6.15, −0.08; P = 0.04). Also, greater adherence to a high CQI dietary pattern, compared to the reference group, was negatively related to HOMA-IR (β = −0.53; 95% CI = −0.94, −0.12) (P for trend = 0.01), WC (β = −3.18; 95% CI = −6.26, −0.10) (P for trend = 0.04), BMI (β = −1.21; 95% CI = −2.50, 0.07) (P for trend = 0.06), and BF (β = −2.06; 95% CI = −3.82, −0.30) (P for trend = 0.02).

Conclusion

In line with previous studies, the CQI was inversely associated with blood pressure, WC, BMI, and BF. Further prospective and clinical trial studies are suggested to confirm these data.

The association between dietary fiber intake and the concentrations of aldehydes in serum

Aldehydes have been shown to be potentially carcinogenic, mutagenic, and cardiotoxic to humans. Dietary fiber reduces exposure to certain environmental pollutants and has been widely used to improve various metabolic disorders. However, the effects of dietary fiber on serum concentrations of aldehydes remain unexplored. Data was collected from the National Health and Nutrition Examination Survey (NHANES) 2013-2014. Generalized linear regression and restricted cubic spline models were performed to elucidate the association of dietary fiber intake with the serum concentration of aldehydes. After fully adjusting for age, sex, education level, race, smoking status, alcohol use, diabetes, hypertension, body mass index, energy intake, poverty-income ratio, and physical activity, dietary fiber intake had a strong negative association with serum levels of isopentanaldehyde and propanaldehyde and a positive association with serum levels of benzaldehyde. The estimated increases in the mean log2-unit (ng/mL) of aldehydes for each fold increase in dietary fiber were -0.140 (95% confidence interval [CI]: -0.195 to -0.085) for isopentanaldehyde, -0.060 (95% CI: -0.099 to -0.015) for propanaldehyde, and 0.084 (95% CI: 0.017 to 0.150) for benzaldehyde, respectively. No significant association was observed between dietary fiber intake and the concentration of any other aldehydes. These results demonstrate that dietary fiber reduces the concentration of certain aldehydes in serum.

Dietary diversity score is associated with cardiometabolic risk factors in patients with hypertension (Hoveyzeh cohort study)

BACKGROUND: Dietary diversity score (DDS) is recognized as an essential factor of a high-quality diet. OBJECTIVE: To evaluate the relationship between DDS and cardiometabolic risk factors in hypertensive patients. METHODS: In this cross-sectional study, 972 hypertensive patients (322 males and 650 females) aged 35–70y participated were recruited. Dietary intake was evaluated using a semi-quantitative food frequency questionnaire and DDS was calculated. Metabolic syndrome was defined according to the IDF/AHA criteria. The anthropometric parameters, fasting blood sugar, lipid profile, and liver enzymes were measured. RESULTS: Male subjects who assigned to the top DDS tertile had 51% lower risk of having low serum HDL-C (OR: 0.49; 95% CI: 0.24–0.96) in the crude model. A similar association was observed for men in the second tertile of DDS after adjusting for covariates (OR: 0.47; 95% CI: 0.23–0.97). A significant inverse association was found between vegetable diversity score and odds of hyperglycemia in the male group in the adjusted model (OR: 0.44; 95% CI: 0.22–0.91). The vegetable diversity score was inversely associated with 67% decreased metabolic syndrome risk in the adjusted model (OR: 0.33; 95% CI: 0.15–0.70). CONCLUSION: These findings clarify the possible preventive role of higher DDS against metabolic syndrome.

Helminth and Host Crosstalk: New Insight Into Treatment of Obesity and Its Associated Metabolic Syndromes

Obesity and its associated Metabolic Syndromes (Mets) represent a global epidemic health problem. Metabolic inflammation, lipid accumulation and insulin resistance contribute to the progression of these diseases, thereby becoming targets for drug development. Epidemiological data have showed that the rate of helminth infection negatively correlates with the incidence of obesity and Mets. Correspondingly, numerous animal experiments and a few of clinic trials in human demonstrate that helminth infection or its derived molecules can mitigate obesity and Mets via induction of macrophage M2 polarization, inhibition of adipogenesis, promotion of fat browning, and improvement of glucose tolerance, insulin resistance and metabolic inflammation. Interestingly, sporadic studies also uncover that several helminth infections can reshape gut microbiota of hosts, which is intimately implicated in the pathogenesis of obesity and Mets. Overall, these findings indicate that the crosstalk between helminth and hosts may be a novel direction for obesity and Mets therapy. The present article reviews the molecular mechanism of how helminth masters immunity and metabolism in obesity.

