Culinary strategies to manage glycemic response in people with type 2 diabetes: A narrative review

Diet plays a critical role in the management of many chronic diseases. It is well known that individuals with type 2 diabetes (T2D) need to pay close attention to foods rich in carbohydrates to better manage their blood sugar. Usually, individuals are told to increase their dietary fiber intake which is associated with better glycemic control and limit their overall carbohydrate consumption. However, there are many other cooking strategies available to reduce the glycemic response to meals rich in carbohydrates and with a high glycemic index, such as adding fats, proteins, or vinegar, modifying the cooking or preparation processes, and even the selection and storage of foods consumed. The aim of the present narrative review is to summarize some of these existing strategies applied to the cooking process and their ability to modulate glycemic response to meals in individuals with T2D.

Review: Chemosensing of nutrients and non-nutrients in the human and porcine gastrointestinal tract

The gastrointestinal tract (GIT) is an interface between the external and internal milieus that requires continuous monitoring for nutrients or pathogens and toxic chemicals. The study of the physiological/molecular mechanisms, mediating the responses to the monitoring of the GIT contents, has been referred to as chemosensory science. While most of the progress in this area of research has been obtained in laboratory rodents and humans, significant steps forward have also been reported in pigs. The objective of this review was to update the current knowledge on nutrient chemosensing in pigs in light of recent advances in humans and laboratory rodents. A second objective relates to informing the existence of nutrient sensors with their functionality, particularly linked to the gut peptides relevant to the onset/offset of appetite. Several cell types of the intestinal epithelium such as Paneth, goblet, tuft and enteroendocrine cells (EECs) contain subsets of chemosensory receptors also found on the tongue as part of the taste system. In particular, EECs show specific co-expression patterns between nutrient sensors and/or transceptors (transport proteins with sensing functions) and anorexigenic hormones such as cholecystokinin (CCK), peptide tyrosine tyrosine (PYY) or glucagon-like peptide-1 (GLP-1), amongst others. In addition, the administration of bitter compounds has an inhibitory effect on GIT motility and on appetite through GLP-1-, CCK-, ghrelin- and PYY-labelled EECs in the human small intestine and colon. Furthermore, the mammalian chemosensory system is the target of some bacterial metabolites. Recent studies on the human microbiome have discovered that commensal bacteria have developed strategies to stimulate chemosensory receptors and trigger host cellular functions. Finally, the study of gene polymorphisms related to nutrient sensors explains differences in food choices, food intake and appetite between individuals.

Physiological and metabolic control of diet selection

The fact that most farm animals have no dietary choice under commercial practices translates the dietary decisions to the carers. Thus, a lack of understanding of the principles of dietary choices is likely to result in a high toll for the feed industry. In healthy animals, diet selection and, ultimately, feed intake is the result of factoring together the preference for the feed available with the motivation to eat. Both are dynamic states and integrate transient stimulus derived from the nutritional status, environmental and social determinants of the animal with hard-wired genetic mechanisms. Peripheral senses are the primary inputs that determine feed preferences. Some of the sensory aspects of feed, such as taste, are innate and genetically driven, keeping the hedonic value of feed strictly associated with a nutritional frame. Sweet, umami and fat tastes are all highly appetitive. They stimulate reward responses from the brain and reinforce dietary choices related to essential nutrients. In contrast, aroma (smell) recognition is a plastic trait and preferences are driven mostly by learned experience. Maternal transfer through perinatal conditioning and the individual’s own innate behaviour to try or to avoid novel feed (often termed as neophobia) are known mechanisms where the learning process strongly affects preferences. In addtition, the motivation to eat responds to episodic events fluctuating in harmony with the eating patterns. These signals are driven mainly by gastrointestinal hormones (such as cholecystokinin [CCK] and glucagon-like peptide 1 [GLP-1]) and load. In addition, long-term events generate mechanisms for a sustainable nutritional homeostasis managed by tonic signals from tissue stores (i.e. leptin and insulin). Insulin and leptin are known to affect appetite by modulating peripheral sensory inputs. The study of chemosensory mechanisms related to the nutritional status of the animal offers novel tools to understand the dynamic states of feed choices so as to meet nutritional and hedonic needs. Finally, a significant body of literature exists regarding appetite driven by energy and amino acids in farm animals. However, it is surprising that there is scarcity of knowledge regarding what and how specific dietary nutrients may affect satiety. Thus, a better understanding on how bitter compounds and excess dietary nutrients (i.e. amino acids) play a role in no-choice animal feeding is an urgent topic to be addressed so that right choices can be made on the animal’s behalf.

