Effect of Oat β-Glucan Intake on Glycaemic Control and Insulin Sensitivity of Diabetic Patients: A Meta-Analysis of Randomized Controlled Trials

Unlocking the potential of beta-glucans: a comprehensive review from synthesis to drug delivery carrier potency

Modernization and lifestyle changes have resulted in a number of diseases, including cancer, that require complicated and thorough treatments. One of the most important therapies is the administration of antibiotics and medicines. This is known as chemotherapy for cancer, and it is a regularly utilised treatment plan in which the medications used have negative side effects. This has resulted in extensive research on materials capable of delivering pharmaceuticals to particular targets over an extended period of time. Biopolymers have often been preferred as effective drug delivery carriers. Of these, β-glucan, a natural polysaccharide, has not been extensively studied as a drug delivery carrier, despite its unique properties. This review discusses the sources, extraction techniques, structures, and characteristics of β-glucan to provide an overview. Furthermore, the different methods employed to encapsulate drugs into β-glucan and its role as an efficient drug, SiRNA and Plasmid DNA carrier have been elaborated in this article. The capacity of β-glucan-based to specifically target and alter tumour-associated macrophages, inducing an immune response ultimately resulting in tumour suppression has been elaborated. Finally, this study aims to stimulate further research on β-glucan by thoroughly describing its many characteristics and demonstrating its effectiveness as a drug delivery vehicle.

The modulatory effect of oat on brain-derived neurotrophic factor, orexigenic neuropeptides, and dopaminergic signaling in obesity-induced rat model: a comparative study to orlistat

BACKGROUND

Obesity is a non-communicable complex disease that is the fifth leading cause of death worldwide. According to a novel viewpoint, the brain plays a significant role in the central regulation of satiety and energy homeostasis. Because of its rich nutritional profile and versatile uses, oat (Avena sativa) is one of the most popular functional foods recommended by many nutritionists. The anti-obesity effect of oat was hypothesized, focusing on the brain as the target organ. In the current study, the interplay between brain biomarkers, obesity, and its related complications was evaluated in diet-induced obese rats for 25 weeks, in which 60 adult male white albino Wistar rats were divided into three control and seven treatment groups given oat extracts in a dose-dependent manner.

RESULTS

Oat significantly improved obesity-related metabolic complications. In terms of brain function, oat significantly increased dopaminergic signaling, brain-derived neurotrophic factor levels, vaspin, irisin, and uncoupling protein-1 brain levels, while decreasing the expression of agouti-related peptide and neuropeptide Y (P-value < 0.05).

CONCLUSION

The current study proposes oat supplementation as a new conceptual framework with numerous implications for hedonic and homeostatic mechanisms that control satiety. © 2024 Society of Chemical Industry.

Interaction between genetic risk score and dietary carbohydrate intake on high-density lipoprotein cholesterol levels: Findings from the study of obesity, nutrition, genes and social factors (SONGS)

BACKGROUND & AIMS

Cardiometabolic traits are complex interrelated traits that result from a combination of genetic and lifestyle factors. This study aimed to assess the interaction between genetic variants and dietary macronutrient intake on cardiometabolic traits [body mass index, waist circumference, total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, triacylglycerol, systolic blood pressure, diastolic blood pressure, fasting serum glucose, fasting serum insulin, and glycated haemoglobin].

METHODS

This cross-sectional study consisted of 468 urban young adults aged 20 ± 1 years, and it was conducted as part of the Study of Obesity, Nutrition, Genes and Social factors (SONGS) project, a sub-study of the Young Lives study. Thirty-nine single nucleotide polymorphisms (SNPs) known to be associated with cardiometabolic traits at a genome-wide significance level (P < 5 × 10-8) were used to construct a genetic risk score (GRS).

RESULTS

There were no significant associations between the GRS and any of the cardiometabolic traits. However, a significant interaction was observed between the GRS and carbohydrate intake on HDL-C concentration (Pinteraction = 0.0007). In the first tertile of carbohydrate intake (≤327 g/day), participants with a high GRS (>37 risk alleles) had a higher concentration of HDL-C than those with a low GRS (≤37 risk alleles) [Beta = 0.06 mmol/L, 95 % confidence interval (CI), 0.01-0.10; P = 0.018]. In the third tertile of carbohydrate intake (>452 g/day), participants with a high GRS had a lower concentration of HDL-C than those with a low GRS (Beta = -0.04 mmol/L, 95 % CI -0.01 to -0.09; P = 0.027). A significant interaction was also observed between the GRS and glycaemic load (GL) on the concentration of HDL-C (Pinteraction = 0.002). For participants with a high GRS, there were lower concentrations of HDL-C across tertiles of GL (Ptrend = 0.017). There was no significant interaction between the GRS and glycaemic index on the concentration of HDL-C, and none of the other GRS∗macronutrient interactions were significant.

CONCLUSIONS

Our results suggest that young adults who consume a higher carbohydrate diet and have a higher GRS have a lower HDL-C concentration, which in turn is linked to cardiovascular diseases, and indicate that personalised nutrition strategies targeting a reduction in carbohydrate intake might be beneficial for these individuals.

Journey of dietary fiber along the gastrointestinal tract: role of physical interactions, mucus, and biochemical transformations

Dietary fiber-rich foods have been associated with numerous health benefits, including a reduced risk of cardiovascular and metabolic diseases. Harnessing the potential to deliver positive health outcomes rests on our understanding of the underlying mechanisms that drive these associations. This review addresses data and concepts concerning plant-based food functionality by dissecting the cascade of physical and chemical digestive processes and interactions that underpin these physiological benefits. Functional transformations of dietary fiber along the gastrointestinal tract from the stages of oral processing and gastric emptying to intestinal digestion and colonic fermentation influence its capacity to modulate digestion, transit, and commensal microbiome. This analysis highlights the significance, limitations, and challenges in decoding the complex web of interactions to establish a coherent framework connecting specific fiber components' molecular and macroscale interactions across multiple length scales within the gastrointestinal tract. One critical area that requires closer examination is the interaction between fiber, mucus barrier, and the commensal microbiome when considering food structure design and personalized nutritional strategies for beneficial physiologic effects. Understanding the response of specific fibers, particularly concerning an individual's physiology, will offer the opportunity to exploit these functional characteristics to elicit specific, symptom-targeting effects or use fiber types as adjunctive therapies.

Greater adherence to the Healthy Nordic Food Index is associated with lower all-cause mortality in a population-based sample from northern Germany

PURPOSE

Dietary pattern scores reflecting a high intake of beneficial food groups were associated with reduced mortality risk. Data on associations of such dietary pattern scores in population-based samples from northern Germany are lacking. Therefore, we examined the association of three dietary pattern scores with all-cause mortality in a moderate-sized prospective sample from northern Germany.

METHODS

The study sample comprised 836 participants (43.8% females, median age 62.4 years). Based on a validated, self-administered Food Frequency Questionnaire, the dietary scores Dietary Approaches to Stop Hypertension (DASH), Modified Mediterranean Diet Score (MMDS), and Healthy Nordic Food Index (HNFI) were calculated. Cox proportional hazard regression models, adjusted for age, sex, body mass index, waist to hip ratio, education, smoking status, total energy intake, and physical activity, were used to separately relate DASH, MMDS, and HNFI to all-cause mortality.