Wheat Bran Modifications for Enhanced Nutrition and Functionality in Selected Food Products

The established use of wheat bran (WB) as a food ingredient is related to the nutritional components locked in its dietary fibre. Concurrently, the technological impairment it poses has impeded its use in product formulations. For over two decades, several modifications have been investigated to combat this problem. Ninety-three (93) studies (review and original research) published in English between January 1997 and April 2021 reporting WB modifications for improved nutritional, structural, and functional properties and prospective utilisation in food formulations were included in this paper. The modification methods include mechanical (milling), bioprocessing (enzymatic hydrolysis and fermentation with yeasts and bacteria), and thermal (dry heat, extrusion, autoclaving), treatments. This review condenses the current knowledge on the single and combined impact of various WB pre-treatments on its antioxidant profile, fibre solubilisation, hydration properties, microstructure, chemical properties, and technological properties. The use of modified WB in gluten-free, baked, and other food products was reviewed and possible gaps for future research are proposed. The application of modified WB will have broader application prospects in food formulations.

Combination therapy of flaxseed and hesperidin enhances the effectiveness of lifestyle modification in cardiovascular risk control in prediabetes: a randomized controlled trial

BACKGROUND

Regarding the increasing prevalence of cardiometabolic abnormalities, and its association with non-communicable chronic diseases, providing preventive and therapeutic strategies is a priority. A randomized placebo-controlled study was conducted to assess the effects of combination therapy of milled brown flaxseed and hesperidin during lifestyle intervention on controlling cardiovascular risk in prediabetes.

METHODS

A total of forty-eight subjects were randomly assigned to receive lifestyle intervention plus combination therapy of brown flaxseed (30 g milled) and hesperidin (two 500 mg capsules) or lifestyle modification alone for 12 weeks. Changes from baseline in anthropometric measures, lipid profile and atherogenic indices, glucose homeostasis parameters, and inflammatory biomarkers was assessed as a primary end point.

RESULTS

Anthropometric data comparison between the two groups showed a significant reduction in weight (p = 0.048). Waist circumference reduction was about twice that of the control group (- 6.75 cm vs - 3.57 cm), but this difference was not statistically significant. Comparison of blood pressure changes throughout the study indicated a greater reduction in blood pressure in the intervention group rather than control group (- 5.66 vs. - 1.56 mmHg, P = 0.049). Improvements of lipid profile and atherogenic indices, glucose homeostasis parameters, and inflammatory biomarkers in flaxseed-hesperidin group was significantly more than the control group after 12 weeks of intervention (p < 0.05).

CONCLUSION

Our results indicate that co-administration of flaxseed and hesperidin as an adjunct to lifestyle modification program is more effective than lifestyle modification alone in the metabolic abnormalities remission of prediabetic patients.

TRIAL REGISTRATION

 The trial was registered with ClinicalTrials.gov, number NCT03737422. Registered 11 November 2018. Retrospectively registered, https://clinicaltrials.gov/ct2/results?cond=&term=NCT03737422&cntry=&state=&city=&dist= .

Body Roundness Index, A Body Shape Index, Conicity Index, and Their Association with Nutritional Status and Cardiovascular Risk Factors in South African Rural Young Adults

BACKGROUND

The study aimed to investigate the association of Body Roundness Index (BRI), A Body Shape Index (ABSI), and Conicity Index with nutritional status and cardiovascular risk factors in South African rural young adults.

METHODS

The study included a total of 624 young adults aged 21-30 years from the Ellisras rural area. Anthropometric indices, blood pressure (BP), and biochemical measurements were measured.

