Postprandial Glycemic and Insulinemic Response by a Brewer’s Spent Grain Extract-Based Food Supplement in Subjects with Slightly Impaired Glucose Tolerance: A Monocentric, Randomized, Cross-Over, Double-Blind, Placebo-Controlled Clinical Trial

Cereal-Derived Water-Unextractable Arabinoxylans: Structure Feature, Effects on Baking Products and Human Health

Arabinoxylans (AXs) are non-starch polysaccharides with complex structures naturally occurring in grains (i.e., barley, corn, and others), providing many health benefits, especially as prebiotics. AXs can be classified as water-extractable (WEAX) and water-unextractable (WUAX) based on their solubility, with properties influenced by grain sources and extraction methods. Numerous studies show that AXs exert an important health impact, including glucose and lipid metabolism regulation and immune system enhancement, which is induced by the interactions between AXs and the gut microbiota. Recent research underscores the dependence of AX physiological effects on structure, advocating for a deeper understanding of structure-activity relationships. While systematic studies on WEAX are prevalent, knowledge gaps persist regarding WUAX, despite its higher grain abundance. Thus, this review reports recent data on WUAX structural properties (chemical structure, branching, and MW) in cereals under different treatments. It discusses WUAX applications in baking and the benefits deriving from gut fermentation.

The effects of a fibre-enriched bakery product on glucose, insulin values and appetite. A pilot randomised cross-over trial

Brewers spent grain (BSG) is a valuable source of arabinoxylans with potential beneficial effects on glucose values. This pilot randomised crossover double-blind trial compared the effects of panettone, a sweet baked-product, enriched with BSG-fibre (p-rich) to unenriched panettone (p-standard) on glucose and insulin blood values and appetite scores. Ten healthy volunteers consumed each food in a random order. Blood variables and appetite scores were assessed at fasting and at different intervals after each food consumption. Glucose values were significantly higher after p-standard intake at 90-min (89.9 ± 16.1 vs 74.6 ± 19.4 mg/dL) and 120-min (81.1 ± 9.85 vs 72.1 ± 14.0 mg/dL). The areas-under-the-curve (AUCs) were lower for both glucose (p = .043) and insulin values (p = .036) with p-rich. At 240-min, satiety was higher (p = .006), and desire-to-eat lower (p = .008) with p-rich; desire-to-eat AUC was lower with p-rich too (p = .029). The integration of a small amount of BSG-derived fibre into a sweet food led to improved glycaemic control and appetite regulation.

Incidence of new-onset hypertension before, during, and after the COVID-19 pandemic: a 7-year longitudinal cohort study in a large population

BACKGROUND

While the augmented incidence of diabetes after COVID-19 has been widely confirmed, controversial results are available on the risk of developing hypertension during the COVID-19 pandemic.

METHODS

We designed a longitudinal cohort study to analyze a closed cohort followed up over a 7-year period, i.e., 3 years before and 3 years during the COVID-19 pandemic, and during 2023, when the pandemic was declared to be over. We analyzed medical records of more than 200,000 adults obtained from a cooperative of primary physicians from January 1, 2017, to December 31, 2023. The main outcome was the new diagnosis of hypertension.

RESULTS

We evaluated 202,163 individuals in the pre-pandemic years and 190,743 in the pandemic years, totaling 206,857 when including 2023 data. The incidence rate of new hypertension was 2.11 (95% C.I. 2.08-2.15) per 100 person-years in the years 2017-2019, increasing to 5.20 (95% C.I. 5.14-5.26) in the period 2020-2022 (RR = 2.46), and to 6.76 (95% C.I. 6.64-6.88) in 2023. The marked difference in trends between the first and the two successive observation periods was substantiated by the fitted regression lines of two Poisson models conducted on the monthly log-incidence of hypertension.

CONCLUSIONS

We detected a significant increase in new-onset hypertension during the COVID-19 pandemic, which at the end of the observation period affected ~ 20% of the studied cohort, a percentage higher than the diagnosis of COVID-19 infection within the same time frame. This observation suggests that increased attention to hypertension screening should not be limited to individuals who are aware of having contracted the infection but should be extended to the entire population.

Incidence of type 2 diabetes before and during the COVID-19 pandemic in Naples, Italy: a longitudinal cohort study

Background

The association of COVID-19 with the development of new-onset diabetes has been recently investigated by several groups, yielding controversial results. Population studies currently available in the literature are mostly focused on type 1 diabetes (T1D), comparing patients with a SARS-CoV-2 positive test to individuals without COVID-19, especially in paediatric populations. In this study, we sought to determine the incidence of type 2 diabetes (T2D) before and during the COVID-19 pandemic.