RESULTS

During a median follow-up period of 11 years, 93 individuals died. While DASH and MMDS scores were not associated with all-cause mortality, greater adherence to HNFI was associated with lower mortality hazards (HR: 0.47 [95% CI 0.25-0.89] when comparing the highest score quartile to the lowest; HR: 0.79 [95% CI 0.64-0.98] for HNFI modeled as a 1-Standard Deviation increment). Among different HNFI components, higher intake of oats and cereals displayed the most conclusive association with all-cause mortality (HR: 0.59 [95% CI 0.38-0.91] when comparing high and low intake).

CONCLUSION

In an elderly general population sample from northern Germany, we observed greater adherence to HNFI to be associated with lower all-cause mortality.

Effect of viscous soluble dietary fiber on glucose and lipid metabolism in patients with type 2 diabetes mellitus: a systematic review and meta-analysis on randomized clinical trials

Background

The effect of viscous soluble dietary fiber on glucose and lipid metabolism in type 2 diabetes mellitus (T2DM) remains controversial, and the dose-response relationship of its effect on blood glucose and blood lipid level is still unclear.

Methods

We conducted comprehensive searches in several databases up to 17 January 2023. We conducted a dose-response analysis of randomized controlled trials (RCTs) to investigate the effect of viscous dietary fiber on glucose and lipid metabolism in patients with T2DM.

Results

Statistical significance was observed in the decreases of glycosylated hemoglobin (HbA1c) (mean difference) [MD = -0.47; 95%CI: (-0.66, -0.27)], fasting blood glucose (FBG) [MD = -0.93; 95%CI: (-1.46, -0.41)], total cholesterol (TC) [MD = -0.33; 95%CI: (-0.46, -0.21)], and low-density lipoprotein and cholesterol (LDL-C) [MD = -0.24; 95%CI: (-0.35, -0.13)]. Contrarily, no difference was observed regarding the level of high-density lipoprotein cholesterol (HDL-C) or triglyceride (TG). In addition, the effect on fasting insulin remains unclear. Results from the subgroup analyses showed that an intervention duration longer than 6 weeks had a significant effect on the HbA1c level; a treatment dosage higher than 8.3 g/day had a significant effect on the FBG level.

Conclusions

Supplementation of viscous dietary fiber is beneficial to control blood glucose and blood lipid in T2DM.

Functional and Nutritional Characteristics of Natural or Modified Wheat Bran Non-Starch Polysaccharides: A Literature Review

Wheat bran (WB) consists mainly of different histological cell layers (pericarp, testa, hyaline layer and aleurone). WB contains large quantities of non-starch polysaccharides (NSP), including arabinoxylans (AX) and β-glucans. These dietary fibres have long been studied for their health effects on management and prevention of cardiovascular diseases, cholesterol, obesity, type-2 diabetes, and cancer. NSP benefits depend on their dose and molecular characteristics, including concentration, viscosity, molecular weight, and linked-polyphenols bioavailability. Given the positive health effects of WB, its incorporation in different food products is steadily increasing. However, the rheological, organoleptic and other problems associated with WB integration are numerous. Biological, physical, chemical and combined methods have been developed to optimise and modify NSP molecular characteristics. Most of these techniques aimed to potentially improve food processing, nutritional and health benefits. In this review, the physicochemical, molecular and functional properties of modified and unmodified WB are highlighted and explored. Up-to-date research findings from the clinical trials on mechanisms that WB have and their effects on health markers are critically reviewed. The review points out the lack of research using WB or purified WB fibre components in randomized, controlled clinical trials.

Dietary Supplements Containing Oat Beta-Glucan and/or Green Coffee (Poly)phenols Showed Limited Effect in Modulating Cardiometabolic Risk Biomarkers in Overweight/Obese Patients without a Lifestyle Intervention

Obesity has reached pandemic proportions and has become a major health concern worldwide. Therefore, it is necessary to find new strategies against this condition and its associated comorbidities. Green coffee polyphenols (GCP) and oat beta-glucans (BGs) have proven their hypolipidaemic and hypoglycaemic effects. This study aimed to examine the effects of the long-term consumption of supplements containing GCP, BG or the novel GCP/BG combination on lipid and glucose metabolism biomarkers in overweight/obese subjects who maintained their dietary habits and physical activity, hence addressing the difficulty that this population faces in adapting to lifestyle changes. A randomised, crossover, blind trial was carried out in 29 volunteers who consumed either GCP (300 mg), BG (2.5 g) or GCP/BG (300 mg + 2.5 g) twice a day for 8 weeks. Blood samples were collected, and blood pressure and body composition were measured at the beginning and end of each intervention. Total cholesterol, triglycerides, high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), very low-density lipoprotein (VLDL-C) cholesterol, glycated haemoglobin, fasting glucose, insulin, aspartate transaminase, alanine transaminase and different hormones and adipokines were analysed. Only VLDL-C (p = 0.01) and diastolic blood pressure (p = 0.027) decreased after the intervention, especially with the BG supplement. There were no other significant changes in the analysed biomarkers. In conclusion, the regular intake of GCP, BG and GCP/BG without lifestyle changes is not an efficient strategy to improve lipid and glucose homeostasis in overweight/obese subjects.

Effect of soluble oat fiber on intestinal microenvironment and TNBS-induced colitis

Soluble oat fibers, including β-glucan, have been shown to alter the gut microbiome composition and ameliorate DSS-induced colitis; however, the beneficial effect of soluble oat fiber on colonic inflammation is not yet fully understood. In this study, we demonstrated that soluble oat fibers ameliorate T cell-dependent colitis through the induction of peripherally induced regulatory T cells (pTregs). Soluble oat fibers elevated colonic butyrate production dose-dependently, which coincided with the overrepresentation of Faecalibaculum rodentium (an analog of butyrate-producing Holdemanella biformis) in the gut microbiome. Soluble oat fibers promoted the growth of F. rodentium and H. biformis even in vitro, and increased the concentration of butyrate in the culture supernatant. These results indicate that soluble oat fibers are an energy source for butyrate-producing bacteria and are a fermentation substrate. Soluble oat fibers increased the percentage of colonic pTregs and ameliorated the weight loss and inflammation in acute 2,4,6-trinitrobenzenesulfonic acid (TNBS)-induced colitis; this may in part be mediated by the increase in IL-10-producing T cells. In conclusion, our results suggest that the administration of soluble oat fibers is a promising prebiotic treatment for the prevention of colitis mediated via altered gut microbiota composition and elevated butyrate production.

[Nutrition for diabetic patients (Update 2023)]

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

Multigrain porridge possesses superior nutritional quality, its consumption alleviates hyperglycemia, hypercholesterolemia and oxidative stress in obese-diabetic wistar rats

There is an increased utilization of wholegrain cereals in food formulations considering their richness in essential nutritional and biological properties. In this study, each component (amaranth, acha and pearl millet) of the multigrain blend was individually pre-fermented. Thereafter, the pre-fermented grain flours were optimized to obtain two unique blends (90:5:5 and 47.98: 26.68:25.34) containing high protein content (~23% and 17%) and low glycemic index (~43). The optimum blends were processed into instant porridges (PR1, PR2) and analyzed for its nutritional composition, blood glucose lowering ability, antioxidant enzyme and tissue/serum biochemical makers modulatory ability in obese-diabetic animals. The porridge showed significant nutritional profile, consumption of formulated multigrain porridge reduced blood glucose level (by 62% and 66%), upregulated the antioxidant defense system to near normal levels likewise, significantly reduced serum biochemical parameters. Thus, suggests that the multigrain blends/porridge is nutrient-dense possessing beneficial effect to maintain antioxidant levels in the diabetic condition with potential to attenuate oxidative damage. PRACTICAL APPLICATIONS: Prolonged feeding with high-fat diet induces hypercholesterolemia in experimental animals. Further interperitoneal injection of streptozotocin induces experimental diabetes with a cascade of oxidative stress related complications in serum and tissue parameters. Porridge is a traditional meal while multigrain porridge is a nutrient dense meal which may exert curative effect. In this work, it was shown that dietary intervention with multigrain porridge product promoted positive weight control, portrayed hepatoprotective effect as shown by the elevated levels of biomarker (ALT, AST, ALP) and antioxidant enzymes (CAT, SOD, GPx) as well as modulation of serum lipid profile (total cholesterol, triglycerides, high density lipoprotein-cholesterol). Thus, the multigrain porridge may be a functional food product to combat hypercholesterolemia and hyperglycemia especially PR1 which appeared to be more efficient than PR2 in modulating oxidative stress, conferring hypoglycemic effect and lowering lipid levels in obese-diabetic rats model studied.