RESULTS

BRI was significantly correlated with insulin (0.252 males, females 0.255), homeostatic model assessment (HOMA)-β (0.250 males, females 0.245), and TG (0.310 males, females 0.216). Conicity Index was significantly associated with pulse rate (PR) (β 0.099, 95% confidence interval (CI) 0.017, 0.143, p < 0.013; β 0.081, 95% CI 0.000 0.130, p < 0.048), insulin (β 0.149, 95% CI 0.286 0.908, p < 0.001; β 0.110, 95% CI 0.123 0.757, p < 0.007). Conicity Index is associated with insulin resistance (IR) (odds ratio (OR) 7.761, 95% CI 5.783 96.442, p < 0.001; OR 4.646, 95% CI 2.792 74.331, p < 0.007), underweight (OR 0.023, 95% CI 0.251 0.433, p < 0.001; OR 0.031, 95% CI 0.411 0.612, p < 0.001), and obesity (OR 1.058, 95% CI 271.5 4.119, p < 0.001; OR 1.271, 95% CI 0.672 1.099, p < 0.001).

CONCLUSION

Conicity Index was positively associated with insulin resistance, hypertension and dyslipidaemia. Further investigation of these indices and their association with nutritional status and cardiovascular diseases (CVDs) could assist in efforts to prevent CVD in the rural South African population.

Spousal Concordance in Dietary Behaviors and Metabolic Components, and Their Association: A Cross-Sectional Study

This study aims to investigate spousal concordance in dietary behaviors, spousal concordance in metabolic components (MCs), and their association. A cross-sectional survey was conducted in Taiwan from November 2014 to May 2015. Matched-pair analysis, McNemar’s test, logistic regression analysis, and stratified analysis were performed. A total of 901 pairs of spouses (1802 participants) were analyzed. Husbands were less likely to report intakes of high-fiber food (OR_MP (matched pairs odds ratio) = 0.30, p < 0.0001), fish (OR_MP = 0.74, p = 0.0128), biscuits or cakes (OR_MP = 0.60, p < 0.0001), and fast food (OR_MP = 0.65, p = 0.01) compared with their wives. Husbands had significantly higher odds of being overweight (OR_MP = 2.34, p < 0.0001); and of having hypertension (OR_MP = 2.14, p < 0.0001), hypercholesterolemia (OR_MP = 1.75, p = 0.0007), hyperlipidemia (OR_MP = 2.96, p < 0.0001), and one or more metabolic components (composite MCs) (OR_MP = 2.50, p < 0.0001) compared with their wives. After adjusting for age and education, the spousal concordance in high-fiber food intake was inversely associated with the spousal concordance in composite MCs (aOR = 0.62, 95% CI = 0.44–0.88, p = 0.0074), whereas the spousal concordance in processed food intake was positively associated with the concordance in composite MCs (aOR (adjusted odds ratio) = 1.56, 95% CI (Confidence Interval) = 1.03–2.36, p = 0.034). An intervention study for couples with intakes of different fiber foods and/or processed foods is critical for future study, in order to test what kinds of fiber foods/processed foods are associated with the development of the spousal concordance of metabolic components.

The Relationship between Low 25-Hydroxyvitamin D and Cardio-Metabolic Risk Factors among Ellisras Young Adults

Introduction: 25-hydroxyvitamin D (25(OH)D) is found in circulating blood and is regarded as an estimate of vitamin D status. Low circulating 25(OH)D levels are associated with a high body mass index (BMI), increased weight and the increased development of adipose tissue. This study aimed to determine the relationship between low 25(OH)D and cardio-metabolic risk factors among Ellisras young adults. Materials and methods: This is a cross-sectional study that took place in a rural area at Ellisras in Limpopo Province South Africa. The study included 631 young adults (327 females and 304 males) aged between 20 and 29 years. Anthropometric measurements including height, weight and waist circumference were measured following standard procedures. Blood pressure, pulse pressure and blood parameters including fasting plasma glucose, total cholesterol and triglycerides were also measured. Correlations and linear regression were performed to determine the relationship between low 25(OH)D and cardio-metabolic risk factors. Results: Descriptive statistics showed significant (p < 0.05) mean difference of LDL, HDL and blood pressure between males and females. There was a significant association between low 25(OH)D and WC (p = 0.010) based on Spearman correlation. There was no association found between low 25(OH)D and HDL in all models (B ranges from 0.072 to 0.075). There was also no association found between low 25(OH)D and systolic blood pressure (SBP) in all models (B ranges from −0.009 to −0.024). Conclusion: Low 25(OH)D was correlated with WC, and therefore with adiposity. Knowledge of the associations between 25(OH)D deficiency and cardio-metabolic risk before the development of the disease is therefore important to establish whether 25(OH)D supplementation can be used for the prevention of these conditions. Educational programmes should be implemented to educate the communities and the nation at large on how to prevent 25(OH)D deficiency.