Methods

In this longitudinal cohort study, we analysed a cohort followed up over a 6-year period using an Interrupted Time Series approach, i.e. 3-years before and 3-years during the COVID-19 pandemic. We analysed data obtained from >200,000 adults in Naples (Italy) from January 1st 2017 to December 31st 2022. In this manner, we had the opportunity to compare the incidence of newly diagnosed T2D before (2017-2019) and during (2020-2022) the COVID-19 pandemic. The key inclusion criteria were age >18-year-old and data availability for the period of observation; patients with a diagnosis of diabetes obtained before 2017 were excluded. The main outcome of the study was the new diagnosis of T2D, as defined by the International Classification of Diseases 10 (ICD-X), including prescription of antidiabetic therapies for more than 30 days.

Findings

A total of 234,956 subjects were followed-up for at least 3-years before or 3-years during the COVID-19 pandemic and were included in the study; among these, 216,498 were analysed in the pre-pandemic years and 216,422 in the pandemic years. The incidence rate of T2D was 4.85 (95% CI, 4.68-5.02) per 1000 person-years in the period 2017-2019, vs 12.21 (95% CI, 11.94-12.48) per 1000 person-years in 2020-2022, with an increase of about twice and a half. Moreover, the doubling time of the number of new diagnoses of T2D estimated by unadjusted Poisson model was 97.12 (95% CI, 40.51-153.75) months in the prepandemic period vs 23.13 (95% CI, 16.02-41.59) months during the COVID-19 pandemic. Interestingly, these findings were also confirmed when examining patients with prediabetes.

Interpretation

Our data from this 6-year study on more than 200,000 adult participants indicate that the incidence of T2D was significantly higher during the pandemic compared to the pre-COVID-19 phase. As a consequence, the epidemiology of the disease may change in terms of rates of outcomes as well as public health costs. COVID-19 survivors, especially patients with prediabetes, may require specific clinical programs to prevent T2D.

Funding

The US National Institutes of Health (NIH: NIDDK, NHLBI, NCATS), Diabetes Action Research and Education Foundation, Weill-Caulier and Hirschl Trusts.

Editorial for the Special Issue "Cardiometabolic Health in Relation to Diet and Physical Activity: Experimental and Clinical Evidence"

This Special Issue seeks to compile a centered, influential, and well-referenced volume on the impact of diet and physical activity on various cardiometabolic risk factors [...].

Spent Grain: A Functional Ingredient for Food Applications

Spent grain is the solid fraction remaining after wort removal. It is nutritionally rich, composed of fibers—mainly hemicellulose, cellulose, and lignin—proteins, lipids, vitamins, and minerals, and must be managed properly. Spent grain is a by-product with high moisture, high protein and high fiber content and is susceptible to microbial contamination; thus, a suitable, cost-effective, and environmentally friendly valorization method of processing it is required. This by-product is used as a raw material in the production of many other food products—bakery products, pasta, cookies, muffins, wafers, snacks, yogurt or plant-based yogurt alternatives, Frankfurter sausages or fruit beverages—due to its nutritional values. The circular economy is built on waste reduction and the reuse of by-products, which find opportunities in the regeneration and recycling of waste materials and energy that become inputs in other processes and food products. Waste disposal in the food industry has become a major issue in recent years when attempting to maintain hygiene standards and avoid soil, air and water contamination. Fortifying food products with spent grain follows the precepts of the circular bio-economy and industrial symbiosis of strengthening sustainable development. The purpose of this review is to update information on the addition of spent grain to various foods and the influence of spent grain on these foods.

Yellow Pea Pasta Enhances the Saltiness and Suppression of Postprandial Blood Glucose Elevation

Salt and carbohydrates, two causes of elevated blood glucose, are essential components for survival; however, excessive intake of either is a known health risk. In a previous study, we reported the usefulness of pasta prepared from yellow pea (YPP) as a functional staple food that is beneficial for blood sugar control. In this study, we investigated the usefulness of YPP in reducing health risks by examining its effects on saltiness, postprandial satisfaction, and second meal. The results showed that YPP tasted saltier than conventional pasta made from semolina wheat when prepared with a 0.75% salt concentration. In addition, we examined blood glucose levels, insulin secretion, and postprandial hunger over a longer period than in previous studies. We observed that when the same amount of YPP and wheat pasta were eaten, the elevation in blood glucose and insulin secretion was lower after YPP consumption while maintaining a similar level of satiety. Furthermore, YPP was also observed to be able to suppress elevated insulin levels at the second meal.