Plasma Metabolomics Reveals β-Glucan Improves Muscle Strength and Exercise Capacity in Athletes

The present study aimed to assess the changes in muscle strength and plasma metabolites in athletes with β-glucan supplementation. A total of 29 athletes who met the inclusion criteria were recruited for this study (ChiCTR2200058091) and were randomly divided into a placebo group (n = 14) and β-glucan group (n = 15). During the trial, the experimental group received β-glucan supplementation (2 g/d β-glucan) for 4 weeks and the control group received an equal dose of placebo supplementation (0 g/d β-glucan), with both groups maintaining their regular diet and exercise habits during the trial. The athletes’ exercise performance, muscle strength, and plasma metabolome changes were analyzed after 4 weeks of β-glucan supplementation. The results showed a significant increase in mean grip strength (kg), right hand grip strength (kg), left triceps strength (kg), and upper limb muscle mass (kg) in the experimental group after the 4-week intervention compared to the preintervention period (p < 0.05). A comparison of the difference between the two groups after the intervention showed that there were significant differences between the control group and the experimental group in mean grip strength (kg) and right-hand grip strength (kg) (p < 0.05). Athletes in the experimental group showed significant improvements in 1 min double rocking jump (pcs), VO2max (ml/kg-min) (p < 0.05). The β-glucan intake increased the creatine-related pathway metabolites in plasma. Overall, these results suggest that 4 weeks of β-glucan supplementation can improve muscle strength in athletes, with the potential to increase aerobic endurance and enhance immune function, possibly by affecting creatine-related pathways.

Associations between dietary fiber intake and cardiovascular risk factors: An umbrella review of meta-analyses of randomized controlled trials

Although several meta-analyses have revealed the beneficial effects of dietary fiber intake on human health, some have reported inconsistent findings. The purpose of this work was to perform an umbrella meta-analysis to evaluate the relevant evidence and elucidate the effect of dietary fiber intake on glycemic control, lipid profiles, systematic inflammation, and blood pressure. Eligible studies were searched in several electronic databases, including Web of Science, PubMed, Scopus, and the Cochrane Library, up to March 2022. A total of 52 meta-analyses involving 47,197 subjects were identified to assess the pooled effect size. Overall, higher dietary fiber intake was significantly associated with reductions in parameters involving glycemic control, including fasting plasma glucose (ES = -0.55, 95% CI: -0.73, -0.38, P < 0.001), fasting plasma insulin (ES = -1.22, 95% CI: -1.63, -0.82, P < 0.001), homeostasis model assessment of insulin resistance (HOMA-IR) (ES = -0.43, 95% CI: -0.60, -0.27, P < 0.001), and glycosylated hemoglobin (HbA1c) (ES = -0.38, 95% CI: -0.50, -0.26, P < 0.001). In terms of lipid profiles, higher dietary fiber intake was associated with significant reductions in the serum level of total cholesterol (ES = -0.28, 95% CI: -0.39, -0.16, P < 0.001) and low-density lipoprotein cholesterol (ES = -0.25, 95% CI: -0.34, -0.16, P < 0.001), but not triglycerides (ES = -0.001, 95% CI: -0.006, 0.004, P = 0.759) and high-density lipoprotein cholesterol (ES = -0.002, 95% CI: -0.004, 0.000, P = 0.087). Higher dietary fiber intake was also significantly associated with improved tumor necrosis factor-alpha serum levels (ES = -0.78, 95% CI: -1.39, -0.16, P = 0.013), while no significant effect was observed for C-reactive protein (ES = -0.14, 95% CI: -0.33, 0.05, P = 0.156). Finally, blood pressure was also significantly improved following higher dietary fiber intake (systolic blood pressure: ES = -1.72, 95% CI: -2.13, -1.30, P < 0.001; diastolic blood pressure: ES = -0.67, 95% CI: -0.96, -0.37, P < 0.001). Subgroup analysis revealed that the study population and type of dietary fiber could be partial sources of heterogeneity. In conclusion, the present umbrella meta-analysis provides evidence for the role of dietary fiber supplementation in the improvement of established cardiovascular risk factors.

Effect of oats and oat ß-glucan on glycemic control in diabetes: a systematic review and meta-analysis of randomized controlled trials

Introduction

Current health claims recognize the ability of oat ß-glucan to lower blood cholesterol; however, its ability to improve glycemic control is less certain. We undertook a systematic review and meta-analysis of randomized controlled trials (RCTs) to update the evidence on the effect of oats and oat ß-glucan on glycemic control in individuals with diabetes.

Research design and methods

MEDLINE, EMBASE and Cochrane were searched (June 2021) for RCTs of ≥2 weeks investigating the effect of oat ß-glucan on glycemic control in diabetes. The outcomes were hemoglobin A1c (HbA1c), fasting glucose, 2-hour postprandial glucose (2h-PG) from a 75 g oral glucose tolerance test, homeostatic model assessment of insulin resistance (HOMA-IR) and fasting insulin. Independent reviewers extracted the data and assessed the risk of bias. Data were pooled using the generic inverse variance method. Heterogeneity was assessed (Cochran Q) and quantified (I2). Pooled estimates were expressed as mean difference (MD) with 95% CI. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations approach.

Results

Eight trial comparisons (n=407) met the eligibility criteria. All trials were in adults with type 2 diabetes who were predominantly middle-aged, overweight and treated by antihyperglycemic medications or insulin. A median dose of 3.25 g of oat ß-glucan for a median duration of 4.5 weeks improved HbA1c (MD, −0.47% (95% CI −0.80 to −0.13), pMD=0.006), fasting glucose (−0.75 mmol/L (−1.20 to –0.31), pMD<0.001), 2h-PG (−0.42 mmol/L (−0.70 to –0.14), pMD=0.003) and HOMA-IR (−0.88 (−1.55 to –0.20), pMD=0.011). There was a non-significant reduction in fasting insulin (−4.30 pmol/L (−11.96 to 3.35), pMD=0.271). The certainty of evidence was high for fasting glucose, moderate for HOMA-IR and fasting insulin (downgraded for imprecision), and low for HbA1c and 2h-PG (downgraded for imprecision and inconsistency).

Conclusions

Consumption of oats and oat ß-glucan results in generally small improvements in established markers of fasting and postprandial glycemic control beyond concurrent therapy in adults with type 2 diabetes. The current evidence provides a very good indication for reductions in fasting glucose and less of an indication for reductions in HbA1c, 2h-PG, fasting insulin and HOMA-IR in this population.