Advanced MRI techniques: biomarkers in neuropsychiatric lupus

Objectives

The objective of this study was to determine whether advanced MRI could provide biomarkers for diagnosis and prognosis in neuropsychiatric systemic lupus erythematosus (NPSLE).

Methods

Our prospective study included 28 systemic lupus erythematosus (SLE) patients with primary central NPSLE, 22 patients without NPSLE and 20 healthy controls. We used visual scales to evaluate atrophy and white matter hyperintensities, voxel-based morphometry and Freesurfer to measure brain volume, plus diffusion-tensor imaging (DTI) to assess white matter (WM) and gray matter (GM) damage. We compared the groups and correlated MRI abnormalities with clinical data.

Results

NPSLE patients had less GM and WM than controls ( p = 0.042) in the fronto-temporal regions and corpus callosum. They also had increased diffusivities in the temporal lobe WM ( p < 0.010) and reduced fractional anisotropy in the right frontal lobe WM ( p = 0.018). High clinical scores, longstanding disease, and low serum C3 were associated with atrophy, lower fractional anisotropy and higher diffusivity in the fronto-temporal lobes. Antimalarial treatment correlated negatively with atrophy in the frontal cortex and thalamus; it was also associated with lower diffusivity in the fronto-temporal WM clusters.

Conclusions

Atrophy and microstructural damage in fronto-temporal WM and GM in NPSLE correlate with severity, activity and the time from disease onset. Antimalarial treatment seems to give some brain-protective effects.

Assessment of Eating Habits and Physical Activity among Spanish Adolescents. The "Cooking and Active Leisure" TAS Program

Worldwide obesity has more than doubled in the last forty years. Even more worrying is the fact that the number of overweight and obese children and adolescents has considerably increased. Socioeconomic development, as well as educational, agricultural and marketing policies have significantly changed dietary and physical activity habits among the youngest, who are thus susceptible to develop chronic and disabling diseases such as diabetes, some cancers and cardiovascular disorders. Adolescence is a critical age, in which the adoption of healthy habits may have dramatic effects on the health state in adulthood. For this reason, prompt interventions are urgently required to prevent the onset of obesity in this time of life. In this regard, the CAL-TAS program from Alicia Foundation was born to combat obesity and promote healthy lifestyles in Spanish adolescents. A total of 2519 students, aged 13–14 years, from 79 schools distributed all over the 17 autonomous communities in Spain were asked to report through the CAL-TAS platform their food intake and physical activity over one week. The body mass index, the consumption of food and beverages, the intake of macronutrients and micronutrients, and the values obtained from the PAQ-A questionnaire, which evaluated physical activity, were analyzed. Twenty percent of the participants were overweight or obese. In general, adolescents did not or poorly respected the recommendations provided by the Spanish Society of Community Nutrition. For example, in more than half of the subjects, the ingestion of fruits and beverages was less than recommended, whereas the consumption of meat, baked goods and fried foods was excessive. Moreover, adolescents with higher body mass index also presented worse eating habits and more inactivity. In conclusion, Spanish adolescents present low adherence to recommendations provided by the Spanish Society of Community Nutrition (SENC) and by the World Health Organization. In order to prevent obesity-related disorders, effective educational programmes have to be designed. Indeed, adolescents and their families should be aware that the early adoption of healthy dietary habits and of a correct physical activity may strongly improve their future quality of life.

Effects of sardine-enriched diet on metabolic control, inflammation and gut microbiota in drug-naïve patients with type 2 diabetes: a pilot randomized trial

BACKGROUND

Nutrition therapy is the cornerstone of treating diabetes mellitus. The inclusion of fish (particularly oily fish) at least two times per week is recommended by current international dietary guidelines for type 2 diabetes. In contrast to a large number of human studies examining the effects of oily fish on different cardiovascular risk factors, little research on this topic is available in patients with type 2 diabetes. The aims of this pilot study were to investigate the effects of a sardine-enriched diet on metabolic control, adiponectin, inflammatory markers, erythrocyte membrane fatty acid (EMFA) composition, and gut microbiota in drug-naïve patients with type 2 diabetes.

METHODS

35 drug-naïve patients with type 2 diabetes were randomized to follow either a type 2 diabetes standard diet (control group: CG), or a standard diet enriched with 100 g of sardines 5 days a week (sardine group: SG) for 6 months. Anthropometric, dietary information, fasting glycated hemoglobin, glucose, insulin, adiponectin, inflammatory markers, EMFA and specific bacterial strains were determined before and after intervention.