The Relationship between Binge Drinking and Metabolic Syndrome Components amongst Young Adults Aged 21 to 31 Years: Ellisras Longitudinal Study

BACKGROUND

Evidence is lacking on the effects of binge alcohol consumption on metabolic syndrome in the rural South African population. The purpose of this study was to investigate the association between binge drinking and components of metabolic syndrome (MetS) amongst Ellisras rural young adults aged 21 to 31 years who are part of the Ellisras Longitudinal Study.

METHODS

Logistic regression analysis was applied to a total of 624 participants (306 males and 318 females) aged 21 to 31 years who took part in the Ellisras Longitudinal Study (ELS). The model was adjusted for covariates, including smoking, age, and gender. Binge alcohol consumption was assessed using a standardised questionnaire that was validated for the Ellisras rural community. A standardised method of determining the components MetS was used after fasting blood samples were collected from all the participants.

RESULTS

Binge drinking remained significantly associated with low levels of high-density lipoprotein cholesterol (HDL-C) (OR = 2.64, 95% CI = 1.23-5.65), after being adjusted for smoking, age, and gender. Other MetS components were not predicted. Instead, gender remained significantly associated with all MetS components, except triglycerides, at multivariate analysis. Age retained significance at multivariate analysis with waist girth (OR = 2.13, 95% CI = 1.37-3.34), triglycerides (OR = 2.30, 95% CI = 1.05-5.02), and the MetS composite (OR = 1.65, 95% CI = 1.12-2.41).

CONCLUSION

Binge drinking was significantly associated with lower levels of HDL-C. Future studies should investigate the relationship between alcohol abuse and the components of incident MetS in this population.

Bioactive Compounds and Their Effect on Blood Pressure-A Review

Elevated blood pressure affects a great part of the elderly population and is the leading risk factor for cardiovascular disease. New approaches have been taken in the fight against this growing problem, in the form of diets (Mediterranean, Dietary Approaches to Stop Hypertension (DASH) and intermittent fasting). Recent research has shown the promising results regarding diets and their effect on the prevention and improvement of elevated blood pressure. This review attempts to take this a step further, reviewing 26 studies in the search for dietary elements that may be causing this improvement. Although good evidence was found in favor of lycopene, Docosahexaenoic acid (DHA), fiber and anthocyanin, further evidence is needed before any conclusions can be made. In contrast, the evidence shows that licorice increases blood pressure.

Flaxseed and/or hesperidin supplementation in metabolic syndrome: an open-labeled randomized controlled trial

PURPOSE

The aim of the present study was to compare the clinical effect of flaxseed and hesperidin alone and with combination in patients with metabolic syndrome. Number of participants with treated metabolic syndrome was assessed as a primary end point.

METHODS

In this 12-week randomized controlled trial, ninety-eight patients with metabolic syndrome randomly assigned to receive either whole flaxseed powder (30 g/day), or hesperidin (1 g/day), or combination of 30 g flaxseed and 1 g hesperidin or no supplement while adhering a lifestyle modification program.