Trial registration number

NCT04631913.

Antidiabetic and Hypolipidemic Efficiency of Lactobacillus plantarum Fermented Oat (Avena sativa) Extract in Streptozotocin-Induced Diabetes in Rats

Antidiabetic properties of fermented foods have been previously demonstrated. This study aimed to examine the antidiabetic and hypolipidemic potential activities of L. plantarum fermented oat extract in Streptozotocin-induced diabetic rats. Firstly, inoculating 1% of L. plantarum starter culture in 10% whole oat flour in aqueous media resulted in 8.36 log CFU mL−1 and pH 4.60 after 72 h of fermentation at 37 °C. With time progression of oat fermentation, total phenolic content (TPC), antioxidant activity (AOA), and γ-aminobutyric acid (GABA) contents were significantly increased up to 72 h. On the contrary, a significant reduction in β-glucan content was observed only after 72 h of fermentation. Secondly, separated aqueous extracts, i.e., unfermented oat extract (UFOE) and L. plantarum fermented oat extract (LFOE) were examined in vivo in a rat model, which consisted of five groups. Group 1 (negative group, NR); GROUP 2 (positive group, STZ), intraperitoneally injected with a single dose of 45 mg kg−1 BW of Streptozotocin and administered 7 mL of distilled water orally per day; Group 3 (STZ+MET), diabetic rats orally administered 50 mg of metformin kg−1 BW daily; Group 4 (STZ+UFOE), diabetic rats orally administered 7 mL of UFOE daily; and Group 5 (STZ+UFOE), diabetic rats orally administered 7 mL of LFOE daily for 6 weeks. Monitoring random blood glucose (RBG) and fasting blood glucose (FBG) showed that both the UFOE and the LFOE alleviated hyperglycemia in the STZ-induced diabetic rats. The extracts were significantly efficient in improving serum lipid profiles as compared with the positive group. Moreover, liver and kidneys’ functions were improved, and both extracts promoted hepatoprotective and nephroprotective characteristics. Furthermore, the administration of the UFOE and the LFOE efficiently attenuated GSH, CAT, and SOD enzymes and decreased MDA levels as compared with the positive group. In conclusion, data indicate the potential of UFOE and LFOE in future strategies as functional supplements against diabetes and diabetes-related complications.

Effect of oat supplementation interventions on cardiovascular disease risk markers: a systematic review and meta-analysis of randomized controlled trials

PURPOSE

Oat supplementation interventions (OSIs) may have a beneficial effect on cardiovascular disease (CVD) risk. However, dietary background can modulate such effect. This systematic review assesses the effects of OSIs on CVD risk markers among adults, accounting for different dietary backgrounds or control arms.

METHODS

We included randomized clinical trials (RCTs) that assessed the effect of oat, oat beta-glucan-rich extracts or avenanthramides on CVD risk markers.

RESULTS

Seventy-four RCTs, including 4937 predominantly hypercholesterolemic, obese subjects, with mild metabolic disturbances, were included in the systematic review. Of these, 59 RCTs contributed to the meta-analyses. Subjects receiving an OSI, compared to control arms without oats, had improved levels of total cholesterol (TC) [weighted mean difference and (95% CI) - 0.42 mmol/L, (- 0.61; - 0.22)], LDL cholesterol [- 0.29 mmol/L, (- 0.37; - 0.20)], glucose [- 0.25 nmol/L, (- 0.36; - 0.14)], body mass index [- 0.13 kg/m2, (- 0.26; - 0.01)], weight [- 0.94 kg, (- 1.84: - 0.05)], and waist circumference [- 1.06 cm, (- 1.85; - 0.27)]. RCTs on inflammation and/or oxidative stress markers were scarce and with inconsistent findings. RCTs comparing an OSI to heterogeneous interventions (e.g., wheat, eggs, rice, etc.), showed lowered levels of glycated haemoglobin, diastolic blood pressure, HDL cholesterol and apolipoprotein B. The majority of included RCTs (81.1%) had some concerns for risk of bias.

CONCLUSION

Dietary OSIs resulted in lowered levels of blood lipids and improvements in anthropometric parameters among participants with predominantly mild metabolic disturbances, regardless of dietary background or control. Further high-quality trials are warranted to establish the role of OSIs on blood pressure, glucose homeostasis and inflammation markers.

The Impact of Cereal Grain Composition on the Health and Disease Outcomes

Whole grains are a pivotal food category for the human diet and represent an invaluable source of carbohydrates, proteins, fibers, phytocompunds, minerals, and vitamins. Many studies have shown that the consumption of whole grains is linked to a reduced risk of cancer, cardiovascular diseases, and type 2 diabetes and other chronic diseases. However, several of their positive health effects seem to disappear when grains are consumed in the refined form. Herein we review the available literature on whole grains with a focus on molecular composition and health benefits on many chronic diseases with the aim to offer an updated and pragmatic reference for physicians and nutrition professionals.

As a Staple Food Substitute, Oat and Buckwheat Compound Has Health-Promoting Effects for Diabetic Rats

Dietary intervention is crucial for the prevention and control of diabetes. China has the largest diabetic population in the world, yet no one dietary strategy matches the eating habits of the Chinese people. To explore an effective and acceptable dietary pattern, this study uses oat and buckwheat compound (OBC) as a staple food substitute and explored its effects on diabetic Sprague–Dawley rats. The model of diabetic rats was established by combining high-calorie feed and streptozotocin (STZ) injection. The dietary intervention for the seven groups, including a normal control group, a model control group, a metformin control group, a wheat flour control group, and three OBC groups with different doses, started from the beginning of the experiment and lasted for 11 weeks, two consecutive injections of STZ in small doses were operated at the 6th week. General states, glucose metabolism, and lipid metabolism indexes were measured. Antioxidant and inflammatory indexes and pathologic changes of kidney and liver tissues were tested. Changes in kidney and ileum ultramicrostructure were detected. What's more, ileal epithelial tight junction proteins and gut microbiota were analyzed. Significant decreases in fasting blood glucose (FBG), glucose tolerance, serum insulin, and insulin resistance were observed in rats intervened with OBC, and these rats also showed a higher level of superoxide dismutase (SOD) together with improved lipid metabolism, attenuated inflammation, and liver and kidney injuries. In addition, in OBC groups, the intestinal barrier was improved, and the disturbance of gut microbiota was reduced. These results suggest that OBC has health-promoting effects for diabetic rats, and since oat and buckwheat are traditionally consumed grains in China, OBC could be a potential and easy-to-accept staple food substitute for the dietary pattern for Chinese.

Role of Whole Grain Consumption in Glycaemic Control of Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

BACKGROUND

Observational studies have indicated beneficial effects of whole grain consumption on human health. However, no evidence based on randomized controlled trials has been established. Our objective was to perform a systematic review and meta-analysis of randomized controlled trials to assess the effects of whole grain consumption in glycaemic control of diabetic patients.

METHODS

A comprehensive search in four databases (Web of Science, Pubmed, Scopus and Cochrane library) was conducted to collect potential articles which measured the roles of whole grain consumption on glycaemic control up to October 2021.