RESULTS

There were no significant differences in glycemic control between groups at the end of the study. Both groups decreased plasma insulin (SG: -35.3%, P = 0.01, CG: -22.6%, P = 0.02) and homeostasis model of assessment--insulin resistance (HOMA-IR) (SG: -39.2%, P = 0.007, CG: -21.8%, P = 0.04) at 6-months from baseline. However only SG increased adiponectin in plasma compared to baseline level (+40.7%, P = 0.04). The omega-3 index increased 2.6% in the SG compared to 0.6% in the CG (P = 0.001). Both dietary interventions decreased phylum Firmicutes (SG and CG: P = 0.04) and increased E. coli concentrations (SG: P = 0.01, CG: P = 0.03) at the end of the study from baseline, whereas SG decreased Firmicutes/Bacteroidetes ratio (P = 0.04) and increased Bacteroides-Prevotella (P = 0.004) compared to baseline.

CONCLUSIONS

Although enriching diet with 100 g of sardines 5 days a week during 6 months to a type 2 diabetes standard diet seems to have neutral effects on glycemic control in drug-naïve patients with type 2 diabetes, this nutritional intervention could have beneficial effects on cardiovascular risk. Furthermore, both dietary interventions decreased HOMA-IR and altered gut microbiota composition of drug-naïve patients with type 2 diabetes.

TRIAL REGISTRATION

Trial number and name of the registry: NCT02294526, ClinicalTrials.gov.

A regulatory gene network related to the porcine umami taste receptor (TAS1R1/TAS1R3)

Taste perception plays an important role in the mediation of food choices in mammals. The first porcine taste receptor genes identified, sequenced and characterized, TAS1R1 and TAS1R3, were related to the dimeric receptor for umami taste. However, little is known about their regulatory network. The objective of this study was to unfold the genetic network involved in porcine umami taste perception. We performed a meta-analysis of 20 gene expression studies spanning 480 porcine microarray chips and screened 328 taste-related genes by selective mining steps among the available 12,320 genes. A porcine umami taste-specific regulatory network was constructed based on the normalized coexpression data of the 328 genes across 27 tissues. From the network, we revealed the 'taste module' and identified a coexpression cluster for the umami taste according to the first connector with the TAS1R1/TAS1R3 genes. Our findings identify several taste-related regulatory genes and extend previous genetic background of porcine umami taste.

"Cooking and Active Leisure" TAS Program, Spain: a Program Impact Pathways (PIP) analysis

BACKGROUND

The "Cooking and Active Leisure" Tu y Alícia por la Salud (CAL-TAS) Program is a school-based pilot that addresses healthy lifestyle needs of Spanish secondary school students with initiatives that research has proven to improve dietary and physical activity behaviors.

OBJECTIVE

The objectives were to perform a Program Impact Pathways (PIP) analysis to describe key activities and processes of the CAL-TAS Program, identify Critical Quality Control Points (CCPs), and identify a suite of common indicators of healthy lifestyles to be applied across participant schools.

METHODS

The CAL-TAS Program designers and implementation team developed this PIP analysis through an iterative process and presented the results for feedback at the seven-country Healthy Lifestyles Program Evaluation Workshop held in Granada, Spain, 13-14 September 2013, under the auspices of the Mondelēz International Foundation.

RESULTS

The team identified three PIP CCPs: teachers' motivation and training, changes in students' knowledge of healthy lifestyles, and changes in students' healthy lifestyle behavior. The selected indicators of the program's impact on healthy lifestyles are adequacy of food intake, level of knowledge of healthy lifestyles gained, and adequacy of physical activity level according to World Health Organization recommendations. A clear definition of impact indicators, as well as collection of accurate data on healthy lifestyle behaviors and knowledge, is essential to understanding the effectiveness of this program before it can be scaled up.

CONCLUSIONS

CAL-TAS is an effective secondary school-based program encouraging healthy lifestyles. The PIP analysis was instrumental in identifying CCPs to sustain and improve the quality of the program. The team hopes to sustain and improve the program through these program evaluation recommendations.

Cocoa consumption reduces NF-κB activation in peripheral blood mononuclear cells in humans

BACKGROUND AND AIMS

Epidemiological studies have demonstrated an association between high-polyphenol intake and reduced incidence of atherosclerosis. The healthy effects of cocoa-polyphenols may be due to their antioxidant and anti-inflammatory actions, although the exact mechanisms are unknown and depend on the matrix in which cocoa-polyphenols are delivered. Nuclear factor κB (NF-κB) is a key molecule in the pathophysiology of atherosclerosis involved in the regulation of adhesion molecules(AM) and cytokine expression and its activation is the first step in triggering the inflammatory process. The aim of this study was to evaluate the effect of acute cocoa consumption in different matrices related to the bioavailability of cocoa-polyphenols in NF-κB activation and the expression of AM.