RESULTS

In comparison to control group, systolic blood pressure (- 5.68 vs. - 2.91 mmHg, P = 0.041) and serum concentrations of triglyceride (- 50.06 vs. 3.87 mg/dL, P = 0.033) in hesperidin group showed a significant reduction over 12 weeks of intervention. Comparison of the results of flaxseed group with the control group showed a significant improvement in serum concentrations of triglyceride (- 66 vs. 3.87 mg/dL, P = 0.028), insulin (- 4.27 vs. - 2.51 mU/L, P = 0.003) and accordingly insulin resistance (- 1.19 vs. - 0.76, P = 0.005) and sensitivity (0.03 vs. 0.01, P = 0.022) indices in flaxseed group. Combination of flaxseed and hesperidin improved three of five metabolic syndrome components including serum concentrations of triglyceride, glucose and systolic blood pressure as compared to placebo. Interestingly, co-administration of flaxseed and hesperidin with 77.3% reduction in the prevalence of defined metabolic syndrome was revealed to be most effective in controlling the metabolic syndrome, after which the group of flaxseed with 76% reduction and hesperidin group with 54.5% reduction were ranked second and third, respectively.

CONCLUSIONS

It can be concluded that co-administration of flaxseed and hesperidin appears to be superior to either supplementation alone on metabolic syndrome treatment, while the effects of flaxseed are stronger than hesperidin supplementation.

Prevalence of metabolic syndrome in sub-Saharan Africa: A systematic review and meta-analysis

BACKGROUND AND AIMS

There are rising levels of cardiovascular diseases (CVDs) and diabetes in Sub-Saharan Africa (SSA). Metabolic syndrome (MS) is a precursor of these conditions, but the data on the prevalence of MS in SSA are fragmented. We conducted a systematic review and meta-analysis to estimate the prevalence of MS in SSA and determine the population groups that are most at risk.

METHODS AND RESULTS

We systematically searched PubMed, Embase and African Journals Online for all published articles reporting MS prevalence in SSA populations. Random effects models were used to calculate the pooled prevalence overall and by major study-level characteristics. A total of 65 studies across fourteen different countries comprising 34,324 healthy participants aged ≥16 years were included in the meta-analysis. The overall prevalence of MS according to the different diagnostic criteria was: IDF: 18.0% (95%CI:13.3-23.3), IDF-ethnic: 16.0% (95%CI:11.3-21.4), JIS: 23.9% (95%CI: 16.5-32.3), NCEP-ATP III: 17.1% (95%CI:12.8-22.0) and WHO: 11.1% (95%CI:5.3-18.9). The prevalence of MS was higher in women than in men, and higher in (semi-)urban than in rural participants. The MS prevalence was highest in Southern Africa, followed by Eastern, Western and Central Africa. Substantial heterogeneity in the prevalence estimates across studies were not explained by major study-level characteristics, while apparent publication biases were likely artefactual.

CONCLUSIONS

MS is not rare in SSA. The prevalence of MS was highest for women, populations in urban areas, and populations in Southern Africa. Public health intervention efforts are needed to prevent further increases in the burden of MS in the region.

Enhancing the prebiotic effect of cellulose biopolymer in the gut by physical structuring via particle size manipulation

Cellulose is generally recognised as dietary fibre with no limit of permissible quantity in food, and its consumption may modulate digesta content and impact positively on the gastrointestinal physiology and gut microflora. However, cellulose in its native form possessed inherent undesirable physical properties, making it unattractive for food applications. Here, we postulate that by changing cellulose size to nanometric scale, its prebiotic effect would be altered and fermented differently in contrast with micro size cellulose by the gut microbiome and promote the yield of metabolites such as short chain fatty acids (SCFAs). Using faecal matter from three healthy human donors as microbial source, in vitro fermentation of variable size fractions of cellulose from the same were fermented under anaerobic conditions, and SCFAs as well Bifidobacterium selectively isolated and analysed. The increase in production of acetate (194%), butyrate (224%) and propionate (211%) after 24 h of fermentation was significantly promoted by the size reduction and revealed size-dependent relationship as exemplified R² values >0.83. Consequently, gavaging rats with nanometric size cellulose (125 nm) significantly (p < 0.05) increased these SCFAs yields as well Bifidobacterium counts in contrast with both control and the micro scale size cellulose. Therefore, engineered nanocellulose might have beneficial physiological impact on the gut with improved prebiotic effect.