RESULTS

A total of 16 eligible trials involving 1068 subjects were identified to evaluate the pooled effect. The overall results indicated that compared with the control group, whole grain intake presented a significantly reduced concentration in fast plasma glucose (WMD = -0.51 mmol/L, 95% CI: -0.73, -0.28; I2 = 88.6%, p < 0.001), a homeostasis model assessment of insulin resistance (WMD = -0.39 μU × mol/L2, 95% CI: -0.73, -0.04; I2 = 58.4%, p = 0.014), and glycosylated haemoglobin (WMD = -0.56%, 95% CI: -0.88, -0.25, I2 = 88.5%, p < 0.001), while no significant difference was observed in fast plasma insulin level between groups (SMD = -0.05, 95% CI: -0.25, 0.14; I2 = 40.7%, p = 0.120). In terms of incremental area under the curve (iAUC), data suggested that whole grain effected a significant decrease in Glucose-iAUC (WMD = -233.09 min × mmol/L, 95% CI: -451.62, -14.57; I2 = 96.1%, p < 0.001) and Insulin-iAUC (SMD = -4.80, 95% CI: -8.36, -1.23; I2 = 89.9%, p = 0.002), although only in a small number of studies. Of note, there is evidence for modest unexplained heterogeneity in the present meta-analysis.

CONCLUSION

Whole grain consumption confers a beneficial effect on glucose metabolism in patients with diabetes. Regrettably, since relevant studies were scarce, we failed to provide confident evidence of whole grain consumption on acute effects including Glucose-iAUC and Insulin-iAUC, which should be addressed in further trials.

Evaluation of novel nutraceuticals based on the combination of oat beta-glucans and a green coffee phenolic extract to combat obesity and its comorbidities. A randomized, dose-response, parallel trial

Obesity and its associated comorbidities are a major public health concern worldwide. Reduced energy intake and increased physical activity interventions have limited success in the long term. Nutraceuticals might be an alternative means to help lose weight and reduce obesity-associated cardiometabolic risk factors without changes in the habitual diet. The objective of the present study was to comparatively evaluate the efficiency of nutraceuticals based on the combination of a decaffeinated green coffee bean extract (GCBE) and two types of oat beta-glucans (BG) with different physiochemical properties on obesity related biomarkers in overweight/obese subjects. A randomized, dose-response, parallel, blind study was carried out in four groups of subjects (n = 15 each) who consumed for 6 weeks, twice a day, a nutraceutical containing 3 g d^-1 or 5 g d^-1 doses of 35% or 70% BG and a fixed amount of GCBE providing 600 mg d^-1 of phenols. 35% BG showed a 10 and 100 times higher molecular weight and viscosity, respectively, compared to 70% BG. Food intake, anthropometry and different cardiometabolic markers were assessed at the beginning and end of the intervention. According to the general model of variance with repeated measure analysis, the intervention caused positive changes in the levels of total cholesterol, LDL cholesterol, VLDL cholesterol, triglycerides, alanine aminotransferase, aspartate aminotransferase, haemoglobin A1c, insulin, systolic blood pressure (SBP), total body fat percentage (TBF%), visceral fat percentage, and waist and hip circumferences without differences among the treatments, except for SBP and TBF%. Looking into the rates of change [(end value - beginning value)/beginning value] of these parameters, 5 g - 70% BG was the treatment that lowered TBF% the most. In conclusion, 5 g - 70% BG may be more effective in helping to lose weight and additionally, it produced the least bloating according to participants' subjective perception.

Dose-dependent effects of insoluble fibre on glucose metabolism: a stratified post hoc analysis of the Optimal Fibre Trial (OptiFiT)

AIMS

As the first long-term RCT on insoluble cereal fibre, the optimal fibre trial demonstrated glycometabolic benefits, confirming cohort studies. The combined study intervention of lifestyle recommendations and supplementation with insoluble oat hulls fibre allows to clarify, which amount of fibre is required for a beneficial effect.

METHODS

One hundred and eighty participants with impaired glucose tolerance underwent the one-year PREDIAS lifestyle programme and received a blinded, randomized fibre or placebo supplement for two years. We conducted a regression analyses and cut-off-based tertile comparisons in subjects with full data on dietary compliance (food records and accounted supplement; n = 120) after one year, investigating effects on fasting blood parameters, oral glucose tolerance test and anthropometry.

RESULTS

We found a nonlinear inverse relation between fibre intake and change in postprandial 2-h glucose levels, showing a metabolic benefit beyond 14 g and a plateau beyond 25 g of total insoluble fibre per day. 2-h glucose levels improved significantly stronger in both upper tertiles (-0.9 [-1.6;-0.2] mmol/l, p = 0.047, and -0.6 [-1.6;0.3] mmol/l, p = 0.010) compared to the lowest tertile (0.1 [-1.2;1.1] mmol/l), also when adjusted for changes in bodyweight. Subjects with the highest fibre intake showed superior effects on fasting and postprandial insulin resistance, hepatic insulin clearance, leucocyte count and fatty liver index.

CONCLUSIONS

Extending the knowledge on the benefits of insoluble oat hulls fibre, our post hoc analysis demonstrates a dose effect for glycaemia and associated metabolic markers. Further research is needed in order to replicate our findings in larger trials.

Yeast Beta-Glucans Ingestion Does Not Influence Body Weight: A Systematic Review and Meta-Analysis of Pre-Clinical Studies

Dietary fiber supplementation has been studied as a promising strategy in the treatment of obesity and its comorbidities. A systematic review and meta-analysis were performed to verify whether the consumption of yeast beta-glucan (BG) favors weight loss in obese and non-obese rodents. The PICO strategy was employed, investigating rodents (Population), subjected to the oral administration of yeast BG (Intervention) compared to animals receiving placebo (Comparison), evaluating body weight changes (Outcome), and based on preclinical studies (Study design). Two reviewers searched six databases and the grey literature. We followed the PRISMA 2020 guidelines, and the protocol was registered on PROSPERO (CRD42021267788). The search returned 2467 articles. Thirty articles were selected for full-text evaluation, and seven studies remained based on the eligibility criteria. The effects of BG intake on body weight were analyzed based on obese (n = 4 studies) and non-obese animals (n = 4 studies). Even though most studies on obese rodents (75%) indicated a reduction in body weight (qualitative analysis), the meta-analysis showed this was not significant (mean difference −1.35 g—95% CI −5.14:2.45). No effects were also observed for non-obese animals. We concluded that the ingestion of yeast BG barely affects the body weight of obese and non-obese animals.

The effect of oat β-glucan on postprandial blood glucose and insulin responses: a systematic review and meta-analysis

To determine the effect of oat β‑glucan (OBG) on acute glucose and insulin responses and identify significant effect modifiers we searched the MEDLINE, EMBASE, and Cochrane databases through October 27, 2020 for acute, crossover, controlled feeding trials investigating the effect of adding OBG (concentrate or oat-bran) to carbohydrate-containing test-meals compared to comparable or different carbohydrate-matched control-meals in humans regardless of health status. The primary outcome was glucose incremental area-under-the-curve (iAUC). Secondary outcomes were insulin iAUC, and glucose and insulin incremental peak-rise (iPeak). Two reviewers extracted the data and assessed risk-of-bias and certainty-of-evidence (GRADE). Data were pooled using generic inverse-variance with random-effects model and expressed as ratio-of-means with [95% CIs]. We included 103 trial comparisons (N = 538). OBG reduced glucose iAUC and iPeak by 23% (0.77 [0.74, 0.81]) and 28% (0.72 [0.64, 0.76]) and insulin by 22% (0.78 [0.72, 0.85]) and 24% (0.76 [0.65, 0.88]), respectively. Dose, molecular-weight, and comparator were significant effect modifiers of glucose iAUC and iPeak. Significant linear dose-response relationships were observed for all outcomes. OBG molecular-weight >300 kg/mol significantly reduced glucose iAUC and iPeak, whereas molecular-weight <300 kg/mol did not. Reductions in glucose iAUC (27 vs 20%, p = 0.03) and iPeak (39 vs 25%, p < 0.01) were significantly larger with different vs comparable control-meals. Outcomes were similar in participants with and without diabetes. All outcomes had high certainty-of-evidence. In conclusion, current evidence indicates that adding OBG to carbohydrate-containing meals reduces glycaemic and insulinaemic responses. However, the magnitude of glucose reduction depends on OBG dose, molecular-weight, and the comparator.