METHODS AND RESULTS

Eighteen healthy volunteers randomly received 3 interventions: 40g of cocoa powder with milk (CM), with water (CW), and only milk (M). NF-κB activation in leukocytes and AM (sICAM, sVCAM, E-selectin) were measured before and 6h after each intervention. Consumption of CW significantly decreased NF-κB activation compared to baseline and to CM (P < 0.05, both), did not change after CM intervention, and significantly increased after M intervention (P = 0.014). sICAM-1 concentrations significantly decreased after 6h of CW and CM interventions (P ≤ 0.026; both) and E-selectin only decreased after CW intervention (P = 0.028). No significant changes were observed in sVCAM-1 concentrations.

CONCLUSIONS

The anti-inflammatory effect of cocoa intake may depend on the bioavailability of bioactive compounds and may be mediated at least in part by the modulation of NF-κB activation and downstream molecules reinforcing the link between cocoa intake and health.

Feed preference in pigs: effect of selected protein, fat, and fiber sources at different inclusion rates

Three double-choice feeding experiments were conducted to study the effect of different feedstuffs on feed preference in pigs. Fifteen protein sources, 6 fat sources, and 3 fiber sources were evaluated in Exp. 1, 2, and 3, respectively. Pigs were offered a series of double choices between a common reference diet and the diet with the ingredient under evaluation. The reference diet contained a soybean meal product with 56% CP (SBM-56), sunflower oil, and wheat bran, which were considered as the feedstuffs of reference for the protein, fat, and fiber sources, respectively. Preference, expressed as percentage of the tested diet to total feed intake, was affected by feedstuff nature and by its inclusion rate. In Exp. 1, feeds with fish meal at 50 and 100 g·kg⁻¹, dried porcine hydrolyzed protein at 50 g·kg⁻¹, and lupine, soybean meal with 44% CP, and dried skim milk at 100 g·kg⁻¹ were preferred (P < 0.05) to the reference feed with SBM-56. On the contrary, relative to SBM-56, an avoidance (preference less than 50%) was observed for potato protein at all inclusion rates tested, rapeseed meal and acid milk whey at 100 and 200 g·kg⁻¹, and dried porcine hydrolyzed protein, soybean protein concentrate, wheat gluten, and sunflower meal at 200 g·kg(-1). The storage of dried skim milk, soybean protein concentrate, and potato protein for 10 mo resulted in a reduction (P < 0.001) of their preference values. In Exp. 2, the feed with palm oil (at 30 g·kg⁻¹) was preferred (P < 0.05), whereas feeds with linseed oil (at 30 and 100 g·kg⁻¹) and soybean oil (at 100 g·kg⁻¹) were avoided (P < 0.05) when contrasted with the reference feed with sunflower oil. Finally, in Exp. 3 diets with dehydrated alfalfa and sugar beet pulp at 130 g·kg⁻¹ had a reduced (P < 0.05) preference compared with the reference diet with wheat bran. It is concluded that feedstuff nature, inclusion rate, and freshness affect feed preference in pigs. Feedstuff preferences should be taken into account during diet formulation, particularly at critical stages such as immediately after weaning.

Feed preferences and performance of nursery pigs fed diets containing various inclusion amounts and qualities of distillers coproducts and flavor