Performance of newly developed body mass index cut-off for diagnosing obesity among Ethiopian adults

BACKGROUND

Obesity is defined as unhealthy excess body fat, which increases the risk of premature mortality from noncommunicable diseases. Early screening and prevention of obesity is critical for averting associated morbidity, disability, and mortality. Ethiopia has been using the international (WHO's) BMI cut-off for diagnosing obesity even though its validity among Ethiopian population was questioned. To address this problem, a new body mass index cut-off was developed for Ethiopian adults using population-specific data. However, its performance in diagnosing obesity has not been validated. Therefore, this study determined the performance of the newly developed Ethiopian and World Health Organization (WHO) BMI cut-offs in detecting obesity among Ethiopian adults.

METHODS

A cross-sectional study was carried out among 704 employees of Jimma University from February to April 2015. The study participants were selected using simple random sampling technique based on their payroll. Data on sociodemographic variables were collected using an interviewer-administered structured questionnaire. Anthropometric parameters including body weight and height were measured according to WHO recommendation. Body fat percentage (BF%) was measured using the air displacement plethysmography (ADP) after calibration of the machine. The diagnostic accuracy of the WHO BMI cut-off (≥ 30 kg/m2) for obesity in both sexes and Ethiopian BMI cut-off (> 22.2 kg/m2 for males and >  24.5 kg/m2 for females) were compared to obesity diagnosed using ADP measured body fat percentage (> 35% for females and >  25% for males). Sensitivity, specificity, predictive values, and kappa agreements were determined to validate the performance of the BMI cut-offs.

RESULTS

In males, WHO BMI cut-off has a sensitivity of 5.3% and specificity of 99.4% (Kappa = 0.047) indicating a slight agreement. However, the Ethiopian cut-off showed a sensitivity of 87.5% and specificity of 87.7% (Kappa = 0.752) indicating a substantial agreement. Similarly, in females, the WHO BMI cut-off showed a sensitivity of 46.9%, while its specificity was 100% (Kappa = 0.219) showing a fair agreement. The Ethiopian BMI cut-off demonstrated a sensitivity 80.0% and a specificity 95.6% (Kappa = 0.701) showing a substantial agreement. The WHO BMI cut-off underestimated the prevalence of obesity by a maximum of 73.7% and by a minimum of 28.3% among males, while the values for underestimation ranged from 31.4-54.1% in females. The misclassification was minimal using the newly developed Ethiopian BMI cut-off. The prevalence of obesity was underestimated by a maximum of 9.2% and overestimated by a maximum of 6.2%. The WHO BMI cut-off failed to identify nearly half (46.6%) of Ethiopian adults who met the criteria for obesity using BF% in the overall sample.

CONCLUSIONS

The findings suggest that WHO BMI cut-off (≥ 30 kg/m2) is not appropriate for screening obesity among Ethiopian adults. The newly developed Ethiopian BMI cut-off showed a better performance with excellent sensitivity, specificity, predictive values, and agreement indicating the diagnostic significance of it use as a simple, cost-effective, and valid indicator in clinical and community setups.

Dietary Fibre Protective against Colorectal Cancer Patients in Asia: A Meta-Analysis

BACKGROUND

The association between dietary fibre and colorectal cancer risk is controversial.

AIM

This systematic review and meta-analysis were performed to determine the dietary fibre protective against colorectal cancer patients in Asia.

METHODS

The authors conducted a meta-analysis of published research articles on dietary fibre protective against colorectal cancer patients in Asia published between January 2000 and March 2019 in the online article databases of PubMed, ProQuest and EBSCO. Pooled odds ratios (OR) were calculated with fixed and random-effect models. Publication bias was visually evaluated by using funnel plots and statistically assessed through Egger's and Begg's tests. Data were processed using Review Manager 5.3 (RevMan 5.3) and Stata version 14.2 (Stata Corporation).

RESULTS

This study reviewed 405 articles. There are 10 studies conducted a systematic review and continued with Meta-analysis of relevant data with several sample 49,964 patients. The results showed dietary fibre protective against colorectal cancer patients in Asia (OR = 0.66 [95% CI 0.56-0.77, p=0.008]). There was significant publication bias for studies included in dietary fibre protective against colorectal cancer patients in Asia.

CONCLUSION

This analysis confirmed dietary fibre protective against colorectal cancer patients in Asia.