[Role of dairy and alternative plant products in a healthy and sustainable diet]

Dairy products and plant alternatives are two food groups that are part of the Spanish population's diet. Both have a very different nutritional composition - unlike plant products, the high nutritional density of dairy products makes it easier to meet nutrient requirements at different stages of life. Although the environmental impact of dairy production is greater than that of plant-based products, it falls below that of other food groups such as red meat, including pork and beef. Dairy and plant alternatives meet critical points of the sustainable diet definition, and several food guides from countries around the world are including them within healthy and sustainable eating patterns. For this reason, it is necessary to clarify that both products can be part of a healthy and sustainable diet, although they belong to different food groups, which are not interchangeable and should not be used alternatively.

Do Bioactive Food Compound with Avena sativa L., Linum usitatissimum L. and Glycine max L. Supplementation with Moringa oleifera Lam. Have a Role against Nutritional Disorders? An Overview of the In Vitro and In Vivo Evidence

Functional clinical nutrition is an integrative science; it uses dietary strategies, functional foods and medicinal plants, as well as combinations thereof. Both functional foods and medicinal plants, whether associated or not, form nutraceuticals, which can bring benefits to health, in addition to being included in the prevention and treatment of diseases. Some functional food effects from Avena sativa L. (oats), Linum usitatissimum L. (brown flaxseed), Glycine max L. (soya) and Moringa oleifera have been proposed for nutritional disorders through in vitro and in vivo tests. A formulation called a bioactive food compound (BFC) showed efficiency in the association of oats, flaxseed and soy for dyslipidemia and obesity. In this review, we discuss the effects of BFC in other nutritional disorders, as well as the beneficial effects of M. oleifera in obesity, cardiovascular disease, diabetes mellitus type 2, metabolic syndrome, intestinal inflammatory diseases/colorectal carcinogenesis and malnutrition. In addition, we hypothesized that a BFC enriched with M. oleifera could present a synergistic effect and play a potential benefit in nutritional disorders. The traditional consumption of M. oleifera preparations can allow associations with other formulations, such as BFC. These nutraceutical formulations can be easily accepted and can be used in sweet preparations (fruit and/or vegetable juices, fruit and/or vegetable vitamins, porridges, yogurt, cream, mousses or fruit salads, cakes and cookies) or savory (vegetable purees, soups, broths and various sauces), cooked or not. These formulations can be low-cost and easy-to-use. The association of bioactive food substances in dietary formulations can facilitate adherence to consumption and, thus, contribute to the planning of future nutritional interventions for the prevention and adjuvant treatment of the clinical conditions presented in this study. This can be extended to the general population. However, an investigation through clinical studies is needed to prove applicability in humans.

The Role of High-Content Complex Dietary Fiber in Medical Nutrition Therapy for Gestational Diabetes Mellitus

Objectives: A controlled open clinical study was conducted to evaluate the role of Ricnoat, a high-content complex dietary fiber powder produced by Zhuhai Aimed Biotechnology Co. Ltd., in medical nutrition therapy (MNT) to treat gestational diabetes mellitus (GDM). The study aimed to investigate glycemic control, lipid control, weight control, and pregnancy outcomes (neonatal weight) in patients with GDM, as well as evaluate the clinical safety of Ricnoat.

Methods: A total of 120 patients with GDM who were admitted to three hospitals in Shanghai between January 2019 and January 2020 were enrolled. Ricnoat was used for intervention for patients in the experimental group. Using a χ² test and t-test, respectively, comparisons were conducted between the measurement data and countable data of the demographics and baseline disease characteristics of the experimental group and control group.

Results: Fasting blood glucose, 2-h postprandial blood glucose, glycated hemoglobin, total cholesterol, triglycerides, low-density lipoprotein, maternal gestational weight gain, neonatal weight, serum creatinine, glutamate transaminase, and aspartate aminotransferase were lower in the experimental group than in the control group, whereas high-density lipoprotein was higher in the experimental group than in the control group. Ricnoat intervention resulted in satiety higher than the expected 80% and more common occurrence of type 4 (smooth and soft, like salami or a snake) and type 5 (a soft mass with clear edges) stools.

Conclusion: Ricnoat intervention had a significant effect on glycemic control, lipid control, weight control, and pregnancy outcomes (neonatal weight) in patients with GDM by enhancing maternal satiety and improving the stool features of pregnant women. It was also found to be safe for application during pregnancy.

Six Weeks of Aerobic Exercise in Untrained Men With Overweight/Obesity Improved Training Adaptations, Performance and Body Composition Independent of Oat/Potato or Milk Based Protein-Carbohydrate Drink Supplementation

Background: Protein availability around aerobic exercise might benefit aerobic capacity and body composition in normal weight adults. However, it is unknown if individuals with overweight/obesity elicit similar adaptations or improve other cardiometabolic/health-related markers in response to different types of protein. Thus, our aim was to study the effect of supplementation of two different protein drinks in conjunction with exercise on aerobic capacity, body composition and blood health markers in untrained subjects with overweight or obesity.

Methods: The present study measured training adaptation and health parameters over a 6 week period in untrained men with overweight/obesity (n = 28; BMI 30.4 ± 2.2 kg/m²) ingesting either plant- (Oat/Potato; n = 8) or animal-based (Milk; n = 10) protein-carbohydrate drinks (10 g of protein/serving), or a control carbohydrate drink (n = 10) acutely before and after each training session (average three sessions/week @ 70% HR_max). Pre-post intervention V˙O2peak, muscle biopsies and blood samples were collected, body composition measured (DXA) and two different exercise tests performed. Body weight was controlled with participants remaining weight stable throughout the intervention.

Results: For the groups combined, the training intervention significantly increased V˙O2peak (8%; P < 0.001), performance in a time-to-exhaustion trial (~ 100%; P < 0.001), mitochondrial protein content and enzyme activity (~20–200%). Lean body mass increased (1%; P < 0.01) and fat mass decreased (3%; P < 0.01). No significant effects on fasting blood glucose, insulin, lipids or markers of immune function were observed. There were no significant interactions between drink conditions for training adaptation or blood measurements. For body composition, the Oat/Potato and carbohydrate group decreased leg fat mass significantly more than the Milk group (interaction P < 0.05).

Conclusions: Aerobic capacity and body composition were improved and a number of mitochondrial, glycolytic and oxidative skeletal muscle proteins and enzyme activities were upregulated by a 6 week training intervention. However, none of the parameters for endurance training adaptation were influenced by protein supplementation before and after each training session.