We evaluated the preferences of nursery pigs for diets containing increasing distillers dried grains with solubles (DDGS), varying in color, or high-protein distillers dried grains (HP-DDG) and the effects of flavor supplementation on pig preference and growth performance. In Exp. 1 through 5, diet preference was determined in weanling pigs adjusted to a commercial diet for at least 10 d, and then housed individually for a 2-d double-choice preference test. In Exp. 1, a total of 60 pigs (11.6 ± 0.3 kg of BW) were given a choice between a reference diet (0% DDGS) and test diets containing 0, 10, 20, or 30% DDGS. In Exp. 2, a total of 80 pigs (10.8 ± 0.1 kg of BW) were given a choice between a reference diet (0% HP-DDG) and diets containing 0, 10, 20, or 30% HP-DDG. In Exp. 3, a total of 80 pigs (10.3 ± 0.2 kg of BW) were given a choice between a reference diet (0% DDGS) and a diet containing 0%, 30% light, or 30% dark DDGS. In Exp. 4, a total of 80 pigs (11.2 ± 0.2 kg of BW) were given a choice between a reference diet without DDGS and a diet containing either 0% DDGS, 10 or 20% light DDGS, or 10 or 20% dark DDGS. In Exp. 5, a total of 108 pigs (9.0 ± 0.2 kg of BW) were given a choice between a reference diet (0% DDGS and no flavor) and a diet without or with flavor and containing 0, 10, or 20% DDGS. In Exp. 1 and 2, DDGS and HP-DDG, respectively, linearly decreased (P < 0.01) pig preference. In Exp. 3, dark DDGS were preferred (P < 0.05) compared with light DDGS. In Exp. 4, preferences were linearly reduced (P < 0.01) with DDGS inclusion, and dark DDGS tended (P = 0.06) to be preferred compared with light DDGS. In Exp. 5, DDGS reduced preference (P < 0.01) and flavor reduced preference (P < 0.01) regardless of DDGS level. In Exp. 6, a total of 192 pigs (6.7 ± 0.1 kg of BW) were fed starter 1 diets without or with flavor for 1 wk. Subsequently, pigs were fed starter 2 and 3 diets (2 wk each) containing 0, 10, or 20% DDGS while continuing to receive their respective flavor treatment. Flavor addition during the starter 1 phase increased ADFI (P = 0.02), and DDGS inclusion tended to decrease ADG (P = 0.06) and decreased ADFI (P = 0.03) during the starter 2 phase. Volatile components in DDGS and HP-DDG varied greatly depending on the source. Nursery pigs preferred a diet without DDGS or HP-DDG, and this appeared to be unrelated to color differences between sources. Knowledge of volatile compounds that enhance or suppress the palatability of feed may lead to further development of feed additives for masking relatively unpalatable, albeit cost-effective, ingredients.

Human urine: Epicatechin metabolites and antioxidant activity after cocoa beverage intake

Associations between cocoa consumption in humans, excreted metabolites and total antioxidant capacity (TAC) have been scarcely investigated. The aims of the study were to investigate the epicatechin (( - )-Ec) metabolites excreted in urine samples after an intake of 40 g of cocoa powder along with the TAC of these urine samples and the relation between both the analyses. Each of the 21 volunteers received two interventions, one with a polyphenol-rich food (PRF) and one with a polyphenol-free food (PFF) in a randomized cross-over study. Urine samples were taken before and during 24 h at 0-6, 6-12 and 12-24 h periods after test intake. The excreted ( - )-Ec metabolites and the TAC were determined in urine samples by LC-MS/MS and TEAC assay, respectively. The maximum excretion of ( - )-Ec metabolites and the maximum TAC value were observed in urine samples excreted between 6 and 12 h after PRF consumption. Significance of TAC increase was found in urine samples excreted during 0-6 and 6-12 h (66.6 and 72.67%, respectively, with respect to the 0 h).

Feed preference in pigs: relationship with feed particle size and texture

In previous studies, we observed important differences in the feed preferences of pigs resulting from changes in only 1 dietary ingredient. The present experiment was conducted to study the relationship between the feed preference values of feeds reported previously and their particle size and texture characteristics. The effect of individual feed ingredients was studied when added to a common basal diet. In addition to the basal diet, which included rice, a soybean meal product containing 56% CP, sunflower oil, and wheat bran, a total of 126 diets were studied. Of these, 63 were prepared by replacing the rice in the basal diet with another cereal, 29 by replacing the soybean product with different protein sources, 19 by replacing the sunflower oil with different lipid sources, and 6 by replacing the wheat bran with different fiber sources. Cereals were studied at inclusion rates of 150, 300, and 600 g x kg(-1); protein sources were studied at 50, 100, and 200 g x kg(-1); lipids were studied at 15, 30, and 100 g x kg(-1); and fiber sources were studied at 65 and 130 g x kg(-1). The particle size profile of all the diets was determined by using a 9-screen sieve shaker. The geometric mean particle size, particle size uniformity, number of particles per gram, surface area (cm(2) x g(-1)), and percentage of fine (passing through a 250-microm sieve) and coarse particles (remaining in a 2,000-microm sieve) were calculated. The texture properties (hardness, fragility, chewing work, and adhesiveness) of the feeds were also determined by using a texture analyzer. The Pearson correlation coefficients of these variables with feed preference were as follows: geometric mean particle size (r = 0.07; P = 0.45), particle size uniformity (r = 0.16; P = 0.07), number of particles per gram (r = -0.05; P = 0.61), surface area (r = -0.07; P = 0.46), percentage of coarse particles (r = 0.04; P = 0.65), percentage of fine particles (r = -0.12; P = 0.19), hardness (r = -0.21; P = 0.02), fragility (r = -0.20; P = 0.03), chewing work (r = -0.33; P < 0.001), and adhesiveness (r = 0.02; P = 0.78). It was concluded that the texture properties of the feed could explain in part the feed preferences observed in pigs, whereas particle size characteristics had less impact.