Whole Fruits and Fruit Fiber Emerging Health Effects

Less than 10% of most Western populations consume adequate levels of whole fruits and dietary fiber with typical intake being about half of the recommended levels. Evidence of the beneficial health effects of consuming adequate levels of whole fruits has been steadily growing, especially regarding their bioactive fiber prebiotic effects and role in improved weight control, wellness and healthy aging. The primary aim of this narrative review article is to examine the increasing number of health benefits which are associated with the adequate intake of whole fruits, especially fruit fiber, throughout the human lifecycle. These potential health benefits include: protecting colonic gastrointestinal health (e.g., constipation, irritable bowel syndrome, inflammatory bowel diseases, and diverticular disease); promoting long-term weight management; reducing risk of cardiovascular disease, type 2 diabetes and metabolic syndrome; defending against colorectal and lung cancers; improving odds of successful aging; reducing the severity of asthma and chronic obstructive pulmonary disease; enhancing psychological well-being and lowering the risk of depression; contributing to higher bone mineral density in children and adults; reducing risk of seborrheic dermatitis; and helping to attenuate autism spectrum disorder severity. Low whole fruit intake represents a potentially more serious global population health threat than previously recognized, especially in light of the emerging research on whole fruit and fruit fiber health benefits.

The effect of artichoke on lipid profile: A review of possible mechanisms of action

Cardiovascular disease is a highly prevalent issue worldwide, and one of its main manifestations, dyslipidaemia, needs more attention. Cooked artichoke (Cynara scolymus) hearts or artichoke leaf extract (ALE) are believed to be helpful in the treatment of dyslipidaemia. In this narrative review, we provide a brief overview of the potential impact of artichoke consumption on lipid profile. We appraised the Cochrane, MEDLINE and Web of Science databases, and included articles published between 2000 and June 2018 on intervention in humans only. The main potential of ALE administration observed on lipid profile relates to decreased serum LDL, total cholesterol and triglyceride concentrations, although no strong evidence for increasing HDL appears to exist. Evidence suggests that decreases of 8-49 mg/dL for LDL concentration, 12-55 mg/dL for total cholesterol, and 11-51 mg/dL for triglycerides, can be attributed to 2 to 3 g/d of ALE, in which its components luteolin and chlorogenic acid may play a key role. On the other hand, the effects of cooked artichoke hearts can be attributed mainly to its soluble fibres, particularly inulin. Despite the convincing evidence on its health benefits, additional long-term clinical trials are pivotal to fully elucidate the potential effects of ALE administration on positive cardiovascular outcomes.

The risk of metabolic syndrome as a result of lifestyle among Ellisras rural young adults

The study aimed to investigate the association between metabolic syndrome (MetS) and lifestyle risk factors among Ellisras adults. A cross-sectional study was conducted on 624 adults (306 males and 318 females). MetS was defined according to the criteria of the International Diabetes Federation. The prevalence of MetS was 23.1% (8.6% males and 36.8 % females). Females appeared to have higher mean values for waist circumference (WC), fasting blood glucose (FBG), total cholesterol (TCHOL) and low-density lipoprotein cholesterol (LDL-C), while males had high mean values for high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), systolic blood pressure (SBP) and diastolic blood pressure (DBP). No significant age and gender differences were observed for dietary intake. Significantly more females (51.9%) presented with increased WC than males (4.6%). Participants who had a high dietary energy intake were significantly less likely to present with larger WC (OR: 0.250 95% CI [0.161; 0.389]), low HDL-C (OR: 0.306 95% CI [0.220; 0.425]) and high LDL-C (OR: 0.583 95% CI [0.418; 0.812]) but more likely to present with elevated FBG (OR: 1.01 95% CI [0.735; 1.386]), high TCHOL (OR: 1.039 95% CI [0.575; 1.337]), high TG (OR: 1.186 95% CI [0.695; 2.023]) and hypertension (OR: 5.205 95% CI [3.156; 8.585]). After adjusting for age, gender, smoking, and alcohol status, high energy intake was more than two times likely to predict MetS in adults with a large WC (OR: 2.766 95% CI [0.863; 3.477] and elevated FBG (OR: 2.227 95% CI [1.051; 3.328]). Therefore, identifying groups that are at an increased risk and those that are in their early stages of MetS will help improve and prevent the increase of the MetS in the future.