Low-carbohydrate diets and cardiometabolic health: the importance of carbohydrate quality over quantity

Carbohydrates are increasingly being implicated in the epidemics of obesity, diabetes, and their downstream cardiometabolic diseases. The "carbohydrate-insulin model" has been proposed to explain this role of carbohydrates. It posits that a high intake of carbohydrate induces endocrine deregulation marked by hyperinsulinemia, leading to energy partitioning with increased storage of energy in adipose tissue resulting in adaptive increases in food intake and decreases in energy expenditure. Whether all carbohydrate foods under real-world feeding conditions directly contribute to weight gain and its complications or whether this model can explain these clinical phenomena requires close inspection. The aim of this review is to assess the evidence for the role of carbohydrate quantity vs quality in cardiometabolic health. Although the clinical investigations of the "carbohydrate-insulin model" have shown the requisite decreases in insulin secretion and increases in fat oxidation, there has been a failure to achieve the expected fat loss under low-carbohydrate feeding. Systematic reviews with pairwise and network meta-analyses of the best available evidence have failed to show the superiority of low-carbohydrate diets on long-term clinical weight loss outcomes or that all sources of carbohydrate behave equally. High-carbohydrate diets that emphasize foods containing important nutrients and substances, including high-quality carbohydrate such as whole grains (especially oats and barley), pulses, or fruit; low glycemic index and load; or high fiber (especially viscous fiber sources) decrease intermediate cardiometabolic risk factors in randomized trials and are associated with weight loss and decreased incidence of diabetes, cardiovascular disease, and cardiovascular mortality in prospective cohort studies. The evidence for sugars as a marker of carbohydrate quality appears to be highly dependent on energy control (comparator) and food source (matrix), with sugar-sweetened beverages providing excess energy showing evidence of harm, and with high-quality carbohydrate food sources containing sugars such as fruit, 100% fruit juice, yogurt, and breakfast cereals showing evidence of benefit in energy-matched substitutions for refined starches (low-quality carbohydrate food sources). These data reflect the current shift in dietary guidance that allows for flexibility in the proportion of macronutrients (including carbohydrates) in the diet, with a focus on quality over quantity and dietary patterns over single nutrients.

The effect of beta-glucan supplementation on glycemic control and variability in adolescents with type 1 diabetes mellitus

AIMS

This study aimed to investigate whether supplemental soluble fiber, oat β-glucan, has any effect on glycemic control and variability of adolescents with type 1 diabetes mellitus.

METHODS

This study was conducted in 30 adolescents with type 1 diabetes mellitus and it consisted of three phases lasting one week. At Phase I, all subjects followed a standard diet program. For Phase II and Phase III, the subjects continued their standard diet program and added natural oat flakes containing 3 g/day and 6 g/day β-glucan, respectively. Glucose levels were monitored by continuous glucose monitoring (CGM). The maximal, minimal, mean and daytime and night blood glucose levels, percentages of glucose values in a target range and below and above a target values were calculated for each of the phases. Premeal, postmeal, peak blood glucose values and peak times of meals were evaluated for each of the phases. Glycemic variability was measured via SD, CV, MAGE, IQR, MODD, LBGI, HBGI, and CONGA parameters.

RESULTS

The maximal, mean and daytime and night blood glucose levels were the lowest at Phase III (p < 0.05). Minimal blood glucose levels were the highest at Phase III (p < 0.05). Phase I, II, and III showed similar durations elapsed for Level 2 and Level 1 hypoglycemia, euglycemia, Level 1 and Level 2 hyperglycemia (p > 0.05). Premeal and postmeal blood glucose levels were lowest at Phase III for breakfast, lunch, and overall (p < 0.05). The lowest peak blood glucose levels were detected at Phase III for breakfast, lunch, dinner and overall (p < 0.05). Phase III also showed delayed peaks for all time-points (p < 0.05 for each) compared to other phases. Phase III had significantly lower levels of SD, CV, LBGI, and CONGA levels than those in either Phase I or Phase II (p < 0.05 for each).

CONCLUSION

6 g/day oat β-glucan have favorable outcomes in glycemic control and variability in adolescents with type 1 diabetes mellitus.

Effect of inulin on rheological, textural, and structural properties of brown wheat flour dough and in vitro digestibility of developed Arabic bread

The brown wheat flour (BWF)-based Arabic bread was fortified with chicory-derived inulin. The objective of this work was to assess the influence of the inulin concentration (1.25 to 5%) on the rheological, textural properties, and fermentation efficacy of enriched BWF dough. Farinographic measurement established that only 3.75% BWF can be substituted by inulin in a dough formulation, which resulted in lowering the water absorption capacity. The peak gelatinization temperature, T_p detected at 74.4 °C by rheometric measurement, which increased linearly with increasing the inulin concentration. The elastic modulus (G'), however, differed significantly among doughs with the addition of inulin. The dough hardness and compressibility increased as a function of inulin concentration. TPA measurement indicated that the Arabic bread fortified with 3.75% inulin was the best in texture. The addition of inulin improved the volume of CO₂ generation in the yeasted dough. The distribution of starch particles on the top layer of bread surface was visualized through SEM. In-vitro digestion and steady-flow measurement of the BWF/inulin bread digesta exhibited a slow digestion and an increment in the apparent viscosity against the control bread, which further confirmed potential health benefits of the developed Arabic bread. PRACTICAL APPLICATION: Arabic bread is a staple food in many Asian countries, and an incorporation of soluble fiber, like inulin, definitely improves its health benefits. This work optimized a formulation based on BWF and inulin with technical feasibility. Rheological and textural studies demonstrated that blend bread could be made by replacing 3.75% BWF by inulin with significantly lower water content. Inulin has replaced the sugar in the yeasted dough, and carried out the bread fermentation adequately.

Dietary Fibre from Whole Grains and Their Benefits on Metabolic Health

The consumption of whole grain products is often related to beneficial effects on consumer health. Dietary fibre is an important component present in whole grains and is believed to be (at least partially) responsible for these health benefits. The dietary fibre composition of whole grains is very distinct over different grains. Whole grains of cereals and pseudo-cereals are rich in both soluble and insoluble functional dietary fibre that can be largely classified as e.g., cellulose, arabinoxylan, β-glucan, xyloglucan and fructan. However, even though the health benefits associated with the consumption of dietary fibre are well known to scientists, producers and consumers, the consumption of dietary fibre and whole grains around the world is substantially lower than the recommended levels. This review will discuss the types of dietary fibre commonly found in cereals and pseudo-cereals, their nutritional significance and health benefits observed in animal and human studies.

Sensory Characteristics Contributing to Pleasantness of Oat Product Concepts by Finnish and Chinese Consumers

Oats are increasingly popular among consumers and the food industry. While data exist on sensory characteristics of oats as such, previous studies focusing on the pleasantness of oats, and especially investigations of a wide range of oat products by European and Asian consumers, are scarce. An online questionnaire was organized in Finland (n = 381; 83.7% Finnish) focusing on the liking and familiarity of oat products, followed by sensory tests in Finland (n = 65 and n = 73) and China (n = 103) using the Check-All-That-Apply method and hedonic ratings. A questionnaire revealed that the Finnish consumers rated the pleasantness and familiarity of several oat product categories, such as breads and porridges, higher compared to participants of other ethnicities. Sensory tests showed both similarities, e.g., porridges were described as “natural”, “healthy” and “oat-like”, and differences between countries, e.g., sweet biscuits, were described as “crispy” and “hard” by Finnish consumers and “strange” and “musty” by Chinese consumers. Sweet products were unanimously preferred. The ethnicity had an important role affecting the rating of pleasantness and familiarity of oat product categories, whereas food neophobia and health interest status also had an influence. The proved healthiness of oats was a crucial factor affecting the choices of consumers and their acceptance in both countries.