Feed preference in pigs: effect of cereal sources at different inclusion rates

The palatability of different cereals was studied in 2 two-way choice (preference) experiments using pigs of 56 d of age and 17 kg of BW. In Exp. 1, the effect of 24 cereals vs. a common reference diet containing white rice on feed preference in pigs was studied. Pigs were offered free choice between the reference diet and a diet with the cereal under study for 4 d. Barley, corn (2 sources), wheat, cassava meal, biscuit meal, rye, sorghum, and 1 source of oats were tested at inclusion rates of 300 and 600 g x kg(-1). Short-grain rice (whole, brown, or extruded white), long-grain white rice (raw and cooked), extruded barley, extruded corn, extruded wheat, oats (2 sources), thick rolled oats, cooked oats, and naked oats (raw, extruded, or micronized) were tested at inclusion rates of 150, 300, and 600 g x kg(-1). Relative preference of cereals (% of total feed intake) was affected by type of cereal and by rate of inclusion. The diets containing extruded rice (150 g x kg(-1)), extruded naked oats (150, 300, and 600 g x kg(-1)), or naked oats (150 and 300 g x kg(-1)) were preferred (P < 0.05) by pigs to the reference diet. However, the reference diet was preferred (P < 0.05) to the diets containing 150, 300, and 600 g x kg(-1) of cooked long-grain rice, oats, or cooked oats, 300 and 600 g x kg(-1) of extruded wheat, wheat, corn, sorghum, or unhulled short-grain rice, and 600 g x kg(-1) of thick rolled oats, extruded corn, rye, extruded barley, micronized naked oats, barley, cassava, or biscuit meal. Extrusion improved (P < 0.05) preference values for corn and naked oats by pigs, but had no effect on barley, rice, or wheat. In Exp. 2, the preferences of pigs for oats and barley were studied using mash and pelleted diets. Diet form did not affect preference in oats diets. However, for barley, greater preference values were obtained when measured in pelleted form compared with mash form. Additionally, direct 2-way choices were also performed between oats and barley diets and between diets presented in mash and pelleted forms. Pigs preferred barley to oats, and preferred diets presented in pelleted form to those presented in mash form. In conclusion, cereal type, inclusion rate, and diet form affected feed preference in pigs. Using cereals with greater preference values may contribute to the formulation of more palatable feeds, which enhance feed intake of piglets at critical stages such as weaning time.

A new LC/MS/MS rapid and sensitive method for the determination of green tea catechins and their metabolites in biological samples

A new rapid and sensitive method has been developed, using liquid chromatography in tandem mass spectrometry (LC-ESI-MS/MS) to identify green tea catechin metabolites in plasma and urine after oral intake of a green tea extract. (-)-Epigallocatechin-3-gallate (EGCG), (-)-epicatechin-3-gallate (ECG), (-)-epigallocatechin (EGC)-glucuronide, (-)-epicatechin (EC)-glucuronide, and EC-sulfate were identified in plasma, whereas in urine only the conjugated catechins were detected (EGC-glucuronide, EGC-sulfate, EC-glucuronide, and EC-sulfate). Standard calibration curves prepared in plasma were found to be linear in the range of 10.9-1379.3 nmol/L for EGCG, EGC, ECG, and EC. The accuracy and precision of this assay showed a coefficient of variation of <15%. The method allowed the detection and quantification limits (for 20 microL injection) from 1.1 to 2.6 nmol/L and 3.8-8.7 nmol/L, respectively, in plasma and 0.8-1.8 nmol/L and 2.6-6.0 nmol/L, respectively, in urine. This method can be applied for future clinical and epidemiological studies, allowing the identification of the active metabolites that will reach the target tissues.

Absorption and pharmacokinetics of grapefruit flavanones in beagles

The present study evaluated the pharmacokinetics of three different grapefruit flavanone forms in dog plasma and demonstrated their absorption after an oral intake of a grapefruit extract; pharmacokinetic parameters of these forms were also determined. Ten healthy beagles were administered 70 mg citrus flavonoids as a grapefruit extract contained in capsules, while two additional dogs were used as controls and given an excipient. The grapefruit flavanone naringin, along with its metabolites naringenin and naringenin glucuronide, was detected in dog plasma. Blood samples were collected between 0 and 24 h after administration of the extract. Naringin reached its maximun plasma concentration at around 80 min, whereas naringenin and naringenin glucuronide reached their maximun plasma concentrations at around 20 and 30 min, respectively. Maximum plasma concentrations of naringin, naringenin and naringenin glucuronide (medians and ranges) were 0.24 (0.05-2.08), 0.021 (0.001-0.3) and 0.09 (0.034-0.12) micromol/l, respectively. The areas under the curves were 23.16 l (14.04-70.62) min x micromol/for nariningin, 1.78 (0.09-4.95) min x micromol/l for naringenin and 22.5 (2.74-99.23) min x micromol/l for naringenin glucuronide. The median and range values for mean residence time were 3.3 (1.5-9.3), 2.8 (0.8-11.2) and 8.0 (2.3-13.1) h for naringin, naringenin and naringenin glucuronide, respectively. The results of the present study demonstrate the absorption of grapefruit flavanones via the presence of their metabolites in plasma, thus making an important contribution to the field since the biological activities ascribed to these compounds rely on their specific forms of absorption.

Total Polyphenol Intake Estimated by a Modified Folin–Ciocalteu Assay of Urine

Background: Plant polyphenols have been studied largely because of the possibility that they might underlie the protective effects afforded by fruit and vegetable intake against cancer and other chronic diseases. Measurement of polyphenol content excreted in urine as an indicator of polyphenol consumption may offer a routine screening method that could be used for these pathologies.

Methods: Thirty-six healthy volunteers each received 2 interventions, one with a polyphenol-rich food (cocoa beverage) and one with a polyphenol-free food (milk) as a control, in a randomized cross-over design with 1-week intervals. The total polyphenol content excreted in urine during the 6 h after consumption of the test meals was measured by a modified Folin-Ciocalteu assay after sample cleanup by solid-phase extraction.

Results: The mean (SD) concentrations of polyphenols excreted in the urine 6 h after consumption of the test meals differed significantly: 140.95 (49.27) mg catechin/g of creatinine after the polyphenol-rich meal vs 90.43 (46.07) mg catechin/g of creatinine after the control meal (P &lt;0.05).

Conclusions: This method allows analysis of a large number of samples per day, which is ideal for use in epidemiologic studies and may enable estimation of polyphenol consumption and determination of their possible role in preventing of certain pathologies, such as cancer, cardiovascular and degenerative diseases.

Rapid liquid chromatography tandem mass spectrometry assay to quantify plasma (-)-epicatechin metabolites after ingestion of a standard portion of cocoa beverage in humans

A rapid liquid chromatography electrospray ionization tandem mass spectrometry with negative ion detection method was developed and validated to determine cocoa flavonoid metabolites in human plasma and urine after the intake of a standard portion of a cocoa beverage. A chromatographic run time of only 9 min provided clear separation of all metabolites and internal standards. Samples were analyzed in a product-ion scan of m/z 289, 369, and 465 to identify the metabolites and in multiple reaction monitoring acquisition mode to quantify (-)-epicatechin ((-)-Ec) (289/ 245), (-)-epicatechin-glucuronide ((-)-EcG) (465/289), and (-)-epicatechin-sulfate ((-)-EcS) (369/289). One (-)-Ec-G and three (-)-Ec-S were identified and confirmed in urine as the major metabolites, and one (-)-Ec-G was the only metabolite present in plasma volunteers (n = 5) at a mean concentration of 625.7 +/- 198.3 nmol/L at 2 h after consumption of a cocoa beverage containing 54.4 mg of (-)-Ec.

Use of a polytetrafluoroethylene tube and patch in the repair of a difficult duodenal stump

In the cases where a primary anastomosis is unable after a duodenal resection, special care must be taken to avoid any complication in the duodenal stump such as suture dehiscence. Wall inflammation is an important factor in the development of this complication. We report a case of a 35-year-old woman who had previously undergone to pyloric exclusion due to a wall defect occurred after a bilio-digestive anastomosis, which complicated with a posterior duodenal stump dehiscence. The acute edema of the stump walls that resulted after it because exposure to bile conducted to heroic measures for its closure: first, the use of a polytetrafluoroethylene tube as duodenostomy and posteriorly a patch of the same material for its final closure. Both gave successful results in the repair of a refractory duodenal stump dehiscence.