Therapeutic effects of different doses of prebiotic (isolated from Saccharomyces cerevisiae) in comparison to n-3 supplement on glycemic control, lipid profiles and immunological response in diabetic rats

BACKGROUND

The regular intake of fiber generates numerous health benefits. However, the efficacy depends on the duration of consumption and the ingested dose. Studies investigating the optimal dose are of interest to enable the inclusion of fiber in the routine treatment of diabetic patients.

OBJECTIVE

We aimed to evaluate the effects of different doses of β-glucan (BG-isolated from Saccharomyces cerevisiae), in comparison to n-3 supplement, on the inflammatory and metabolic parameters of Wistar rats induced to diabetes by streptozotocin.

METHODS

Forty animals were randomly divided into six groups receiving 0 mg/kg, 10 mg/kg, 20 mg/kg, or 40 mg/kg BG daily for 4 weeks or fish oil derivative [1000 mg/kg of omega-3 fatty acids (n-3)] for the same period. One additional group was composed of healthy controls. Serum metabolic and immunological parameters were evaluated by colorimetric and ELISA assays respectively. Histopathological analysis of the liver, small intestine and pancreas were also conducted. Significant changes due to BG intake were set into regression models with second-degree fit in order to estimate the optimal BG dose to achieve health benefits.

RESULTS

The animals that ingested BG had lower food and water intake (p < 0.05) than the negative control group (0 mg/kg). However, consumption was still elevated in comparison to healthy controls. Blood glucose and serum levels of total cholesterol, LDL-c, and TG (p < 0.05) reduced in comparison to diabetic animals without treatment (better or similar to n-3 group depending on dose), but did not reach normal levels (in comparison to healthy controls). HDL-c was not different (p > 0.05) among all groups. These reductions were already seen with the lowest dose of 10 mg/kg. On average, the serum levels of the hepatic enzymes ALT and AST were 40% and 60% lower in the BG groups in comparison to diabetic animals without treatment (better results than n-3 group). The group receiving 40 mg/kg reached similar values of healthy controls for ALT; whereas the same result occurred from the dose of 10 mg/kg for AST. The ideal dose, estimated from the mean of all metabolic parameters was approximately 30 mg/kg/day. Regarding the immunological profile, TNF-α significantly decreased in the BG groups compared to controls (p < 0.05), reaching better values than n-3 group and similar to healthy controls. No significant differences were found between the groups in IL-1β or IL-10 (p > 0.05). No histological changes were found in the pancreas, liver, or intestine due to treatment among diabetic animals.

CONCLUSIONS

BG significantly reduced blood glucose as well as serum total cholesterol, LDL-c and TG. There was a hepatoprotective effect due to the reduction in ALT and AST and a reduction in TNF-α, indicating a modulation of the immune response. In general, BG effects were better than n-3 supplement (or at least comparable) depending on the dose.

Hypocaloric, plant-based oatmeal interventions in the treatment of poorly-controlled type 2 diabetes: A review

BACKGROUND

Lifestyle interventions, including dietary modifications, play a key role in the treatment of type 2 diabetes. By the second half of the last century, dietary oatmeal interventions had frequently been used in patients with diabetes; however, with the widespread introduction of insulin, this practice gradually fell into disuse. Within the last decades, the original oatmeal intervention, first described in 1903, has been modified towards a hypocaloric, low-fat, and plant-based intervention.

AIM

The aim of this review was to investigate the current role of these adapted short-term dietary oatmeal interventions in the treatment of patients suffering from poorly-controlled type 2 diabetes. A special focus was put on opportunities for and barriers to its clinical implementation and its potential mechanisms of action.

METHODS

The electronic databases of PubMed and Google Scholar were searched using the keywords "oat," "oats," "oatmeal," and "diabetes."

RESULTS

While there are a limited number of clinical studies including hypocaloric short-term dietary oatmeal interventions, there is evidence that these interventions may lead to a significant decrease in mean blood glucose levels and a significant reduction of insulin dosage in patients suffering from poorly-controlled type 2 diabetes.

CONCLUSION

Modified short-term dietary oatmeal interventions are an effective and economical tool in the treatment of patients suffering from poorly-controlled type 2 diabetes.

[Nutrition for diabetic patients (Update 2019)]

Evidence demonstrates that medical diabetes treatment has to be accompanied by lifestyle modifications. Structured nutrition interventions and increased physical activity will help patients to normalise, respectively maintain their body weight.The main target of a medical nutrition therapy aims at achieving normal or nearly normal blood glucose levels, prevention of delay of diabetes associated complications.

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.

Dietary Fiber Intake and Type 2 Diabetes Mellitus: An Umbrella Review of Meta-analyses

Objective

The purpose of this study was to review previously published meta-analyses on the effectiveness of dietary fiber on type 2 diabetes.

Methods

An umbrella review of all published meta-analyses was performed. A PubMed search from January 1, 1980, to April 30, 2017, was conducted using the following search strategy: (fiber OR glucan OR psyllium) AND (meta-analysis OR systematic review). Only English-language publications that provided quantitative statistical analysis on type 2 diabetes, fasting blood glucose concentrations, or glycosylated hemoglobin were retrieved.

Results

Sixteen meta-analyses were retrieved for inclusion in this umbrella review. In the meta-analyses comparing highest versus lowest dietary fiber intake, there was a statistically significant reduction in the relative risk (RR) of type 2 diabetes (RR = 0.81-0.85), with the greatest benefit coming from cereal fibers (RR = 0.67-0.87). However, statistically significant heterogeneity was observed in all of these meta-analyses. In the meta-analyses of supplementation studies using β-glucan or psyllium fibers on type 2 diabetic participants, statistically significant reductions were identified in both fasting blood glucose concentrations and glycosylated hemoglobin percentages.

Conclusion

This review suggests that those consuming the highest amounts of dietary fiber, especially cereal fiber, may benefit from a reduction in the incidence of developing type 2 diabetes. There also appears to be a small reduction in fasting blood glucose concentration, as well as a small reduction in glycosylated hemoglobin percentage for individuals with type 2 diabetes who add β-glucan or psyllium to their daily dietary intake.

In Vitro and In Vivo Antioxidant and Anti-Hyperglycemic Activities of Moroccan Oat Cultivars

Improvement of oat lines via introgression is an important process for food biochemical functionality. This work aims to evaluate the protective effect of phenolic compounds from hybrid Oat line (F11-5) and its parent (Amlal) on hyperglycemia-induced oxidative stress and to establish the possible mechanisms of antidiabetic activity by digestive enzyme inhibition. Eight phenolic acids were quantified in our samples including ferulic, p-hydroxybenzoic, caffeic, salicylic, syringic, sinapic, p-coumaric and chlorogenic acids. The Oat extract (2000 mg/kg) ameliorated the glucose tolerance, decreased Fasting Blood Glucose (FBG) and oxidative stress markers, including Superoxide dismutase (SOD), Catalase (CAT), Glutathione peroxidase (GPx), Glutathione (GSH) and Malondialdehyde (MDA) in rat liver and kidney. Furthermore, Metformin and Oat intake prevented anxiety, hypercholesterolemia and atherosclerosis in diabetic rats. In vivo anti-hyperglycemic effect of Oat extracts has been confirmed by their inhibitory activities on α-amylase (723.91 μg/mL and 1027.14 μg/mL) and α-glucosidase (1548.12 μg/mL & 1803.52 μg/mL) enzymes by mean of a mixed inhibition.