Effect of dietary energy level and oil source on broiler performance and response to an inflammatory challenge

Broiler chicks were fed one of five diets from 3 d of age: a low energy diet containing 7% cellulose (ME 2,714 kcal/kg), or high energy diets containing approximately 7% of either tallow, corn oil, safflower oil, or fish oil (each 3,302 kcal/kg). Half of the chicks were injected intra-abdominally with Salmonella typhimurium lipopolysaccharide (LPS) on Day 11, sephadex on Day 13, and Freund's complete adjuvant on Day 15; samples were collected on Day 16. The uninjected chicks served as controls. In a second experiment, 3-d-old chicks were fed one of eight isocaloric diets containing tallow as the sole supplemental fat source, or tallow plus either 2% corn oil, 1, 1.5, or 2% fish oil, or fish meal at an amount to provide 1, 1.5 or 2% supplemental oil. Half of the chicks were injected intra-abdominally with S. typhimurium LPS on Days 10, 12 and 14; the uninjected chicks served as controls. Samples were taken on Day 15. In Experiment 1, the cellulose diet decreased performance to 10 d of age relative to the other diets, whereas immunogen injection decreased weight gain and feed efficiency and increased indices of inflammation among all dietary groups. Fish oil at approximately 7% of the diet did not improve weight gain. Fish oil diets improved weight gain and feed efficiency in Experiment 2 relative to the other diets, in spite of minimal effects on indices of inflammation. Injection of LPS decreased performance and increased inflammation across dietary treatment, although the second LPS injection was less potent in altering performance responses and inflammation compared to the first injection, indicating that repeated injections of LPS amy cause the chicks to become refractory to that stimulus. The fish meal diets resulted in poorer performance than similar levels of lipid provided as fish oil. Lower levels of dietary fish oil were more efficacious in improving broiler performance than higher levels, and fish oil provided from fish meal was not as efficacious as oil per se, possibly due to nonlipid components of the meal.

Dietary energy source and density modulate the expression of immunologic stress in chicks

To determine how dietary energy level and source influence feed intake, growth and energy partitioning drug immunologic stress, growing chicks were fed diets based on cornstarch and casein with varying energy densities and injected every other day for 6 d with either saline (control), Salmonella typhimurium lipopolysaccharide or heat-killed Staphylococcus aureus. Salmonella typhimurium lipopolysaccharide decreased growth and feed consumption at low energy densities. When the dietary energy density was increased above 13.4 kJ/g using cornstarch, but not corn oil, the growth depressing effect of immunogens was eliminated. Immunologically stressed chicks had a greater proportion of gain in visceral organs and less in the carcass, regardless of the nutrient density of the diet. Immunologic stress decreased intake of metabolizable energy of chicks fed a diet with low nutrient density and increased it for those fed a diet with high nutrient density. Chicks injected with S. typhimurium lipopolysaccharide lost more energy as heat than controls when differences in metabolizable energy intakes were accounted for and modified their preference between two diets differing in metabolizable energy density and fat content as a result of the challenge. Control chicks selected between the 11.7 and 14.2 kJ/g diets to obtain an energy density of 13.2 kJ/g compared with 12.5 kJ/g in the S. typhimurium lipopolysaccharide-challenged chicks. The S. typhimurium lipopolysaccharide-challenged chicks consumed similar amounts of the low energy diet but decreased intake of the high energy diet.

Prevention of immunologic stress contributes to the growth-permitting ability of dietary antibiotics in chicks

The growth-permitting ability of antibiotics fed to broiler chicks was studied as it relates to the state of activation of the immune system. In Experiment 1, chicks were fed two levels of antibiotics (0 or 100 mg streptomycin + 100 mg penicillin/kg diet) and were raised either in an environment with poor sanitation to create a chronic immune stress or in a clean environment. Chicks raised in the unsanitary environment and not fed antibiotics had significantly lower (P < 0.05) rates of weight gain and efficiencies of feed utilization, and higher levels of plasma interleukin-1, compared with chicks raised in the clean environment or chicks raised in the unsanitary environment and fed antibiotics. Adding antibiotics to the diet of birds in the clean environment did not affect any variable. In Experiment 2, chicks were raised in a conventional environment and fed two levels of an antibiotic (0 or 100 mg tetracycline/kg diet). After a 15-d feeding period, half of the chicks were injected with Salmonella typhimurium lipopolysaccharide to create an acute immunologic stress. Feeding antibiotic resulted in improved weight gain, feed consumption and efficiency of feed utilization. Lipopolysaccharide-injected birds developed heavier livers, spleens and intestines relative to body weights and higher rectal temperatures and hepatic metallothionein concentrations, presumably due to an immunologic stress. Omitting antibiotic from the diet resulted in similar changes. These results indicate that feeding antibiotics may permit growth by preventing immunologic stress and associated metabolic changes brought about by monokines including interleukin-1.